With the holidays quickly approaching; our minds are filled with excitement, anticipation, and a sense of eagerness to join our family and friends in celebration of the events to come. But along with the excitement we are often exposed to high levels of stress. In the plans that we have to make, deadlines that we have to keep, and frequent entertainment requirements, stress can build during this time of the year to extreme levels. So how can we identify stress? And once stress is identified, what is the impact of stress on our body. Is there a way to organize a stress management reduction plan?
Stress is defined in how the body reacts to an underlying stressful event; whether external, internal, real, or imagined. When we receive a stress stimulus, our body can react in an unhealthy manner. There is both acute stressors and chronic stressors. Acute stressors affect us over the short term while chronic stress affects us over the long term. The impact of stress is certainly important regarding our physiology and health related adverse effects. It is estimated that 43% of all adults suffer stress related health effects. Over 80% of visits to primary care physicians are related to complaints or disorders that are stress related. Stress has also been linked to most of the leading causes of death which include cardiovascular disease, depression and suicide, cancer, pulmonary disease, and accidents. Stress is responsible for over 25 billion workdays that is lost annually in United States, with an estimation of over 1 million workers being absent each day with stress related complaints. The physical impact of stress is very real. When stress affects our brain, there is neural excitability which results in immunoexitotoxicity. This is a reaction between glutamate receptors in our brain and the pro-inflammatory cytokine receptors which causes toxicity in our central nervous system. There is activation of cells called “microglia” which when stimulated release excitotoxins that can cause inflammation and damage to the cells within the brain. Stress can affect our muscles and joints causing inflammation and chronic pain. Since cortisol is a catabolic hormone, it acts to reduce muscle mass and builds fat. As this progresses, chronic inflammatory states often develop. Stress affects our heart and has been linked to cardiovascular disease. Stress certainly affects our stomach and intestinal system altering the digestion and absorption of nutrients, and causes inflammation that may affect our immune system. So as you can see, the physical impact of stress upon our bodies can be quite deteriorating.
So if stress is so important regarding our health status, how can we identify the stress that is within our body? Let’s take a quick look at the origin of various stressors before we discussed the tools that are used to identify stress. Stress can be broken down into three basic origins: psychological stress, physical/ environmental stress, and physiological stress. Psychological stress is any emotional strain which results in anxiety and depression. This is where neurochemical imbalances occur which result in the alteration of various neurochemical pathways. Neurotransmitter testing from the urine will help aid in these imbalances and identify amino acid deficiencies that may be necessary in the recovery process. Physical and environmental stress is related to toxins within our environment that we are exposed to. Our world has become full of environmental toxins that are present in the air we breathe, the water we drink, and the food that we eat. Food intolerances/allergies, sleep disturbances, light cycle disruption, as well as temperature extremes are other forms of physical stress. Physiological stress can originate from chronic infection, underlying chronic inflammatory diseases, neurotransmitter imbalances, lack of sleep, glucose abnormalities/dysregulation, and chronic pain.
Now that we have looked at the origin of stress that can affect our body, let’s examine some tools used to identify stress. An important principle in any management tactic includes the measurement of what is to be managed. The principle that you cannot manage what you cannot measure is certainly true and also applies for stress management. Let’s take a quick look at some basic tools that are often utilized in the measurement of stress which will help define a treatment program. The first is called bioelectrical impedance analysis, or BIA. BIA is a test that measures several values which are related to the biomarkers of aging. These include: Resistance, which measures voltage change that is inversely proportional to total body water; Reactance, which is related to the ability of the cell membrane to store electrical charges; and Phase Angle, which is the measurement of electrical speed of current as it travels through our body’s water versus cells. BIA analysis can give biomarkers of aging which include muscle mass, basal metabolic rate, and fat mass. These are important factors when it comes to stress management as they are affected by our stress hormone, cortisol. Stress can also be evaluated by looking at cortisol in the saliva. Saliva samples are taken in the early morning, noon, late afternoon, and bedtime. Different types of cortisol patterns allow the clinician to identify the severity of the body’s response to underlying stress factors. When incorporated with other types of hormones, such as DHEAS, the information is useful in determining the severity and duration of the underlying stress response. Acute stress usually results in elevated cortisol patterns or the possibility of an irregular cortisol pattern. Chronic stress exposure or higher intensity stress results in a communication breakdown between the brain and the adrenal glands, resulting in a very low and flattened cortisol response. This commonly involves immune system imbalances, which places oxidative stress upon the brain that will eventually lead to damage. A third way stress can be measured is with heart rate variability. We typically like to see good variability in our heart rate as we proceed throughout the day. Immediate physical effects of stressors result in elevated heart rates, increased heart contractions, and an increase in active muscle blood flow and metabolic rate. Poor variability is often related to both stress intensity and duration.
Now that stress is been identified, what can be done to limit the body’s negative response to external and internal stress factors? Here are some common areas frequently looked at when stress reduction is necessary. One area involves the assessment and management of chronic inflammation. I often incorporate G.I. testing here as gastrointestinal issues may be responsible for inflammation within the body. Common inflammatory markers include C-reactive protein, Sed Rate, and inflammatory immune markers such IL6 or IL1. There may be underlying chronic infections present such as intestinal candidiasis, mold exposure, or an underlying viral / bacterial illness which can produce inflammatory stress. Dietary imbalances are often associated with chronic inflammatory stress rosponse, which can be identified by using urinary organic acids. Any type of food allergy or food intolerance will result in a stress response which can be identified utilizing food sensitivity testing. The environment in which we live is highly toxic, and our bodies are often exposed to multiple toxins through the air, water, and food. Various markers can be utilized to identify toxic environmental exposure. Toxic metal exposure can be evaluated with heavy metal testing. Once these areas have been identified, a treatment program can be designed which utilizes the correct detoxification process. This will help reduce the internal stressors of the body. Hormonal balance is also very important. An imbalance in hormones will produce stress within our system. I often find that when we relieve toxicity through various detox programs, and balance the patient’s hormones, recovery will be optimized. One important factor in stress management is adequate sleep. Sleep affects our cortisol, melatonin, progesterone, and magnesium. During sleep our body undergoes repair and we release growth hormone which is a powerful hormone in tissue regeneration. Emotional strain must also be considered in stress issues. I frequently asked my patients to get involved in meditation, biofeedback, and activities such as tai chi or yoga.
As the holidays approach, our stress factors start to escalate. Here are some simple techniques that we can we use to calm the craze of the season? First of all, we shouldn’t sweat the small stuff. Reacting to situations like holiday lines, traffic buildup, and the heightened irritability of those around us should be minimized. Keep your routine as close to normal as possible and allow yourself a good night’s sleep. Get involved in some meditation on a daily basis and schedule time when you can reflect, be alone, and meditate on the things that matter. If you live in a warm climate take off your shoes and allow your feet to contact the earth. As our informational world with computers, cell phones, blackberries, and iPads increase; so does the exposure of electromagnetic force. Allowing your body to have direct contact with the earth helps minimize the stress factors of EMF. Watch the use of alcohol. The holiday season tends to heighten alcohol use and this can have a negative effect on both your physiological health and the ability to sleep. Finally, if you have lost a loved one, then the holiday season can be very difficult. In this situation I usually advise my patients to remember to remember. Be open about your feelings and discussed with your loved ones memories and situations that you have enjoyed about the person who is gone. Finally, celebrate wisely. Bigger is not always better, and the simple things during this holiday season will often bring you the most joy. I hope you and your family have a wonderful holiday season and I wish you blessings in the year to come.