Understanding the Link between Stress and Inflammation

How are stress and inflammation linked?

You’ve probably told your patients that stress isn’t great for health. But what’s actually happening inside the body when we're under pressure? The connection between stress and inflammation runs deep, involving complex systems like the hypothalamic-pituitary-adrenal (HPA) axis, the sympathetic nervous system (SNS), and our immune response (Chen et al., 2017).

In the short term, stress is the body’s way of protecting us. When we face a threat, our system responds with a burst of inflammatory activity to help heal or fight off illness (Rohleder, 2019). But when stress lingers—whether it’s work deadlines, relationship strain, or ongoing life challenges—that response doesn’t shut off.

The constant release of stress hormones like cortisol begins to disrupt your body's natural checks and balances.

This leads to what’s known as stress-induced inflammation, a chronic state that can quietly contribute to long-term health problems like cardiovascular disease and inflammatory bowel disease.

Here’s where it gets even more complex: under psychosocial stress, the overactivation of the SNS prompts the body to release pro-inflammatory cytokines, chemicals that essentially tell our immune system to stay on high alert (Alotiby, 2024). Meanwhile, the immune cells get less efficient at keeping inflammation under control, allowing it to simmer in the background and feed into conditions like autoimmune disorders and metabolic syndromes.

Understanding how all of this works opens the door to better strategies for reducing inflammation and improving overall well-being, especially if clients are dealing with long-term stress.

Consequences of chronic stress on the body

Living with constant pressure doesn’t just leave patients feeling worn out, it can quietly reshape how the brain, hormones, and immune system work (American Psychological Association, 2024).

Over time, that relentless “fight‑or‑flight” signal sparks a low‑grade inflammatory response that raises risk for several stress‑related disorders. Here’s what unchecked stress can do:

Anxiety and depression

When stress hangs around, cortisol stays high and pro‑inflammatory cytokines keep circulating. Together, they throw off the balance of mood‑regulating brain chemicals. As serotonin and dopamine dip (Mora et al., 2012), you may notice worries creeping in more often or feel the familiar weight of low mood.

Memory impairment

Too much cortisol is tough on the hippocampus, the part of our brain that files away memories (Kim et al., 2015). For example, walking into a room and forgotten why, or struggled to take in new information during a stressful season, chronic stress may be the culprit.

Increased risk of cardiovascular disease

A racing heart and rising blood pressure are normal in short bursts. But when the stress response never takes a break, those spikes become a new baseline. The resulting vascular inflammation and endothelial “wear and tear” pave the way for atherosclerosis, hypertension, heart attacks, and strokes (Alfaddagh et al., 2020).

Negative metabolic effects

Stress hormones make you crave quick energy. Think sugary snacks or salty comfort foods. Over time, this pattern can tip you toward weight gain, insulin resistance, and eventually type 2 diabetes (Ryan, 2014).

Some people swing the other way and lose weight because stress blunts appetite; either extreme signals metabolic imbalance.

Gastrointestinal issues

The immune system and gut microbiome are highly sensitive to stress (Foster et al., 2021). Chronic stress exacerbates digestive disorders such as inflammatory bowel disease, irritable bowel syndrome (IBS), and gastroesophageal reflux disease (GERD). It alters gut motility, increases stomach acid production, and triggers inflammation in the gastrointestinal tract.

Additionally, stress weakens the gut barrier, making it more susceptible to harmful bacteria and inflammation.

What exacerbates chronic stress and inflammation?

Chronic stress isn’t just something clients feel. It has a direct impact on the body, often showing up as inflammation.

One powerful example comes from the Crohn’s & Colitis Foundation (n.d), which shared the story of a one who experienced a severe flare-up of Crohn’s disease during exam season. The intense academic pressure triggered a rapid inflammatory response in her digestive system. Within just a few weeks, she lost a significant amount of weight—dropping from 135 to 85 pounds—and even began losing her hair.

This case clearly shows how psychological stress can tip the immune system into overdrive, especially when it’s prolonged or tied to emotionally charged events. The body reacts to this stress as if it's under constant threat, and for individuals with underlying inflammatory conditions, this can mean sudden, intense flare-ups that affect quality of life.

Management strategies for stress and inflammation

Making a few smart lifestyle changes can go a long way in easing inflammatory stress and managing chronic psychological stress. Both of which are major risk factors for serious health issues.

Things like regular exercise, mindfulness, and good sleep habits don’t just improve your mental health. They also support your body’s ability to regulate inflammation. And the best part? These strategies are backed by science and come with no commercial or financial relationships involved.

Lifestyle modifications

Regular physical activity improves stress recovery by regulating cortisol levels and reducing systemic low-grade inflammation. A balanced diet rich in omega-3 fatty acids, antioxidants, and fiber helps control inflammatory responses while maintaining metabolic health.

Moreover, avoiding processed foods, excessive alcohol, and smoking further reduces chronic inflammation.

Sleep quality

Poor sleep exacerbates stress inflammation by increasing cortisol levels and impairing the body’s ability to regulate inflammatory responses. Establishing a consistent sleep schedule, limiting blue light exposure before bed, and prioritizing deep sleep improve overall stress management and enhance immune function.

Healthy weight maintenance

Obesity contributes to systemic low-grade inflammation, increasing the risk of metabolic and cardiovascular diseases. Maintaining a healthy weight through proper nutrition and regular exercise helps reduce inflammatory markers and protects blood vessels from stress-induced damage.

Mindfulness and relaxation practices

Mindfulness practices — meditation and deep breathing — have been shown in a randomized controlled trial with Crohn’s disease or ulcerative colitis patients to significantly lower inflammatory biomarkers after six months: fecal calprotectin dropped by 367 µg/g (95% CI: –705 to –29) and C‑reactive protein decreased by 2.82 mg/L (95% CI: –5.70 to 0.08) (González‑Moret et al., 2020).

Social support

Strong social connections mitigate the impact of chronic stress. Engaging in supportive relationships helps regulate stress hormones and protects against systemic low-grade inflammation.

Cognitive behavioral therapy (CBT)

CBT is an evidence-based intervention that addresses maladaptive thought patterns contributing to chronic stress. It has been shown to improve stress recovery, reduce stress inflammation, and lower inflammatory markers in individuals with prolonged stress exposure.

Main takeaways

Understanding the connection between stress and inflammation is essential when it comes to managing stress-related diseases and their long-term health effects. Stress sets off an inflammatory response that leads to chronic diseases, inflammation, which in turn raises the risk of cardiovascular disease, inflammatory bowel disease, autoimmune diseases, and metabolic disorders.

By identifying the key physiological stressors and applying evidence-based interventions—like lifestyle modifications, stress resilience strategies, and cognitive therapies—you are better equipped to reduce stress-induced inflammation. Putting stress management at the forefront not only leads to better patient outcomes, but also supports professional well-being, lowers disease risk, and promotes overall health in clinical practice.

References

Alfaddagh, A., Martin, S. S., Leucker, T. M., Michos, E. D., Blaha, M. J., Lowenstein, C. J., Jones, S. R., & Toth, P. P. (2020). Inflammation and cardiovascular disease: From mechanisms to therapeutics. American Journal of Preventive Cardiology, 4, 100130. https://doi.org/10.1016/j.ajpc.2020.100130

Alotiby, A. (2024). Immunology of stress: A review article. Journal of Clinical Medicine, 13(21), 6394–6394. https://doi.org/10.3390/jcm13216394

American Psychological Association. (2024, October 21). Stress effects on the body. https://www.apa.org/topics/stress/body

Chen, X., Gianferante, D., Hanlin, L., Fiksdal, A., Breines, J. G., Thoma, M. V., & Rohleder, N. (2017). HPA-axis and inflammatory reactivity to acute stress is related with basal HPA-axis activity. Psychoneuroendocrinology, 78, 168–176. https://doi.org/10.1016/j.psyneuen.2017.01.035

Foster, J. A., Baker, G. B., & Dursun, S. M. (2021). The relationship between the gut microbiome-immune system-brain axis and major depressive disorder. Frontiers in Neurology, 12. https://doi.org/10.3389/fneur.2021.721126

Kim, E. J., Pellman, B., & Kim, J. J. (2015). Stress effects on the hippocampus: a critical review. Learning & Memory, 22(9), 411–416. https://doi.org/10.1101/lm.037291.114

Mora, F., Segovia, G., Del Arco, A., de Blas, M., & Garrido, P. (2012). Stress, neurotransmitters, corticosterone and body-brain integration. Brain Research, 1476, 71–85. https://doi.org/10.1016/j.brainres.2011.12.049

Rohleder, N. (2019). Stress and inflammation – The need to address the gap in the transition between acute and chronic stress effects. Psychoneuroendocrinology, 105, 164–171. https://doi.org/10.1016/j.psyneuen.2019.02.021

Ryan, K. K. (2014). Stress and metabolic disease. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK242443/

Crohn’s & Colitis Foundation. (n.d.). Managing stress and Crohn’s disease. https://www.crohnscolitisfoundation.org/personal-stories/shauntae

González‑Moret, R., Cebolla, A., Cortés, X., Baños, R. M., Navarrete, J., de la Rubia, J. E., Lisón, J. F., & Soria, J. M. (2020). The effect of a mindfulness-based therapy on different biomarkers among patients with inflammatory bowel disease: A randomised controlled trial. Scientific Reports, 10, 6071. https://www.nature.com/articles/s41598-020-63168-4