Stress has been named the health epidemic of the 21st century. 70-90% of all GP visits are potentially thought to be due to stress related complaints and there is more and more research into how stress can cause conditions ranging from high blood pressure and type 2 diabetes to hormonal issues, autoimmune diseases and Alzheimer's.
We are at a time where being constantly busy is the norm, with never ending to do lists!
It used to be that, many years ago, our stress response would be activated when we were being chased by a lion. Now it is activated when our toast comes out slightly too burnt or someone in front of us is driving 4mph below the speed limit! Instead of acute stress, which is a normal helpful response to a life or death situation, we are in a state of chronic stress, where our bodies are constantly on overdrive.
To understand this better, let's look at the neurology and physiology behind our stress response...
The Autonomic Nervous System:
The Autonomic nervous system is largely automatic and unconscious (unless we learn how to train it- more of that later). It is divided into two parts: Sympathetic and Parasympathetic.
Our Sympathetic Nervous System is in charge of our stress response. It is the 'Fight or Flight' state. It switches off our digestive and reproductive systems, increases heart rate and breathing rate, increases muscle tension and directs sugar into the blood for energy.
This is triggered by: The Amygdala (part of our limbic system/emotional brain). Signals are then sent to the Hypothalamus and Pituitary Gland, excreting a substance called Adrenocorticotropic hormone (ACTH), which then signals the Adrenal glands (on top of the kidneys) to release Cortisol, Adrenaline and other chemicals to rocket us into action!
Looking at this from a Chiropractic/spinal point of view, the Sympathetic part of the nervous system is primarily found in the spinal cord/nerves at levels T1 (upper back/base of neck) to L2/3 (lower back).
The nerves then run into sympathetic trunks and ganglia (2/3 cervical, 11 thoracic, 4 lumbar and 4 sacral, 1 coccyx) to supply: the eyes (pupil dilation), salivary glands (inhibits secretion), heart (increases rate/force of contraction), lungs (opens air ways), stomach/intestines (reduces digestion), liver (glycogen--> glucose), adrenal glands (adrenaline secreted), kidneys (decreases urine secretion), sex organs (usually constricts vessels).
Our Parasympathetic Nervous System is the opposite, in charge of our 'Rest and Reset' state.
Acetylcholine is the main substance released.
From a Chiropractic/spinal point of view, there are Cranial and Sacral divisions. The Cranial part is found in the brainstem and cranial nerves 3, 7, 9 and 10. The Sacral division is within S2-S4 spinal cord segments.
The nerves supply: the eyes (pupil constriction), salivary glands (increases secretion), heart (decreases rate/force of contraction), lungs (closes air ways), stomach/intestines (increases digestion), liver and gallbladder (increased bile), kidneys (increases urine secretion), sex organs (usually dilates vessels).
As stated earlier, we need our sympathetic nervous system to fire at the right times when we are under genuine threat. However, this system may become overactive chronically due to various traumatic experiences and every day 'micro-stressors'.
This may cause all sorts of conditions, such as: depression (due to running out of dopamine), anxiety (due to increases in the size of the amygdala of the brain), cold hands and feet, high blood sugar, high blood pressure, digestive problems and stomach ulcers, compromised immune system (or sometimes overactive immune system leading to autoimmune diseases), sexual dysfunction and reproduction system abnormalities, issues with attention and memory (hippocampus of brain decreases in size) and musculoskeletal complaints such as muscle tension and headaches.
So, how do we help switch off the sympathetic nervous system and switch on the parasympathetic nervous system?
We can buffer/control our stress response by looking at the following factors...
1) Breathing...
Diaphragmatic breathing- ideally start by lying on your back with your knees bent up. Put one hand on your abdomen and one on your chest. Focus on letting the hands that's on your abdomen move up/out to the ceiling, trying to keep the hands that's on the chest fairly still. Repeat for a few minutes at a time.
Diaphragmatic breathing has been shown to lower cortisol and increase focus.
Variations of breathing also include '3, 4, 5' breathing- breathe in for 3 seconds, hold for 4 and breathe out for 5 seconds. When we breathe out for longer than we breathe in, we trigger our parasympathetic nervous system.
Nose breathing is also better than mouth breathing, as it has been shown to increase oxygen and nitric oxide, widening the blood vessels and therefore increasing brain function and decreasing blood pressure.
2) Mindfulness/Meditation...
A Harvard study showed that on average, only 53% of our time is spent thinking about the present moment. So that's a lot of other time spent worrying about the past or the future!
Mindfulness can include: concentrating on your breathing, doing a Body Scan and using Progressive Muscle Relaxation.
Meditation could include a type called Loving Kindness Meditation where you say phrases such as 'May I/you be... safe and secure, healthy and strong, happy and purposeful and at peace' about yourself or another person.
These techniques may aid sleep quality, decrease blood pressure and increase concentration.
Apps such as Calm and Headspace are great for this.
Visualisation- is also an amazing skill. Why not visualise yourself in your safe haven, such as in the middle of a field or on a beach. Or try imaging yourself as your most confident, calm and happy self before a stressful situation. This is where techniques such as Hypnotherapy can work wonders for people.
3) Negative thought patterns...
Reframe stressful situations- write them down, replay them as an observer. Try and empathise with people. Perhaps they said something that upset you because they are not in a good place emotionally themselves. Perhaps they accidentally cut you up while driving as they were rushing to get to see their ill mum in hospital. Practicing compassion and empathy is a great stress reliever!
Gratitude diary- Our brains are 2x as likely to focus on losses than gains. By writing down 3 things we are grateful (every day/few days/week) we can shift our brain to focus on positives through the day rather than negatives. Feeling grateful can also help you be more productive, as it puts you in a more alert and energetic mood.
Affirmations- as cringey and difficult as it sounds, telling yourself each day how great you are can eventually make your brain believe it! Work out your negative thought patterns first and chose affirmations to oppose them. Repeating things like 'I am confident. I am smart. I am thoughtful...' etc can help boost your belief in yourself.
Decrease technology use- according to research, we check our phones 221 times per day and on average spend 25% of our lives on our phones. For some of us, using our phones can be a positive experience, but at other times it just acts as a distraction when we're bored/upset/angry. Try and take note of how much you're using your phone and how you feel when you stop using it. Do you scroll through social media, feeling envious or upset at everyone else's 'perfect' life? Do you look at the news and catastrophise about the bad that is happening? Why not try a few hours with your phone on silent/Do not Disturb or try a screen free day per week?
Seeing a professional counsellor/CBT therapist can greatly help some people identify where negative/limiting thought patterns may stem from and work out how to address them.
4) Life Purpose & Core Values...
Finding purpose in life and living to work towards that has been shown to be of key importance in decreasing stress. What are your core values in life? These may include: social connection, kindness, honesty, fun, creativity, personal growth, wisdom, optimism, balance... and the list goes on. Questionnaires have been developed to help you get to the bottom of what your core values are so that you can then understand what needs to change for you to feel like you're living in harmony with them. For example, if family relationships are of key importance to you, yet you're working very long hours at work, this may create an underlying stress. Once you've worked out your true core values, you can work out your life purpose (your 'why' of being alive)! Then it's a case of setting specific goals to help you work towards your purpose each day.
5) Schedules...
Our brains like familiarity and get stressed when we are uncertain of what will happen. This is where morning routines and planning your day ahead can come in very handy. Why not get up a bit earlier and get into a morning routine such as listening to upbeat music, stretching and reading something educational instead of rushing around to get out of the door straight away (creating a micro-stress dose already)? Try and include Movement, Mindfulness and Mindset within your morning routine.
Schedule in 'me time' to your day and week! Make a promise to yourself that you will do something you enjoy in this time. Getting into a 'flow state' is great by doing anything from coloring, to playing a musical instrument or gardening. Trying new skills is key in keeping our brains healthy. Scheduling time to socialise and build healthy relationships is extremely important too (loneliness has been linked to numerous poor health outcomes).
6) Senses...
Visual: Nature- it has been shown that the fractals (recurring patterns) within nature help to buffer stress. Walking in nature actually causes our pre-frontal cortex of our brains (the part in charge of planning and decision-making) to relax!
Auditory: Music- research has shown that listening to a happy playlist, even for 12 minutes a day for 2 weeks can increase happiness and mood. Music has been shown to increase the release of dopamine and oxytocin (which increases bonding and trust). Make yourself a Happy or Calming playlist that you can listen to when you feel stressed.
Kinesthetic: Physical Touch-research has shown that touch, at a rate of around 5cm per second, releases oxytocin and decreases cortisol, especially around the neck/head. It can also activate the opiate pathway, responsible for decreasing pain. This is one way physical treatment such as Acupuncture, Massage, Chiropractic and Reflexology may help. Hugging has also been shown to increase oxytocin release. Heat- can be calming as well, such as a sauna or hot bath.
7) Sleep, Nutrition and Exercise...
Stress is not only emotional in nature. Poor sleep, diet and lack of exercises can also increase stress on the body.
Poor sleep quantity and quality can decrease our ability to regulate emotions. Melatonin helps us sleep but also decreases oxidative stress within the body. A study showed that getting less than 6 hours sleep a night for just 1 week increased distortion of the genes responsible for stress and decreased heart rate variability (see below).
Poor diet (high in processed food) also creates a stress on the body and increases inflammation. The Vagus nerve relays information between the gut and the brain. Research is starting to show more and more links between a heathy gut microbiome and a healthier brain, including diet's effect on depression.
Exercise has been shown to buffer the effects of stress by decreasing cortisol, especially mild-moderate intensity aerobic exercise. (While too much exercises/high intensity exercise late in the day may increase our stress response).
* See my Blog posts on Sustainable Nutrition, Sleep and The Lesser know benefits of Exercise for more information on these topics!
How can we measure stress?
Stress can be subjective and difficult to measure although new technology like Heart Rate Variability is now more widely available. The higher the heart rate variability the better, as it means our hearts are more readily able to react to and recover from stressful situations as and when needed. Cortisol levels can also be measured and new technology is even looking into eye (pupil) responses to measure stress.
As a Chiropractor we find out about stress in a few different ways:
A thorough history and getting to know each patient individually- in terms of diet/sleep/exercise and emotionally in some cases.
Physical findings such as increased muscle tone and joint restriction in certain areas.
If thought necessary, I will often discuss referral to a Counsellor, CBT therapist or Hypnotherapist if this could be of benefit to an individual.
Without assessing and trying to aid stress relief, some patients are more predisposed to recurrent musculoskeletal complaints such as upper back tension and headaches. Often to get to the route cause of musculoskeletal issues, stress has got to be taken into account.
So, try the above 7 top tips to buffer stress, find what works for you and get your parasympathetic nervous system going!
For more information:
Read...
Why Zebras don't get Ulcers by Robert Sapolsky.
The Stress Solution by Dr Rangan Chatterjee
Feel Better Fast and Make it Last by David Amen MD
The Mindful Day by Laurie J. Cameron
Listen to...
Podcasts by Dr Rangan Chatterjee on Stress- Feel Better Live More.