This week we'll continue our discussion on stress and its impact on us. So far, everything I've talked about has pertained to medicine's "normal", a 20 year old male. While I won't agree that today's average 20 year old male is either healthy or "normal", we use this group in medicine as our standard test subject for one simple reason: we can get 20 year old males to do just about anything for beer money. We find it more difficult to get 20 year old women to do the same, and once they are out of college and into the work force, we have a harder time getting male subjects as well. For this week's discussion, it's important to remember that men and women are different (and that's OK), kids are NOT little adults, and we change as we age.
Women and Stress
In general, women secrete a higher level of cortisol (remember that's our hormonal end product of exposure to stressors). This higher secretion means that all of the cortisol effects will be higher in women than men. However, there are some differences in how cortisol affects women. When a man's brain is exposed to cortisol, we found they had a decreased memory function overall, but specifically a decrease in spatial memory. We find neither of these happen in women. When I lecture to peace officers, they are not surprised by this. In stressful situations, women will have a better recollection of the details of what happened, and not fill in as much as men do. That means that in a given stressful situation, women are generally the more reliable eye witnesses.
The cortisol production fluctuates in women according to their menstrual cycle. This makes sense when you look at the biochemical pathways, and how intricate hormones interact. Starting on day one of the menstrual cycle (follicular phase), women will have a blunted response for the next 14 days. This means they will produce less cortisol during this time in response to stressors. For the last 14 days of the cycle (luteal phase), there is a significant increase in production. In this time period, stress will have a more detrimental effect on their health. When we add in oral contraceptives, we see a response much like that of the follicular phase. If you look at total levels given the same stressor, you see cortisol secretion as follows (high to low): luteal > men > follicular > oral contraceptives. Does this mean oral contraceptives are a good thing in relation to the stress response? No. The negative effects created by oral contraceptives far outweigh any changes we may see in relation to stress. Look for a future blog that explains how oral contraceptives are causing many health problems for women today.
While women have a higher level of cortisol secretion compared to men, they also have a blunted response to its feedback. Their brains are less sensitive to its effects, so when the levels increase, they have a slower "off" switch than do men. This means it will stay in their system longer, creating more potential negative effects in the long run. When we add the fact that cortisol inhibits the secretion of estrogens and progesterone to the equation, we see that stress can have a significant effect on fertility and the ability to get and stay pregnant. This makes perfect sense if you consider the developmental aspect: are you concerned with reproducing when the saber tooth tiger is breathing down your neck? Probably not.
In addition to differences in memory and feedback, cortisol also changes how the brain of a woman focuses. When exposed to stressors, the limbic section of a woman's brain shows significant increase in function. This section of our brain is where all of our "feelings" are housed and expressed. There is also a significant increase in ruminative thinking or rewinding. When stressed, women start rewinding and reviewing past events, what I call "ruminatin' and cogitatin'". They use their past memories, going over and over them, trying to make sense of what's happening now. Stress also increases anxiety more in women than men.
When we compare overt actions in response to stress, we find another significant difference. While men express the classic "fight or flight" mechanism, women will express a "tend and befriend" response instead. When you think again of development, this makes sense. With most hunter/gatherer societies, men could be gone from camp for most of the day, and often for extended periods on week long hunts. That left the camp with minimal protection from neighboring tribes who weren't always friendly. If an unwelcome visitor came calling, a "fight or flight" response could often lead to unwanted trouble. If instead, a "tend and befriend" attitude, where the unwelcome visitor was welcomed in, tended to, and conversed with was adopted, it could often give the hunters time to get back to camp and expel the visitor. Different survival mechanisms develop based on different situations.
Stress and Kids
In Mom's Stress Isn't Trivial, I discussed prenatal stress exposure and the profound changes it can have on our kids. In addition to that, we see long term effects when our kids are stressed. Early life stress can elevate CRH levels for life, creating all the negative effects associated, including increased risk of affect disorders, like depression, anxiety, schizophrenia, and bipolar. Before puberty, we see kids reacting the same, regardless of sex, but once adolescence starts, we see a divergence based on sex, where boys start acting like men, and girls like women.
Stress and Aging
It's very interesting to look at the stress response as we age. When we look at women, we really don't see much change except a gradual decline in response. However, when we look at men, we see their responses, including hormone levels, biochemical responses, and reactions, look much more like adult women, with the overall response being less. Whether this is part of the deterioration caused by aging or causes some of this deterioration, we really don't know. I hypothesize that if we could improve our response to stressors early in life and reduce their overall effects, we might see less deterioration, but I haven't seen anyone out there yet studying that.
It is important to remember that stress affects us differently based on our age and sex. Expecting a male response from a female, or a female reaction from a male, will only lead to more stress to ourselves. Part of coping with stress well and minimizing its effects on us includes knowing how to best interact with those around us. Treating your kids and your spouse the same isn't effective. Knowing those who influence your life, and how they react compared to yourself can have a profound impact on your happiness.
Look for future blogs that will give more information and insights into improving your health with natural health care. You can also visit my website, like me on Facebook, follow me on Twitter, or listen to my radio show.
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