Fig. 2.

Pathways and points of intervention between stress and chronic disease. The relationship between stress and chronic disease is highly complex, bidirectional, and often self-reinforcing (blue and light gray arrows). Intervention opportunities to reduce the negative health burden of stress along the pathway appear below the dashed line. See Fig. 1 for additional physiological changes. PNS=parasympathetic nervous system; SNS=sympathetic nervous system.