Your brain on stress: How chronic pressure reframes neurological health

Stress is a natural survival response. However, when it becomes chronic, it begins to take a toll on our brain not just emotionally, but physically and chemically. During periods of prolonged stress, the brain is continuously exposed to elevated levels of cortisol and other stress hormones. While these are helpful in the short term, sustained exposure can disrupt essential neurological functions.

One of the initial brain regions impacted is the hippocampus the part of the brain in charge of learning and memory. Chronic stress will decrease the size of this region, causing forgetfulness or the inability to hold onto new material. At the same time, the amygdala becomes overactive, amplifying fear and emotional sensitivity. The prefrontal cortex, which regulates decision-making, attention, and emotional regulation, also begins to underperform during chronic stress. These alterations are not necessarily reversible and may become fixed over time if not treated.

Neurologically, chronic stress can be a causative or exacerbating factor in a variety of conditions. It is a recognized precipitant for migraines, usually raising both frequency and severity. Stress can decrease the threshold for seizures in epilepsy, especially in patients with poorly controlled seizures. Increasing evidence suggests that stress can also worsen autoimmune disease such as multiple sclerosis, although it is unknown whether this is through its effect on the immune system. Also, the connection between chronic stress and stroke is troubling in that elevated blood pressure, heightened risk of clotting, and systemic inflammation are all byproducts of ongoing exposure to stress.

Even with these risks, the brain is resilient. There are excellent protective mechanisms that can buffer it against the long-term effects of stress. Physical exercise on a regular basis stabilizes mood and enhances blood flow to the brain. Activities such as mindfulness meditation, yoga, or the practice of deep breathing decrease the functioning of the amygdala. Getting adequate sleep (minimum 7–8 hours a day) provides the brain the opportunity to recharge and heal. Dietary wise, foods high in omega-3 fatty acids, fruits, and leafy green vegetables nourish the brain. Equally important, having good social relationships and emotional support networks ensure a psychological buffer against chronic stress.

For at-risk patients, I suggest incremental but regular changes: adopt a daily schedule, screen time (particularly before sleep), limit caffeine consumption, and boundary setting to avoid spillover of work into life. Stress is a given in the modern world, but its neurologically damaging effects don't have to be.

(By Dr. Ganesh Kini, Consultant Neurologist, K J Somaiya Hospital and Research Centre)