The connection between cognition and stress and how to mitigate it

METERMost of us assume that our brains will stay fairly healthy well into relatively old age. But our lifestyle can make a big difference. In particular, chronic stress can lead to lower cognitive function, no matter our age.

This is important, because cognition plays an important role in our daily lives. Specifically, GIA Healthcare neurologist Antonello Bonci, MD, says that cognition refers to the brain’s ability to focus, learn, complete tasks, solve problems, and memorize things. So if you want to be able to trade effectively and efficiently throughout life, learning how to manage your stress is a must.

Symptoms of chronic stress

Feeling momentarily stressed is part of being human. However, feeling chronically stressed doesn’t (or at least shouldn’t) be.

“Stress is a natural response that we (evolve) to protect ourselves from potential threats or to be more aware of unsafe situations,” says Dr. Bonci. When faced with stressful encounters, the brain releases stress hormones (adrenaline, norepinephrine, and cortisol), which in turn leads to a faster heart rate, rapid breathing, and tense muscles ready to attack; These are all signs of a fight or flight response. “It is a survival mechanism that allows mammals (including humans) to react quickly to a life-threatening situation,” explains Dr. Bonci.

While this sequence of events is helpful when facing extreme situations, such as escaping from dangerous encounters, stress responses aren’t always accurate, Dr. Bonci explains. “Our brains can overreact to non-life-threatening stressors,” he says. When this happens, and a person becomes chronically stressed, we go into survival mode, which Dr. Bonci says can have a negative impact on our physical, mental, emotional, and, yes, cognitive functions.

“One of the most frequent cognitive effects is forgetting or misremembering things,” he says. “Chronic stress can also lead to rigid thinking behavior, so when we’re under stress, we’re more likely to make decisions based on our habitual habits.”

“One of the most frequent cognitive effects is forgetting or misremembering things.” —Antonello Bonci, M.D.

Thats not all. Dr. Bonci says that chronic stress triggering can also lead to constant worry, which can potentially manifest as anxiety. Also, being constantly stressed can noticeably affect our concentration and focus.

“(People with chronic stress) can usually pay a lot of attention to the situation that causes them stress, but they can’t direct their attention to much else,” he says. “In more severe cases, people may experience diversion of their attention from one topic to another, even during important meetings or conversations.” This inability to focus can, in turn, lead to poor performance at work, reduced function at home, and a general lack of presence.

How stress affects the brain

Stress literally has the ability to change our brain. “Short-term stress in the body—physical, mental, emotional, even existential—prompts cells to switch into ‘danger mode,’” says neurologist and herbalist Maya Shetreat, MD. “In danger mode, cell function favors survival rather than optimal function. In the brain, the effects manifest differently in (each) individual, but can include insomnia, moodiness, lack of concentration, forgetfulness and even headaches.”

That being said, human cells are resilient and built to bounce back once the stressor passes. The problem is that if you’re under chronic stress, your cells don’t have a chance to recover.

“Repeated and prolonged stress can cause short- and long-term changes in the activity of our brain circuits, interfering with cognition, attention, and memory,” says Dr. Bonci. This happens because, in stressful situations, some areas of the brain are so involved in survival mode that others run out of energy to process, he explains.

While we can maintain this state for a short period of time, it can eventually overwhelm the body and mind, to the point that being in a perpetual fight-or-flight state can rewire the brain.

“Several scientific studies have shown that animals experiencing prolonged stress have less activity in brain areas that control higher-order functions, such as the prefrontal cortex,” says Dr. Bonci. These systems are responsible for problem solving, decision making, personality expression, self-awareness, the ability to learn and remember, and more. So without them intact, you could become a totally different person.

Trauma and cognition

Not all stressors are dire, however, some stressors are so profound that they can change the state of cells permanently, says Dr. Shetreat. “This is known as trauma,” she says. “In those cases, the cells get ‘stuck’ in danger mode. When left unaddressed, the pathways in the brain can eventually change and chronic conditions can arise as a result. Along with other risk factors, people can experience PTSD, depression, anxiety, OCD, dementia, and more. It is even believed that addiction is related to this mechanism.

How to reverse the effects of stress on cognition

Considering that chronic stress can lead to long-lasting, if not permanent mental changes, it’s important to address the problem head-on. But if all these effects of stress are stressing you out, know this: There are steps you can take to mitigate the problem.

“Stress-induced brain changes may be reversible depending on the type and duration of stressful situations, individual vulnerability, and the social environment,” says Dr. Bonci. Countering stress-induced maladaptive brain changes can reduce cognitive dysfunction and lower the risk of developing chronic diseases, he says.

With that in mind, here are seven ways to ease the burden of stress.

1. Talk to a health professional

There is no shame in working on your mental health; in fact, today, it is typically applauded. (See: caps that joke “BRB Going to Therapy” and T-shirts that say “I Love My Therapist.”) One of the best ways to seek help is to speak to a reputable healthcare professional who is well versed in the subject. “Communicating can help you cope better with stress and become more resilient,” says Dr. Bonci. “Early intervention can reduce the complications induced by a prolonged stressful situation.”

2. Establish a routine

You know all those TikToks and Reels that put morning and evening routines on a pedestal? While they may seem too complicated or even impossible to maintain, routines are key to managing stress, says Dr. Bonci.

“Stress is often unpredictable, so it can help to focus on controlling the things that we can,” she explains. This can manifest in many ways, but it’s most helpful when a routine is centered around health and connection. Think: adequate sleep, nutritious meals, regular exercise, and quality time with loved ones. Having a continuous and manageable to-do list centered around certain hours can also help.

3. Prioritize good sleep hygiene

Stress can make falling asleep and staying asleep more difficult, so it’s important to make your sleeping space as relaxing as possible. “Stress can result in difficulty sleeping, inducing a vicious cycle,” says Dr. Bonci. “Having healthy sleep habits, like avoiding technology devices before bed, going to bed and getting up at the same time every day, and not consuming caffeine after noon can really help.”

4. Take time to relax

Life is about more than morning and evening routines, work and sleep. Dr. Bonci says it’s important to make time to relax away from major personal care responsibilities for him so he can really recharge. Catch up on your favorite shows, have lunch with a friend, take a bath, sit outside, you do it.

5. Get organized

Getting back to those to-dos, Dr. Bonci says having a concrete to-do list for each day can help make managing your daily workload less stressful. “It’s also a good idea to rank your tasks by priority, accomplishing the most urgent ones first,” he adds.

6. Avoid drugs and alcohol

Here in 2023, more and more people are turning to the understated and curious lifestyle, and for good reason. “While these substances may initially appear to help with stress or anxiety, many studies have shown that they can create significant health problems and worsen symptoms,” says Dr. Bonci.

With that said, Dr. Shetreat notes that psychedelics are one of the most exciting therapies on the medical horizon. “What we are finding is that, with the right support before, during, and after, psychedelics can rewire the brain out of trauma and chronic stress pathways and literally get cells back to functioning optimally,” he says. “Most major academic centers around the world now have dedicated research exploring the benefits of psychedelics for treatment-resistant depression, OCD, PTSD, dementia, eating disorders, and sexual trauma.” (However, it’s important to note that psychedelics are still illegal in most of the US.)

7. Ask about TMS

If you feel like nothing is working to relieve your stress, Dr. Bonci suggests looking into transcranial magnetic stimulation (TMS). “It is a painless, non-invasive brain stimulation technique that modulates brain activity through the delivery of magnetic pulses,” he says. “Depending on the frequency of the pulses delivered, TMS can help our brain circuits work better and reduce anxiety, insomnia, and depression.”

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