Until recently, managing stress has been something explored mostly in the realm of mysticism and psychotherapy. It was understood as an unfortunate state brought on by the pressures of life and accepted as something we have to live with. But no more.
At medical school stress came up as a contributory cause of almost every chronic disease, but how it did that or how to teach our patients to manage it was never in the curriculum. We certainly touched on its importance during our psychiatry rotations, where almost every psychiatric illness was preceded by stress on some level, but again we were too busy learning about the drugs used to treat the psychiatric disease to care about to how to manage the stress. This was ironic too, since every medical student can tell you that studying medicine is itself one of the most stressful things a person can endure. With a little stress management practice, we would have been better students, doctors and people.
When practicing as a new GP, people often would began their consultation with “I’m so stressed right now doctor”, followed by a list of symptoms that finally brought them to me. People didn’t come for stress but waited for the stress to cause dis-ease. Other than prescribe anti-depressants, or sedatives, refer them to therapy or offer my own limited advice, I had little left in my doctor’s toolbox to help. In those years I wished I had studied psychology.
Instead I studied integrative medicine. One of the first things we learnt was to manage our own stress, and then help our patients manage theirs…
In prehistoric times, the stress response was intended to help us survive natural threats. Being faced with an attacking animal for example, would trigger a response in the brain to mobilise all our energies into the ‘flight or flight’ response. It would send a rush of hormones helping our muscles fire, our senses to be on high alert, our blood pressure to rise making sure we survive the encounter. The problem with an evolved, thinking brain is we’ve traded the attacking animals with daily delusions of perceived survival threats. Most of our stress is no longer worthy of a fight or flight response and yet, when triggered, we cannot escape or fight it, and so our bodies deteriorate in a way reminiscent of an animal being chased by a pack of predators, day and night… We break down.
Being chronically stressed means the body has little energy left to deal with daily activities like digestion, libido, immunity and metabolism. So it isn’t surprising that symptoms of chronic stress include constipation, weight gain, depression, recurrent infections, infertility or erectile dysfunction. Diseases like angina, diabetes, thyroid disease and cancer – almost all chronic diseases, have been proven to be caused by stress.
In this age where anti-aging and preventative medicine is commonplace, how do we go about containing this universal problem? Here are some practices I recommend to my clients.
1. Change your perception. During periods of high stress, actively remind yourself that it’s not actually a threat to your survival and so not worthy of a flight or flight response. Realise that you can only do so much until the outcome is no longer in your hands. Most of the things we stress about never actually happen, leading us to the next point…
2. Live in the moment. Hundreds of bestsellers, blogs, tweets and millions of articles say so too. Finding what works for you simply requires a desire to learn. I love the idea of mindfulness, that teaches you to live in a meditative state, always keeping your mind on the task at hand. Stilling a wandering mind is scientifically proven to reduce the physiological stress response. Among others, the Mindfulness Based Stress Reduction course is an effective way of learning this priceless practice.
3. Breathe. Slow deep breaths that expand the rib cage, restricts the fight or flight signal passing from the brain through the spinal cord. That’s why breathing into a brown paper bag helps stop a panic attack. Healing exercise practices like yoga and tai chi all teach breathing and most meditative practices require specific breathing to reach relaxation.
4. Exercise. Moving your body releases endorphins, which immediately reduces stress. Certain exercises can be better than others. Competitive sports and things like pumping iron increase testosterone, which can contribute further to an already stressed mind and body, where relaxing movements like tai chi, yoga and pilates promote stress release.
5. Seek help. Psychotherapy plays a huge role with managing stress more efficiently. Be wary of using therapy as a crutch though. Its purpose should be to empower you with the tools to cope on your own.
6. Journal. Allowing yourself a set time in the day to deal with the stressors in your life is fundamental to letting it go for the rest of the day. I recommend setting aside a few minutes in the day to stress. This could mean writimg all your feelings and thoughts in a journal and then brainstorming solutions to the problems. Once the time slot is over, no more worrying is allowed till the next stress session. This allocates efficient energy spend to the problem.
7. Sleep for 7 – 8 hours a night. Sleeping is one of the most de-stressing activities you can do. Insomnia is of course one of the top symptoms of stress, but managing the anxious feelings associated with stress goes a long way to restoring a normal sleep pattern.
8. Maintain a healthy intake of good nutrition and limit the toxins. Nutrients are needed for all the natural anti-stress pathways to work effectively. Supplement where your diet may be lacking.
9. Use the correct nutriceuticals, homeopathics or herbal medicines to assist the process. A stress assessment can determine your specific stress response. You may have an overactive response, or an underactive/ burntout response, or perhaps an inflammatory response. Most people have a combination. Depending on the results, you can tailor your remedial help or use alternative medicine to treat accompanying anxiety, depression or other psychiatric manifestations of extreme stress.
10. Spiritual practice. A connection with a higher consciousness has many benefits. Many people become more involved in their spiritual practice when under stress. Prayer is a wonderful form of meditation and often even the social support one finds in spiritual or religious groups can be enough.
This list excludes pharmaceutical interventions, rarely do I have to prescribe chemical drugs. In general I prefer to practice in the words of Hippocrates ‘to help, or at least do no harm’. In my learning, suppressing a process does more damage in the end and pharmaceutical drugs tend to stop the symptoms and not the cause so I prefer to use alternatives wherever possible.
Stress management steps
1. Change your perception
2. Be mindful and live in the moment
3. Breathe deeply
4. Move your body
5. Seek help
6. Journal your sources of stress
7. Sleep for 7 – 8 hours a night
8. Follow a healthy diet and limit the toxins
9. Look at natural supplements
10. Cultivate a spiritual practice