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Stress, Burnout and Chronic Disease Series: Part 1

The impact of Perceived Stress on Burnout and Chronic Disease


Stress is a part of life, but how does chronic stress lead to a myriad of health issues? One of the main players in the stress response is the HPA (hypothalamic-pituitary-adrenal) axis, which regulates cortisol production. Chronic stress can cause dysregulation of this HPA axis, which can be a big contributor to chronic disease. In this blog series, we'll explore the connection between stress, the HPA axis, and chronic disease, and provide tips for managing stress and supporting the HPA axis for better health.


Perceived stress: What is a stressor? The stress response is designed to assess threats, combining the information we get from our senses (what we see, hear, smell, feel, taste) with the memories of stressful events in order to make a decision as to how to respond to such threats. This is commonly referred to as the “Fight, flight, or freeze” response. It can be very useful in preparing our bodies to deal with real dangers to avoid injury, or help us cope with injuries. Unfortunately, the body cannot easily distinguish what is a real threat and those that are perceived threats. So that assignment, the deadline, the big event that is coming up, relationship or financial issues, or traumas – these may not be physically a danger to you, but your body will pump out cortisol (a stress hormone) to deal with that stress. Perceived stressors typically increase HPA axis activation, but with burnout due to chronic stress, you can actually get an adaptive down-regulation of the HPA axis.

Neurotransmitters and mood: When a stress is perceived, it has to be translated into neurochemical signals before it can activate the HPA axis. These signaling neurotransmitters – such as glutamate, GABA, serotonin, norepinephrine, dopamine, etc. are also involved in mood and other functions in the brain. So when we have a stressful event, these signaling neurotransmitters play an important role in how sensitive we are to that stress. That is why a lot of HPA dysfunction caused by stress overlaps with conditions such as anxiety and depression.


1) Your outlook on stress: Taking control of your stress (not feeling like everything is out of your control) can reduce your perception or feeling of stress. Thinking of your stress response as tool that helps you overcome these tasks can help. Working with a clinician to help re-frame your perception of stress, and problem-solving ways to reduce stress from work, finances, and relationships, can help reduce the effects felt by the body afterward.

2) Glutamate: Glutamate or L-Glutamic acid is an excitatory neurotransmitter that activates receptors in the brain. Abnormal function of the glutamate system can lead to several disorders such as depression or bi-polar disorder, anxiety, Alzhemier’s disease and many more. Studies show that chronic stress can affect the transmission of glutamate in the brain, and Omega-3 fatty acids can help protect this damage and prevent stress-related disorders such as depression or anxiety.

3) GABA: GABA is an inhibitory neurotransmitter and counteracts the activities of glutamate. It helps inhibit the HPA axis function. Lower levels of GABA means we cannot properly down-regulate the HPA axis. GABA is commonly supplemented in people for its anti-anxiety effects. You can find get some natural sources of GABA in foods such as kefir, kimchi, sauerkraut, and tempeh.

4) 5-HTP: 5-hydroxytryptophan (5-HTP) is a precursor to serotonin, which is often used in the treatment of depression. Serotonin is involved in the regulation of emotion, aggression, mood, and sensitivity to stress and pain, and is also converted into melatonin (the sleep-regulating hormone). 5-HTP can be inhibited by high stress levels, vitamin deficiencies and insulin resistance.

All of us deal with stress, but understanding how our perception of stress can affect the HPA-axis, as well as how different neurotransmitters can affect this system, is important step in treating and preventing burn-out and the chronic diseases that come about due to stress.

Need more help? Book an initial consultation with Dr. Min.


Dr. Daniel Min, ND

I believe in an integrative, evidence-based approach to get to the root of my patients’ health concerns. As a second generation Korean-Canadian, I’ve seen the effectiveness of both eastern and western medicines first-hand, and how the body has an amazing capacity to heal itself from a cellular level if given the right environment to thrive. By utilizing tools gained from my training in sports injuries, nutrition, lifestyle counselling, supplementation, and botanical medicine, my goal is to provide a truly integrative and individualized treatment plan to help empower you towards optimal physical, mental, and emotional health.


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