Part 3 of 3
Increased emotional distress results in the release of catecholamines (substances allowing us to respond to stressors), which is damaging to the intimal endothelium (inner-most lining) of the coronary arteries. That, in turn, leads to release of free fatty acids, which results in increased platelet aggregation and lipid deposition at the site of the endothelial damage. The catecholamines also contribute to hypercholesterolemia. Subsequent increases in cortisol contribute to still further damage. Catecholamines include dopamine, epinephrine, and norepinephrine.
I have noticed that after a physically stressful event, such as a treadmill EKG stress test, blood pressure normalizes quite rapidly, but that after an emotionally stressful event, it can take hours to normalize blood pressure. This is because the stress ends when exiting the treadmill, but in the case of emotional distress, the stress continues as long as we are emotionally distressed. Allostatic load increases in proportion to the length of time we experience emotional distress, and high allostatic load translates into catabolic processes.
A catabolic state results in:
• Cessation of protein, fat, and carbohydrate synthesis.
• Increased breakdown of protein, fat, and carbohydrate.
• Elevated blood levels of glucose, free fatty acids, and LDL cholesterol.
• Decreased bone remodeling.
• Decreased repair and replacement of cells that require high turnover.
• Decreased production and circulation of WBCs, and general immune function impairment.
• Increased salt and water retention.
• Increased systolic and diastolic BP.
• Increased HR and stroke volume (SV).
• Increased serum uric acid levels.
• Increased platelet adhesion and increased platelet aggregation.
• Increased blood viscosity.
• Constriction of peripheral resistance and capacitance vessels.
• Arterial wall damage.
• Impaired left ventricular (LV) function.
• Lethal dysrhythmias.
• Coronary vasospasm induced by hyperventilation.
• Increased blood pressure leads to heart failure, atherosclerosis, heart attacks, kidney damage, ischemic strokes, and hemorrhagic strokes.
Living in a catabolic state can present differently in different individuals. For example, generalized anxiety disorder (GAD) (unlike other anxiety disorders) does not typically manifest in sympathetic activation in the presence of worry, challenges or threats. Instead, there is a reduction in heart rate variability (HRV) along with deficient parasympathetic tone. The way this is understood is that because of such frequent detection of threat but no place to run and no one to fight, sympathetic activation is not adaptive, so it is suppressed. Nevertheless, people living with GAD do live in a catabolic state.
Emotional distress and physiological stress have been measured through lab values, fMRI, biofeedback, and other methods. The following is an account of a particularly innovative method.
Psychophysiology researcher Carmen Uhlmann wired computer keyboards to biofeedback (BF) instruments. Collaborating with psychoneuroimmunology (PNI) researcher Dr. James Pennebaker and computer programmer Martha Francis, they were able to measure electrodermal activity (EDA) as subjects (all SMU college students) wrote about various traumatic experiences in their lives. The sensors in the pads of the computer keyboard went to a separate computer that was programmed to function in harmony with the one on which the subjects typed. The researchers were able to get readouts of the writer’s EDA fluctuations on a word-by-word, phrase-by-phrase basis.
This unique BF hookup allowed the researchers to determine the features of language that are related to autonomic activity. They discovered that specific words were associated with specific physiological changes. The BF computer tracked EDA from the computer keys and HR from a sensor on the writer’s body. These BF measures were synced to the text of the computer on which the subjects typed. Negative descriptors of emotion such as words like scared, hate, hurt, guilt, and shame correlated with increased autonomic arousal as measured by increased HR and EDA. Words associated with positive emotion correlated with reduced autonomic activity as measured by reduced HR and EDA.
A surprising finding of this experiment was that words associated with reflection and insight and with a degree of resolution of a problem such as understand, realize, because, and reason also correlated with increased HR and EDA.
The explanation for the increased HR and EDA with words associated with insight and understanding was that when the students were writing about an event or problem, despite having a level of understanding, they felt emotional as they wrote, and the emotions correlated with increased HR and EDA. However, when the subjects wrote about the trauma or problem over a period of several days, a diminution of autonomic activity was noted.
Pennebaker concluded that although writing (or verbally sharing) about one’s trauma or problems triggers autonomic arousal, the more we do it, the more we acquire insights and resolution of whatever had been troubling us, and that this continued exploration leads to a more calm, peaceful state of mind.
It was also discovered during that study that when the researchers followed the health of the subjects over the next few months, based on visits to the university medical clinic, the students who expressed negative emotion words experienced better health than those who continually expressed positive emotion words. Dr. Pennebaker explained this surprising finding by concluding that the expression of negative emotion contributed to increased self-awareness, self-understanding, and self-appreciation, and the resulting improved mind-state led to improved health.