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How Pandemic Stress Can Hurt Your Health

Doctors report physical symptoms from high blood pressure to GERD — and yes, acne too

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En español | Even if you're avoiding COVID-19 by keeping your distance from others and wearing a face mask, the pandemic can be affecting your health in other ways. Many, for instance, are missing their usual yoga or fitness class. For others, the fear of illness, the absence of family and friends, and the unwelcome lifestyle changes are sending stress levels through the roof.

These are no small things when it comes to your health. “Stress expresses itself in all of the body's organs — and usually not in a good way,” says dermatologist David J. Leffell, chief of dermatologic surgery and cutaneous oncology at the Yale School of Medicine.

Like our early ancestors, humans are wired to spring into action when faced with a threat (think: snarling tiger), and our bodies have evolved to release a cascade of hormones that help us face it down or run away — the fight-or-flight response. “Adrenaline, cortisol and norepinephrine activate the body to deal with a real or perceived threat,” says Melanie Greenberg, a clinical psychologist in Mill Valley, California, and author of The Stress-Proof Brain: Master Your Emotional Response to Stress Using Mindfulness and Neuroplasticity.

The problem occurs when people stay in a continuously activated state. Marinating in stress hormones can lead to a multitude of health issues, including headaches, heart attacks, weight gain, digestive troubles, skin rashes, general aches and pains, and even accelerated aging. Stress can also shorten telomeres, the caps at the ends of strands of DNA that protect chromosomes from damage, Greenberg says. “Over time, they can fray, almost like a shoelace, and stress makes them fray quicker,” she says.

Here's where you may be seeing the effects COVID-related circumstances and worry now:


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Your heart and blood flow

Higher blood pressure is the immediate concern of cardiologists watching the effects of stress on their patients. It in turn makes blood vessels stiffer and more prone to inflammation.

Plus, “if you are in a constant heightened stress state, the normal processes that occur to heal your blood vessels get switched off, because your body needs to respond to the threat,” says Tomas H. Ayala, a cardiologist at Mercy Medical Center in Baltimore. “It doesn't have time to heal.”

Fewer blood vessel cells regenerate, and vessels become damaged and more vulnerable to the buildup of plaque. “That's what leads to cardiovascular complications like heart attacks and strokes,” Ayala says. (Time to get your meditation or yoga on!)

What you generally don't have to worry about much? Heart palpitations. A rapidly beating heart is pretty common right now. “It's actually your awareness of your heart beating when in most cases nothing is wrong,” says Ayala.

Another potential result of pandemic stress can be felt as a tingling in your fingers and toes. This happens when the body perceives a threat — say, when another shopper gets too close at the grocery store — and shunts more blood toward the brain, heart and large muscles of the arms and legs and away from the extremities. “When you have reduced blood flow to your fingertips, you can get that numb, ants-crawling sensation,” Ayala says.

Your skin and hair

Have you noticed patches of dry, itchy skin or even an outbreak of rosacea or acne lately? You're not alone, says Caroline Nelson, a medical dermatologist at the Yale School of Medicine who says she's seeing an uptick in adults reporting these conditions.

And even 50-somethings are seeing zits when they look in the mirror. “Cortisol increases oil production in the skin and therefore can make you more susceptible to developing acne,” Nelson explains. “At the same time, everyone is wearing masks, which are occlusive. When you combine the cortisol-driven increase in oil production with the occlusion of the mask, you get a perfect storm.”

Constant handwashing and the frequent use of alcohol-based sanitizers also deal the skin a blow. These practices can dry the skin and break down its natural barrier. “These are critical steps during the pandemic, but they do lead to more redness, dryness and cracks,” Nelson says. (To protect the hands after washing them, apply lotion while they are still damp, which traps moisture next to the skin.)

Nelson says more people are experiencing telogen effluvium, a type of sudden but temporary hair loss associated with stressful events. “Your hair is constantly cycling between the anagen [growing] phase and the telogen [resting] phase,” she says. “But severe physical or psychological stress can cause your body to shift more follicles into the resting state.” That means less hair is growing to replace lost strands.

Fortunately, you can expect your follicles to flip back into the anagen phase when the stress dips, and your hair should regrow. Still, you may want to have your hair loss evaluated to rule out problems with your thyroid or a nutritional deficiency.

Your digestive system

The gastrointestinal (GI) tract is a major target for stress. It's no wonder that “we've seen a surge in GI manifestations of stress and anxiety,” says Richard DePalma, a gastroenterologist at the Einstein Healthcare Network in the Philadelphia area.

Irritable bowel syndrome (IBS) — a spectrum of symptoms, including cramps, bloating, irregular bowel habits, often with chronic diarrhea or constipation — is high on the list of complaints. There's also a rise in upper GI side effects like gastroesophageal reflux disease (GERD), which is signaled by a burning feeling in the chest or throat, chest pain, belching and bloating.

Stress isn't the only culprit in the current wave of digestive distress. “Patients are home more,” DePalma says. “They're sedentary, their diet has changed, and they've gained five to seven pounds. That will trigger acid reflux and worsen preexisting disease.”

More patients are also experiencing a stress-related disorder called globus, the sensation of a lump or something stuck in the throat when there's no blockage. “People have trouble swallowing even though food is not getting stuck,” DePalma says.

Although a number of medications are available for IBS and GERD, lifestyle changes often do the most good. “We have a more sedentary lifestyle and a low-fiber diet, and those tend to lead to more GI symptoms,” DePalma says. “Increased exercise and a high-fiber diet with lots of fruits and vegetables are my first go-to tips.”

Though he and other doctors suggest many stress effects will eventually peter out along with the pandemic, they worry that patients delaying routine care and screenings could face a poorer prognosis if problems are found. With clinics opening back up with strict safety measures in place, says Nelson, “it's very important that patients not neglect their preventive care.”

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