Sleepless nights, hair loss, cracked teeth, shingles: Pandemic stress taking a toll

In late March, shortly after New York state closed nonessential businesses and asked people to stay home, Ashley Laderer began waking each morning with a headache.

“The pressure was so intense it felt like my head was going to explode,” said the 27-year-old freelance writer from Long Island.

She tried spending less time on the computer and taking over-the-counter pain medication, but the pounding kept on — a drumbeat accompanying her equally incessant worries about COVID-19.

“Every day, I lived in fear that I was going to get it, and I was going to infect my whole family,” she said.

After a month and a half, Laderer saw a neurologist. But the doctor found no physical cause. An MRI scan was clear.

He asked: Are you under a lot of stress?

People who never had the coronavirus have been reporting puzzling, seemingly unrelated symptoms: excruciating headaches, hair loss, upset stomach for weeks on end, sudden outbreaks of shingles and flare-ups of autoimmune disorders.

There’s a common thread: chronic stress. A growing body of research shows high stress over an extended time can drastically alter physical function and affect nearly every organ.

Surveys have found increasing rates of depression, anxiety and suicidal thoughts during the pandemic. But many medical experts said it’s too soon to measure the related physical symptoms, which generally appear months after the stress begins.

Still, some early research points to an uptick. Data from FAIR Health, a nonprofit database that provides cost information to the health industry and consumers, showed slight to moderate increases in the percentage of medical claims related to conditions triggered or worsened by stress, like multiple sclerosis and shingles. The portion of claims for the autoimmune disease lupus showed one of the biggest increases — 12%.

Perhaps the strongest indicator comes from doctors reporting a growing number of patients with symptoms for which they can’t determine a cause.

Dr. Shilpi Khetarpal, a Cleveland Clinic dermatologist, used to see about five patients a week with stress-related hair loss. Since mid-June, that number has jumped to 20 or 25, Khetarpal said.

In Houston, at least a dozen patients have told fertility specialist Dr. Rashmi Kudesia they’re having irregular menstrual cycles, changes in cervical discharge and breast tenderness, despite normal hormone levels.

Stress also is the culprit dentists are pointing to for increases in people with teeth grinding, tooth fractures and TMJ.

When the body feels unsafe — whether from a physical threat or fear — the brain signals adrenal glands to pump stress hormones. Adrenaline and cortisol flood the body, activating the fight-or-flight response. They also disrupt bodily functions that aren’t necessary for immediate survival, like digestion and reproduction.

When the danger is over, the hormones return to normal. But during times of chronic stress, the body keeps pumping out stress hormones, leading to increased inflammation throughout the body.

Studies link chronic stress to heart disease, muscle tension, gastrointestinal issues and even physical shrinking of the area of the brain associated with memory and learning. Some people develop new allergic reactions, said Kate Harkness, a professor of psychology and psychiatry at Queen’s University in Ontario.

For Alex Kostka, pandemic-related stress brought on mood swings, nightmares and jaw pain. He’d been working at a Whole Foods coffee bar in New York City about a month before the pandemic hit, suddenly anointing him an essential worker. As deaths soared, Kostka kept riding the subway to work, interacting with co-workers and working longer hours for a $2-an-hour pay increase. It left the 28-year-old feeling constantly unsafes.

“It was hard not to break down on the subway the minute I got on it,” Kostka said.

He began waking in the middle of the night with pain from clenching his jaw.

By the end of summer, he started using the seven free counseling sessions his employer offered. That helped, he said. But as the sessions run out, he worries the symptoms might return if he’s unable to find a therapist covered by his insurance.

With chronic stress, seeing a doctor can address physical symptoms. But the root is mental, medical experts say. That means the solution will often involve stress-management techniques such as:

• Exercise. Even low- to moderate-intensity activity can help counteract stress-induced inflammation in the body. It can also increase neuronal connections in the brain.
• Meditation and mindfulness. Research shows this can lead to positive changes in the brain.
• Fostering social connections. Talking with family and friends, even virtually, or staring into a pet’s eyes can release a hormone that can counteract inflammation.
• Learning something new. Learning supports brain plasticity, the ability to change and adapt, which can be protective against depression.

Kaiser Health News, a nonprofit health newsroom, is an editorially independent part of the Kaiser Family Foundation.