Raise your hand if you didn’t have any stress last week. Anyone? No?! That’s what I thought.
Because here’s the thing about stress – it’s relative. We ALL have it. And it’s not always a bad thing. Stress is what drives us to get shit done. If there were no stress, why would we go to work? Why would we even care about money? Stress is a motivating factor and is necessary for not only success, but for survival.
So before we go any further, let me go through a basic run-down of our nervous system. Keep in mind, it is way more complex than this. People devote their careers to studying the nervous system; I got a Bachelor’s in neuroscience and only got the tip of the iceberg. But what I can do is try to explain how our nervous system is organized, so that we can better understand the human stress response:
As humans, we have a central nervous system and a peripheral nervous system. The central nervous system is comprised of the brain and the spinal cord. The peripheral nervous system is made up of all of the nerves outside (or peripheral to) the brain and spinal cord. We can then break the peripheral nervous system down into two main branches: the somatic nervous system and the autonomic nervous system. The somatic nervous system essentially controls voluntary movements by innervating our skeletal muscles. The autonomic nervous system, on the other hand, can be further broken down into three branches: sympathetic nervous system (SNS), parasympathetic nervous system (PSNS) and the enteric nervous system. The sympathetic nervous system creates our fight-flight-or-freeze response when faced with stressors, life-threatening, or otherwise. The parasympathetic nervous system drives us to find food, sleep and reproduce. The enteric nervous system is responsible for the function of our gut and can act independent of the PSNS and SNS, but is still affected by them (read: this is far too complex for this post, but it will certainly be discussed in future posts, because it is SO interesting!).
For those of you that love outlines (or lost interest above), here you go:
- Central nervous system: The brain and spinal cord
- Peripheral nervous system: The nerves lying
outside of the central nervous system
- Somatic nervous system: The nerves innervating skeletal muscle to create voluntary movement
- Autonomic nervous system
- Sympathetic nervous system: Fight, flight or freeze
- Parasympathetic nervous system: Rest and digest/feed and breed
- Enteric nervous system: Innervates the gastrointestinal tract
Ok, so let’s delve into the sympathetic nervous system a bit more: the SNS is only concerned with keeping us alive. That’s it. The PSNS on the other hand, works to stimulate digestion after eating, sexual arousal, urination, and defection. These are all necessary functions, but not really pertinent in life-threatening situations. Let’s think about our ancestors: if faced with a saber-toothed tiger they would either try flee, fight or freeze and hide in order to ensure survival. A variety of physiologic changes happen to ensure survival. Here are two examples: blood gets shunted from the GI and reproductive system to the muscles, heart and lungs. Think about it: increased heart rate, dilation of the bronchioles in the lungs, and more blood flow to the muscles facilitates physical performance, so we have a better chance to survive the threat we’re facing. A second example is activation of the hypothalamus-pituitary axis (HPA), which ultimately leads to cortisol release from our adrenal glands in order to get stored glucose out into our blood so that our muscles can use this fuel to deal with the threat. In those instances, our bodies aren’t concerned with digesting food or reproducing. Our body only wants to survive the threat in front of it. Once we get away from a threat, the PSNS takes over and the body sends blood back to the GI system, kidneys and reproductive system and the body can now focus on finding its next meal, safely resting, or propagating the species.
Great. But, how does that apply to modern life, where we don’t have to worry about saber-toothed tigers? Our autonomic nervous system is not intelligent. It is literally our “reptile” brain that is ONLY concerned with keeping us alive. It is NOT a gray scale; you’re either in sympathetic state or you’re in parasympathetic. That means: the autonomic nervous system cannot discern between the stress related to work and a gun being held to your head. Here’s the thing: As humans, we are supposed to be in parasympathetic state about 80% of the time and in sympathetic no more than 20% of the time. But for so many people, it is the opposite. Which is a HUGE problem, an epidemic, even! Consider this: how would your body respond if you had to live with a gun held to your head 80% of the time?!
I frequently hear patients say, “my body turned on me” or “my body betrayed me.” I’d argue that this simply is NOT the case; our bodies don’t “turn on us,” they want us to survive. Of course, there are exceptions to this such as certain disease states, but stress can affect this due to epigenetics, but that’s a whole different discussion… When a person lives with chronic stress, other systems will be compromised due to persistent sympathetic arousal. The breakdown of other systems is their body’s attempt to keep them alive! It’s only focused on surviving this stressful event, so it isn’t going to expend any extra energy on helping their other systems (gut, hair/skin, sex drive) when it is sole focus is simply keeping the person alive.
But, here’s the beautiful thing, as humans, we are conscious and can override the sympathetic nervous system.
Bottom line: it’s not about how we deal with our stressors (although planning ahead and appropriate organization can certainly be helpful for managing our stressors effectively), it’s about how we deal with the stress response that the stressors cause. It’s easy to fall into the mindset that we can mitigate stress by avoiding our triggers. Wrong! Stress is a normal part of daily life: your job, your kids, traffic, the list goes on! Good luck eliminating those things from your life. But what you CAN do is identify your triggers, then really think about HOW and WHY you respond the way you do. What can you do in these moments to stop the cycle and change your behaviors? I read The Seven Habits of Highly Effective People years ago and have always remembered this quote:
“Look at the word responsibility – ‘response-ability’ – the ability to choose your response. Highly proactive people recognize that responsibility. They do not blame circumstances, conditions, or conditioning for their behavior.” – Stephen R. Covey.
Man, this still really resonates with me. For example, while I’d prefer to not have to work 40 hours per week, I made the choice to pursue this career and I’ve made a commitment to my patients, so in moments of stress I restructure my mindset and remind myself that these were my choices and I have an opportunity to respond in the best way possible.
So how do you deal with stress? There are thousands (maybe millions) of books, podcasts, articles, etc. written on this topic. So, rather than listing them out, I figured I’d share some pieces of advice that really worked for me; you’ve probably heard most of them before in some capacity:
- Connect! Spend quality time with your partner, call a close friend that you haven’t spoken with in a while, or my personal favorite – pet a dog! Positive interaction with someone we trust not only lends to a feeling of safety, but also creates a sense of meaning in our life. Along these lines, express gratitude for this relationship! It’s hard to be stressed when we are feeling grateful.
- Exercise! Remember that in moments of stress, our body wants to move, it has mobilized glucose into the blood stream and shunted blood to your muscles, so exercise can be a very effective way to address daily stress. Remember that getting past that anaerobic threshold (read: breathlessness) IS a stress to your body! That said, I always encourage people to fully cool down and normalize their breathing before they head out of the gym. So, for example, you wouldn’t want to hustle out of a HIIT class and immediately start rushing in order to arrive at work on time. Take a few moments to breathe deeply (see below for more on this) and signal to your body that the “threat” is gone.
- However, here is the caveat to exercise: your body can’t differentiate between exercise-induced stress and life-threatening stress. So, if I find myself overwhelmed with stress that I cannot seem to handle (e.g. mind racing, unable to sleep, lowered patience with my partner, etc.) I avoid high-intensity exercise for the short term. Instead, I focus on lower intensity exercise, like walking my dog or hiking. Which leads me to my next point…
- Spend time outside. A patient once told me, “you should spend at least 20 minutes per day outside, and if you don’t have 20 minutes to spare, you need an hour outside.” While it’s true that some days I can’t get outside as much as I’d like, just 10 minutes of sun exposure can not only help your mood and stress, but also helps with vitamin D production. There have been some studies that have suggested that vitamin D deficiency may be correlated to with excess production of cortisol (our stress hormone). Plus, getting outside can just be so rejuvenating.
- Along these lines, I make sure that I am consuming adequate magnesium, B vitamins and I also supplement with glutathione, which works as an anti-oxidant. Any time we are under stress, our bodes create free radicals, which lead to an inflammatory response. Glutathione helps to mitigate this effect.
- Diaphragmatic breathing is THE most effective way to reduce stress in the moment. Remember, breathing is an automatic function, therefore, it is controlled by our autonomic nervous system! But, we have this muscle called the diaphragm that allows us to take a deep breath, and it’s under voluntary control. The significance of this is that we can override our sympathetic nervous system (think: shallow, fast breathing when stressed) to slow our breathing down and send a signal to our brain that we are safe. Research has shown that diaphragmatic breathing is an effective strategy to immediately reduce stress! Wonder if you’re doing it correctly? Your ribcage and abdomen should expand with an inhale and passively fall with an exhale; your chest should NOT move. Try taking 5-10 diaphragmatic breaths in moments of stress and when falling asleep at night. I promise, it is pretty damn effective!
I hope that this has given you a basic understanding of how your autonomic nervous system functions, so that you can understand the importance of stress management as it relates to your health.
I want to hear from you! How do you manage your stress levels?