STRESS!!! Three Easy Changes You Can Make Today to Decrease your Stress and Improve Your Health

Anyone out there feeling extra stressed lately? No? Just me? Great…

In reality, I think I’d be hard pressed to find someone who hasn’t been unusually stressed out this year. 2020 has been a veritable buffet of stressors - there’s been something for absolutely everybody. Job insecurity? Check. Overworked and underprotected? Check. Fear for your children? Check. Fear for your aging parents? Check. Fear of death or disability from a mysterious illness no one fully understands that is spreading like wildfire through the world? CHECK!  Loneliness, isolation or stuck in the house with your entire family for months on end? Check, check and check. For even the most stoic of individuals, 2020 has shaken us to our core, and more than likely, given each of us more than our fair share of things to worry about. 

Stress is a fact of life. In fact, some stress is actually helpful. Our bodies are designed to respond to stress in a way that keeps us safe in the presence of impending threat or danger. But while the experience of stress is natural and unavoidable, stress is meant to be experienced in the acute state: ‘Oh, is that a bear? I better prepare to run. Body: Send blood to my extremities, shut down my immune system and digestion. Get my heart pumping and let’s get some extra glucose circulating so I can move even faster.’ However, the body is not designed to react in an adaptive way to chronic stress. All the physiologic reactions to stress (increased cortisol, glucose and adrenaline release) act to shunt resources away from non-essential functions like the immune and digestive systems, to redirect the body’s resources to systems involved in response to the present physical threat. The cardiorespiratory system revs up, increasing the heart rate to pump more blood into circulation and triggers you to breathe faster to increase oxygen uptake to respond to increased energy demands. Blood (and the oxygen and glucose circulating within the blood) is sent to the extremities and large muscle groups to prepare to run or fight. While these physiologic reactions are super helpful when you’re face to face with a bear, they can be quite maladaptive and destructive to your body when they don’t shut off after the source of stress has been resolved (like in response to chronic anxiety) - or in the case of 2020, if the stressors just keep coming. 

Exposure to chronic stress results in an increased state of systemic inflammation. And again, while inflammation can be a good thing (it is how we heal from a cut or virus or other invading pathogen), chronic inflammation is associated with nothing but bad outcomes. Chronic systemic inflammation has been linked to increase risk of cardiovascular disease, metabolic syndrome, diabetes and cancer. It is associated with the development of arthritis, Alzheimer’s, IBS and a host of other bodily dysfunctions. It is one of the primary theories linked to aging in general. And also, it makes you feel like crap. Chronic inflammation increases aches and pains, disrupts your sleep and increases anxiety and depression. So, if you haven’t been feeling yourself this year, you can probably chalk it up to chronic stress, systemic inflammation and the fact that your entire life and physiologic sense of homeostasis is TOTALLY OUT OF WHACK. 

Now, (and I say this with total lack of judgement because I 100% fall into this camp) some of us think that ‘we can handle it’ or that living a busy, stressful life is simply your status quo. While this may be true, this doesn’t mean your body is handling it any different then the rest of us frazzled, stressed out hot-messes (I also fall into this camp sometimes, too. Lucky me.) Whether you’ve got your make-up on, kids out the door (or at their zooms) and to-do list half finished by 7am, or you’re simply struggling to find the motivation to pour a cup of coffee and deal with the mess you’ve left from the night before, under the surface, we are all the same. When we don’t address how we respond to stress, our body experiences inflammation. No matter what. And as I briefly explained before, inflammation causes disease and dysfunction. So what do we do about this? How do we stop the cycle?

Personally, (and I’m writing this partly to give myself a concrete stress-reduction plan) I suggest trying to reduce stress in two ways. First, I think it is critical to find ways to interrupt the stress-response cycle. This requires two steps - learning to identify when you are experiencing stress, and making the choice, then and there, to ‘change the story’. Second, it is important to minimize the state of systemic inflammation throughout your body, not only to promote improved health, but also to set yourself up to better respond to stress in the first place.

Interrupting the stress-response cycle:

The first step in interrupting the stress-response cycle is to identify that you’ve begun to feel a reaction to stress. Note that I didn’t say identify the stress. The stressor itself is immaterial, it doesn’t matter if it’s a bear or a work deadline. Your body responds in the same exact way (though in variable degrees of severity). Try to notice next time you encounter a stressor what happens in your body. Do you get tense and find your shoulders riding up to your ears? Does your heart race? Do you get a headache or experience nausea? Some people get strong somatic responses - increased heart rate, flushing, muscle tension, headaches or other bodily responses. Other people (myself included) experience more emotional responses. You may feel angry, overwhelmed, irritated or worried. Try to make a list of your specific stress responses and then try to be mindful of these throughout the day. The first step in interrupting the stress-response cycle is simply identifying when you are experiencing it. 

The second step is to change the story. In my experience, this is the most helpful thing you can do right now to reduce the effect of stress on your body. By consciously changing the way you react to the stressor, you change the way your body perceives it. This is the key to stopping the cascade of the physiological responses that lead to systemic inflammation and the physical effects of stress. I learned to use this technique when I experienced sudden onset tinnitus last year. Everytime my ears would start to ring, I’d panic. The anxiety and panic would worsen the experience of the tinnitus, and the worsening of tinnitus would increase the feelings of anxiety. See the problem here? The key to curbing my tinnitus was not getting rid of the stressor (as often, we can’t), but changing my reaction to it. When I would notice the ringing, I taught myself to stop and listen to it. I’d simply identify it for what it was, literally tell myself this is a symptom, not a crisis. This is a sound, not a bear. Then, I’d take a few minutes to listen to the ringing while taking slow deep breaths. Within a few days of practicing this behavior, the ringing didn’t trigger the panic response anymore, and eventually, the tinnitus improved. Even though I still am aware of the tinnitus at times,  it no longer initiates the stress, panic, inflammatory cycle for me, it’s just simply ‘there.’

You can adopt this two-step stress reduction plan to address any stress you encounter. Whether it’s pain, background noise, or demanding coworkers or children - when you identify the onset of the physical effects of stress, stop. Stop and identify the stress for what it is and remind yourself this is not a crisis, or a threat or an oncoming train. Then, take whatever actions best help you retrain your body to enter a state of calm, instead of a state of fight or flight.  If the deep breathing works, great. If you respond well to meditation, use that. Take a walk, go outside, read a book, write in your journal. Whatever you associate with calm, substitute that behavior for your instinctual response to the stressor. It takes practice, but your body will adapt and you can extinguish this response, despite how automatic it may initially be.

Decreasing systemic inflammation: 

Lastly, find ways to lower your systemic inflammation. According to the American College of Sports Medicine, there are four methods to decrease systemic inflammation. First is to take anti inflammatory medications. Second is to ingest antioxidant foods and supplements. Third is by caloric restriction. And the fourth is to exercise. Guess which is the most effective? Exercise. No joke. How great is that? The most effective solution to reduce inflammation is something you can do on your own, for free, right now. It doesn’t even need to be aggressive exercise! Low impact steady state cardio has been shown to reduce cortisol levels and is great for stress-reduction. More moderately intense exercise has even greater benefits on your mental and physical health. Effects start right after you exercise and last hours, and are cumulative over time. There is literally no downside to making exercise part of your regular routine. There is also substantial evidence there are benefits in following an anti-inflammatory diet (like the Medeterranean diet), getting adequate sleep and practicing habits like gratitude, yoga and other mindset-shifting activities daily. You don’t need to follow a guru or pay thousands to a health coach to get in these habits either. Just sit down, in the morning, and try to write a few things you’re grateful for. Make time to exercise. Drink plenty of water. Go to sleep on-time. 

So, am I writing about this because I am a stress-management expert? No. I’m writing this because I’m a frazzled, stressed out control-aholic trying to manage my home, my children, my career and my life in the middle of a dumpster fire of a year. I’ve turned to my vices more often than I’d like to admit, found myself grumpy, irritable, achy and run down and I know perfectly well that this is because I’ve been letting my reaction to stress run the show, instead of using these strategies to change the story. 

I hope you find this information useful and these strategies helpful. Not only do I find that these techniques help me, but these are skills I teach to my patients who struggle with pain management and anxiety related to physical dysfunction and disability. Of course, my advice does not take the place of the advice of your doctor or other clinical professional, and if you feel like your level of stress is unmanageable, please reach out to those individuals for help. And if you see me somewhere staring off into space taking nice slow breaths, now you know why:)

#justtryingtokeepmyishtogetheroverhere