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Sick Of Stress: Is Fear Making Us Ill?

Sick Of Stress: Is Fear Making Us Ill?

Fear of terror increases pulse, the risk of disease and subsequent death.

The jitters, cold sweats, fast heart rates, heavy breathing. Fear is known to provoke strong bodily reactions. But how much does fear really influence our health? Can fear make you ill? And if so, is this preventable?

In a study published in PNAS last December Shenhar-Tsarfaty and colleagues of the Hebrew University of Jerusalem demonstrated that a persistent state of fear may increase resting heart rate, which in turn increases the risk of serious illnesses, consequently increasing death rates.

Fear of terror

The scientists focused on the so-called ‘fear of terror’, which is experienced constantly by many people living in war zones and under the threat of terrorist attacks. Their goal was to understand if living under this type of stress, knowing that violence can strike unpredictably at any moment, could have effects on health. They conducted their research in Israel, a country that has been exposed to this kind of fear for over sixty years, and studied the reaction to ‘fear of terror’ of over 17.000 apparently healthy individuals. As an indicator of disease risk, the researchers measured the resting heart rate, which is the number of heart beats per minute, or put simply, the pulse. It is known that elevated pulse accompanies various medical conditions, including systemic inflammation and cardiovascular disorders. In turn, these medical conditions  may promote states of illness leading to death.

To assess the level of fear of terror in people participating in the study, the scientists asked them a series of psychological questions concerning how worried they were about their personal safety, about being in crowded places, and about the possibility of a terrorist attack affecting their families. In addition, they measured a series of physical parameters that can influence heart rate, like smoking habits, sport activity, and the presence of indicators of inflammation. When they combined the scores and values obtained over several years from these analyses, they  found that fear of terror significantly increased the annual pulse. This effect was particularly strong in individuals with high levels of inflammatory markers. In other words, people in a state of general, low-grade inflammation (that was not symptomatic and could derive from disparate causes) were more vulnerable to fear of terror and more exposed to the risk of falling ill and dying, especially from heart attacks and strokes.

Disease prevention

This study suggests that pulse monitoring can be an effective preventive measure in populations under constant fear of terror: its variations can help identify persons who are apparently healthy but who in fact are at risk for developing a serious illness. Significant increases in pulse could be appropriately counteracted with medications combined with life-style changes (in diet, physical activity, sleeping habits), aimed at decreasing inflammation.

On the other hand, future research should address the biochemical mechanisms of “fear of terror” and try to understand how “fear of terror” contributes to increases in pulse and disease risk. It is known that the brain responds to fear by sending a series of chemical mediators into the body. These mediators influence the functions of various tissues and organs. This is essential to regulate body reactions to challenges: in the case of fear, the brain prepares the body to protect itself or to run away from the potential danger that provoked fear by increasing breath and heart rate, energy production and immune defenses. In a situation of chronic stress, like the stress caused by persistent “fear of terror”, these brain-periphery circuits can break down and produce abnormal responses that, if not controlled, may seriously damage health in the long term. Understanding which networks are specifically impacted by “fear of terror” to the extent of increasing pulse and the risks of illness and of death will be a very important challenge because it could open the way to developing suitable treatments to control the effects of this type of chronic stress.

Shenhar-Tsarfaty, S., Yayon, N., Waiskopf, N., Shapira, I., Toker, S., Zaltser, D., Berliner, S., Ritov, Y., & Soreq, H. (2015). Fear and C-reactive protein cosynergize annual pulse increases in healthy adults Proceedings of the National Academy of Sciences, 112 (5) DOI: 10.1073/pnas.1418264112
fear, terror, death, disease, pulse, sick, inflammation, ill, stress

Agnese Mariotti

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  • Nance
    February 23, 2015, 00:18

    I do not know how it feels to live in a war torn environment. There is no amount of stress that I could measure up to not being able to sleep comfortably at night. We all deal with stress in different ways, but one way that can possibly be beneficial is mediation. Pulse monitoring appears to be a type of mediation. With meditation it allows us concentrate on a single image, or repeat a statement that represents good. The thought behind it all is to replace the bad that is going on, with the good. The point of meditation is to relax, decrease pain and anxiety, and increase health. Hopefully someone can find your article to be helpful in a time of need.

    • Agnese Mariotti@Nance
      February 23, 2015, 11:45

      Just to sign the answer above, since I appear only as “guest”.

  • Guest
    February 23, 2015, 11:39

    Thank you Nance for your thoughtful comment.
    I agree that meditation can help manage psychological stress, yet it is still undervalued. I think that it will be given more consideration when scientists are able to show how it works physiologically, meaning what brain circuits it affects and how it can then influence body functions and health. The good news is that research is ongoing in this sense, and scientists are collecting data that will help understand the real potential of meditation as a form of therapy.
    As for pulse monitoring, in the study I report it was only used as an index of general health; what you point out suggests that it would be interesting to examine its variations during meditation especially in the long term, like in people practicing meditation regularly.
    I’ll look for information about what’s known on the effects of meditation on the brain and body for a future post, thanks for the input.

  • Sarah Chan
    February 25, 2015, 05:36

    I believe that everybody copes with stress in different way. It just depends on who you are and how you feel is the right way to do it. Some ways are positive and some are negative. Some negative ways are drugs or alcohol. And some positive ways are working out or meditation and relaxation. This helps relieve anxiety, pain and discomfort. When you are meditating, you are focusing on a single thing that has happened or something that has been said to you and think of positive reinforcement to replace the bag thing that has happened. Meditation can affect the brain and the body in many ways that could help with stress. In your article, I believe that somebody who is in pain and is suffering, could benefit from this.

    -Sarah Chan

    • Agnese Mariotti@Sarah Chan
      February 26, 2015, 14:16

      Thanks Sarah for your comment. I also think that meditation can alleviate stress and should be combined with other specific treatments in therapeutic plans to manage stress-related disorders. Of course doctors want to understand what it does, meaning how it influences brain and body activities, before deciding whether it can be prescribed as a therapy. Scientific studies are collecting data on this. Meanwhile one should turn to meditation just knowing that it can help, by what mechanisms is not important.

  • Chelsea
    March 2, 2015, 05:12

    The stress of living in a war zone probably feels like a nagging fear. If the heart rate is continuously high for decades in a population, could it potentially affect future generations? Could this initiate a genetic predisposition to heart disease? The high heart rate is most likely caused by the activation of the sympathetic nervous system, so could constant stimulation of this system lead to damage? Medication is not a cure, but a temporary fix. Certain forms of exercise are proven to lower resting heart rate, so perhaps implementing those could be a possible solution. It seems like if you are living in a constant war zone, lowering your heart rate might be one of the last things you are concerned about. Living to an age where dying from heart disease is even an option might be a goal for people living in a war zone. However, if you take this research and apply it to other people under constant stress, there might be other applicable options. There are many ways of coping with stress, but not all work for everyone the same. Some cope by distraction, others by meditation, dwelling on the situation, exercise, etc. It is important to find what works for you, and try to utilize it as best as you can.

    • Agnese Mariotti@Chelsea
      March 5, 2015, 11:49

      Thanks Chelsea for your comments and suggestions.
      As far as I know there’s no study examining how persistently increased heart rate in parents impacts the health of their children, and I think that it’s an interesting point that deserves consideration.
      I also think that constant stimulation of the sympathetic system can have consequences on health in several ways. In the case of chronic stress-related diseases it’s true that medication does not cure but just alleviates the symptoms. It may happen though that by reducing the symptoms the mind/body reacts and sets off recovery.
      Solutions should target the cause, as always. In this case, if the cause of stress cannot be easily eliminated, as it is the case for people in war areas who cannot leave their country, effective remedies should promote relaxation that can be obtained by the means that you mention. Physical exercise is also an excellent mean to cope with stress. In this regard, you can find several reports published in UA magazine about the mechanisms by which exercise counteracts stress-related illnesses (some shown at the end of this post).
      As you mention, the observations raised by this study apply to other situations in which people are under constant stress and possibly have increased pulse. It would be interesting to understand which types of stress cause similar changes in heart rate.

  • Erin
    March 2, 2015, 06:53

    I enjoyed this article, however just wondering with the discussion of future research, how would that help those that are currently living in a stressful environment such as a war zone to not develop illness.

    • Agnese Mariotti@Erin
      March 5, 2015, 12:11

      Thank you Erin for your comment and question.
      Researchers in the field of chronic stress are trying to understand how the brain can influence the functions of different organs and tissues in the body. In the case of “fear of terror” the brain certainly activates at least some of the mechanisms that are already known to be set off by chronic stress, yet the molecules that are specifically involved and how they interact with each other are not well defined. For example, if scientists identify some of the key molecules that maintain the pulse high in people with “fear of terror”, they could then design drugs that interfere with these molecules and that help reducing the pulse.
      On the other hand, as already said in this interesting discussion you are contributing to, the best solution should be to help distressed people cope with hardship by techniques that promote relaxation and reduce the brain response to chronic stress (like physical exercise). These techniques can promote adaptation and health, and they would avoid, or at least limit, the use of drugs.