Stress Less! by Serena Satcher, MD

Stress Less! by Serena Satcher, MD

Welcome to my Q and A on stress which is the most frequent issue I see as a root cause of illness and disease. Stress is also what drove me to learn Functional, Integrative and Holistic Medicine and to help Women to pinpoint their stressors as root causes of their health issues.

Stress is a natural part of life, but when is there too much or even not enough it can be a problem. It is like Goldilocks, it has to be just right!

Stress

  1. Overview/Basics of Condition

What separates stress from other conditions?  

When most people think of stress, they know that it can create illness and that it can make illnesses worse but it tends to be a second thought and not the first.  Many people think of stress as an emotion that they are feeling but have difficulty describing what they feel. Many emotions can be associated with stress.   They may say they feel anxious, depressed, overwhelmed, exhausted, or frustrated.  

Stress has been described as any type of strain causing a response of the mind or body and can deplete the ability to respond or tax the body’s resources.  It can be something that requires the body to respond with an action, either internal or external.    

Stress can trigger a subconscious or conscious reaction in the body that can lead to both mental health and other health and body issues.  It can be difficult and impossible to separate stress from other physical issues, other than by carefully evaluating the patient, their situation, and their labs and tests.  

We know now that most illnesses can be connected to stress.  In looking at the person as a whole human being, stress is often looked at as a part of the illnesses that a person has.

Are there different types of stress?

There are many different types of stress and stress-related disorders and diseases.  Many and most of the people that I see having health issues have had exposure to trauma.  It could be little “t” trauma or big “T” trauma.  They may fit the standard definition of Post Traumatic Stress Disorder (PTSD) or other less intense diagnoses such as anxiety and anxiety stress, or chronic stress. 

PTSD is a complex mental health diagnosis that is best made by mental health professionals but needs to be suspected when people are having behavior problems that interfere with their home life or work life.  There are many different symptoms and behaviors that go along with PTSD.  Other diagnoses that I have often seen come along with PTSD, are depression, anxiety, Attention deficit disorder, obsessive-compulsive disorder, addiction disorders, Panic disorder, and Brain Injuries.  

Something that is often overlooked by clinicians depending on their comfort level is ancestral trauma, and or race-based trauma.  The patient should be asked about that possibility and often the patient does not understand what it is or has not heard about it.  For example, most African American families have been exposed over a number of years to race-based trauma but may not understand that they are at risk.  Many survivors of the holocaust or of the atrocities committed on the Native American tribes in the US are aware of Ancestral trauma because some have received acknowledgment or compensations.  

How common is stress?  

In the past year, more than 70% of people have stated that they are overwhelmed and unable to cope. 

“Stress from COVID-19 — along with stress related to health care, the economy, racism, and the presidential election — is seriously threatening the mental health of our country, particularly our youngest generation, according to a new national survey from the American Psychological Association.

Stress in AmericaTM 2020: A National Mental Health Crisis, conducted by The Harris Poll on behalf of APA, found that nearly 8 in 10 adults (78%) say the coronavirus pandemic is a significant source of stress in their lives, while 3 in 5 (60%) say the number of issues America faces is overwhelming to them. Gen Z adults, on average, say their stress level during the prior month is 6.1, on a scale from 1 to 10 where 1 means “little to no stress” and 10 means “a great deal of stress.” This compares with a reported average stress level among all adults of 5.0” from the American Psychological University.

In what areas of life does stress occur? (Stress Eating)

Stress often affects people’s behavior, concentration, appetite, and sleep.  People who have more body awareness and established habits of exercise recognize that they are better able to handle stress when they have been exercising regularly.

Stress affects our cortisol levels.  Cortisol is a stress hormone that throws the other hormones and neurotransmitters out of balance.  Cortisol is made by the adrenal glands along with other hormones and neurotransmitters.   Cortisol is a fight or flight hormone that helps us to run away from a bear when we need to.  Cortisol helps the liver to produce blood sugar to supply muscles, and is stimulating for the brain, helps the body hold on to sodium to help with increasing the blood pressure so that our body is ready to run.  Cortisol also increases the appetite and is the driver behind stress eating.  Cortisol stimulates us to eat more carbohydrates and salty foods.  It can be difficult to get under control because people are going into fight or flight while driving in traffic or running to catch the bus.  The stimulating effects of cortisol on the brain can make sleeping or falling asleep difficult and result in stress insomnia

Symptoms

What physical symptoms are associated with stress? (mention stress eating, stress breakdown in your answer – high number of keyword searches for this term)

Stress often affects people’s behavior, concentration, appetite, and sleep.  Stress eating we mentioned before because it can result from spikes in Cortisol, increasing cravings.  High blood pressure, strokes and heart issues can result from stress.  Digestive disorders like reflux, indigestion, IBS, IBD, inflammation/colitis/gallbladder disease and pancreatic disease can be related to stress.  Skin disorders like eczema.   Most all disease can be made worse with stress. 

At what point should a doctor be consulted about stress? When stress is causing problems with a persons’ behavior, coping, eating habits, sleep, relationships, or causing a decline in work or school performance.  If the person develops physical issues or is experiencing overwhelm, anxiety, depression these are indications that help is needed.

Are there any varieties of stress that would require immediate medical attention?  If the stress is resulting in Panic disorder that is poorly uncontrolled, or blood pressure or blood sugars that are out of control, which may necessitate immediate medical attention.  Stress may cause mental health conditions to worsen and if presenting signs of suicidality or of doing harm to others then immediate help is needed.

Is there anything that might look like stress but is something else? 

Hormonal issues such as hypothyroidism, hyperthyroidism, blood sugar issues, male and female hormonal issues should be considered because these issues may contribute to anxiety, depression, and other mental health issues.  An exacerbation of mental health issues may also look like stress and may require a physical exam or lab work to differentiate

Causes 

There are some commonly mentioned causes of stress that come up in surveys and studies on stress: 

Lack of job satisfaction,

Heavy workload or too much responsibility,

Working long hours, or dangerous conditions, no chance for advancement

Having poor management and unclear expectations of your work or lack of input in decision making, race-based stress, sexual harassment, and sex-based stress and discrimination, 

Major life stressors- examples are recent family deaths, new babies, new job, new marriage, and new home or neighborhoods.

Internal Stress- worrying, anxiety, mental health issues, depression, racialized discrimination, and stress or belonging to marginalized groups.  Uncertainty, fear, attitudes, and perceptions, unrealistic expectations, any major life change.

What factors can make stress worse or exacerbate it?

Lack of good lifestyle habits will increase cortisol levels in the body and make stress from the inside or outside worse.  Lack of sleep, lack of exercise, and poor diet.  Strained relationships, history of trauma, or grief that is unresolved.  Major life stressors as we discussed.  Work stress, family stress, lack of housing or poor living conditions, chronic noise above a certain level, lack of hope, not having control over an outcome, worrying,  times like these of uncertainty with the pandemic.

There can be lasting effects on a person’s mental health and chronic stress can result in mental health diagnoses.  Stress may result in diseases of the cardiovascular system which includes heart attacks, strokes, arrhythmias, and blood pressure issues.  It can result in digestive, obesity, and eating disorders.  It can result in problems with the sexual functioning in men and women, skin and hair problems, sleep issues, and menstrual cyclical issues.

Can stress be prevented?

Stress can be lessened and we can avoid stress by adopting as much stability in our life as possible.  We can avoid stress by eating at the same time, going to bed on the circadian rhythm which is 10 pm-6 am, exercising regularly but not too strenuously, spending time in nature with our skin in contact with the ground or soil, spending time on the ocean or forest where there are more negative ions in the air.  Also consider exploring relaxation practices that benefit us like spending quality time with loved ones, trying relaxation, mediation, prayer, energetic therapies, listening to music, participating in mind-body exercises like tai chi, or creating art

Treatment 

Do the treatment options for stress differ according to the severity? 

The treatment options differ according to the root causes.  An example is a person who works on the third shift who is newly married and having problems in their marriage.  A holistic doctor will address and test hormonal functioning in the third shift worker.  That person with chronic stress and lack of sleep is likely to have blood sugar and insulin problems, problems with their sex hormones, and sexual functioning due to the off circadian or going against normal sleep rhythms for a human.  This person would likely feel a lot of anxiety and may also have blood pressure issues and complex problems with sleep.  They may be sleeping during the day during the week and while off work, sleeping at night on the weekends.  This would make the issues I mentioned even worse and difficult to deal with.  If the sex hormones are low, the person would be short-tempered and inflexible.

Are there any medications given to treat stress? (

Medications are not the first line of therapy for stress.  “Stress pills” such as benzodiazepines like valium contributed to the opiate issues that we are working to now overcome.  They were sometimes given in combination with stimulants or pain medications.  All of these medications are strongly addictive and in the long run more detrimental than helpful.  

I sometimes recommend herbal teas, certain essential oils, and supplements to help with symptoms of stress.  The person gains the most benefit by working with the Holistic practitioner to find the root causes of stress and to work to decrease those.  Often times there are nutrient deficiencies or hormonal imbalances associated with anxiety, depression, and panic attacks or symptoms.  Changing the nutrition, mindset, and lifestyle can often help people to feel better within hours.

What steps can be taken to relieve stress?

What steps should be taken to keep stress from coming back? Working with ministers, clergy, mental health professionals, and other medical and holistic practitioners can provide a multipronged stress management treatment strategy.  There are typically many root causes to address and so including many treatment options can be helpful.  Sometimes it is helped with energy work, counseling, changing nutrition, improving sleep, essential oils, group therapy, regular exercise, learning meditation, using Energy medicine, music and art, learning relaxation techniques, and family systems therapy to name a few.

References

American Psychological Association. (2020, October 20). Stress in America 2020 survey signals a growing national mental health crisis [Press release]. http://www.apa.org/news/press/releases/2020/10/stress-mental-health-crisis

Harvard Health:  – https://www.health.harvard.edu/staying-healthy/why-stress-causes-people-to-overeat

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