Lately I find myself feeling stuck in a chronic state of stress, constantly worrying about my work, my kids’ futures and yes, the health of my retirement portfolio. Sound familiar?
I didn’t always worry so much, but life has a funny way of piling on the pressures as we get older and take on more responsibilities. While my family is not in crisis now, it has gotten harder to manage this stress.
Because my specialty is urology, I also care about what acute and chronic stress are doing to your bladder and hormones as well as your overall health.
Difference between acute and chronic stress
It helps to distinguish between two types of stress: acute and chronic.
Acute stress is your body’s immediate reaction to a perceived threat. Think about how your heart pounds before a big presentation or how you jump when you hear a loud noise. It’s intense but usually short-lived. Our bodies are built to handle acute stress and typically return to normal afterward.
Chronic stress, however, is persistent. It’s the daily weight of ongoing issues, such as financial woes, relationship issues, work pressures or health concerns. Unlike acute stress, chronic stress keeps you in a constant state of high alert — chipping away at your health, often without you noticing.
When you are stressed, your body launches a carefully coordinated response known as the fight-or-flight reaction. It all begins in the hypothalamus, the brain’s command center, which activates two parallel systems in your adrenal glands: the sympathetic nervous system and the hypothalamic-pituitary-adrenal, or HPA, axis.
The sympathetic nervous system triggers the release of adrenaline, which primes your body to act quickly. This fast-acting hormone increases your heart rate and blood pressure, opens up your airways, heightens your senses and sends more blood to your muscles.
Cortisol is released a little later through the HPA axis. Unlike adrenaline’s quick action, cortisol plays a longer-term role in helping the body cope with sustained stress. Cortisol increases blood sugar, enhances the brain’s focus and memory, and puts things such as digestion, fertility and immunity on the back burner — because in a crisis, your body is focused on survival.
Working together, adrenaline and cortisol seamlessly help the body cope with short-term threats. However, if stress becomes chronic, elevated cortisol levels can lead to fatigue, sleep problems, weight gain and other health issues.
For me, this response kicks in during intense moments in surgery — such as seeing an unexpected gush of bleeding. Instead of fleeing (which would be frowned upon in the operating room), my body shifts into fight mode: I zero in on the bleeding vessel, focus sharply and act swiftly to get things under control.
In such high-stakes moments, the stress response is not just helpful but essential. But when the triggers are constant — unpaid bills or work deadlines — your body can get stuck in that heightened state.
Over time, consistently high cortisol levels disrupt your immune system, impair metabolism, affect mood regulation and even contribute to chronic inflammation — all of which can increase the risk of long-term health issues.