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There are many conditions that are directly associated with stress.

While that includes most, if not all, mental illnesses, it also includes very physical conditions such as diabetes, many forms of coronary disease, and asthma, to name a few.

Functional Neurological Disorder(FND) is also considered a stress-related condition.

Today, let’s talk about how stress works, and why this ‘stress-related condition’ label matters.

Stress and disease

According to the Cleveland Clinic: Stress is the body’s reaction to any change that requires an adjustment or response.

Our bodies often associate stress with the fight/flight/freeze instinct, and there’s a whole slew of ways our bodies react to that pressure.

Often, our heart rates go up(putting extra pressure on our hearts), our digestive and reproductive systems get put on the back burner, extra energy gets sent to muscles, blood flow increases, and our bodies get an extra dose of adrenaline.

All of this kept us alive during earlier times when most of our stresses were about visible threats that could kill us, and we needed to be able to hide, run away, or fight back.

However, it has become obvious that while short-term stresses may help our focus and survival, stress over the longer term has a detrimental effect on our health.

Staying in that ‘high alert’ position increases the amount of stress and pressure on our bodies, increases our chances of becoming ill, weakens our immune systems, and increases our chances of developing or worsening stress-associated health conditions

Emotional and psychological stress

Now, that fight/flight/freeze instinct is less helpful, and instead, we may need to focus better, think more carefully, or simply learn to calm down a bit.

Our bodies and brain function really don’t distinguish between physical or environmental threats(like a predator approaching or standing on the edge of a cliff) and psychological or emotional threats(such as losing a beloved family member or worrying about how well we can do on an exam).

Our brains process all of it as ‘stress’ and as if it’s something that can be responded to the same way – going onto ‘high alert’.

Meditation or simply taking some time to breathe can help you manage stress

The longer-term and more uncertain a stress is, the more it affects how our immune systems function. Uncertainty and fear about the duration of a condition or uncertainty about how long something will take can increase the stress dramatically, and this affects the resistance of the person’s immune system.

In this study, the most stressful, ‘worst case’ scenario was one of developing a chronic and disabling condition.

You don’t know how long it will last(‘it’ll last your entire life’ is very different, emotionally, from, say, ‘it’ll last for 3 years or so’), nor if or how you will recover(the better you know the parameters, the better you can plan, but there will always be unknowns). The more uncertainty, the stronger the stress.

Contrast this with an event, like losing a loved one, and it becomes more clear. When somebody you love dies, the worst part of it has already happened – they are gone.

The time afterward is spent adjusting to their absence from your life, and while that’s painful, each day takes you further from that initial trauma.

For those of us with chronic conditions though, there’s a potential to be retraumatized every day, and we will be living with uncertainty and stress from both the physical effects of our conditions, and the emotional effects of that uncertainty every day for the rest of our lives.

Stress-related conditions in particular

So, some chronic illnesses and disabling conditions are stress-related, while others aren’t as sensitive to stress.

Stress-related conditions reliably worsen when the person with them is under stress, and are unlikely to worsen if the person is in a relatively low-stress situation.

My FND symptoms, as an example, increase whenever I undergo extra stress.

Sometimes, I am aware of the stresses and can try to manage them(starting graduate school only once my symptoms seemed stable), other times, the stresses involved are things I am less aware of(like my body trying to fight off a virus) or unable to control(like my partner getting injured).

Usually, though, I can find a correlation between the increase in symptoms and my state of mind or bodily stress level.

Many stress-related conditions can be managed through stress management combined with proper treatment.

managing your condition is vital – but the medications only help so much

For example, many types of heart conditions are managed through appropriate medications, but best helped by dietary management, exercise, and improved stress management.

Heart attacks are more likely to occur during periods of stress, when the body is under additional pressure.

Diabetes is known to worsen under stress.

How often do you hear people mentioning ulcers or heartburn or other stress-associated or stress-related conditions during those moments of severe, extreme, or prolonged stress?

These stress-responsive conditions flare during stress, and are generally less severe when you are under less stress, so it is in your best interest if you have a stress-associated condition to learn how to best manage the stresses in your life and adjust your mindset to better manage them.

Identity and stress-associated conditions

Unfortunately, stress-associated conditions do not impact in all races equally. It’s likely that stress impacts all disempowered identities in a similar way

Both the stresses to manage and the severity of stress you need to manage may vary based on your identity and life situation. Minority-identified people and poor people both have higher stress-levels and shorter life-spans than wealthier white people.

This may not be particularly surprising, but it is important to recognize how deeply interdependent the many stress-associated variables can be – and how much better our society would likely be if fewer people were experiencing these high stress levels.

While it appears that black people and white people are diagnosed with mental illness at a similar rate, studies suggest that some of the differences in health outcomes is due to the coping mechanisms used.

In this case, the study argues that, collectively, black people have found tools to help manage their mental health under increased stress, but these tools to manage their mental health increase their likelihood of developing long term health issues. Examples of these tools include eating comfort food, smoking, drinking alcohol and illicit drug use.

Being a minority is stressful

This doesn’t mean that only black people do these things, of course, but that when you step back and look at the big picture, it appears likely that the reason black people aren’t diagnosed with more mental health conditions isn’t that they are under less pressure, but rather because enough were able to protect their mental health through habits that damage their physical health in the long term.

Many scientists argue that simply having a stigmatized identity in modern society is stressful in and of itself. This designation, ‘minority stress‘ covers not only racial minorities(like Blacks, Asians, Native Americans, or Hispanics), but also other minority identities, such as the LGBT community.

While minority stress was initially explored as a model covering non-heterosexual orientations, it has been applied to other communities as well, including women, religious minorities, and more. I’d argue that this model could likely also be applied to the disabled community as well, though I haven’t seen much literature on that.

The LGBT community is subjected to extra stresses, especially LGBT youth. In general, the LGBT community struggles more with mental health than straight people do. Bi folks have the highest rates of depression and suicidality of all the orientations.

Transgender people are even more of a minority within the community(trans folk seem to make up under 1% of the US population). and generally have even more health issues than the rest of the LGBT community. On top of the mental health challenges mentioned above, doctors are even less prepared for trans health considerations than they are for the rest of the community.

The disabled identity is a minority identity

Disabled people are the largest minority identity in the US, covering about 26% of the US population. This covers a very broad definition of disability and a very wide range of symptoms and limitations.

We also experience minority stress, plus the individual challenges that our disabilities(and society’s lack of accessibility) create. That’s a lot of chronic stress to manage.

Being disabled is also stressful. Many of us have intersectional identities, which can multiply this stress

Not only that, but many of us with disabilities have intersectional minority identities as well. As I’ve mentioned in other posts, people with intersectional identities often face extra challenges than others who share either identity.

So, for those of us who are disabled, we’re managing the stress of our conditions(chronic illness being recognized as one of the biggest situational stresses out there), the stress of societal response to our being disabled, and the stresses that most folks who share other aspects of our particular identity share with us.

As an example, I am a disabled bisexual cis-gendered white woman. I’m managing the stresses of chronic illness, FND(a stress-responsive neurological condition that’s poorly understood), a history of mental illness(and the stigma that goes with that), the stress of being bisexual and the stress of being a woman. That’s a lot!

There’s a lot to unpack, but my point is that there are a lot of aspects of who I am that exposes me to extra stresses. Is it any wonder that my immune system seems weaker than average?

Having multiple stress-responsive conditions means that the better I manage my mindset and the more succesful I am at managing my stresses, the more likely I am to have a better quality life.

What can you do to manage your stress-responsive condition?

So, now that you better understand how stress works and how identity and stress often intertwine, what can you do to manage all of this?

Well, the first thing, very simply, is to recognize what is and isn’t under your control.

You can’t prevent major changes from happening in your life – time is always moving forward and it’s mentally and emotionally better for you to have social connections and interactions, which means that some of these will be stressful, one way or the other.

You also can’t go back in time and ‘fix’ whatever your condition is.

In many cases, there’s a genetic component, so you likely were born with a tendency towards whatever happened. You can’t change the past, but you can manage the present with the goal of improving your future.

By understanding how stress works, and what stresses you are or have been exposed to, you can take concrete actions to manage your particular stresses especially those that cause or increase your particular symptoms.

In addition, what is likely to help you most is to get a firm understanding of your particular condition. How it works, what’s missing/damaged/dysfunctional, the long term prognosis, and what you can do to manage it.

Every condition has its own unique stresses, and honestly each person has their own mix of stresses to manage. The better you understand how your condition works and what symptoms to expect(and how to respond to them), the less stress you may have about the uncertainties around your condition.

One big step is often to take a moment and breathe.

Reducing those uncertainties is one of many ways to manage and reduce your stress. As you understand what is happening, there’s a degree of comfort to be found in that understanding.

In some cases, the deeper understanding is scary, but it does put limits on the extent or reality of your fears. As an example, hemipelagic migraines are so similar to strokes that a person with them often goes through stroke protocols if they go to the emergency room to be on the safe side. So, knowing you have a history of hemipelagic migraine may lead to emergency room trips, but you’ll know what treatments and procols to expect when you get there.

Understanding how to track and manage sugar and insulin levels if you have diabetes(and how to balance your diet to help manage your condition) can be extremely empowering, and understanding the effects of not maintaining your health(losing limbs, weight gain, shock, and death) should help you stay firm in your management practices.

Knowing what the risks are, and roughly how likely the negative effects are to happen can greatly help you have a realistic assessment of your needs, limits, and abilities.

With mental illness, recognizing that you have a condition that may skew your perspective can help you learn to recognize when things start to go off-track and course-correct earlier than you would otherwise.

For example, I have years of experience with my anxiety and depression, so can usually recognize when I’m emotionally off-balance in hours, rather than days or weeks. That lets me make active decisions to help pull myself out of the funk quickly, rather than getting stuck there.

It’s much better to have an ‘off’ day or two than to lose myself for weeks and then beat up on myself for not noticing it sooner – reinforcing that negative cycle.

Most of the posts in my blog are, in one way or another, about understanding and managing life’s stresses.

If you are dealing with a lot of physical or physiological stresses, like allergies, weakness, injuries, or pain, you can learn how to manage, minimize, or work around those issues through a deeper understanding of your condition and experimenting to learn what particular techniques are most helpful for you.

If you are dealing with mental or emotional stresses, you likely need to focus on mindset management, self-awareness, and other self-analysis skills, possibly combined with finding helpful medications that ease symptoms.

All of this is about recognizing the limits and rules and then working within them to build up your best possible life.

The better you can recognize and then manage the variables, the less extra stress you’ll need to manage and the more likely you’ll be to manage the stresses you can’t prevent!

Conclusion: stress can have a huge impact on your health

Stress is a change that pushes your body to make an adjustment. Some stress is positive, other stress is more negative, but it’s impossible(and boring) to live a stress-free life.

Stress can and does cause or worsen some conditions in obvious or measurable ways, while other conditions are less obviously impacted.

Temporary and short-term stress will increase pressure on your body by provoking the fight/flight/freeze response, while chronic stress, through that pressure, is likely to weaken your immune response and increase symptoms of any stress-responsive condition you may have.

Many identities are under ‘minority stress’, including including the disabled identity itself and many intersectional identities such as non-whites and the LGBT community. The degree to which this pressure is felt varies based on your identity and mindset.

If you have a stress-responsive condition, the best thing you can do for yourself is recognize your stresses and then learn to recognize, control, and manage your stresses, so that you can create your best possible quality of life.

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  1. This is really interesting to read in the context of the current pandemic. I know I’ve been so stressed that my pain levels have risen. When we look at Covid numbers in the US, minorities are much more likely to die. This is due to a number of factors related to racism, but I wonder if stress is a part of it.

    1. I also have a post specifically about stress and Covid19! Stress is generally part of the cause for a lot of issues. Black people in general have a lot more stress-related conditions, and more black people are disabled than any race but Native Americans. Black babies are smaller on average than white babies, and black women are more likely to die in childbirth. Racism and implicit bias play their parts, but yes, minority stress likely does too!

  2. Gosh yes. Stress as I learned the long, hard, painful way – is the number one killer and pain flare trigger. Healthy people really don’t realise this, and how hard their bodies truly are working for them! Physical stress also, unfortunately, triggered all my other comorbities 🙁

    1. I know! It’s a lot to manage. Recognizing the problem is the first step towards solving or managing it though, so I wanted to make it clear to our community that stress really is a huge deal, and why that’s so!

  3. I think I have an issue when people speak about “good stress” – it kind-of glorifies stress and promotes that concept that stress can actually help us but we don’t realise we’re about to go over-board until we haven’t. Very helpful article for sure.

    1. eustress – ‘good stress’ is still stress! My FND symptoms have really brought that home for me. I need to manage my eustress just like any other – generally, that means planning recuperation times for the fun stuff too, but it also means that I need to recognize that getting excited about things takes energy too! I agree with you though that that ‘positive’ descriptor can throw you and make it seem like something it isn’t!

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