We all deal with stress at times during our lives. Whether it’s worrying about relationships, work or family, it’s a common human experience that affects us all. With the pandemic and health concerns in the news recently the situation has only gotten worse. While some level of stress is normal and manageable, when it lasts for a long time or becomes chronic it can become a serious issue and even manifest in physical complications. What you might not know is that psychological stress can also have an impact on the immune system and the wound healing process.
Why Wounds Take Longer to Heal When Stressed
It has become widely recognized that psychological stress can affect how the immune system functions and a healthy immune system plays a crucial role in effective wound healing. To understand how this works it’s important to first explore how the body reacts to stress.
When we are in a stressful situation, a small part of the brain (also known as the hypothalamus) puts the body on alert. Our body then releases epinephrine and norepinephrine; the chemicals responsible for our ‘fight or flight’ response. While in certain situations this can be helpful, for example when we are in danger, in others, these chemicals can result in physical complications such as an increase in blood pressure and heart rate.
Another chemical called cortisol is also released which provides the body with additional energy and adrenaline in these situations. Cortisol provides sugar for energy and other substances that help repair tissue while suppressing other systems so the body can focus on responding to stress.
Unfortunately, over time elevations in cortisol can affect the immune system and interfere with the body’s ability to produce cytokines which can be integral during the early stages of the healing process. If stress continues, the body has a more difficult time fighting off toxins and controlling inflammation which is a necessary element to wound healing. This effect was further supported by a clinical study that assessed wound healing progress and cortisol levels in 24 individuals after a small punch biopsy was made.
Additional Research On The Impact of Stress On Wound Healing
- The first study exploring the connection between stress and wound healing assessed the impact of chronic stress on caregivers looking after a loved one with Alzheimer’s disease or other dementia. They found that the woman caregivers took 24% longer to heal.
- In another sample of 11 dental students, biopsy wounds healed 40% more slowly on average during examination time compared to during vacation. In fact, every student in the study healed at a lower rate during exams.
- A later study that examined blister wounds in 36 women found those who reported greater stress had significantly lower levels of 2 important cytokines at the wound site.
Although multiple factors can impair wound healing, these (and other) studies clearly indicate the potential impact of stress on the body and its ability to recover efficiently.
Stress and Recovery From Surgery
The impact of psychological stress can be particularly relevant when someone requires surgery; as depression, anxiety, and pain are common and can result in even more stress. In fact, several studies have uncovered that higher levels of anxiety and depression even before surgery have been associated with poorer outcomes and can affect wound healing.
Further, chronic or slow healing wounds that aren’t properly treated can get worse; resulting in infection and longer hospital stays.
The Effect of Stress On Diabetic Wound Healing
Individuals struggling with diabetes often suffer from slow healing wounds like diabetic foot ulcers. If these are not addressed, these types of wounds can result in serious complications such as amputation. It’s estimated that diabetic foot ulcers are a leading cause of about 80% of lower limb amputations.
A study published in the Journal of Diabetes Science and Technology found an association between stress and relaxation and wound healing in patients with diabetic foot ulcers. They went on to note that while the impact of physiological stress on wound healing hasn’t been explored within the diabetes population specifically, studies have shown that managing stress has a positive effect on those with diabetes.
Helpful Tips For Managing Stress
Another factor to consider here is often people adopt unhealthy ways to cope with psychological stress which can make the situation even worse. Unhealthy behaviors such as smoking, poor diet, and less sleep can certainly play a role in increasing stress levels and impairing the healing process.
Fortunately, including healthy habits and coping strategies in your life when you come across stress can help in preventing it from escalating into a much larger issue. Here are a few tips for dealing with stress and triggers:
- Get out and exercise.
- Practice deep breathing exercises.
- Maintain a healthy diet.
- Challenge the thoughts and try to reframe your thinking.
- Try counting to 10 or developing a mantra.
- Listen to your favorite music or watch something funny.
- Learn mindfulness and meditation techniques.
- Write down your thoughts in a journal.
- Focus on something positive.
- Speak to a professional, find social support, or take a class in stress management.
At West Coast Wound Center, we understand the potential impact of chronic stress and an unhealthy lifestyle can have on the healing process. Our holistic approach to wound and skin care considers the whole person — body, mind, spirit, and emotions — in the quest for optimal health and wellness. We believe proper healing requires not just treating the wound but the whole person. We work to restore our patients’ quality of life with each healed wound!