Stress

Episode 11

Stress is the most underappreciated cause of chronic disease.  Stress that is put on the body (physiologic stress) can be helpful in the right circumstances, but prolonged stress causes numerous unwanted effects.  Mental stress is a powerful stimulator of the body’s physical stress response and can lead to and worsen chronic disease.  Learn how both types of stress affect the body and what you can holistically do to protect yourself from the effects of chronic stress in this week’s episode of the Strive for Great Health Podcast with Dr. Richard Harris.

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Episode Transcript

Join me, Dr. Richard Harris, as we strive to unlock the secrets of the human body, strive for wellness, strive for great health. Follow the show on iTunes, Spotify, Google and Android, and Patreon.

                                                Welcome to this episode of the Strive for Great Health Podcast. And we’re getting into close to the end of our six root causes of chronic disease, well, actually seven with the bonus of genetics. But we’re talking about the second to last one, physiologic and mental stress.

                                                So what do I mean by physiologic stress? So physiologic stress is anything that our body perceives as a stressor and then causes a response in the body. So historically, if you look at most of our existence, this has been literally stuff trying to eat us or kill us in other really, really bad ways. So a lot of the stress responses in our bodies are to get us in a place where we need to run from a tiger because that, for most of human history, is what we had to be aware of.

                                                So what happens when your body hears that noise in the bushes and there’s a tiger and you start running. You get an increase in cortisol. Cortisol is the major stress hormone from the adrenal glands. And so what cortisol is designed to do is in that acute stress moment to increase our blood pressure. We need increased blood pressure to deliver more blood to the muscles because you don’t want your blood going to your gut when you need to run. You want it being delivered to your muscles so there’s nutrients there, so there’s more oxygen so that you can run.

                                                What else does cortisol do? It increases blood sugar. Well, that extra muscular movement needs more energy, so you’re going to need higher blood sugars to do that. And what does it also do? It decreases concentration, decreases focus. So when you have that cortisol spike, when there’s that acute physiological stressor, what happens is the part of your brain that deals with decision making gets toned down. Why is that?

                                                Well, if there’s a tiger in the bush and you stop and think for a minute, well, is there a tiger or is there not a tiger? And there’s a tiger. You get eaten. If you have that cortisol spike and the cortisol shuts that process off, and it just tells you to run, you don’t get eaten. So if there is a tiger, if there isn’t a tiger, it’s to our survival advantage to just run. To not think about it. To just run. And so that’s why cortisol decreases concentration, decreases your ability to make complex decisions and you’re just left with simple, easy decisions, like run or not.

                                                Cortisol levels also lead to impaired immune system. So we see this classically in medicine and people who are on steroids. Steroids are medications that work to depress the immune system and what happens with that, you get sick a lot. This is also why people who are stressed oftentimes get sick. The cortisol response causes some changes in the way the immune system works and the immune system is less able to fight off infection at that time. So that’s why you see when periods of stress that we tend to get more infections. And also during periods of stress, you get an increase in heart rate. You get more perspiration, more sweating. So you feel that physiological stress. You feel that as in getting amped up.

                                                So not only do you get an increase in cortisol, but you get an increase in adrenaline and that also works to increase the blood pressure, increase the heart rate so you have that response to run from the tiger. Now, that’s acutely what happens. Now, chronically what happens with elevated physiological stress. Now you can see how these situations, what I just talked about, would be good for an acute situation, but would be bad for a longterm situation. Under chronic stress, long-term increases in blood pressure. That’s not good. We know increased blood pressure increases your rate of cardiovascular disease, of stroke, of heart attacks, of heart disease. Increased blood sugars, diabetes, insulin resistance and all the things that we talked about insulin resistance can lead to.

                                                Increased body fat. So initially, you’ll get a surge to burn more fat and release more sugar so you can fuel the muscles. But chronic release of cortisol what it’ll tell your body is that, hey, we’re in a very stressful situation. We never know when a new stressor is going to pop up. Let’s store more body fat to prepare us for these further stressful situations. And so that’s why you’ll see an increase in central obesity, that belly fat around the belly, and that has been linked to numerous conditions. That central belly fat to diabetes, to higher blood pressure, to higher cholesterol, to Alzheimer’s, to increased rate of cancer. It’s just a very pro-inflammatory state when you have a lot of central body fat. So that’s what happens in the body with chronic stress, with chronically elevated cortisol levels.

                                                But also you get a remodeling in the brain. We just talked about that. Cortisol literally makes you dumber. That’s why I like to explain to people, it literally makes you dumber. It impairs your ability to make complex decisions while you’re just focusing on simple yes or no, run or not run, life-saving survival decisions. Well, over time, chronically with high cortisol levels, high amounts of stress, you get an increase in the responsiveness of the fear center of the brain and that’s the amygdala. And so what the amygdala does, some people like to call it the reptile brain, the primitive part of the brain. It is there and it’s designed to take in inputs from our environment and decide, is this going to kill us or is this not going to kill us? Do I need to run? Do I need to watch out for this? Do I need to prepare my defenses? That’s the amygdala. Some people will classically refer to it as the fear center.

                                                Now what happens over time with chronically elevated stress levels is that amygdala gets hyper-responsive. Well, what does that mean? It means that your amygdala gets supercharged. That it is more aware of the environment. Now, what does this lead to? That leads to a hypersensitivity, or just means that you are more sensitive to fear signals than you used to be. And it can even get to the point in chronic elevation, where you start to interpret normal signals as abnormal.

                                                And this is the underlying pathology behind a lot of disorders like PTSD, like generalized anxiety and chronic anxiety disorders, where you have that hypersensitive amygdala, which is now taking signals that should be normal, but it’s telling you, hey, this is abnormal. This is something we need to worry about. And then you get the increased blood pressure and increased blood sugar, and you get all that fear response, that stress response when you don’t need it. And so that is physiological stress. That is the literally body’s stress response in order to mount a defense against something that is attacking us and chronically you can see how that can lead to some of these health conditions and chronic disease.

                                                So mental stress. So what is mental stress? And I talk about mental stress as sort of anguish. It’s that emotional response. This is not what we see when we need to run from a tiger or there’s something in our environment that is literally trying to cause us physical harm. This is that emotional stress. This is, oh, I’m stressed out at work, or I’m worried about this or I don’t know how I’m going to get over this, or I don’t know how I’m going to solve that. Well, even though that’s stress and it seems different than the physiological stress, our body still interprets that mental stress the same way it does physical stress, that physiologic stress. So you get an increase in the cortisol. You get an increase in the adrenaline.

                                                One thing I didn’t mention, but it’s very important is that you get a decrease in serotonin and some of these other happy feel-good neurotransmitters or brain chemicals. Serotonin is the main one that you hear about. When I talk about serotonin I describe it as the happy neurotransmitter, the happy brain chemical, but we have others like endorphins as well. And so those get down-regulated and then the stress responsers will get upregulated. So you’re more likely to experience a stress response than you are to experience a hey, everything’s okay, green response. And from an evolutionary perspective, that makes sense.

                                                If you’re in an environment where there was a chronic danger, you wouldn’t want high levels of the happy hormones, the happy neurotransmitters, because then you’d just be sitting there like that meme where the house is burning down and the dog is like, everything’s fine, where everything is clearly not fine. But chronically, as we talked about, is that amygdala in the brain gets rewired and you have a chronic decrease in the happy chemicals then we can see where this can lead to problems like depression, anxiety, PTSD. And so the mental stress aspect is a big portion of what can lead to chronic disease.

                                                Now the flip side of this, and a lot of people think that all this is just hooey and this is not science and there’s no data behind this and this is too spiritual or touchy-feely for me, but this is actually medicine. This is what us holistic doctors try to do is to get people to realize that there’s more in medicine than just taking pills and that what we especially do in lifestyle medicine, what I practice is correlate every daily behaviors to health outcomes.

                                                So what do I mean by this? What am I trying to say? I’m trying to talk about the impact of positive thinking. The impact of optimism. There are multiple studies that show reductions in cardiovascular disease, heart attack, strokes, heart disease, in the mid-thirties, mid-30% reduction in cardiovascular disease from just by thinking positive. When you control all other factors, people who think positively, who are optimisms, have lower cardiovascular disease, but it’s not only that cardiovascular disease. Studies have shown that optimism, positive thinking increases longevity, you have increased productivity. People tend to make more money when they’re positive thinkers. They’re more often promoted. They have better relationships.

                                                Who do you think you want in your life? Do you want the classical Debbie Downer who’s always woe is me and never has any positivity injected in your life? Or do you want the guy who’s like, “Hey man, I got your back. Hey, things might be hard right now, but there’s beauty on the horizon. Just keep going. Things will get better.” You want that person who has that positive energy in your life. This is done a lot in practice by cognitive behavioral therapy, where you’re really working on reframing how we approach problems and how we think about things.

                                                Reframing is really, really powerful. And this is something that I talk to people about when I do health coaching is trying to take a look at the problems from a different lens. The third level of the mind is a self-transforming mind. Most of us are stuck in the second level which is a self-offering mind. The self-offering mind takes everything around you and it puts it through your own lens, where the self-transforming mind you’re able to put on the lenses of other people or other situations, and then able to look at things from multiple different angles. So reframing how you approach the problem and how you think about the problem is very, very important. This is the classical is the glass half full or half-empty?

                                                Technically it could be either, but how you look at it determines a lot about what you’re going to do next. If I think about something being half full I’m happy because that associates it with full, that feeling of fullness and that feeling of completeness. But you think about something being half empty and then it pulls in feelings of emptiness, of loneliness, of isolation. So those little differences can make a big impact, even just how you think about or even how you say the problem.

                                                So one of the books I recommend, and it’s a great book, it’s called Hardwiring Happiness. And Hardwiring Happiness talks about the classical principle. In medical school and biology, we always learn that neurons that fire together wire together. And that means that when pathways are activated in the brain, the more these pathways are activated, the stronger they get and the more they recruit like-minded pathways. So people who say, “Oh, I’m not an optimist. I can’t think like that. I’ve never been like that.” You can actually train yourself to think that way. And the first start of doing that is just thinking that way.

                                                What I’ve really tried to work on in these last month or two was gratitude. Instead of saying that, oh, I don’t want to go to work today. I wake up and I say, thank you, God, for giving me the opportunity to help people. I still have to do the same thing. I still have to go to work. But what I’m trying to do is shift how I frame going to work instead of looking at it like a burden. And it’s December. The hospital is extremely, extremely busy right now. And it will be busy well into January, February, who knows, probably even March. Usually, it slows down in the summer months. Hospital didn’t slow down at all this past year.

                                                So even though it’s December right now when I’m recording this, the business in the hospital could last for a long time. And it’s a very stressful job working in the hospital. And so instead of saying, oh, I don’t want to do this. This is not where I want to be. Today is going to kill me. I’m just literally trying to express more gratitude. And the way I’ve decided to do this, as far as related to my job is just say, thank you, Lord, for giving me the opportunity to help people today. And that subtle change has made a big difference in how I approach going to work and how my flow at work has changed.

                                                So that is hard wiring happiness. That is taking these positive thoughts, thinking about things positively and then all of a sudden when you start to run into other things, you’ll also think about them more positively. So you’ll have changed your brain into a positive thinking machine.

                                                Another thing about framing that I like to tell people is something I heard from Daniel Kahneman. There was a story that someone wrote him a question saying what is the one thing that you have to tell someone that’s the most important? If you have one thing to tell someone, what is the most important thing that you could tell them? And he wrote back in an essay, but the moral of the essay… Nothing is as important in that moment as you think it is. And this is the focusing illusion. And this goes back to that, is there a tiger in the bush? So what people in this field like to say is what’s focal is causal. So we overweight and overvalue things that are right in front of us.

                                                And this also makes sense from the evolutionary perspective, again, the tiger in the bush. That’s right in front of us. If we hear that, if we see that, if we think that there’s something in that bush that’s going to kill us, we’re going to assign a very high value to that. And that made a lot of sense when we had a lot of stuff in our environment that was very dangerous. That’s not so much the case anymore, but we still had that hardwired into us to have this focusing illusion. And once you start to realize that the things that I’m stressing about, the things that I’m putting a lot of value on aren’t really that important.

                                                What I like to tell people is, okay, walk through it sequentially. Is this going to be important in three days? Is this going to be important in three weeks? Is this going to be important in three months? Is this going to be important a year, two years, three years? The things that are really important are things that are going to be important in a couple months, in a couple years. Those are the things are important, but a lot of times we stress over decisions that aren’t even going to matter three hours later. And that is part of that focusing illusion and that is part of reframing in making sure that we deal with the problem in the correct way. Einstein said that the most important part about the problem is asking what actually is the problem. And so how can you get to the right answer if you haven’t even asked the right question?

                                                So what are some holistic treatment principles for stress, physiologic, stress and mental stress, and these go back to things that you’ve heard me talk about? The things that I put in the five pillar lifestyle system because they are important. Meditation, mindfulness. That is a very powerful stress mediation technique. I meditate every day, usually for about five minutes in the morning, after about 20 minutes of prayer, but meditation has been shown in clinical trials to increase focus, decrease, stress, improve concentration, enhance self-awareness.

                                                Self-awareness is a huge aspect. A lot of times we just go through life, and we just react without thinking about it. We just react. Now, most adults don’t even reflect on their choices anymore. They don’t look back and say, well, based upon the information I had, did I make the right choice at that time? Yes or no. What could I have done better in that situation? My mind is always going back and looking at these scenarios and saying based upon what I knew at that moment, not the outcome, I don’t look at the outcome. I look at what did I know before I made that decision and then based upon that, did I make the right decision?

                                                So meditation. Very, very important. Very important to decrease stress levels. It’s something that all throughout human history societies have meditated, have practiced meditation, knew the importance of meditation before they knew it was important. And I always tell people the two best things that you could do to improve the quality of your health starting today are meditate and fast. Two very, very, very potent and powerful lifestyle tools that have dramatic impact on health.

                                                One of the things I like to tell people when I talk about meditation is that there was a study that was done that was very, very interesting. It was on people who have pre-dementia. So these people will have something called mild cognitive impairment. A lot of these individuals convert over to Alzheimer’s, but they were looking for lifestyle interventions that may help, and they had them do a meditation practice for about a month. What was really cool was that they did functional MRIs. These are specialized MRIs that you can look at in real-time, which areas of the brains light up depending on what you’re doing.

                                                And so after a month of meditation, there was a dramatic improvement in memory games, scores on memory tests in this population. The FMRIs showed that their frontal lobes, the area of the brain that deals with executive function and decision-making, not only got bigger but more active. That’s incredible. Like we talked about neurons that fire together wire together. Well, that meditation impacted literally structure and function of the human brain. That is very, very powerful. So easiest way to jump into meditation. Headspace, Calm, Muse. There are some great apps there. I have some other techniques that I put into my five-pillar system, really just to get people in on meditation and talk to them about the right ways to meditate and the right ways to think about meditation.

                                                Another, exercise. Exercise is king. It is that most powerful keystone habit. What does exercise do related to stress? Well, it increases endorphins. Our body’s own natural happy chemicals. Not only that, but you gives you a feeling of well-being. The feeling of accomplishment is massive. Think about the last time you accomplished something that was really tough. Something that you really wanted to do and think about how great you felt. And that’s the same way I feel after exercising because I’m pushing myself. I’m forcing myself to get better, to accomplish something. And that’s how I look at it at the end of my workout. Whenever I drink my protein shake at the end of my workout, that is like my trophy, my accomplishment. That day I know that I accomplished my workout, but not only that, it gives you a feeling of being strong and secure. And that’s very powerful.

                                                That’s very important to our overall well-being is to feel like we are secure, is to feel like we’re safe and it’s to feel like that we’re strong enough to handle what goes on throughout the day and exercise, you can get physically strong doing that, of course, but it’s also a mental strength that comes with exercise. There’s a mental strength that comes with routine exercise because you’re pushing yourself, you’re making yourself better. You’re doing the hard things. The things that other people may not want to do in order to improve yourself.

                                                Sleep. Very, very important to decreasing stress. When we are sleep-deprived, we get elevations in the stress hormone and cortisol and adrenaline and those hormones that say the environment’s not quite right, we need to be on guard. So that’s what happens when you don’t get enough sleep. Our bodies interpret that signal as something’s not quite right with our environment, I need to be on the lookout. Not only that, but while we sleep, our body’s repairing and recovering and regenerating these brain chemicals, these neurotransmitters, and these other signaling molecules throughout the body. So that’s why sleep is very, very important to decreasing physiologic and mental stress.

                                                Nutrition. Obviously nutrition is always, always, always the most important thing. What you’re putting in your body can lead to physiological stress. If you’re putting a lot of processed foods in the body, if you’re eating a high carbohydrate diet, if you’re not getting the right amount of nutrients, that is a physiological stressor. The main problem with a lot of our nutrition intake these days, 60, 65% of foods in the U.S. are highly processed foods according to some studies, is that they are devoid of nutrients. Now, if the body sees not enough nutrients coming in, it thinks it’s in a starvation environment and then it will increase the stress hormones. So even though there are enough calories on board, there’s not enough nutrients on board and the body will tell you to eat and to seek out things that have nutrients.

                                                The problem is with these processed foods, the food companies have made them taste like they have the nutrients in them where they don’t. So you’ll eat them. Think you’re getting the nutrients. Then your body’s fooled and says, oh, wait, no, wait. We don’t have them. Eat more. And this leads to a vicious cycle. And that’s why we always recommend whole food nutrition plans. If you go to our Facebook groups, Strive for Great Health, there is the five pillar system, nutrition part is in there for free. This could be life-changing information for yourself, for your family, or for someone struggling with chronic disease. So please, I urge you to go to that Strive for Great Health Facebook group. Check out the free nutrition document and video posted there. It could be life-changing.

                                                Now, supplements. Of course, there’s always supplements that can help, the right supplements. And these are some of my favorite supplements to help with stress. Ashwagandha. It’s been used in Indian medicine for thousands of years. It’s what we call an adaptogenic. Ashwagandha, rhodiola, eleuthero. These are all adaptogens. And what adaptogens are, these are really cool molecules. What adaptogens do is they help balance the system. So if you’re in a stress situation where your stress hormones are too high, it brings them down. If you’re in a situation where your stress hormones have been high for so long and your body’s now depleted of the stress hormones, and you can’t release them when you need to, it helps bring them up.

                                                So these are really potent and powerful molecules. Actually, I take some ashwagandha daily because of the stress of my job. Especially when I was working nights, I started using it and it made a dramatic improvement. I knew I was adrenally fatigued or what we now call HPA axis dysfunction. That my adrenal glands had gotten to that point where they had released so much stress hormone for so long that they were burnt out. And I knew this because I gained 10 pounds of central body fat, and I was having all kinds of immune system dysregulation.

                                                And so once I stopped working nights and I started taking the ashwagandha that’s in our alpha male supplement, I started losing the central body fat. And that’s the stress reaction I was getting, it’s called dermatographia. Basically what that means is if you scratched my skin, I would break out in hives. If I even rubbed up against a wall, my entire arm would break out in hives. And that is caused by stress. It’s a stress reaction. And that went away once I removed the stressor and also got my body the support it needed.

                                                Another thing is lavender essential oils. We use them in a diffuser at night at the house to prepare our minds for relaxation. Vitamin B5 is absolutely necessary for healthy adrenal function. The other B vitamins are necessary for maintaining the brain chemicals and appropriate balance and also for energy balance. That’s the main reason a lot of people take B vitamins is to help with energy generation. Lemon balm and chamomile. These are two supplements that are regularly used for relaxation. They probably work on GABA. GABA is the major relaxation molecule in the brain. So it tells the systems hey, calm down. Everything’s good. Everything’s green. You can relax. Another system that helps with that is citicoline and the lemon balm and the chamomile probably work on one or two of these systems to help calm things down.

                                                Magnesium. Magnesium is very, very, very important. And if you can’t tell magnesium is very, very, very important. We’re going to actually talk about magnesium in the final podcast series, the root causes of chronic disease, nutrient deficiencies because magnesium deficiency affects a lot of people. Again, magnesium is very, very, very important. So magnesium does a lot as far as stress goes. It counteracts the effects of stress by increasing that GABA I talked about. You get more serotonin in the brain, more of that happy brain chemical.

                                                BDNF, which is brain-derived, neurotrophic factor. BDNF is so vitally important. BDNF is what keeps our brain neurons, our brain cells, nice and strong and working well. It’s what we call a trophic factor. It makes sure that the cells are well oiled and ready to go. That’s its job. So BDNF is very, very important for maintaining appropriate brain function and also healing the brain when it’s been damaged. Magnesium also helps moderate cortisol release from the adrenals. So it helps prevent that initial phase where you get too much cortisol, but also stress causes a loss of magnesium.

                                                So when the body is stressed, it actually causes more magnesium to be released from the bone. About 99% of the body’s magnesium is stored in the bone. So initially to help counteract that stress response, you get more magnesium released, but over time, because you have more magnesium in the blood, now you have more excretion of magnesium and you also have a higher utilization of magnesium. So magnesium gets depleted. So as you can see, magnesium is very, very important to dealing with stress, but also very important in daily life. And we’ll talk about this in nutrient deficiencies.

                                                Now, what I recommend is as a supplement we have in our e-store at store.TheGHWellness.com called daily stress. It has the ashwagandha, the rhodiola, the B vitamins, magnesium, the lemon balm, the chamomile, just to help deal with a lot of these daily stressors. It’s a great product for people who undergo a lot of physiologic stress or a lot of mental stress. If you’re having issues, medical issues related to chronic stress.

                                                And so the article that I wanted to talk about today, that we posted in our Facebook group, the Strive for Great Health group is called Working. Americans are Getting Less Sleep. Well, that’s no shocker there, but why I really want to talk about this article is it relates to the healthcare industry. A lot of my health care coworkers, unfortunately, do not prioritize their own health. And we’re sacrificing our own health to take care of others. This doesn’t make sense. The whole concept to me, doesn’t make sense because if you’re drowning, how can you help someone else that’s drowning? If your health is suffering, how can you optimally help someone else whose health is suffering? You just can’t. And so it goes back to this notion that, oh, we don’t really need sleep. Sleep when we’re dead. I’ll work hard. No, prioritize your sleep. Make sure you get enough sleep.

                                                Sleep is very, very important. That’s why the five pillar system has an entire section devoted to sleep hygiene and the best behaviors to optimize sleep. So I think this notion that we don’t need sleep, and we need to just push through it. No, we need to prioritize our sleep. And this goes back to a principle I mentioned earlier that nothing is as important as you think it is in that moment. You can put off a lot of the things that you have on your to-do list till tomorrow and nothing bad is going to happen. Once I started prioritizing sleep, I would push a lot of things on my to-do list to the next day or next week or whatever. And I’m still functioning the same. It’s been a year since I started doing that, but I feel so much better now prioritizing my sleep and making sure I get good sleep.

                                                So this is to all the healthcare professionals out there. Sleep disorders or not getting enough sleep is linked to a host of chronic diseases, obesity, cancer, diabetes, adrenal fatigue, or HPA axis dysfunction, Alzheimer’s. So please start prioritizing your sleep. Please start prioritizing yourselves. To be the best healthcare providers that we can be. To be what the American people deserve in their healthcare we need to make sure that we’re running at a hundred percent.

                                                So thank you for listening to this podcast. I hope it was enjoyable. I hope it was informative. Hope you got something out of it that you can start using in your life today. We’ll finish up the six root causes with nutrient deficiencies. And if you like the podcast, make sure you like, subscribe, rate, comment and share. All right, thank you. God bless.                 The journey towards great health continues. Thank you for listening to the Strive for Great Health Podcast by Dr. Richard Harris. Please subscribe and give feedback by leaving a positive rating and review on your preferred podcast listening platform. Follow the show on iTunes, Spotify, Google and Android and Patreon.

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