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What is Stress?

by Samuel Snyder, D. O.

E

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Dr. Samuel Snyder is Associate Professor and Chair of Internal Medicine at Nova Southeastern University College of Osteopathic Medicine. He is a Fellow of the American College of Physicians, the American Society of Nephrology, and the American College of Osteopathic Internists. He is board certified in both Internal Medicine and Nephrology. He writes scientific and popular articles and lectures widely on a wide range of medical subjects.
ons ago, before industry, before agriculture, when our ancestors lived as hunter gatherers, their systems were designed to deal with the kinds of stress they faced then, as predators or as potential prey. Much of the time, hunter gatherers lived in a kind of calm. This was punctuated occasionally by the chase. Either as hunters, rushes of cortisol and andrenalin (epinephrine) stimulated a surge of strength and energy, to bring them success; or as prey, the same hormones surged to give them speed to flee. Then, after the rush, relaxation, and these hormones subsided to their base levels. This pattern is an adaptation to periodic stress which was handed down to us.
The problem is that modern life is different. We have abandoned the behaviors of our hunter gatherer forebears. Modern life is filled with stress all the time. The phrase 24/7 had no meaning until the past few years. But it perfectly characterizes the way stress shapes our daily experience now. This is having effects on our physiology. The stress hormones are now secreted with a regularity and intensity that nature did not really intend. The base levels of these hormones are also higher than nature intended, as they have been “upregulated” because of overstimulation.
What are the consequences of always being in “fight or flight” mode, of being perpetually in a state of stimulation, seldom in one of relaxation?
When the “fight or flight” mode is appropriately stimulated—when a lion is chasing us—these hormones have numerous effects. Blood pressure goes up, heart rate goes up, respiratory rate goes up. Pupils dilate, sweat glands secrete. Blood flow to muscles goes up, and the flow to organs goes down. These hormones have cascading effects on other hormones as well, such as glucagon and insulin.
But when this stimulation continues for a long time, after the threat of the lion is gone—or if the “lions” of modern life never go away, and stress continues on and on—the effects of these hormones do not abate. The long term effects include changes in the resting tone of blood vessels, persistent elevation of blood pressure, increased work of the heart. In addition, levels of blood sugar may stay elevated, and the stressed cells cease to respond to insulin correctly.
The results can include any or all of the following: chronic or recurrent anxiety, hypertension (high blood pressure) and the increased risk of heart disease it brings, problems with insulin metabolism including obesity, diabetes and the metabolic syndrome. Serious medical problems, indeed.
How can we best deal with this situation? We can’t simply reshape modern life. Instead, we have to learn to deal with stress, to reduce it—to bring our physiology back to that of our hunter gatherer ancestors, so that our bodies can deal with single episodes of “fight or flight” rather than nonstop streams of stress.
This is medicine, but the answer is not medication. The answer is prevention. Physicians, patients, and the public at large have to be aware of the need to reduce stress, and that there are ways to reduce stress. Most of us can’t really change our jobs. But maybe we can get some leverage to reduce our job hours. Americans are notorious for not taking earned vacation time. Maybe we would be better off if we did take this vacation time after all.

There are numerous techniques that people can learn or practice in order to reduce stress. What does “reduce stress” mean? It means “relax”. Hobbies are an ancient and simple form of relaxation. Model building, gardening, collecting are examples. Relaxation can go hand in hand with exercising creativity; art, sculpture, painting, poetry can all be sources of stress reduction.

Exercise is an important component of this effort. Exercise is a physiologic way that we stimulate the stress hormones. Performing regular exercise is a way that we can re-regulate our bodies secretion of the stress hormones, and re-teaching our bodies to down regulate the hormones when the stress level is reduced.

Meditation is one of the best ways to reduce stress. The physiology of meditation has been studied scientifically. It is clear that
the “fight or flight” hormones of prolonged stress reactions can be returned to physiologic levels with meditation. Blood pressure and heart rate can be reduced. In addition, the psychological effects of stress are markedly reduced by meditation. There are many ways to learn meditation: through tapes and CD’s, through classes at local community centers, from teachers. As a form of disease prevention, this is probably one of the most important public health measures that a person can incorporate into their own lifestyle.
Don't Stress!