Here’s something your general practitioner and your therapist may have forgotten to tell you: the more stress you’re under, the more vulnerable you are to becoming sick. If you are under stress while also feeling isolated, this is when your risk for illness – pneumonia, malignancies, chronic disease – is highest. Addicts isolate themselves by the very nature of addiction; they often feel shamed; they may wish to escape the judgment of family and friends, present or former colleagues, everyone. Their activities are sometimes illicit. So it stands to reason that addicts may be particularly vulnerable to becoming ill, and not simply because of the drug or alcohol use or the ways or amounts in which they use them, although these things play a factor. At any given time, we’re carrying cancer cells and toxins in our bodies. It’s up to our immune systems to fight these intrusions. When we’re under stress, our immunity is suppressed. When that stress is long-term, our immune response becomes chronically suppressed. You may be feeling pressure at work, heat from family, the urge to use again, along with the tension and anxiety of your conscience telling you not to. You’re feeling internal conflict. I don’t wanna go back down that road. I can’t give up on this. You’re frustrated. You might be having tension headaches, dry mouth, a stomach in knots. Inability to sleep. Anxiety. All very real, physiological processes related to stress. This stressed-out state has engaged your pituitary gland, a pea-sized endocrine gland at the base of your brain. The pituitary gland then engages your adrenals, two small, triangular shaped glands that sit atop each of your kidneys. The adrenals’ job is to release the stress hormones, that primitive and wholly necessary part of the body’s response to danger. You’ve heard of the fight-or-flight response. There’s also the freeze response – when you’re faced with a grizzly bear or a tax bill, and you shut down. In the case of the grizzly, it might save your life, which is its purpose. Your body can’t tell the difference between the stress you feel from a grizzly and the IRS; they both threaten you a great deal. Your body knows only three ways to react to that degree of stress. The chemicals released during stress – the stress hormones – are primarily cortisol and adrenaline. What cortisol tells the body to do is this: increase blood pressure, sending glucose and oxygen to the brain in order to more efficiently combat the stressor; elevate blood sugar (same purpose); suppress the immune system, so that energy diverted from there will be immediately available to combat the stressor. Literally every system in the body is impacted during a stress event – the circulatory, cardiovascular, nervous system, digestive, and neurological. The heart pumps faster, the legs move faster, the brain is more alert. But in chronic stress, these systems begin to break down. A heart under chronic stress will become itself stressed, at risk for heart attack or heart disease, one of the leading causes of death. Blood pressure that is elevated for too long becomes a condition we call hypertension, which places an individual at risk for stroke, another of the leading causes of death. Certain cancers are also linked to chronic stress. Diseases like childhood asthma are linked to stress in mothers. Diseases such as adult asthma, obesity, diabetes, the autoimmune diseases (e.g., scleroderma), and gastrointestinal conditions (e.g., Crohn’s) share causal relationship to and are exacerbated by stress. This is in no way to suggest that people who experience these diseases or who die from chronic disease or infections cause their own disease or deaths because they allow themselves to be stressed. The cause of disease is a multi-layered thing, and as medical sociologists are seeing, it is indeed much larger than the germ alone. People become vulnerable to disease through multiple factors, and one of those factors, indeed a very important one, is stress. Stress combined with social isolation – even just the psychological sense that “I am misunderstood and therefore alone in this” is a witch’s brew; it is the cocktail that makes susceptibility to sickness possible. Whether you have asthma, scleroderma, lupus, or hemorrhoids, at some point your doctor is likely to treat you with hydrocortisol – which is cortisol, the stress hormone. The body’s reaction to stress is its most primitive survival mechanism. In a modern world, where literally everything can trigger these defenses, it stands to reason that so many things have the potential to make us sick. The rate of addiction is no surprise either. Every system of our body is being flipped on and off like a switch; we’re, perhaps unconsciously trying to reset the wiring. Lower the dimmers. Cool down. After all, it appears most of us die from this process of being too long stressed. We don’t have to be worried about spiders or snakes any more, but our evolution hasn’t caught up with our environment and even those frighten us. We’re afraid to fly, afraid of things we can’t see. Marsha Linehan. Thich Nhat Hanh. Pema Chödrön. There are wise teachers who can give us tools, teach us how to be here in this moment. To breathe and center and look. Teach us how to move through our addictions, and how to let go of our attachment to the stress reaction, because that is what it is. Anything that becomes an emotion you don’t have control over might be just that.