STRESS! The Good, the Bad, and the Coping
Stress is something that we all feel, at some point. Some of us experience stress in temporary spurts, whereas others experience constant stress.
I often discuss stress with my patients during clinic visits and ask each individual what significant life stressors they have. The question is first frequently met with a look of confusion, as in, “Why would my doctor care to know?” Then, when they see that I actually do care to know, I am met with a look of relief, followed by a deep breath, and then the sharing of internalized stressors that each person carries.
So what are the health impacts of stress? Why do I ask? Read below to learn about the different health impacts of acute versus chronic stressors. Last, you will find some of my recommendations for healthy coping strategies for chronic stressors.
Acute Stress
These short-term or short-lived stressors actually can be quite beneficial. Feeling pressure that may result from an impending deadline, or having to present to a group, or perform in an event, frequently results in individuals focusing on the task and preparing for the defined outcome.
Physiologically, stress causes cortisol levels (one of the stress hormones) to increase. Same with adrenaline. All of these are secreted from the adrenal glands to ensure there is enough energy, in the form of glucose, available for the cells throughout the body (especially the brain cells) to step up to the task. This helps enhance productivity and motivates completion of the task at hand.
The key to these acute stressors, as mentioned above, is that there is a defined outcome and therefore anticipated end to the stressor. Since once the task is complete the stressor goes away, the stress hormones secreted from the adrenal glands will go back to baseline levels. This is followed by the reduction in the sense of hyper-awareness or hyper-alertness and feelings of completion and even relief after the task.
Acute stress is also beneficial when it comes to certain types of exercise. Yes! Some exercises, namely, resistance training exercises, will increase cortisol and adrenaline and this is a good thing. One of the most frustrating things that I have recently seen circulated on the internet is that certain people with certain medical conditions should not engage in weight training/resistance training because it raises cortisol. This is not true - resistance training is something everyone should engage in, regardless of whichever medical condition they have (modifications are always important depending on physical limitations one may have). The reason it is important for cortisol levels to go up during resistance training is because the muscles need glucose (the preferred energy source of cells) to pull or push against a load. And because that energy is needed immediately, cortisol gets secreted, which then signals to the liver to release its stores of glucose. These released stores enter the bloodstream and then the muscles use it immediately to complete the task at hand. And then you know what happens to cortisol levels once the weight training session is over? They go back down. This acute stress generated during resistance training is important for maintaining and building skeletal muscle mass. Therefore, there is no reason to avoid resistance training for the temporary cortisol increasing effects it has, since there are a vast amount of health benefits that result from maintaining and building skeletal muscle.
Chronic stress
Stress can be counterproductive when it does not simmer down and instead, persists and seems to exist within an individual. This persistent, non-stop stress has many harmful effects on health.
Recall that cortisol is a main stress hormone and one of the things it does is signal to the liver to release glucose into the bloodstream. Now imagine that this signal does not stop. Instead, it is constantly telling the liver to release, and release, and release glucose into the blood. This leads to higher blood sugars. Chronic stress and cortisol release can also promote insulin resistance which increases the risk of type 2 diabetes, metabolic dysfunction associated liver disease and increased accumulation of visceral adipose tissue. The unending alarm signals given to cells to work overtime leads to cell fatigue. In fact, at a cellular level, chronic cell stress can lead to cell apoptosis, aka, cell death. Other negative impacts of chronic stress is the stiffening of blood vessels and retention of sodium, both leading to increases in blood pressure.
Other negative impacts of chronic stress:
Sleep
Under chronic stress, some individuals will sacrifice sleep, or worse, will be unable to fall asleep or get interrupted sleep. This results in higher levels of cortisol while individuals try to sleep and leads to higher fasting blood sugars.
Nutrition
When stressed, nutrition behaviors can also unravel. Maladaptive coping behaviors to stress lead some individuals to turn to ultra processed foods for comfort. Under chronic stress and frequently choosing foods low in fiber, high in added sugars, fats, and salts can lead to long-term detrimental health impacts, ironically causing increased stress on the body in diseased states.
Exercise
Chronic stress may have individuals feeling pressed for time and in addition to sleep, time being carved out for intentional movement and exercise is often sacrificed.
Mental Health
Aside from the indirect ill-effects stress causes when an individual sleeps less, eats poorly, and does not exercise, the direct impact that stress has on mental health is significant. Chronic stress increases depression and anxiety.
Coping with Stress
Taking the time to think about if you have chronic stress and what is causing it is an important first step to also taking the steps to minimize the negative health effects it could be causing. Here are four tips for dealing with chronic stress I encourage you to try out:
Set Boundaries
This means being comfortable with saying no. No to professional over-reaches, to family overcommitments, etc. It is perfectly alright to say “Thank you for considering me for this additional project. With my present commitments I will have to decline the opportunity this time so that I may continue to give the amount of attention and focus necessary for the successful completion of the other projects I am presently working on”. And while this is not easy, it is absolutely necessary. Set your boundaries and stick to them.
Exercise
This has a two-for effect. Moving one’s body is a very effective way of dissipating internalized stress. Increased blood flow delivers more oxygen to all the tissues and helps create a sense of relaxation after movement. Second, it also can help deal with any of the adverse mental-health effects chronic stress causes. In fact, a recent study demonstrated how resistance training, twice a week, had a similar effect on improving depressive symptoms as some antidepressant medications!
Stick to a sleep schedule
Choose a bedtime and wake time and stick to it. Sleep is so incredibly important and not something that we should flippantly reduce when we are feeling stressed. In fact, getting 7-9 hours of sleep helps restore and improve energy levels for the following day and can even help resolve pending questions from the day(s) before.
Find and seek out your crew
Constant internalization of stressors, as you now know, has many adverse health effects. Having an individual (like a family member, close friend, or therapist) or a crew of people you trust can be a very therapeutic and effective way of coping with chronic stress. Reach out to your trusted crew and plan a visit or an outing as a means of coping with chronic stress.
Meditate
There are different ways to meditate, whether it is through guided meditation or my favorite, transcendental meditation. This allows an opportunity to be still and allow the mind to settle, allowing space for the release of internalized stressors.
In summary, while acute stressors can inspire focus and productivity, it is important to be attune to the detrimental effects that chronic stress imposes on health. Identifying chronic stressors and learning healthy coping behaviors undoubtedly results in improved overall health.