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The Neurobiology of Stress and Emotions By: Emeran A IFFGD PO Box 170864 International Foundation for Milwaukee, WI 53217 www.iffgd.org Functional Gastrointestinal Disorders Stress (106) © Copyright 2002 by the International Foundation for Functional Gastrointestinal Disorders The Neurobiology of Stress and Emotions By: Emeran A. Mayer, M.D., Director, UCLA Oppenheimer Center for Neurobiology of Stress; Director, UCLA Center for Neurovisceral Sciences and Women’s Health; Director, UCLA Center for Functional Bowel and Motility Disorders; and Professor, Department of Medicine, Physiology, Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA We often hear the term “stress” associated with The organism’s stress response often, but not functional gastrointestinal (GI) disorders, such as necessarily, includes subjective emotional feelings like irritable bowel syndrome (IBS). Many patients fear and/or anger. However, similar responses can also experience a worsening of symptoms during times of be observed in situations that are perceived as threats severely stressful life events. But what is stress? How but which do not represent actual life-threatening often does it occur? How does our body respond to situations, such as public speaking or the memory of a stress? This article explores the mechanisms that link natural disaster. The associated subjective emotion stress and emotions to responses that have evolved to associated with such non-life threatening stressors is ensure survival and that, in the modern world, affect frequently referred to as anxiety. health – including gastrointestinal function. Emotions, stress, and conscious feelings Introduction One environmental situation that triggers a distinct Stress is an adaptive response that is not unusual or emotional response of the body is a real or perceived unique to only certain individuals. In humans and threat to the organism. The stressor is the event that animals, internal mechanisms have developed triggers this particular response; fear and/or anger is the throughout evolution, which allow the individual to emotional feeling that may be associated with the maximize their chances of survival when confronted bodily response. However, stress and fear are not the with a stressor. A stressor in this context is any situation only emotions that our organism is programmed to that represents an actual or perceived threat to the respond to. Emotions are stereotypic patterns of the balance (homeostasis) of the organism. In a wide body, which are triggered by the central nervous system variety of real, life-threatening situations – such as an in response to distinct external environmental situations actual physical assault or a natural disaster – stress or to the recollection of memories related to such induces a coordinated biological, behavioral, and situations. In evolution, the basic mechanisms psychological response. generating an emotional response of the body evolved long before the conscious feeling of emotions evolved In many ways, the stress response of an organism can in humans and in non-human primates. The reason for be understood in analogy to the response of a nation this is simple: Emotional responses are essential for the confronted with an actual or perceived threat to its survival of all living organisms. For example, the stability. As we are all too familiar, such a threat will emotion of fear and/or anger, and the associated fight or result in the activation of a series of preprogrammed flight response is essential to avoiding harm from an civilian (economic, security) and military measures, aggressor; the emotion of love (attachment) is essential optimizing the chances of the nation to overcome or for bonding between individuals; the emotion of disgust avoid the threatening situation. On the one hand, the may have evolved initially as food aversion to avoid readiness to quickly mount such a response is ingestion of harmful materials. paramount to the long-term survival of the nation; on the other hand, the longer this response has to be In these different situations, the body consistently maintained, the greater the toll will be on other responds in an automatic, stressor-specific way, at times functions of the society. We will return to this analogy without our being aware of the response. Conscious later. emotional feelings may or may not be associated when the body responds to a stressful situation. It is important to realize that the frequently associated conscious intestine to ingested food and waste material during a feelings of emotions, such as fear, anger, sadness, time when all energy is shunted toward the disgust, or love, are not essential to the understanding skeletomotor system to maximize success of the fight of the basic biological mechanisms underlying the and flight response. Interestingly, when the emotion emotions. As expressed in a concise way by Joseph E. shifts to anger, the pattern of upper GI activity is LeDoux of the NYU Center for Neural Science: From reversed, with stimulation of gastric contractions and the perspective of the lover, the conscious feeling of acid secretion. love is the only thing that is relevant. For the scientist who wants to understand the biological mechanism The beneficial and detrimental effect of the stress underlying the emotion of love, the biological responses response of the organism are the only relevant aspects. In addition to elaborate mechanisms that have evolved Basic biological mechanisms by which stressors are to activate the stress response when needed to protect translated into distinct bodily responses the organism, equally effective mechanisms have evolved to turn it off immediately when no longer Whenever an emotion is triggered, a network of brain needed, or to rapidly habituate to repeated occurrences regions (traditionally referred to as the “limbic system”) of the same stressor. Apparently these systems of generates a pattern of stereotypic outputs, which activation and inactivation of the stress response, which ultimately induce a biological response of the body. The have evolved over millions of years, have been circuits within the brain that generate the emotional perfected to deal with the daily threats to survival for all responses can be referred to as the emotional motor organisms involved in the cycle of prey and predators. system (EMS). Via parallel outputs of the autonomic However, in humans living in modern societies we are nervous and neuroendocrine systems, the EMS plays increasingly beginning to realize a phenomenon that has out an emotional response in the “theater of the body.” been referred to as the wear and tear, or the allostatic For example, every human being produces similar load, of stress. This detrimental effect of stress may facial expressions associated with specific emotions. manifest following a one time severe stressor (life Facial expressions of fear, anger, and sadness are so threatening situation), following repeated smaller universal that a primal tribe member living in the stressors, or following a major sustained stressor over a Amazonian jungle has the identical pattern as a broker period of time. at the New York stock exchange. Specific circuits of the emotional motor system have evolved to both Let us again take the example of a nation responding to generate this stereotypic emotional facial response, as an acute or perceived threat by mounting a massive well as instantaneously recognize it when it occurs in mobilization of civilian and military resources (“fight somebody else. Other examples of musculoskeletal response” or “defense reaction”). In the majority of responses associated with emotions include tightening situations, mounting the response will be sufficient to of muscles or changes in posture. avoid the potential damage, and the country can return to its normal civilian function within a relatively short Even though most of us are completely unaware of it, time. However, if the threat persists, or the response is similar stereotypic emotion-specific responses are also maintained over a long period of time, there will be generated within our internal (visceral) organs. In a substantial costs to the society (i.e., allostatic load) such stressful situation they include responses such as as the channeling of resources from civilian to military stimulation of the cardiovascular system (increased projects, and dealing with psychological and physical blood pressure, heart rate, cardiac output) required to impact of military conflicts. prepare the body for the “fight or flight” response. Of particular relevance for those with a functional GI What is the wear and tear of severe, repeated, or disorder like IBS, is the fact that the emotion of fear is sustained chronic stress in humans? The remarkable associated with inhibition of upper GI (stomach and thing is that in the absence of predisposing duodenum) contractions and secretions, and with “vulnerability” factors (e.g., genetic factors, adverse stimulation of lower GI (sigmoid colon and rectum) early life experiences) or in the presence of “resilience” motility and secretions. The former may contribute to a factors (e.g., possibly genetic, strong social support sensation of fullness and lack of appetite, the latter to system), a large number of people are remarkably diarrhea and lower abdominal pain. This response resilient to this wear and tear of chronic stress. pattern of the digestive tract may have evolved in order However, in the vulnerable person, it has frequently to minimize
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