Fight the Battle Against Stress
LIFESTYLE
Erin Stubblefield
DC
We go to battle every day against stress. Something happens — maybe a car accident or a looming work deadline — and it starts. The flushing of skin and a racing heart rate. Maybe some indigestion that we blame on “poor diet.” But then it progresses. Now we haven’t slept well in three days. We start becoming irritable with those around us. We might raise our voice to the CA who scheduled a last-minute new patient (that we need!). We take it one step further and unload all our frustrations on our unsuspecting spouse or partner. Which causes an argument. Which causes more stress. And the cycle continues.
But once that “something” is no longer present, no more stress, right?
Our patients may not fully understand that stress occurs in a cycle. It is a multiphasic process that causes both chemical and physical changes within the body. The unfortunate reality is that even though the original stressful “event” is over, the body is still dealing with the effects of the event. The other reality is that another stressful event is going to happen, and the effects are cumulative.
Let’s talk about the stages of the stress response,1 what happens in the body, how it can manifest physically, and how chiropractic may help the effects!
1. Stage one - the external stressor. The cycle begins with this stressor. Sometimes the stressor is unpredictable, like the example of a car accident. In the case of work, the stressor is a slow build with workload and deadlines.
2. Stage two - the internal assessment of the stressor. When our senses (sight, smell, touch, etc.) detect a stressor or anything perceived as a threat, they communicate with the amygdala.
The amygdala is the part of the brain responsible for processing emotions, particularly strong emotions such as fear. When the amygdala is alert, it communicates with the hypothalamus and the pituitary gland to figure out how to deal with the stressor.
3. Stage three - the physiological response. Once the hypothalamus and pituitary gland receive signals, they alert the part of the nervous system responsible for dealing with a crisis — the autonomic nervous system, specifically the sympathetic (or “fight or flight”) nervous system. This alert is accomplished by the brain sending signals to different organs but primarily the adrenal glands. Once stimulated, the adrenal glands release the hormones adrenaline and cortisol (sometimes called the “stress” hormone). These hormones have profound effects on other body systems. They cause the heart to divert blood from the torso and into the arms and legs (to “fight or flee”). It also forces more blood to larger muscles and away from other body parts like the stomach or digestive system. This keeps the brain in a state of hyperarousal, which makes the brain more aware of the body and its surroundings. Simultaneously, these hormones turn off the rational part of your brain known as the prefrontal cortex, which we will discuss the importance of shortly.
It’s important for patients to know that much of stages one through three are out of their control. We really can’t control the unpredictable external stressor or how the body kickstarts the stress cycle, but as we talk about stage four and beyond, we are able to be more aware of the effects and how to manage them.
4. Stage four - internalization. During this stage, we become aware of bodily changes. The time it takes to get from stage one to stage four may only be a few seconds, but once stage four is reached, we start to feel the physical effects of the stressor. Does this feel familiar? Heart racing, stomach cramping, back pain? When this happens to our patients, they may be thinking, “Calm down!” or “What is going on?” Unfortunately, prolonged mental thoughts like that are what ultimately lead to stage five.
5. Stage five - maladaptive coping. Once we notice that we are in physical or emotional distress, most of us will do something to reduce or alleviate those feelings. It is what you choose to do in this moment that dictates if the stress response lessens or worsens. Maladaptive coping simply means that our patients choose a coping mechanism that isn’t healthy or helpful for reducing the internal stress response. This can include outside substances such as caffeine, tobacco, alcohol, or even prescribed medications (perhaps not being used as intended). Coping mechanisms can also be a physical act. Patients may choose to deal with work stress by burying themselves in more work to “take their mind off’ of the stress. The irony in this stage is that many things we choose to do to relieve stress do not help; it perpetuates the stress response by repeating stage four, and in turn, stage three.
The stress response cycle is akin to starting a car and flooring the gas pedal while the car is in park. If done for long enough, the car’s engine is going to break down. In a prolonged stress cycle, the effects of cortisol become more evident:
• Fatigue
• Irritability
• Headaches, neck, and back pain
• Digestive issues like cramping, bloating, constipation, or diarrhea
• Anxiety or depression
• Weight gain
• Increased heart rate and blood pressure
• Low sexual desire or erectile dysfunction
• Irregular menstrual cycles
• Difficulty in recovery (post-exercise, for example)
• Poor sleep
• Increased likelihood of other illness like colds and flu due to depressed immune system2
The message? Perpetual stress through inappropriate coping mechanisms keeps the body in a hyperaroused state, which means the body will subconsciously perceive more potential stressors and put a greater sense of urgency or danger on the nervous system. This becomes systemic and eventually affects every body system — not to mention many coping mechanisms involve unhealthy eating, sleeping, and social habits — and manifests as physical symptoms and pain. This also means the logical part of the brain is forced to take a back seat, which reduces the ability to think rationally and make better decisions.
Supporting the body is essential in helping our patients better cope with the stress response. In a U.S. National Health Survey of adults who utilize chiropractic care, 40% of patients reported feeling calm and more at ease following adjustments; 42% reported better sleep; and 67% reported feeling better about their health overall.3 Can this be a step in helping our patients deal with the effects of stress and perhaps help them end the cycle?
In addition to the chiropractic adjustment, consider supporting your patient with custom flexible orthotics that support all three arches of the foot. Custom three arch orthotics alone have been shown to reduce back pain more than 34%. Additionally, they’ve been shown to increase function — activities of daily living such as sitting, standing, walking, and social and personal activities — by over 30%!4
This combination is a one-two, knock-out punch to stop stress in its tracks.
Dr. Erin Stubblefield is a 2006 graduate of Palmer College of Chiropractic in Davenport, IA. After years of private practice in Illinois, she moved to full-time teaching in Overland Park, KS, a suburb of Kansas City. Dr. Stubblefield is an Associate Professor, author, and presenter. For additional information, she can be reached at Stubblefield.erinl [email protected].
References
1. “The Holmes-Rahe Stress Inventory, ” the American Institute of Stress, https: //www. stress.orgholme s-rahe-stress-inventory
2. (https://www.premierhealth.com/your-health/articles/women-wisdom-welhiessbeware-high-levels-of-cortisol-the-stresshormone)
3. Adams J, Peng W, Cramer H, Sundberg T, Moore C, Amorin-Woods L, Sibbritt D, Louche R. The Prevalence, Patterns, and Predictors of Chiropractic Use Among US Adults: Results From the 2012 National Health Interview Survey. Spine (Phila Pa 1976). 2017 Dec 1;42(23): 1810-1816. doi: 10.1097/ BRS.0000000000002218. PM1D: 28459779.
4. Cambron JA, Dexheimer JM, Duarte M, Freels S. Shoe Orthotics for the Treatment of Chronic Low Back Pain: A Randomized Controlled Trial. Arch Phys Med Rehab 2017 Sep. 98(9):1752-1762. doi: 10.1016f.apmr2017.03.028. E.pub 2017 Apr 30. PMID: 28465224.
