6 Chronic stress and increased inflammation may cause or aggravate anxious and depressive disorders. 5 Chronic stress can lead to premature aging, immunosuppression, mental disorders, reproductive suppression, and a decreased ability to terminate the stress response. Chronic stress involves a prolonged or repeated threat to homeostasis that may result in dysregulation of the hypothalamic-pituitary-adrenal axis and autonomic nervous system. Stress is a state of disharmony caused by perceived threat and other intrinsic or extrinsic adverse factors that is counteracted by multiple behavioral and physiological responses, which represent an adaptive response to reestablish homeostasis. Similarly, anxiety is the strongest risk factor for depression, and both conditions are associated with anomalies in mood-related areas of the brain. 3 Stress can also exacerbate disorders such as cardiovascular disease, obesity, and chronic pain as well as mental health, gastrointestinal, and sleep disorders. Stress-induced disorders such as anxiety represent the leading causes of adult disability worldwide 1, 2 and account for an estimated 60% to 80% of physician office visits.
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