“Reality is the leading cause of stress…among those who are in touch with it.” I’ve got to agree with Lily Tomlin on that one, and I’m sure that most stress physiology researchers would too.  

The Health Impact of Stress (It’s No Laughing Matter)

I realize the health impact of stress is no laughing matter, but I’m a firm believer that laughter is a form of medicine and I encourage you to look for reasons to smile and find the funny side of life throughout the day. If you are feeling tense, a good joke, hilarious show, or just a little silliness may be just what the doctor ordered.

On a more serious note, a lot of people are feeling stressed out these days. I find myself having frequent conversations with my patients about the so-called “stress response” and how this natural physiological process impacts health.

As I’m sure you’re aware, there’s a lot of evidence linking the “fight or flight” response to negative health outcomes. And a new study, just published in the journal Psychological Science, confirms that people who have trouble “letting go” of stress tend to suffer lingering effects much later in life.

As the study’s lead author, Dr. Kate Ledger of the University of California explains, “Our research shows that negative emotions that linger after even minor, daily stressors have important implications for our long-term physical health.”

In a moment, I’d like to share some tips on how you can better manage stress. I’d also like to explain how your body’s natural stress response gets hijacked. Understanding how this system works can provide you the kind of insight that may help you dial it back a bit. But first, here are a few well-established ways that chronic stress can take a toll on your well being:

• Chronic stress has been linked to the six of the leading causes of death (including heart disease, cancer, lung ailments, accidents, cirrhosis of the liver and suicide).
• Three out of every four doctor visits involve stress-related ailments.
• More than one adult in five reports feeling very stressed on a daily basis.
• According to a report by researchers at the Harvard Business School and Stanford’s Graduate School of Business, workplace stress contributes to deaths of as many as 120,000 people every year.

Don’t Let The Stress Response Get the Better of You

There’s a huge irony here because the stress response is an evolutionary system designed to keep us alive, but when it gets hijacked and misused, it ultimately threatens our lives.

The “fight or flight” response is a natural way of keeping an animal alive and safe. If you are a mouse trying to escape a cat, then you need every bodily resource available to immediately maximize your chances of getting away.

When a mouse sees a cat, stress hormones (most notably cortisol and adrenaline) quickly flood the mouse’s bloodstream. This dramatically increases the heart rate, respiration, and blood glucose that the mouse needs to have a sudden burst of energy that will help it outrun the hungry cat. The turning up of those body systems and resources that are necessary for survival is called “upregulation.”

But those extra resources have to come from somewhere. As the stress response kicks in and specific body systems are upregulated, other less immediately important systems are “downregulated” or turned down. These include immunity, digestion, and fertility…which are essentially put on the back burner until the threat is over.

Cats running from mice or zebras running from lions on the Serengeti plains use the same playbook that we do. Although we share the same type of stress management system as a cat or a zebra…most of the threats we face in the modern world are much less existential. When is the last time you found yourself running from a predator who wanted to eat you?   

For most people today, the “fight or flight” response is being triggered by unsettling but decidedly non-life threatening situations.  Your boss yelled at you, you got a flat tire, or you can’t get online. These are not life-threatening events… but our stress management system reacts as if they are. There’s nothing terribly unhealthy about the stress response like that happening every once in a while, but when it happens all day every day, for weeks, months, or years… that’s “chronic stress” and it can be a killer.

The problem is that when high levels of cortisol and adrenaline are constantly in the bloodstream the body is in a constant state of fight or flight so the upregulated systems (heart rate, blood pressure, blood sugar etc.) stay turned on and downregulated systems (immunity, digestion, fertility etc.) stay turned off.  It’s no wonder, chronic stress is correlated with hypertension, diabetes, digestive problems, and chronic disease.

Tips For Managing Stress

Appreciating why we react to stressful events the way we do can be the first step to modifying our responses. Here are several other stress reduction techniques:

• Get lots of activity. Exercise help to neutralize the effect of stress hormones.
• Eat better food. Eat magnesium-rich vegetables like whole grains, beans, nuts and seeds.  Magnesium is Nature’s “chill pill” and most Americans (60 percent) are not getting enough of a nutrient that helps keep your stress management system working properly.
• Cultivate social relationships. Strong and rich social networks help boost immunity and resilience.
• Practice relaxing techniques such as yoga, tai chi, and meditation. Studies show that meditation is a great way to alleviate stress-related anxiety and depression.
• Take up a hobby. If you want to take a page from my playbook, a few of my favorites include hiking, gardening, and playing the guitar.  
• Listen to music. Studies show that enjoying your favorite tunes can modulate the stress response. And of course, dance like nobody’s watching…
• Take a B-complex. B-vitamins are involved in the chemistry of the stress response.  Look for a B-100 supplement and take 1 per day.

There’s only so much you can do to avoid stressful events, but there’s a lot you can do to change how you react to them. Learning to let stressful events flow over you “like water off a duck’s back” requires a mental shift (and sometimes some therapy) but there are plenty of habits you can cultivate that can be key too. Eating right, exercise, practicing mindfulness, and all of the tips above are strategies that can all help modulate the “fight or flight” response. Stress is less about reality than it is about the way we have learned to respond to it.

Take good care,

Dr. Josh