Nancy W. Burkhart, EdD
  • Why worry about your stress level?
  • What connection could your state of health have to do with stress?
  • You have lichen planus and this disorder is from an unknown cause?
  • You say that you are not stressed?

The type of stress that is detrimental to your health is termed “Unmanaged Stress” and “everyday stress” that we all encounter is universal. What is considered highly stressful to one person may be more of a positive challenge to someone else.

It has been documented that centenarians view life as a challenge and tend to deal well with new problems that occur throughout life. When the sympathetic nervous system is in a state of chronic arousal, the body may reach what is termed an “allostatic load” status. At an undetermined point, there is sheer overload in handling and processing the chronic stress and its cumulative affect upon all organs/systems of the body will be detrimental. Researchers have reported that one of the worse types of stressors are those that make the person feel “out of control” with minor and major issues in their lives.

The stress may be much worse when a person believes that whatever action they may take will not make a difference in the outcome (essentially, no control due to their actions). Sometimes these factors are job-related pressures, family pressures, or health related issues that are already in play. Often situations involving severe grief and loss promote a long-term chronic type of stress. Losses come in many different forms such as the loss of a loved one, loss of pets, divorce, the loss of one’s identity or possibly even a job loss that was part of one’s identity.

Some of the diseases and disorders related to stress are:

  • Heart Disease
  • Hypertension
  • Immune suppression
  • Gastrointestinal disorders
  • Anxiety
  • Certain cancers
  • Low back pain
  • Skin disorders (lichen planus is one such skin disease)
  • General declines in health and possibly premature aging
  • Certain cancers that may be lifestyle related


  1. START A JOURNAL. Writing brings your observations into focus. Additionally, writing is a stress-reducer on its own, and focus promotes a sense of well-being. Record your reactions to everyday events. For patients with chronic and intermittent diseases, a chronicle of daily events, foods consumed and anything that you come in contact with through the environment should be documented. When an outbreak occurs, you can begin to assess a connection that might be meaningful to you.
  2. OBSERVE ANY PATTERNS IN YOUR OWN LIFE. Begin to review your journal periodically and observe items that do not promote a sense of well-being. These may be activities, (unfortunately) people in your life that may be causing you undo stress, and continued thoughts of past events that may not have been beneficial to you (termed rumination).
  3. OBSERVE PATTERNS THAT PROMOTE RELAXATION: What events bring you pleasure? When do you feel that you are at your best?
  4. HOW DO YOU VIEW CHANGES IN YOUR LIFE (BOTH SMALL AND SIGNIFICANT CHANGES)? Results from studies indicate that individuals who view change as a life-challenge have what is termed “hardiness” and generally stay healthier. Additional studies have reported that patients who have “persistence” as a characteristic trait in everyday life tend to remain healthier as well.
  5. DO YOU SEE THE GLASS AS HALF FULL OR HALF EMPTY? Individuals who are optimistic rather than pessimistic are more resilient and are able to cope with stress more favorably. Optimism, it is believed, can be learned.

Although, it is true that we do not know the cause of lichen planus, most practitioners and patients with lichen planus will tell you that they can document the development of lesions when their stress levels increase. The information below provides some facts that we know occur in the body.

Mason differentiated between the arousal of the sympathetic adrenal-medullary system by the fight-flight response (based on work by Selye) and the pituitary adrenocortical response. It has been documented that if the sympathetic adrenal-medullary system is activated excessively, persistently and too often, illness and disease may occur. The release of catecholamines, epinephrine and nor epinephrine by the adrenal medulla and/or sympathetic nerve endings is believed to induce many of the pathological states associated with psychological stress: increased blood pressure, cardiac arrhythmias and sudden death.

Stress and stress-related illnesses have been studied extensively in the last 30 years. The results clearly indicate that stress, especially chronic stress, may have profound effects on the body. The well-known Framingham, Mass. Heart study identified the type A personality and associated it with a doubling of the risk of coronary heart disease in men and women. Animals subjected to repeated stress show significant decreases in the total number of mononuclear cells, especially T cells, in the spleen and blood. Chronic stress can cause a reduction in mitogenesis, alterations in lymphocytes, reductions in the ratio of T-helper cells to T-suppressor cells and an elevation in the number of natural killer cells.

Life events that produce chronic stress have been shown to have a wide range of effects on the body. Recently a major emphasis has been placed on the patient’s ability to cope with the chronic stress of daily life.  Coping skills can be developed and learned. If this is a factor for you, seeing someone who can help you make a plan to increase your coping skill repertoire will help. Adverse life events have also been documented as occurring before the onset of functional abdominal pain, alopecia areata, headaches, cancer, heart disease, low back pain, and psoriasis.

Exercise has profound positive effects on the body and the mind. An exercise program that includes strength training, aerobic activity and meditation is optimal for anyone. Tai chi, Yoga, cycling, dance class, walking, running or any physical activity is beneficial. Select one that you like so that you will stick with it and continue to improve. Journal your progress and note your physical responses as you continue your journey.

Mate G. When the body says NO. 2003, John Wiley & Sons, Inc. Hoboken New Jersey.
McEwen B. The end of stress and we know it. 2002; Joseph Henry Press, Washington D.C.
Burkhart N. W. Assessing the Characteristics of Patients with Oral Lichen Planus: Burkhart, et al. JADA 127:5, 1996.