Monday, March 16, 2009

Mastering Stress Related Disorders

Stress-related disorders has been called America’s number one health problem because it sets the stage for so many other health problems. Stress has been linked to heart disease, cancer, neurological problems, depression, sleeplessness, changes in blood sugar and body composition, and a host of other maladies.

It is interesting to note that those who have a positive outlook on life and generally feel that things just always seem to work out also generally enjoy better health phyically and emotionally. However, those who feel that life is hard and that fortunate breaks are few and far between suffer more health problems. Those who focus on bad news and tend to revolve their lives around the predictions of economists and so on are those who also tend to have the most negative outlooks and tend to suffer more health challenges.

The current statistics on stress taken from are as follows:
  • 43% of all adults suffer from stress (probably a very conservative number)
  • As much as 90% of all visits to primary care physicians are for stress-related complaints and/or disorders
  • Stress has been linked to ALL leading causes of death
  • National turbulence causes stress to escalate. Doctor visits related to stress went up 40% after 9/11, and current economic concerns have increased the stress load significantly.

Selye’s 3 Stages of Stress
There are 3 stages of the stress response, as identified by Dr. Hans Selye, who pioneered much of the work that has led to our current understanding of the body’s stress response and the disorders that can ensue under chronic stress. The three stages are:
  1. Arousal, which is characterized by a rapid release of catecholamines and a slower release of corticosteroids.
  2. Adaptation, which is characterized by a sustained increased levels of corticosteroids and alarm molecules. This stage often leads to altered glucose tolerance, blood pressure, thyroid hormone and sex hormone metabolism.
  3. Exhaustion, often characterized by degenerative diseases due to the adverse influence of chronic high levels of corticosteroids and alarm molecules.

According to Selye's theory, anything that causes stress endangers life unless it is countered by an adequate adaptive response. If the stress is severe and/or prolonged enough, the body often cannot counter sufficiently, and all manner of maladies can result.

The list of maladies caused by chronic stress is too long to list completely, but here is a partial list:

  • Fatigue
  • Loss of libido
  • Inflammatory disorders like autoimmune disease and allergies
  • Apathy
  • Chronic pain
  • Restless sleep
  • Heart attack and increased risk for CVD disease
  • Inability to cope with mild and routine stressors in everyday life
  • Agitation/irritability
  • Depression
  • Impaired memory/learning
  • Digestive disorders
  • Poor immunity
What Stress Does Metabolically

Stress pretty much disrupts everything. It increases insulin, cortisol, ephineprhine and norepinephrine, while diminishing all the sex hormones. It also increases oxidative stress and inflammatory mediators, which can set the stage for profound degenerative changes throughout the body.

The thesis for Robert Sapolsky’s excellent book, Why Zebras Don’t Get Ulcers, is that stress in its acute state is necessary and not harmful to the body. When a herd of zebras is confronted with a danger like a predator, for example, the sympathetic dominant state kicks in and stress hormones skyrocket in order to engage all the body systems in preserving life and escaping danger. But when the predator is outrun, they immediately go back to their baseline autonomic state and all is well. The basis for the human stress-related disease, however, is the high percentage of time spent in the sympathetic dominant state, and that chronic state of alarm sends molecules constantly racing throughout the body that can have extremely detrimental consequences when exposed to them long term.

For example, one study in the American Journal of Epidemiology 2003 showed that there was a clear correlation between the risk of breast cancer in women and stressful life events such as divorce/separation and the loss of a husband. Similarly, the British Medical Journal in 2002 showed that “people who reported persistent stress due to high work demands, low job security, or few career opportunities had the same level of risk for fatal heart attacks as people who smoke and do not exercise.”

Dealing with Stress
There are a number of ways to help the body to cope with stress more capably. Moderate exercise, relaxation techniques such as those correlated with prayer/meditation, biofeedback and deep breathing, and diet all play an important role. Also, practicing thankfulness and focusing on what is right in one's life has also been associated with relieving depression and generating a more positive outlook, as has getting involved in humanitarian efforts and community service. Of course, getting out from under chronically stressful situations is the best method of dealing with stress, but that is not always possible in today’s world of fast-paced job demands and dysfunctional families.

Many people simply do not have the reserves to deal with even small amounts of stress, and for them a multi-faceted approach of the above list along with therapeutic supplementation is in order. Certain micronutrients can help the body to interpret the stress differently, and certain combinations of novel botanical agents along with specific micronutrients can help support the hypothalamus/pituitary/adrenal (HPA) axis and invigorate a lack-luster stress response.

The nutritional approach to stress-related disorders will be the focus of the next couple of posts. Stay tuned.