Stress and the Body

“The issues are in the tissues.” - Dr. Vasant Lad

Stress, Fascia & Mental Health

We often think of stress and emotions as experiences of the mind, but our bodies experience them too. During a stressful moment, your heart may beat faster, your breathing changes, your jaw, shoulders, or hips tighten, or you may find yourself physically bracing without realizing it.

These aren't imagined responses. Stress creates real changes throughout the nervous, hormonal, immune, and musculoskeletal systems.[3]. So when we say we're “holding tension” or “carrying stress,” there may be some physiology behind those expressions.

What Happens When We're Stressed?

When we experience a physical or psychological stressor, our body prepares us to respond. The sympathetic nervous system becomes more active, while the HPA axis helps coordinate the hormonal stress response. This involves chemical messengers including adrenaline, noradrenaline, and cortisol.[3] These responses are commonly associated with our “fight, flight, or freeze” response.

In the short term, this response can be useful. It mobilizes energy, changes our heart rate and breathing, sharpens attention, and prepares our muscles for action. But when stress becomes persistent, these same systems may be activated repeatedly. Breathing, muscle tension, posture, movement, sleep, pain, and recovery can all be affected.[3]

Where Does Fascia Come In?

Fascia is a network of connective tissue found throughout the body, surrounding and interacting with muscles, nerves, blood vessels, organs, and other structures. Rather than simply being passive wrapping, fascia is living tissue containing blood vessels, nerve fibers, immune cells, and cells called fibroblasts and myofibroblasts that help maintain and remodel connective tissue.[3]

This is where the stress connection becomes interesting. A scientific review examining stress and fascia describes how stress-related signals- including cortisol, adrenaline, noradrenaline, nervous-system activity, and immune signaling, may influence fibroblasts and myofibroblastsand the environment surrounding connective tissue.[3]

There is a biologically plausible connection: our psychological experiences create real chemical and physical responses throughout the body, and our connective tissues exist within and respond to that environment.

Fascia & Depression

Researchers have also found some interesting associations between fascia and mental health.

In one study, researchers compared 40 hospitalized people with major depression with 40 people without a history of depression. The group with depression had greater myofascial stiffness and lower elasticity in the neck and upper back.[1]

The researchers then studied 69 people with depression who received either a single session of self-myofascial release using a foam roller or a placebo intervention. Afterward, the myofascial-release group showed greater positive affect and less negative memory biasthan the placebo group.[1]

These studies were preliminary. But they raise an interesting possibility: our psychological state may influence our physical state, while changes in our physical experience may also influence how we feel and think.[1]

Fibromyalgia & the Nervous System

Fibromyalgia offers another example of how closely pain, the nervous system, and psychological stress can interact. The pain of fibromyalgia is real, but it isn't always explained by visible injury or damage to the areas that hurt. Research increasingly points toward changes in how the nervous system processes and regulates pain, often discussed in terms of central sensitization or altered nociceptive processing.

Stress doesn't mean someone “caused” their fibromyalgia, nor does fibromyalgia mean symptoms are psychological. But stress, sleep, mood, physical activity, and pain can influence one another, sometimes creating a cycle in which the nervous system becomes increasingly sensitive to sensory input.

If this resonates with you, it may be worth becoming curious about your patterns: When does the sensitivity seem to increase? What emotions, themes, or stressors tend to be present? Are there recurring emotional themes beneath them, and where else do those same themes appear in your life?

Pain, Mood & Somatic Symptoms

Pain is another place where the connection between mental and physical health becomes apparent. In a study of 136 adults receiving outpatient medical care, people with significant somatic symptoms reported more frequent, severe, and longer-lasting pain, along with greater psychological symptoms. Pain intensity and depressive symptoms were independently associated with somatic symptoms.[2]

Importantly, somatic simply means relating to the body. A connection between psychological distress and physical symptoms does not mean that someone's pain or symptoms are imaginary.

Pain can affect mood. Stress can influence pain and muscle tension. Poor sleep can worsen both. Chronic symptoms can create emotional distress, and emotional distress can change how we experience our bodies. Rather than occurring in separate boxes, these experiences can influence one another.[2]

The Body Keeps the Score

You may have heard that “trauma is stored in the fascia,” emotions become “trapped in the body,” or “the body keeps the score.” There may be some interesting physiology behind why we experience stress and emotions so physically. Stress produces real changes in our nervous system, hormones, immune signaling, muscles, breathing, movement, and behavior. Some of these signals may also influence connective tissue.[3] Research has found differences in myofascial properties among people with depression,[1] while pain, somatic symptoms, and depression frequently overlap.[2]

A valuable question to ask ourselves is: How has my body adapted to what I've experienced?

Maybe we brace when we're stressed. Maybe our breathing changes or certain muscles remain tense. Pain may change the way we move, while prolonged stress can affect our sleep and recovery. And signals traveling from the body back to the brain may, in turn, influence how we feel and experience the world. Perhaps the body isn't simply carrying us through our emotional experiences. It's participating in them.

A Personal Observation

I spent many years working as a Personal Trainer, Stretch Coach, and Corrective Exercise specialist. Over time, I began noticing during periods of prolonged or heavier stress, my clients often seemed to carry more physical tension, particularly through the hips, upper back, neck, and shoulders.

Working with the body through stretching, mobilization, and tissue work sometimes seemed to offer more than physical relief. As the body softened, something in the person often seemed to soften with it. But when the stress returned, so often did the tension. And when there was resistance in the mind, there was resistance in the body.

Written by: Vivek Patel, MSN, FNP-C, PMHNP-BC

Medical Disclaimer: This article is for educational purposes only and is not a substitute for individualized medical advice.

References

1. Michalak J, Aranmolate L, Bonn A, et al. Myofascial Tissue and Depression. Cognitive Therapy and Research. 2022;46(3):560–572. doi:10.1007/s10608-021-10282-w.

2. Fresán A, González-Castro TB, Pool-García S, et al. Chronic Pain and Depression are Increased in Outpatient Adults with Somatic Symptoms from Secondary Health Care Services. Pain Management Nursing. 2023;24(4):436–441. doi:10.1016/j.pmn.2023.02.004.

3. Barsotti N, Chiera M, Lanaro D, Fioranelli M. Impact of stress, immunity, and signals from endocrine and nervous system on fascia. Frontiers in Bioscience (Elite Edition). 2021;13(1):1–36. doi:10.2741/870.