What is stress?

One of the major modifiable lifestyle factors that I love addressing with clients is stress. I find that addressing this early on in our work together makes changing other things easier.

Having listening to thousands of patients throughout the years, it's amazing how central the concept of stress is in the development and perpetuation of disease. This happened to me too! Unmanaged stress led to my insulin resistance and hormonal imbalance (more on that later).

Let me make one thing clear- we all have stress and stress will always be present in our lives.

However, we are in control with how we react to and managing stress.

Click here to grab your copy of my free stress busting guide to help learn ways to react to and manage stress. 

Okay! Ready to learn more about stress? Let's dive in! 

What is stress? 

Stress is a complex concept. There have been multiple definitions and the concept also varies among different disciplines. Generally speaking, stress is both psychological and physiological. It is a state that arises from how a person relates to a situation, how they perceive or appraise and react to an experience that in turn creates a physiologic response.

For example, you're at work and are about to have a challenging conversation with your boss. Preparing yourself for what you are going to say, you notice your heart rate goes up, you feel a bit sweaty, your tummy starts to gurgle. Your mind has deemed this a stressful situation and your body has reacted by activating your sympathetic nervous system (read on to learn more).

Stress can also be just a physiological response. You are feeling good and decide to go all out on a run. Your body identifies this as a physical stressor and temporarily increases cortisol levels to eventually get more food for your cells so they can continue to make energy. You aren't feeling stressed. Your mind doesn't think you're stressed, but your body identifies this run as a stressor.

Stress can be both a good thing and a bad thing - it is necessary for optimal functioning but when we push past our allostatic load (think stress bank account) - we reach a point of burnout. 

What is Allostatic Load?

The allostatic load is the individualized cumulative amounts of stressors that exist in our lives and that influence our physiologic responses.

Allostatic load includes our:

• genetic makeup
• our lifestyle
• daily events
• dramatic events

Overtime this load creates a wear and tear on our bodies. It is imperative to recognize that stress interactions are nonlinear and are complex. Allostasis is considered an adaptive physiologic response to stressful events. There are a number of variables at play and your behavioral responses (sleep, physical activity, substance use, social interactions, nutrition) significantly impact your allostatic load. We will talk about these behaviors and how they affect your stress levels in upcoming posts, so make sure to follow along! The big key to note here is that chronic or dysregulated allostasis can lead to disease. 

The stress response - HPA axis

One of the primary stress pathways is called the Hypothalamic-Pituitary-Adrenal axis. Say that three times fast! 

Otherwise known as the HPA axis, this is an intricate system of communication between your brain and your endocrine (hormone) system. The HPA axis is made of 3 key parts. 

1. The Hypothalamus - located in your brain, the hypothalamus acts as a control center to keep your brain in homeostasis (balance). It regulates certain metabolic processes and activities of the autonomic nervous system (discussed below). It links the nervous system to the endocrine system via the pituitary gland. The hypothalamus releases corticotropin-releasing hormone (CRH) in order to talk to the pituitary gland. 
2. The Pituitary Gland - located at the base of the brain, is also known as the master gland. It has two main parts, anterior and posterior. The anterior pituitary is our primary focus as it receives the signal from the hypothalamus via CRH and in turn releases adrenocorticotropic hormone (ACTH). This hormone travels to the adrenals.
3. The Adrenal Glands sit on top of the kidneys and are stimulated by ACTH to release cortisol. Cortisol is known as your major stress hormone. I'll talk more about this hormone next week. 

The stress response- ANS response

The autonomic nervous system (ANS) also plays a role in stress. The ANS has two primary divisions, the sympathetic nervous system and the parasympathetic nervous system. The sympathetic nervous system (SNS) is often described as our fight/flight/freeze mode, while the parasympathetic (PSNS) side is our rest/digest mode.

Perceived stressors will elicit an anticipatory response that generally begins in the limbic system of the brain. The limbic system is responsible for emotions and cognition. It will indirectly elicit both an endocrine stress response (HPA axis) and an autonomic nervous system (ANS) response which will cause the release of norepinephrine. Norepinephrine is a neurotransmitter that promotes increased vigilance, increased anxiety and other protective emotional responses.

Norepinephrine leads to activation of the SNS. This leads to:

•  increased heart rate
• more rapid and shallow breathing
• dilated pupils
• slowing down of digestion
• activation of energy stores in your liver so that your muscles have enough energy.

All of this prepares us to fight or run away. 

Our parasympathetic system on the other hand balances the sympathetic nervous system. It opposes the catecholamine responses through the release of acetylcholine. This neurotransmitter helps to contract smooth muscles, dilate blood vessels, slow heart rate, and increase bodily secretions. This allows for focused thinking, relaxed state of being, digestion and for functions of elimination (urination and defecation .... can I say pooping? Well, I did any way!).

When we face chronic stress, our parasympathetic nervous system is often downregulated (underactive) and we get stuck in fight/flight/freeze mode. This can lead to a number of changes in your body including chronic inflammation and ultimately diseases associated with this- hypertension, type 2 diabetes, atherosclerosis, joint and muscle pain, fibromyalgia, autoimmune disorders, IBS and other functional gastrointestinal issues.  

Identifying sources of stress in daily life

Let's be real - stress is all around us and we can feel stressed from anything. Everyone experiences stress differently due to our individual and unique allostatic loads. 

When I work with clients, we often will work together to categorize their stressors into three groups:

1) Routine stress - work, school, kids, partners, responsibilities at home

2) Disruptive change- new job, new home, moving, marriage, illness

3) Traumatic experiences- abuse, loss, accidents

Once you've identified stressors and put them into categories, you can take a look at areas that you can actually work on to change. For example, if you have experienced traumatic stress, are you working with a counselor or do you have a support system in place? If you've got some ongoing routine stress- what are some ways you can work with it? Delegating house tasks? Doing meal prep on the weekend? Adding in a 5 minute walk around the block when you get home to help you leave work at work? 

 Techniques for managing and reducing stress levels

Over the next few weeks, we are going to take a deeper look at different ways of reducing stress through modifiable lifestyle factors. What I love about addressing lifestyle is knowing that you generally have ultimate control over these, which means you can take action. You are not at the mercy of your body or others for how you feel. You get to choose and are there for ultimately responsible for how good (or crummy) you feel.

For the majority of us, we can use the modifiable lifestyle factors to face our stress head on and mitigate anxiety, depression, joint pain, muscle tension, fatigue, headaches, weight issues, insulin resistance and a whole laundry list of chronic diseases. 

Here's a sneak preview of what we are going to look at over the next few weeks:

Nutrition and stress

Sleep and stress

Exercises and stress

Mindfulness and stress 

Self-care techniques to lower stress

With all of these, we are also going to be talking about their relationship to cortisol (one of our primary stress hormones). I'm so excited to share with you some of these things that you can take control of to help you health and wellness! 

 See You Next Week! 

As always, I'd love to hear from you! If you have any questions or comments, please don't hesitate to reach out to me here. 

You can also follow along on instagram @lolamacleanDNP