Stress – Stress is a normal part of life – we are designed to be able to cope with stress and the mechanisms with which we are designed to cope with stress are maintained by ‘Stress hormones’. These hormones alter body chemistry so that we can deal with stress to get ourselves away from it. People who cannot manufacture stress hormones due to genetic defect or organ damage often feel apathetic when stress comes or their reactions are delayed. I will use the term stress hormones to describe the set of hormones which influence our body chemistry and to describe the effects of these hormones.
But first of all I don’t want you to think of stress as a bad thing. We are all influenced by the images we see and in the western world there is a tendency to view the world as rosy, safe and hopeful, so that when something bad does happen we are shocked and surprised. In fact life is the other way around – it is normal and natural for shock, trauma, sickness and bad things to happen, when we get a reprieve from this we can call ourselves lucky, people who live in non-westernised nations know this to be true. This simple mind-set change can help us cope better when life appears to turn unfair on us.
Secondly our bodies are designed to adapt to stress, so stress is not necessarily a bad thing, we will discuss this more shortly.
Ok so lets get into it. Right now there is a large earthquake, it comes out of nowhere so we are not expecting it, we get a fright, jump up and grab the kids, or try and run out side or whatever. We are all familiar with this response and it has been termed ‘Fight or flight’ response. This response is controlled by a group of stress hormones usually just called ‘adrenaline’ found in the adrenal medulla. For those who don’t know the Adrenal glands are found just above the kidneys which are behind the rib cage nice and protected and in the centre of the body. Adrenaline is also fired out from the ends of nerve cells so this is a very quick response, it opens the lungs, raises the blood pressure and increase the heartbeat – sound familiar? You don’t need to remember any of this – just observe your body next time you get a fright!
It also increases glycolysis in the liver and increases the conversion of fats back to sugars which means the blood sugar levels can raise so that there is instant energy provided to the body. The blood pressure and pulse also raises instantly to keep the blood pumping and getting the nutrients flowing. We hyperventilate slightly in order in get more oxygen. So this all happens seconds after the quake. Doe anyone feel stressed just thinking about it? All of these conversion reactions involve nutrients. Adrenaline is made from tyrosine which uses SAdenylMethionine and Vitamin B5 to covert the tyrosine and and B12, B6 and folate to regenerate the SAMe. So if we are stressed we use heaps of these nutrients as well! The body recycles as much as possible by soaking it back into the nerve cell after the stress is over.
The body also produces another response, the second wave of stress hormones. This is the response produced from the adrenal cortex normally called ‘cortisol’. Cortisol’ is actually a bunch of hormones that work together but we will use the term cortisol to describe these stress hormones. Cortisol is already produced by the body every day – in fact it is what wakes us up in the morning and it increases even if we don’t have a flight or flight response – it increases when we have non-reactive stress such as financial stress, emotional stress and work pressure. Stress in general causes an up regulation of cortisol which means it tells the body to produce more. It is the slow releases stress hormones which has longer lasting effects. This happens in the adrenal glands in the cortex hence the name corticosteroids. The reason for this is because we need to remain alert after a fright to get us through, it isn’t over til the fat lady sings so to speak. Cortisol keeps the blood sugar levels high so that we still have energy to burn. It helps us to retain memories so we know what to do next time and in the moment epinephrine one of the adrenaline hormones also causes us to have retrograde enhancement of the event – this is why it seems like time can slow down after a crisis event. Importantly in terms of health, cortisol suppresses the immune system, reduces any pain and inflammation, postpones digestion and repair and keeps us alert and awake.
We often focus on cortisol’s role in the body because it is our key stress hormone and the one that affects us daily, even without the adrenaline shocks. When people refer to stress hormones they are mostly referring to cortisol. It backs up adrenaline’s action. Cortisol is neither good nor bad – we need it, we just need to understand what it does so that we can understand our bodies better and realise what our symptoms mean – it needs to be in balance – too much stress for too long will cause excess cortisol release. Too little also causes problems from not enough cortisol release. So let’s look at what exactly cortisol does to understand its effects on us.
Circadian rhythms – First let’s take a brief look at what happens to cortisol during a normal day without any major stress – Cortisol levels are highest in the morning and lowest at night. Basically because the normal physiological functions are dependant on the stress hormones they are a normal part of your day. Cortisol peaks at 8 am in the morning, essentially it wakes us up in the morning. We may notice that if we have any inflammation, pain or a cold or flu that the symptoms are more at ease during the day and worse at night. This is because cortisol drops throughout the day and is at its lowest at night. Cortisol’s major effect is surpressing the inflammatory response.
Now let’s look at the Effects of high cortisol – As mentioned cortisol keeps the production of blood sugars high so we have more energy. It also stops the body forming bone and collagen molecules (repair), so that the body can use the amino acids for other more important and immediate uses. This slows wound healing. It helps the body retain sodium and excrete potassium in order to increase the blood pressure. This keep s blood pressure high. Cortisol also increase stomach acid secretion temporarily which may cause reflux in some people but it down regulates intestinal digestion. The causes reflux and impairs digestion. Cortisol helps to create memories but impairs recall. Sound familiar?
Cortisol’s buddy is Cortisone – This is the main corticosteroid that supresses the immune system. This is the strongest anti-inflammatory known to man and equals pain relief. This is why when we feel slightly stressed our pain can temporarily be alleviated. This is also why hydrocortisone is used in inflammatory conditions such as arthritis, asthma, and eczema to control the inflammatory response. It is the best drug that has ever been discovered in order the stop the inflammatory response in its tracks. Just ask anyone who has had to use them! It also has side-effects so needs to be used in moderation.
Another buddy in the system are the mineralocorticoids – which affect mineral balance – mainly sodium and potassium – by actively reabsorbing sodium and therefore water (by osmosis) increasing blood volume and blood pressure. This is the process that helps keep the blood pressure up when we need it but also what contributes to some cases of high blood pressure.
So let’s look at the side effects of high cortisol to see what happens when we are under stress:
• Pain relief – anti-inflammatory – stops the inflammatory process and keeps the inflammatory process in check
• Supressed immune system – slow to recover from illness
• Enhanced formation of memories but inability to recall events a.k.a a bad memory
• Energy and lots of it often the feeling of being overstimulated/anxious
• Slow wound healing and decreased skin elasticity i.e. increased wrinkles
• Raised blood sugar levels
• High blood pressure
• Reduced bone density
• Poor digestion, increased reflux
• Muscle breakdown and reduced muscle repair
• Insomnia
• Psychosis, or aggression
• Anovulation (lack of ovulation)
• In fact, there isn’t one part of the body that doesn’t respond to stress as all cells contain receptors for stress hormones.
Once again to understand the symptoms of high stress hormones we don’t need to remember what I have just told you – simply observe your body soon after a stressful event to notice the changes for yourself. So what else affects cortisol levels apart from stress?
• Caffeine
• Infection
• Sleep deprivation
• Trauma
• Emotional trauma
• Starvation
• Intense exercise (temporarily increase but restores to normal again as soon as food is taken in)
• Anxiety
So we need to take into account that is prolonged stress and anxiety is really a state of prolonged stress. Most of the literature explaining the negative effects of stress are referring to the effects of prolonged stress without periods of rest. Temporary stress is a good thing and generally the body recovers. But having anxiety means signals from the nervous system are telling the hormonal system that we are in trouble. This can lead to fatigue and if the anxiety is not addressed will continue to lead to depression and a lack of adrenal hormones. This is what we refer to as adrenal fatigue. Instead of adapting to the stress the stress takes its toll and we actually end up burning out due to the effects of firstly elevated cortisol and then following this lowered levels of cortisol due to lack of recovery time. This is why we need to take into account the nervous system as well as the stress hormones.
Prolonged stress is when the effects of stress are ongoing. Earthquakes in the manner that we had them caused a prolonged stress response in most people due to the ongoing nature of them and the constant release of both adrenaline and cortisol. Some people jobs and relationships are a form of prolonged stress. So when in these situations for a long period of time to body is being asked to put out cortisol at higher levels ongoing. The symptoms that we referred to just before will all be apparent. Insomnia, low immunity, pain relief, lack of ovulation, slow wound healing etc. After a period of time which is different for each one of us, we get to a point where we can no longer keep up with the demand being placed on our body and we are no longer able to adapt to the situation. This causes the third stage of the stress response known simply as exhaustion or the feeling of being run down. Prolonged stress causes a temporary depletion of stress hormones, in other words the body can’t keep up with the production of stress hormones required.
The result of this is the effect of low cortisol, and a shrinking of the adrenal glands. When the effects of stress were proven in mice they would weigh the adrenal tissue – after a period of prolonged stress the adrenal glands weighed less and after periods of low stress they adrenal glands weighed more.
The symptoms of low cortisol are the opposite effects such as:
• Exhaustion
• Excess sleep required and no get up and go in the morning
• Lack of motivation and response – sometimes depression
• Drops in blood sugar levels during the day
• Underactive immune system – tendency to get colds [the phenomenon known as getting sick as soon as you take a rest]
• Increased pain and inflammation – flaring of inflammatory disorders such as asthma, eczema, arthritis, fibromyalgia etc
• Low blood pressure – feeling dizzy when standing up too quickly
• Improved wound healing and digestion
• Slow pulse
• In children a delayed growth or development
• Depression
• Loss of sex drive
• Hormone imbalance – Irregular periods
• Thyroid hormone problems
So these are the 3 phases of the stress response, the initial reaction which causes adrenaline and the upregulation of cortisol, the effects of high cortisol, and if the stress doesn’t resolve, the effects of low cortisol. So the negative effects of stress really actually only occurs when we have an increased level of stress and no time to recover from the stress.
The effects of cortisol depletion also become more apparent as we age, because there is increasing adrenal depletion with age. This is due to both a build-up of stress over a lifetime and also the general effect of depletion over time. When we are young we have more reserves, as we get older we have a tendency to become depleted because of previous depletions.
What causes stress in today’s world – Work pressure, financial pressure, relationship stress, deadlines, emotional stress, study and traffic! However anxiety is a major cause so we need to look at anxiety as a form of stress in itself. A lot of us put undue pressure on ourselves and so other forms of stress such as rushing can also increase our stress. A quick rundown of the way to body determines stress would be this example: Stress that I see or feel comes in through my senses e.g. I sense anxiety which is triggered by doing a public speech. {earthquake or a car stopping in front of me while I am driving} I react through the nervous system and then secondly through the hormonal system, I get flooded with adrenaline and cortisol, which increases my nervous activity so I feel more anxious, cortisol lasts all day and drops at night, and I either feel wired at night or exhausted, I sleep but might wake in the night due to low blood sugar levels or higher than normal cortisol, and I wake feeling unrefreshed, so I have caffeine to stimulate me which affects the nervous system and the cycle continues. Most of us are at varying degrees of stage 1, 2 or 3 most of the time. But the key is knowing how to look after ourselves so that we don’t end up in stage 3 even if the stress is persisting. We need to break the cycle and simultaneously relax the nerves and protect the stress response while we are under stress in order to prevent the burnout form happening. Don’t despair! If you are in stage 3 then treatment with herbs is highly recommended to help you recover fully and bring your energy levels and stress hormone levels back to normal. So let’s look at the research and see what we can do to help us rest and recover!
Anxiety needs to be looked at from an emotional and cognitive perspective as well as on the physical level. Why are we anxious? Has it become habit? Has life thrown us a few too many curveballs? Are we over analysing our situations? Do we have faith that all will work out in the end? Are our nervous systems wired that way? Are we able to observe our mental processes without reacting to them? Has the stress of modern life with its overproduction of information and lack of silence affected our nervous systems? Do we rely too much on caffeine to the detriment of ourselves? Do we talk about our situations enough and get perspective on our issues? One way to prevent PTSD is to talk about a situation afterwards which helps the brain shelve our experience. Do we expect life to be like Disney films? Have we learnt anxiety from our parents? Are we retaining the right nutrients our body needs? Are we supported in our relations hips through friendships and partners and therapists. We all need therapists! Are we supporting our body to relax by getting regular touch, regular nature walks, regular exercise? Have we even identified what makes us anxious? Do we have outlets for your nervous energy? Do we laugh enough? Do we play enough? Do we rest enough? Do we escape from time to time?
As herbalists we are in a good position to treat stress because of the two classes of herbs that hep to reduce symptoms of stress and help the body to recover. Namely, nervine relaxants and adaptogens which help us to rest and recover or heal the adrenal glands faster. By coming to this talk and knowing where you are in the stress cycle, helps you to tell us where you are at, and helps us decide on what herbal treatments to give you.
Nervine relaxants are a class of herbs that help to reduce the nervous activity that is part of the stress response. During stage 2 these herbs can help us to sleep, relax the nervous system, calm the mind and reduce anxiety. Down regulating nervous system is key in stage 2 because this will help you to sleep better and prevent burn out. I live on nervines!
Anxiety itself acts as a stressor so an anxious person can have adrenal exhaustion due to the ongoing nature of the anxiety on the body. Nervine relaxants can be used daily to help prevent cortisol levels from getting so high during the day. Nervine relaxants also help us to recover faster so that we are getting better sleep and rest, lower anxiety and therefore we are less likely to enter phase 3 (exhaustion). At this stage we may also use herbs to protect adrenal function, herbs that help the cortisol that we do have circulating to last longer, meaning our body doesn’t have to upregulate as much, one of these herbs is Liquorice – you couldn’t invent a better drug! It prevents the breakdown of cortisol which means that the adrenal glands don’t have to produce as much therefore don’t get as depleted. We decide which herbs to use by your symptoms and reported levels of energy, sleep and anxiety. We also take blood pressure to get an indication of whether it is high or low. We have many different herbs to use depending on your presentation whether it be anxiety, low mood, high blood pressure, low blood pressure, low energy, insomnia, rheumatism, low blood sugar levels, high blood sugar levels, low immunity, poor digestion, irregular periods etc etc etc.
Adaptogenic herbs are herbs that help upregulate the stress response and help the body adapt to the high stress levels. These are particularly useful as we age because we use these successfully during stage 3 where exhaustion has already hit and inflammation has taken hold. Adaptogens have been shown to increase the output of the adrenal tissue and increase output of stress hormones but conversely reduce the circulating level of stress hormones at night. We use these when we are treating exhaustion but these herbs can also be used to treat the person during stress also at different doses. We may also use adaptogens and nervine relaxants at the same time if anxiety is still present. Or we may combine with herbs to treat mood or other symptoms that have flared up because of the lack of cortisol. Remember that cortisol is a potent anti-inflammatory? Well when you are in stage 3, inflammation rises and other health issues can flare. Treating the stress is treating the underlying cause of this but we also may combine with immune supportive herbs, anti-inflammatory herbs, digestive herbs or other herbs to support your whole body. Again we go by your symptoms and reported levels of energy, sleep, anxiety, depression and other symptoms. We also take blood pressure to get an indication of whether it is high or low. In stage 3 it is likely to be low.
But we also need to mentally rest, take our mind off things, change the way we think about stress and eat a healthy diet. Obviously coping mechanisms kick in – what we learned as a child.
Many interventions have been shown to reduce plasma cortisol levels:
• Exercise
• Diaphragmatic breathing
• Meditation
• Magnesium supplementation
• Omega 3 fatty acids
• Music therapy
• Massage therapy
• Laughter – the best medicine
• Black tea
• Many herbs especially Withania or Ashwaganda
• Mindfulness
• Yoga
• Probiotics
We need to unlock our core muscle tension as muscle tension tells our body we are under stress and this perpetuates the cycle. Diaphragmatic breathing – why this helps. Take people through it. Why it helps is because it immediately takes away the pressure from our core body. This is where the cortisol lives. You can almost feel it. Next time you are rushing around or stressing feel your body and try to find the tension and release it. This is a very simple self-help tool that can be and should be used every day when tension rises and you start to feel stressed. You will understand why it is there – to help keep us going and keep us focussed – but you can still focus in a relaxed way – so just try it – all you need to do is take a deep breath or two and let the tummy go. That’s it – no mind tricks no trying to talk yourself out of it – just a few deep breath and let go of the tension.
Relaxing – choose your form of relaxation and do it. Walking, exercise, shopping, TV, reading, having fun, watching movies and sleeping. Remember also that on your days off if you feel tired that is ok – it is the cortisol dropping, it will pick back up again, but you need to feel tired sometimes in order to rest. Take a break from caffeine every Sunday – the day of rest. Even in biblical times they knew about cortisol!
So this is the stress response in a nutshell. I hope this helps you to know and understand your physiology a little more. The way we treat is to take into account all disruptions in the body including stress, diet and gut health.
We also treat other symptoms you may be experiencing because of stress be it irritable bowel syndrome, sleeplessness, anxiety. These are individual so make a booking and start herbal treatment today.
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