Fearless MD

Our Response To Stress: A Double-Edged Sword

Healthy Food Choices Help

FEARLESS (Lessening Stress)

Can you imagine living every day without stress? I can’t imagine a day without it. People have different stressors which are triggers of stress. Lately, there’s a lot to stress over. Anxiety can emerge and attack your mind and body, whether in relationships with spouses, partners, children, neighbors, coworkers, employers, friends, or associates. People handle stress differently, but chronic stress usually spells trouble for the person experiencing it.

Though relationship stress is common, other stressors include illness, news headlines, homicides, bullying, job loss, grief, anxiety, etc. We all know people that seem to always be calm and undisturbed. They don’t appear upset or stressed about anything, but is this true? Some would say this is true for those who may have a certain natural tendency to handle stress, yet others have intentionally prepared themselves for it.

How do you handle life’s stressors? Does Increased stress make you anxious, moody, tense, have difficulty sleeping, eat more, drink alcohol, or have headaches?

Our response to sudden stressful situations is a healthy defense mechanism. For example, when an unleashed dog dashes toward you, growling and barking, specific actions in your body occur immediately. We have built-in mechanisms for preparing us to either stand our ground and fight or take off like a rabbit to make our getaway.

Our fight-flight hormones are epinephrine and norepinephrine (aka adrenaline and noradrenaline). Our adrenal glands, located on the top pole of our kidneys, produce these incredible biochemicals. Norepinephrine also serves as a neurotransmitter when released from nerve endings, as a signal for skeletal muscle to contract. As the word implies, neurotransmitters are biochemical substances originating from nerves and transmitting signals to other nerves or muscle cells. When we suddenly face danger, our sympathetic nervous system responds by sending messages to skeletal muscle, heart, gastrointestinal tract adrenal glands to prepare us for action. All of this takes place over seconds and can be lifesaving. 

Interestingly, the same neurotransmitter, norepinephrine, that causes contraction of skeletal muscle has the opposite effect on the tiny smooth muscles in the walls of intramuscular blood vessels. They respond to norepinephrine by relaxing or dilating, allowing more blood flow into the tissue. More blood flow makes sense because muscles require more oxygen and glucose when suddenly called into action. 

Our stomach and intestines also have tributaries of blood vessels that contract during the flight-flight response, under the influence of norepinephrine. It’s not essential to digest and mobilize food from our previous meal when we are under attack. That taco can wait.

Our adrenal glands respond to signals from our sympathetic nervous system and release the same biochemicals, norepinephrine, and epinephrine, for additional fight-flight responses. Hormones, unlike neurotransmitters, travel long distances through blood flow to influence target organ activity. At the level of the heart, these hormones further stimulate the heart muscle to beat faster and stronger. The smooth muscle surrounding small and medium-sized airways in the lung responds to epinephrine by dilating to allow more air to enter.

Many other things happen in the time of crisis to protect us from bodily harm by quickly preparing us to confront or flee. It’s easy to understand why this would be so important but suppose we feel as if we’re constantly under attack. The steady release of norepinephrine and epinephrine is unhealthy for our heart, blood vessels, and brain. 

Another hormone released from our adrenal glands during the fight-flight response is cortisol. This hormone influences just about every organ or system in the human body. Since the energy demand is high, we need more glucose in a crisis. That’s where cortisol comes in. It floods the system with glucose and inhibits insulin production, allowing for less glucose storage in cells and more of it available for skeletal muscle and other tissue. Cortisol also stimulates gluconeogenesis, the production of glucose from protein.

Imagine all these seemingly protective physiologic processes going on for days, weeks, or months. Our physiologic response to chronic stress often leads to unhealthy consequences.

Chronic stress, via the prolonged influences of the above neurotransmitters and hormones, can cause anxiety, depression, emotional instability, heart disease, kidney disease, gastrointestinal problems (stomach ulcers, reflux), immune suppression, and worsening many other ailments. Cancer and dementia risks are increased by chronic stress. The chronically high cortisol level is associated with serotonin depletion, our contentment hormone, and decreased dopamine receptors (our pleasure zone). It also causes weight gain and disrupted sleep (my last article highlighted how important it is to get good sleep).

What can we do to cope with stress? Here are seven tips:

  1. We often can’t control the triggers of stress (stressors), but we should try to eliminate or reduce them when possible. The stressor may be an avoidable circumstance, a specific friend or acquaintance, a task related to work, or negative news reports. Take some time to reflect on how to distance yourself from the stressor(s). Some friends, and I hate to say it, and relatives may represent a significant source of stress. Distancing yourself from them can work wonders if you can’t work things out with them. If it’s a partner, spouse, or child, counseling may be helpful if you can’t work something out. Sometimes we take on too many jobs, tasks, or responsibilities. We need to know when to say no to a request and withdraw from some commitments. I’m still working on this tip.
  1. Eating more of a plant-based diet helps to create a higher sense of well-being and happiness. Dr. Michael Greger of NutritionFacts.org presented a study that reported that people were happier when they consumed seven or more servings of fruit and vegetables daily. A healthy mind and body certainly set the table for better stress management.
  1. Adequate sleep is quintessential to handling stress, although high-stress levels can be disruptive to sleep. The key is to do everything possible to give yourself the best sleep opportunity. See my previous posting about sleep and tips to improve sleep. Seven to nine hours of restorative sleep enriches the body and mind and allows better handling of the physiologic consequences of chronic stress and accompanying emotional turmoil.
  1. Meditation and mindfulness can play a crucial role in stress management. Meditation puts the mind into a deep state of conscious relaxation, different from sleeping or napping. The mind focuses on breathing and a specific established focal point while, at the same time, kicking out all the other thoughts, concerns, or worries fueling stress. There are three critical factors in meditation: mindfulness, focus, and breathing. There are many ways and types of meditation, and anyone can do it. Online (free and for pay) sources for instruction on meditation are just a click away. Add this to your toolbox to address stress and preserve mental and physical health. Most of us are extremely busy with jobs, school, family, meal prep, and exercise, but taking time to meditate is an excellent investment, if only 5 minutes at a time.
  1. Exercise is another enemy of stress. The endorphins and brain-derived neurotrophic factor (BDNF) gained from this activity are invaluable. Endorphins are generated from regular exercise and make you feel good. They also have a pain reduction effect which is rewarding to people that have been around for several decades (like me). Many studies prove exercise helps you handle stress and, at the same time, contributes to better sleep quality. If you are not already exercising regularly, talk to your primary doctor before engaging in a new routine if you are over 30 years of age. Brisk walks for 20 to 30 minutes a day may be all you need to make the difference, but you can start with 10 mins a day and work your way up every 2-3 weeks.
  1. Deep breathing is another tool in your toolbox that you can call upon under almost any circumstances. There are many deep breathing demos on YouTube, but my favorite is “4-7-8 breathing.” Dr. Andrew Weil has a YouTube presentation on this form of deep breathing that you can access (use the YT search engine and type in: Dr. Andrew Weil and 4-7-8). In summary, blow all the air out of your lungs, then: A. Slowly, over about 4 seconds, breathe air in through your nose. B. Hold your breath for 7 seconds, silently counting in your head 1:1000, 2:1000…. C. Purse your lips and exhale as if you are blowing out a candle, regulating the blow to release the air from your lungs over 8 seconds. Repeat this sequence 2-5 or more times. This breathing routine has a calming effect, slows your heart rate, and provides more oxygen to your mind and body. It also briefly shifts your focus away from the moment, which aids in stress relief.
  1. Mindfulness and Reflection involve identifying and addressing stressors, but sometimes we need to understand when we are in over our heads and need professional help. Experts in counseling (psychologists and other therapists) can assist with severe stress-related problems, including anxiety, depression, and PTSD. Sometimes, our stress relates to distant experiences we incurred in childhood. The first six tips may not adequately address deep-seated stressors from our past. Discuss getting professional help with your doctor.

Lessening stress may be challenging and sometimes not achievable but using all available tools to reduce the impact of stress on our mental and physical health gives us a fighting chance.

I hope this article and the tips provided above are helpful.

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