pathway.	Nerve	pain	increases	the	expression	of	the	neurotransmitter	PACAP,
which	is	the	same	neurotransmitter	the	brain	releases	in	reaction	to	stress.	In
other	words,	stress	can	bring	on	and/or	worsen	physical	pain	symptoms.
The
	
body’s	biological	response	to	stress	can	also	significantly	impact	our
cardiovascular,	digestive,	respiratory,	and	endocrine	systems.	In	a	large	meta-
analysis	examining	over	20	studies	and	about	250,000	individuals,	researchers
found	that	anxiety	was	associated	with	a	26	percent	increased	risk	of	coronary
heart	disease	and	a	48	percent	increased	risk	of	death	due	to	a	cardiac-related
incident.
The	stomach	and	bowel	are	directly	impacted	by	the	body’s	fight-or-flight
response.	Over	time,	nerves	that	manage	digestion	can	become	reactive,
causing	unpredictable	abdominal	discomfort,	such	as	irritable	bowel	and
upset	stomach.	Although	the	symptoms	are	not	life	threatening,	they
significantly	impact	quality	of	life	and	can	be	quite	difficult	to	manage.	In
addition,	people	are	more	vulnerable	to	stomach	ulcers	when	the	stress
hormone	cortisol	is	released	on	a	chronic	basis.
Anxiety	is	often	present	in	people	with	respiratory	disease,	particularly
asthma	and	Chronic	Obstructive	Pulmonary	Disease	(COPD).	Fear	and	worry