Stressing About Stress

November 5, 2014

Stressing About Stress

Stress, we all know it well. So what’s the big deal, we’re all stressed right? Actually stress is a big deal and what it does to the body when it’s chronic is very significant. How we manage our stress is of critical importance to our health and well being. Let’s discuss it in a little more detail.

Let’s begin with the autonomic nervous system, which I think of as the “automatic” nervous system. It handles things we don’t consciously think about, like regulating our gut function, heartbeat and even our skin temperature. The autonomic nervous system has two “branches” so to speak. The sympathetic branch is the “gas pedal”. When activated, it triggers our “fight or flight” response, which prepares us for a physical threat. The sympathetic response increases our heart rate, dilates the lungs, decreases blood flow to the skin and gut and literally prepares us to fight or run away. This is a great response to have if you happen to walk up on a bear while out in the woods, and could save your life in that circumstance.

The other “branch” is the parasympathetic, which functions as the “brakes” and helps us “rest and digest.” When the parasympathetic system is active, we relax, our heart rate slows, and there is increased blood flow to our gut and skin. This helps us digest our food. Ideally, we should relax after a meal to allow for optimal digestion. These “branches” are not exclusive. I think of it as a spectrum. At any given time we can be anywhere on the spectrum, from extremely stressed, like running for our life away from an angry bear, to being extremely relaxed, like a day at a spa. Think of it as a see-saw which can lean one way or the other depending on circumstances.

All of us also have a “set point” somewhere on this spectrum where we naturally exist most the time. You might think of it like the speed at which a mechanic sets an engine to idle. Some people are stressed out all the time, even when no serious threat is occurring. They have adjusted their “set point” over to the sympathetic end of the spectrum. Other people are easy going and never seem to worry about anything. Their “set point” is over to the parasympathetic side of the spectrum. Most people have a fairly consistent “set point”, whether they realize it or not. The brain and body adjust to what they do repeatedly. When we stress out often, we get really good at stressing out. That resets our “set point” over to the “fight or flight” side. So is that a bad thing? Let’s discuss that next.

The ability to have an acute stress response is a good thing and is produced in times of danger. A prolonged or chronic stress response eventually becomes maladaptive and will eventually cause problems. To examine that in more detail, think about some of what occurs in an acute stress response. The brain interprets something as a threat to our wellbeing, such as seeing a bear. Hormones like cortisol and adrenaline are released to prepare us to fight for our life. These hormones cause many changes in our physiology, including raising our blood pressure, raising our heart rate, raising our blood sugar, decreasing blood flow to the skin and the gut, and decreasing release of our growth and sex hormones.

All of these things are good if you are about to participate in extreme physical exertion, but it is preferable for these changes to be as short lived as possible. When a stress response becomes chronic, it predisposes towards hypertension, vascular disease, insulin resistance, diabetes mellitus, gut dysfunction, and hormone imbalances. This includes disruption of thyroid physiology, and dysregulation of growth and sex hormones.


Hmmm, I think I just described the condition of many adults here in the U.S.


So, we were designed to be able to run from a bear, but we were not designed to handle a long-term chronic stress response. We just haven’t adapted to modern life. Most of us don’t really have to worry about running into wild animals these days, but chronic stressors surround us all time. Most of the time just watching the news creates stressful feelings! Fears of war, terrorism, Ebola, economic downturn, taxes, government regulation, national debt, just to name a few, are constant reminders that we live in stressful times. Then throw in relationship stress, worries about family, traffic, job stress, and you have the perfect recipe for a chronic stress response. Yikes! So what can we do?

I suggest two broad solutions. First, take stock of any modifiable stressor in your life and address it. Forgive. Avoid toxic people and places. Do what you really love. Build healthy relationships. Eat healthy. Then, because several stressors will never be under our control, we must find ways to relax and mitigate the effect this stress has on our physiology. Recent studies by the NIH and several academic universities have shown that almost all mind-body techniques lead to a similar result – that is, the relaxation response. Studies suggest that yoga, biofeedback, breathing exercises, autogenic training, and the many different forms of meditation all work equally well. I strongly encourage you to find a modality that you enjoy and make it part of your daily routine. Like anything, we get good at what we do repeatedly. So with repeated practice, it gets easier and more effective. Within 6 to 8 weeks of frequent practice, your “set point” will be moved further over to the parasympathetic side of the spectrum. You will feel more relaxed most of the time, and will be better able to recover from acute episodes of stress. Other benefits include lowered blood pressure, lower heart rate, lower blood sugar, lower inflammatory mediators, and the list goes on.

Breathing is one function that is under direct control by both the autonomic and voluntary nervous systems. This gives us one tool we can use to directly regulate our autonomic nervous system. One of my favorite breathing techniques is the “4-7-8 breath”. Inhale deeply to a count of four. Hold your breath for a count of seven. Then exhale slowly to a count of eight. Do this for about four breath cycles and see how you feel – it’s great!

The last thing I want to mention is perception. Our perception of our environment is very important since it directly affects our response. What if we didn’t perceive the bear as a threat? In that circumstance there would be no stress response. That might be a bad thing if the bear truly is a threat! But the lesson to remember is to identify if a stressor is really worth worrying about or not. I could sum that up by saying, “don’t sweat the small stuff”. One last technique to use when feeling stressed is to remember to count your blessings. No matter what situation you find yourself in, try to focus on the positive things in your life. With practice, this too becomes easier.

To summarize, chronic stress is more detrimental to our health than most of us realize. In today’s modern world, chronic stress is practically unavoidable. Finding active ways to deal with and mitigate the effects of chronic stress is of critical importance to our long term health. Stress management is as important as proper diet, proper sleep, and proper exercise, but is often overlooked. Please find a stress management technique that you enjoy and squeeze it into your daily routine, it is essential for your health.

Ready, set… meditate!


Yours In Health,

William J. Weirs, M.D., F.A.C.E.P.
Center for Occupational & Environmental Medicine

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