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Stress damage to brain


Neurobiological and Systemic Effects of Chronic Stress

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6 Ways Stress Affects Your Brain

The brain is a fascinating and complex organ. It’s the primary control center for our whole body, and it can be affected by stress in many different ways. Stress itself is an important part of life – it helps us prepare for danger or respond to emergencies. But when we’re constantly stressed out, that’s when our brain starts to pay the price. This blog post will explore how stress affects your brain, both positively and negatively, so you can develop strategies to reduce your brain’s vulnerability to its harmful effects.

For starters, it is important to understand how our body processes stress. In the simplest terms, stress is basically the “fight or flight” response to a perceived threat. This activates the amygdala, or “fear center” of the brain, and causes a cascade of events. These include the production of the stress hormone cortisol, an increase in glucose levels, increased heart rate, and an increase in blood flow to the muscles in the arms and legs. After the threat has passed, then the body will eventually return to normal. 

In the case of chronic stress, however, the fear center of the brain is constantly activated, meaning that the body is in a constant state of stress. Cortisol levels are also constantly elevated, which can eventually start to cause problems with digestion, sleeping, and the immune system. Not only that, but when one part of the brain is constantly engaged, it is postulated that the other parts of the brain may not have enough energy to carry out their own functions properly. As a result, here are six ways that stress can affect the brain: 

Impairs Memory

One effect of chronic stress that researchers have observed is memory impairment.   Specifically, it has been noted that people who are stressed tend to be more forgetful and less likely to remember specific information. Researchers believe that even minor stress, such as being late to work, can cause you to forget simple things like where your keys are. One study performed on older rats even noted that high levels of cortisol caused short-term memory declines. According to Dr. Kerry Ressler, chief scientific officer at McLean Hospital and professor of psychiatry at Harvard Medical School, “The basic idea is that the brain is shunting its resources because it’s in survival mode, not memory mode”. 

Changes the Brain’s Structure

Your brain is composed of both gray matter and white matter. Gray matter is used for decision-making and problem-solving, while white matter is used to connect regions of the brain and communicate information. It has been noted that during times of chronic stress, the myelin sheaths that make up white matter become overproduced, while less gray matter is produced. When this happens, there can be an imbalance in gray and white matter. In some cases, this results in permanent changes to the brain’s structure. 

More Susceptible to Mental Illness

An imbalance between white and gray matter can also play a role in the development of mental illness. The theory is that having excess myelin in certain areas of the brain interferes with the timing and balance of communication. It was also noted that chronic stress can negatively alter hippocampal function. The hippocampus is involved in memory, specifically spatial memory, memory consolidation, and memory transfer. 

Stress Kills Brain Cells

It has been suggested by researchers that chronic stress can even kill new neurons in the brain’s hippocampus. The hippocampus is one of only two locations where neurons are produced. Despite the fact that the formation of new neurons does not seem to be affected, research shows that new neurons produced during periods of stress are more likely to die within a week.  

Stress Shrinks the Brain

While the overall volume of the brain tends to remain about the same, it has been found that chronic stress in otherwise healthy individuals can cause areas of the brain associated with emotions, metabolism, and memory to shrink. Chronic stress also made people more likely to experience brain shrinkage when exposed to intense stressors. This means that people under constant stress may find it harder to deal with future stress. 

Improves Cognitive Function

Stress is not all bad for your brain. In fact, moderate stress can actually improve brain performance by strengthening the connection between neurons in the brain. This helps to improve memory and attention span in order to make you more productive overall. This is why some people tend to perform “better under pressure”.

Dr. Kashouty, a diplomate of the American Board of Psychiatry and Neurology (ABPN), practices general neurology with fellowship trained specialization in clinical neurophysiology. Dr. Kashouty finds the form and function of the nerves and muscles the most interesting part of neurology, which is what led him to specialize in neurophysiology with more emphasis on neuromuscular conditions. He treats all neurological diseases, but his main focus is to treat and manage headaches, movement disorders and neuromuscular diseases. 

We talk about the impact of coronavirus on the brain and psyche, the likely consequences and psychological rehabilitation.

The illness may be accompanied by shortness of breath, fever, cough, and loss of smell. But the infection also affects the mental and neurological state of the patient. In addition to disorders of the central nervous system at the height of the disease, a third of those who recover have long-term complications: depression, anxiety, increased risk of stroke, parkinsonism. We talk about the impact of coronavirus on the brain and psyche, the likely consequences and psychological rehabilitation. nine0003

Why violations occur

COVID-19, like any other virus, affects the functioning of many body systems and affects not only the respiratory tract and lungs, but also the central nervous system. This is called neurotropism - the ability of an infection to infect the cells of this system. Moreover, researchers believe that the virus replicates inside the nerve cells of the brain.

The results of post-mortem autopsies demonstrate that the coronavirus leads to inflammation of the brain tissue. And neuroimaging methods that show the structure and dysfunction of the brain detect microstrokes and leukoencephalopathy - a condition that leads to demyelination, when the coating of the processes of the nerve cell is destroyed. nine0003

These organic damages lead to the development of mental and neurological disorders in a person, which are complications.

What's going on

In a systematic review, researchers report that 20-40% of patients with coronavirus have psychiatric disorders:

  • insomnia - in 42% of patients
  • violation of attention and concentration - in 38%
  • anxiety - 36%
  • memory impairment - 34%
  • depression - 33%
  • disturbance of consciousness - in 21%
  • post-traumatic stress disorder - 4-7%

Every fourth patient has a severe headache and dizziness, 69% have psychomotor agitation, 0. 7% have convulsions and movement disorders. Elderly people may develop delirium - a disorder of consciousness in which thinking, attention and perception of the world around are disturbed. However, most often delirium occurs in elderly patients with dementia, a syndrome of cognitive decline. Sometimes this is the only symptom of coronavirus in them without respiratory system disorders. nine0003

“People with coronavirus infection often have negative psychological reactions: an acute reaction to stress, depression, emotional disturbances, obsessions and dysphoria — a combination of a gloomy mood and irritability,” says Olga Markina, candidate of psychological sciences, SberHealth consultant.

A large-scale outbreak of coronavirus is not the first case in history. During previous epidemics, doctors observed depressed mood and anxiety in patients - the most common symptoms in the acute phase of intoxication that accompanies the disease. In a small part of patients, psychosis occurs - an acute disturbance of mental activity, in which mental processes are out of sync, the perception of the real world is disturbed, and behavior and emotional reactions do not correspond to the real situation. nine0003

“During illness, patients experience fear and anxiety,” Tigran Makichyan, a neurologist and rehabilitation specialist at GMS Clinic, shares his experience. “This is due to many factors: pressure from the media, stories that someone you know has died, heart palpitations, which causes anxiety and anxiety in a person.”

Another part of the patients develops catatonia, a movement disorder accompanied by either complete stupor or increased arousal. nine0003

“Work experience shows that a coronavirus infection associated with intoxication, oxygen starvation of the brain, can cause an exacerbation of diseases of the neurological and psychiatric spectrum,” warns Olga Markina. - In elderly patients, emotional and intellectual disorders may worsen. Also, COVID-19 can cause a psychotic state: confusion, hallucinations and delusions. Quite often there are episodes of anxiety-depressive disorder, panic attacks and obsessive-compulsive disorder. nine0003

If a person with a mental disorder has a coronavirus, then the infection and its treatment can provoke a relapse and aggravate the course of the disorder. For example, medications for the treatment of COVID-19 can provoke psychosis in a patient with schizophrenia - delusions, hallucinations and inappropriate behavior, for example, the patient will think that medical personnel are trying to infect him.

“Coronavirus leads to decompensation of all chronic diseases, including schizophrenia,” says Tigran Makichyan, “Against the background of hypoxia, when there is not enough oxygen to the brain, patients become disoriented, but after recovery, as a rule, this disappears.” nine0003

Mental disorders are caused not only by the direct impact of the infection on the brain, but also by socio-psychological and economic factors associated with the coronavirus. A pandemic is associated in people with instability and unpredictability. Quarantine, social restrictions, uninterrupted news flow about morbidity and mortality from COVID - all this affects the emotional state and mood of people. So, depression, anxiety, sleep disturbance, feeling of loneliness, depression and apathy can be caused by: nine0003

  • high frequency of contact with infected people
  • fear of infecting loved ones
  • the need for physical distancing and wearing masks
  • feelings of medical and social insecurity
  • regular media reports about coronavirus
  • lack of information about when the pandemic will end

A Chinese study shows that the very fact of a virus pandemic outbreak already affects the mental state of people who have not contracted the coronavirus. So, about one in six, under the influence of the epidemic, developed symptoms of moderate and severe depression, and one in three - signs of an anxiety disorder of moderate or severe degree. nine0003

In addition, some respondents have symptoms of post-traumatic stress disorder and psychological distress. The pandemic is also reported to worsen the course of mental disorders in people who do not have coronavirus.

Covid affects not only the patient himself. It is reported that 50% of family members where there is a coronavirus patient have symptoms of depression.

Complications after recovery

nine0002 The more severe the infectious disease, the higher the chance of complications after recovery. So, about a third of those who have recovered have complications from the central nervous system and psyche.

Many people who have been ill talk about fatigue and malaise, difficulty in choosing words, memorizing, and reduced concentration. Some describe their condition as a kind of haze after COVID-19. Researchers report that one in three regularly experience headaches and dizziness, loss of smell and taste, and muscle weakness. nine0003

“Many negative psychological reactions appear after recovery,” Olga Markina shares her experience, “Sometimes symptoms do not appear immediately, but several months after recovery. Patients develop malaise, drowsiness, and stamina decreases. Many people experience anxiety and fear of re-infection, up to hypochondria and phobia.”

A professor of psychiatry at the University of Maryland reports that, in his opinion, about 30-50% of those who recover in the future have an increased risk of mental disorders, such as depression and anxiety. Also, about half of people who have had symptoms of coronavirus suffer from insomnia and depressed mood. nine0003

Recent studies say that one in ten people who recover from coronavirus develop post-traumatic stress disorder, a third develop depression and anxiety disorder. In addition, 54% of people develop chronic fatigue syndrome within three months of infection.

A recent but not yet peer-reviewed study reports that people who recover from coronavirus are more likely to experience intracranial hemorrhage, ischemic stroke, parkinsonism, Guillain-Barré syndrome, dementia, and insomnia than those who recover from other common infections, including the flu. nine0003

Psychological and cognitive rehabilitation

In addition to physical rehabilitation, which we have already talked about, those who have been ill need cognitive and psychological rehabilitation. The WHO reports that a recovery course is indicated for people who experience cognitive impairment during illness and after recovery, including memory and concentration decline, anxiety, depression, post-traumatic stress disorder and chronic fatigue.

There is still not enough information about which methods of rehabilitation are better. Now doctors practice cognitive-behavioral rehabilitation, which includes: nine0003

  • memory and attention training
  • speech therapy
  • mental exercises
  • psychological support

The task of psychological rehabilitation is to normalize the emotional background, relieve anxiety, tension and depression. Psychotherapy helps survivors reduce stress caused by social isolation and physical distancing. Psychotherapy can be done both online, if a person needs to observe isolation, or face-to-face, individually or in a group. nine0003

“Psychological assistance to covid patients can be provided at all stages of the disease. Medical psychologists work with patients in the "red zones". They provide psychological assistance to both patients and relatives of patients. Such help is vital for people who are in a state of great concern for their health and the health of their loved ones,” says Olga Markina.”

Psychological rehabilitation is provided to children and adults. To restore preschool children, psychologists and psychotherapists use the methods of play and fairy tale therapy. For older children - art therapy: sand therapy, isotherapy and music therapy. Adults are shown cognitive behavioral therapy, family and interpersonal psychotherapy. nine0003

Important to remember:

  • Coronavirus is a neurotropic infection that multiplies in nerve cells. It is the cause of many neurological and mental disorders
  • Patients with coronavirus may experience disorders of the central nervous system and psyche: headache, dizziness, fatigue, insomnia, anxiety, symptoms of depression. In severe patients - catatonia and disorders of consciousness
  • Long-term complications may occur in recovered people: decreased memory and concentration, regular headaches, depression and anxiety, post-traumatic stress disorder, chronic fatigue syndrome
  • Cognitive behavioral rehabilitation, cognitive behavioral therapy, art therapy, family and interpersonal therapy are used for mental and cognitive recovery.

Perinatal lesions of the central nervous system in Moscow - Central Clinical Hospital of the Russian Academy of Sciences

Perinatal lesions of the central nervous system (PP CNS) or hypoxic-ischemic encephalopathy is a group of pathological conditions associated with brain damage in the perinatal period. nine0003

The main causes of PP CNS:

  • Fetal hypoxia (chronic intrauterine; acute in childbirth)
  • Birth injury
  • Intoxication (bilirubin encephalopathy)
  • Hypoglycemia
  • Infectious factor

Clinical manifestations of CNS PP

  • Nervous system excitability syndrome: excessive and multiple movements, tremor of the chin, tongue, limbs, regurgitation, sleep disturbance (excessive wakefulness), spontaneous Moro reflex (spreading of the arms in the supine position)
  • Syndrome of depression of the nervous system: decrease in spontaneous motor activity, short-term wakefulness, excessive sleep, weakness of the sucking reflex, insufficient emotional response when interacting with the child.
  • Syndrome of vegetative-visceral dysfunctions: thermoregulation disorders, transient cyanosis, disturbances in heart rate and respiratory rhythm, marbling of the skin, hypothermia of the extremities, vegetative-vascular spots on the skin, regurgitation, vomiting, unstable stool. nine0018
  • Intracranial hypertension syndrome, hydrocephalic syndrome: excessive increase in head circumference, fontanel bulging, head tilting back, loud monotonous crying (brain scream), head tilting back up to trunk arching (opisthotonus), persistent vomiting and regurgitation not associated with eating, increased sensitivity to sound stimuli (hyperesthesia), spontaneous bulging of the eyes (Gref's syndrome), difficulty falling asleep (wants to sleep, but cannot), short-term and superficial sleep, excitability. nine0018
  • Convulsive syndrome: a variety of sudden and repetitive contractions of the eyelids, facial muscles, eye abduction, paroxysmal chewing, swallowing, sucking, sticking out of the tongue, swimming movements of the arms, pedaling, tonic tension of the trunk or limbs, single or group twitching of the muscles of the limbs, accompanied by convulsive movements eyes or "stopping" gaze, apnea.
  • Dysregulation of muscle tone (muscle dystonia) increased, decreased, mixed muscle tone in the limbs, range of motion in the joints, spontaneous posture in sleep and wakefulness, position of the hands and feet, support during verticalization, head position during traction (pulling up) by the handles . nine0018

Outcomes and consequences of CNS PP

The consequences of PP CNS can be determined by the age of 1 year. Below are their main manifestations:

  • Impaired motor development: delayed acquisition of head holding skills, coups, sitting, crawling, standing up, independent walking relative to the physical age of the child.
  • Formation of paresis and paralysis of both one and several limbs (monoplegia, diplegia, hemiparesis, tetraparesis), which are related to various forms of cerebral palsy. nine0018
  • Violation of psycho-speech development: delay in acquiring the skill of cooing, babble, the first words and phrases, the quality of the sounds uttered, the timing of the formation of pincer grip and pointing gesture, understanding of addressed speech, interest in surrounding objects and their intended use, the nature of the game, memorizing a new information, concentration of attention with the formation of attention deficit hyperactivity disorder.
  • Violation of behavior and emotions: the timing of the formation of the animation complex, differentiation of relatives and strangers, emotional resonance, the degree of expression of emotions, communication with peers and adults, the possibility of playing together, the formation of neatness skills, possibly leading to autism spectrum disorders. nine0018
  • Hydrocephalus: excessive increase in head circumference, head deformity, pronounced saphenous veins in the temporal regions, signs of hypertension and hydrocephalus syndromes.
  • Paroxysmal conditions of non-epileptic origin: affective-respiratory attacks, benign myoclonus of infancy (Fijerman's syndrome), benign neonatal sleep myoclonus, Sandiffer's syndrome, infantile torticolis, restless sleep, night terrors, rhythmic movements in sleep (rocking, shaking head, thumb sucking, gnashing of teeth). nine0018
  • Age-dependent epileptic syndromes: early infantile epileptic encephalopathy (Otahara syndrome), early myoclonic encephalopathy, Dravet syndrome, West syndrome, benign neonatal epileptic syndromes, benign myoclonic epilepsy of infancy, benign partial epilepsy of infancy.

Instrumentation

In the CDC Research Institute of Pediatrics and Rehabilitation Treatment, instrumental diagnostics are carried out in order to clarify the diagnosis: nine0003

  • Ultrasound of the brain (neurosonography)
  • EEG of daytime sleep and wakefulness
  • CT scan of the brain
  • MRI of the brain and spine

Our help

Specialists from the Department of Developmental Neurobiology of the Research Institute of Pediatrics and Health Protection of the Central Clinical Hospital of the Russian Academy of Sciences work on the basis of the CDC: