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Some facts about stress

 

What is stress?Good stress/bad stressHow stress affects your body: symptomsThe effects of prolonged stress symptom by symptomStress-related disordersReducing the effects of stressMassage, the antidote to stressSimple relaxation exercises you can do at home

 

What is stress?

 

The concept of stress as a physiological condition was first formally identified and studied by Hans Selye who, as a medical student, noticed that most patients had the same general symptoms, of ‘just being ill’. Selye noted that ‘just being ill’ was manifest by symptoms such as:

 

  • Feeling ‘unwell’

  • Joint pain

  • Muscular aches

  • Gastro-Intestinal upset

  • Loss of weight and appetite [or weight gain].

 

Also that predictable physiological changes accompanied these symptoms, such as:

 

  • Enlargement of the adrenal glands

  • Reduction of the thymus

  • Reduction of the lymph nodes

  • Stomach ulceration

 

In 1936 Selye identified the term stress as ‘the non-specific response of the body to any demand’.

 

In the last 70 years there has been a phenomenal amount of research on the physical, psychological, organisational and social impact of stress, and many new definitions of the phenomenon have emerged.

 

 

Good stress/bad stress

 

It is now accepted that stress is an important part of every day life and without it we would cease to function. However, the body has evolved to cope with short term bursts of stress which it ‘works out’ by physical exertion. Such short term bursts of stressful activity can sharpen the senses and improve performance. However, long term chronic stress can have serious and degrading effects on our well-being.

 

Stress and stress related behaviours have been clearly identified as contributing factors in our susceptibility to most of the main causes of death in the western world including heart disease, cancer, auto-immune diseases and immune deficiency diseases. A more exhaustive list of diseases thought to be caused or exacerbated by stress can be found below.

 

 

How stress affects your body: symptoms

 

The HPA (hypothalamus, pituitary, adrenal gland) axis is responsible for releasing a hormone known as cortisol, most commonly known as the stress hormone. Cortisol has many diverse physiological functions that occur throughout the body, such as suppressing immune function, increasing blood glucose levels, and breaking down different body tissues.

 

After you’ve fought, fled or otherwise escaped your stressful situation, the levels of cortisol and adrenaline in your bloodstream decline. When the stressor is removed, cortisol levels drop and the body returns to its normal level of activity.

 

As a result, your heart rate and blood pressure return to normal and your digestion and metabolism resume a regular pace. Problems result, however, if the perceived stress is not removed. Unless the body has a chance to recover, the effects of stress hormones tend to accumulate and build up. Chronic stress can result in either an over-activation or an under-activation of the HPA axis, depending on the individual. Over-activation of the HPA axis may result in increased and sustained levels of the stress hormone cortisol. This in turn can result in a variety of symptoms such as:

 

  • Anxiety

  • Agitation

  • Irritability

  • Depression

  • Lowered immune response

  • Altered reproductive function

  • Elevated cholesterol levels

  • Elevated triglyceride levels

  • Elevated blood pressure

  • Insulin resistance

  • Fatigue

  • Impaired memory

  • Central obesity

  • Loss of muscle tone and protein wasting

  • Bone mineral loss and impaired injury recovery.

 

In addition, people under stressed emotional states tend to have cravings for sweeter, higher fat foods and more energy dense meals. Without a corresponding increase in physical activity, these individuals tend to experience weight gain as a result.

 

Alternatively, the other type of stress response that an individual may experience is an under-activation of the HPA axis. Symptoms associated with this state may include:

 

  • An increased risk of autoimmune diseases

  • An increased risk of inflammatory conditions

  • Apathy

  • Malaise/fatigue

  • Weakness

  • Reduced libido

  • Weight loss

  • Poor, restless sleep

  • Chronic pain

  • Asthma

  • Allergies

  • An inability to carry out routine tasks

 

 

The effects of prolonged stress system by system

 

As said before, if stressful situations pile up one after another, your body has no chance to recover. This long-term activation of the stress-response system can disrupt almost all your body’s processes, increasing your risk of obesity, insomnia, digestive complaints, heart disease and depression.

 

Digestive system: It’s common to have a stomach ache or diarrhoea when you’re stressed. This happens because stress hormones slow the release of stomach acid and the emptying of the stomach. The same hormones also stimulate the colon, which speeds the passage of its contents. Chronic stress can also lead to continuously high levels of cortisol. This hormone can increase appetite and cause weight gain.

 

Immune system: Chronic stress tends to dampen your immune system, making you more susceptible to colds and other infections. Typically, your immune system responds to infection by releasing several substances that cause inflammation. In response, the adrenal glands produce cortisol, which switches off the immune and inflammatory responses once the infection is cleared. However, prolonged stress keeps your cortisol levels continuously elevated, so your immune system remains suppressed. In some cases, stress can have the opposite effect, making your immune system overactive. The result is an increased risk of autoimmune diseases, in which your immune system attacks your body’s own cells. Stress can also worsen the symptoms of autoimmune diseases. For example, stress is one of the triggers for the sporadic flare-ups of symptoms in lupus.

 

Nervous system: If your fight-or-flight response never shuts off, stress hormones produce persistent feelings of anxiety, helplessness and impending doom. Oversensitivity to stress has been linked with severe depression, possibly because depressed people have a harder time adapting to the negative effects of cortisol. The by-products of cortisol act as sedatives, which contribute to the overall feeling of depression. Excessive amounts of cortisol can cause sleep disturbances, loss of sex drive and loss of appetite.

 

Cardiovascular system: High levels of cortisol can also raise your heart rate and increase your blood pressure and blood lipid (cholesterol and triglyceride) levels. These are risk factors for both heart attacks and strokes. Cortisol levels also appear to play a role in the accumulation of abdominal fat, which gives some people an ‘apple’ shape. People with apple body shapes have a higher risk of heart disease and diabetes than do people with ‘pear’ body shapes, where weight is more concentrated in the hips.

 

Other systems: Stress worsens many skin conditions, such as psoriasis, eczema, hives and acne, and can be a trigger for asthma attacks.

 

 

Stress-related disorders

 

Stress-related disorders, i.e. illnesses caused by stress, include most instances of high blood pressure, migraine and tension headaches, and peptic ulcer as well as many other problems. It is commonly estimated about 70% of visits to the GP are motivated by symptoms of stress-related illnesses.

 

The following disorders are known either to be caused by stress or exacerbated by stress:

 

ADDICTIVE DISORDERS

alcohol addiction, anorexia, bulimia, drug addiction, multiple substance abuse, overeating/obesity, smoking addiction, weight addiction, others

 

ANXIETY DISORDERS

agoraphobia, generalized anxiety disorder, obsessive/compulsive disorder, panic attacks, performance anxiety, phobias (simple), post-traumatic stress disorder, social phobias, examination anxiety, others

 

AUTOIMMUNE DISORDERS

allergies, arthritis, fibromyalgia, fibromytosis, lupus, multiple sclerosis, rheumatoid arthritis, Sjogren’s syndrome, vitiligo, others

 

CANCER

bone cancer, brain cancer, breast cancer, cervical cancer, colon cancer, Hodgkin’s disease, leukemia, liver cancer, lung cancer, lymphoma, multiple myeloma,ovarian cancer, pancreatic cancer, prostate cancer, skin cancer

 

CARDIOVASCULAR DISORDERS

arrhythmia, arteriosclerosis, Burger’s disease, essential hypertension, fibrillation, mitral valve prolapse, palpitations, peripheral vascular disease, Raynaud’s disease, stroke, tachycardia, Wolff-Parkinson-White syndrome, others

 

DEVELOPMENTAL DISORDERS

attention deficit, concentration problems, conduct disorder, dyslexia, hyperkinesis, language and speech disorders, learning disabilities

 

TENSION DISORDERS

headache, neck/back pain, temporal mandibular joint disorder, fibrositis, carpal tunnel, torticolis, blepharospasm Skin disorders acne, hives, other blemishes, eczema, psoriasis, rosacea, vitiligo

 

Other stress-related disorders with a strong correlation to stress: alopecia, bruxism, insomnia, chronic fatigue syndrome, post traumatic stress disorder (PTSD), depression, Raynaud’s syndrome, hyperhydresis, urinary incontinence, herpes simplex, and many more…

 

(Source: The Life Sciences Institute of Mind-Body Health)

 

 

Reducing the effects of stress

 

Stress develops when the demands or perceived demands in your life exceed your ability to cope with them. The related problems can usually be prevented or treated effectively by learning to regulate the autonomic nervous system, the musculature, and the central nervous system. You can manage stress by:

 

  • Changing your environment so that the demands aren’t so high

  • Learning how to better cope with the demands in your environment instead of adopting negative coping techniques

 

Here are some techniques for getting there:

 

Look after your body: To handle stress, your body requires a healthy diet and adequate rest. Exercise also helps by distracting you from stressful events and releasing your nervous energy.

 

Learn to relax: It’s the polar opposite of the stress response. Deep-breathing exercises may put you in a relaxed state. Everyone assumes they know how to breathe or they wouldn’t be alive, but there are different breathing patterns. With diaphragmatic breathing, when a person exhales with a hand on the stomach, that hand moves toward the backbone. With inhalation, the stomach area expands like a balloon filling with air. Many people with asthma breathe exactly opposite of this, while many other people do not move the stomach at all. The first pattern is known as ‘reverse breathing’ and the second one as ‘thoracic breathing.’ Neither of these patterns is as healthy as diaphragmatic breathing which allows the air in the bottom of the lungs to be efficiently scavenged out to be replaced by fresh air.

 

Seek relaxation in laughter: Laughter therapy combines laughing, yogic breathing and stretching. Laughter boosts the interferon levels of the immune system which helps the system’s ability to fight illness, even if you are faking it. So laugh as much as you can – even if it’s not funny :-)

 

If you have persistent trouble relaxing, consider taking up meditation or studying yoga or tai chi, Eastern disciplines said to focus your mind, calm your anxieties and release your physical tension.

 

Shift your outlook: In many cases, simply choosing to look at situations in a more positive way can reduce the amount of stress in your life. Step back from the conflict or worry that’s put you in knots and ask what part of it is troubling you most. Are you afraid of losing face? If so, would it really be that bad? Are you angry or frustrated to the point of losing self-control? If so, is your reaction out of proportion? Take a break, talk to someone close and get a different perspective on your troubles.

 

On your own, you may have limited success trying to change the habitual patterns of thought and behaviour that trigger your stress response. Psychiatrists, psychologists and licensed clinical social workers are trained to help you break free of these patterns.

 

Muscle Relaxation: Muscles are activated in response to stress as part of the fight-flight pattern. When muscles are active they use much more energy than when relaxed. When muscles are relaxed, messages are sent to the brain to the effect ‘everything is OK.’ This helps to relax both the sympathetic nervous system and the central nervous system, loosens taut muscles and calms frazzled nerves.

 

 

Massage, the antidote to stress

 

Massage or other forms of touch therapy can be used a powerful tool to help with the above, namely to learn to relax and to achieve muscle relaxation. Nurturing touch stimulates the release of natural pain-killers and ‘happy hormones’ (endorphins, serotonin, oxcytocin, etc.), and the reduction of stress-hormones like cortisol and adrenaline. This is one of the reasons why people might feel ‘blissed out’ during or after a massage, but these hormones also play a major role in the complicated balance of body systems.

 

Certain massage techniques, in particular long, slow strokes and holds, are known to trigger the ‘relaxation response’. Due to the many nerve endings in the hands, feet and face, massage of these body areas is also extremely relaxing. Massage stimulates the parasympathetic branch of the autonomic nervous system (the ‘rest and digest’ system), which might be suppressed if stress is sustained over a period of time, and need reactivating. Therapeutic massage mainly aims at stimulating the parasympathetic nervous system, but does normally include other elements as well, such as passive joint mobilisation and working with acupressure points. By counteracting the adverse effects of stress, therapeutic massage will help relieve a variety of symptoms.

 

Every body is different, and every person responds differently to massage. Some like deeper work, some prefer more gentle work. An experienced massage practitioner will vary his or her work according to the needs of the person and the problems presented. If you are receiving regular work, your perception of pain, flexibility, and ability to relax are most likely change, and along with it the focus of the work.

 

Massage will show you and raise awareness of where in your body you are holding tension caused by postural or emotional holding patterns and stress. You can use a massage session for a body scan and as a practice in mindfulness. Try to stay with the touch and movement. Define and discern what it feels like: is it actually pain that you are feeling or pressure, or maybe a tingling? How does work on one side of the body compares to work on the same area on the other side of your body? Did you know that you had that muscle? Where do you find it easy to let go and where it seems nearly impossible to start with. What thoughts, emotions or memories do you associate with certain parts of your body? It often helps to direct the breath into the area that is being touched, maybe imagining to bring fresh, oxygenated blood into tense areas with the inbreath and transporting away any tension with the outbreath.

 

Staying in the room and in your body often is easier said than done. If you realise that you have been drawing up your shopping list for the past few minutes or anything that has happened before starts preoccupying your mind, gently try to bring your attention back into your own body. It’s absolutely normal that the mind wanders off, it’s just how our brains work. Try not to focus on ‘goals’ or ‘outcomes’ for the massage session, but focus on the inner experience and enjoy the sensations.

 

 

Exercises you can do at home:

 

Deep breathing

 

Change into something comfortable, then lie on your back on the floor, or another hard surface, and put a rolled towel or pillow under your knees.

 

Extend your arms out from your shoulders and relax the back of your hands on the floor. Close your eyes and envision your diaphragm and the deep abdominal muscles. Inhale deeply through your nose and pull the air down into your midsection. When you exhale through your nose, feel your midsection pull in.

 

If your chest is expanding and you’re pulling in your belly on the inhale, then you are reverse breathing. Keep practising until you feel the difference. While you are practising, you will be giving your body a healthy dose of oxygen, so you’ll feel more and more relaxed. The more relaxed you become the easier these exercises will be.

 

Follow these steps:

 

1. Inhale through your nose to a count of 6. As you inhale, imagine the breath to lift you up like a wave, starting from the abdomen, going into the rib cage and then into the chest.

2. Exhale slowly and completely, to a count of 6.

3. Repeat five to 10 times. Try to do this several times every day, even when you’re not feeling stressed. As you are getting more comfortable with this exercise and breathing deeply feels more natural to you, gradually try to lengthen the count to 10 (on the inbreath and the outbreath).

 

Progressive relaxation

 

Progressive relaxation helps to become aware of your state of tension and to relax surface tensions, i.e. in the voluntary muscles.

 

It is learned by sitting or lying comfortably, and one at a time, slightly tensing a group of muscles such as those in the legs, then slowly relaxing them. Move from legs to hips and abdomen, to chest and back, to arms and neck, and lastly face and scalp. When the head has been relaxed, start back at the legs and repeat. Each time tense a little less until there is only the feeling of tension followed by the feeling of relaxation. The attention may wander again and again, perhaps to get lost in thoughts, but gently bring it back to just the physical sensation of the tension and relaxation. This last point is important, because it is when the mind loses its busy thinking and is involved in just physical sensation, that deep and healing relaxation occurs.

 

A more detailed progressive relaxation routine can be found here.

 

 

If the stress continues unabated your body has no chance to recover and can actually experience adrenal fatigue, where the body can no longer deal adequately with the perceived stress. Commonly known as burnout, the body’s ability to respond to any stress becomes compromised.