Understanding and Managing Stress - by Emmett Miller MD

These days all of us are aware that most of our illnesses and our suffering is the result of the choices we make – how we, as individuals, eat, sleep, exercise, and live our lives. We now need to be aware of the two kinds of stress, and the two realms in which stress expresses itself – the inner and the outer.

What is Stress?
Stress is, most simply, “the nonspecific response to a perceived demand.” The way to evaluate the presence and degree of stress is by observing its symptoms. According to the Mayo Clinic, these symptoms include (but are not limited to):
Physical Symptoms

Headacher
Back painr
Chest painr
Heart diseaser
Heart palpitationsr
High blood pressurer
Decreased immunityr
Stomach upsetr
Sleep problemsr
Irritable Bowel Sxr
Gastritis/GERD
Mental/Emotional

Symptoms
Anxiety
Restlessnessr
Worry/Obsessiveness
Irritability
Depressionr
Prolonged Sadness
Anger
Insecurityr
Lack of Focusr
Burnout/Fatiguer
Forgetfulness
Behavioral Symptoms

Overeatingr
Lack of Appetiter
Angry Outburstsr
Drug/Alcohol Abuser
Increased Smokingr
Social Withdrawalr
Crying Spellsr
Relationship Conflictsr
Poor Work Habitsr
Compulsive Disorders

Type I Stress

There are two types of demands we encounter in life; our bodies and our nervous systems are geared to “type I stress.”

When your nervous system believes it is faced with a demand – be it physical, emotional, or social – it produces the alarm response.

Your nervous and endocrine system pump special chemicals into the bloodstream – Adrenaline and Cortisol, for instance – so you will be prepared to fight or run. They temporarily alter your glucose metabolism, blood pressure, insulin level, immune function and inflammatory response – temporarily, until the most appropriate (specific) response is identified, at which time the alarm phase ends. At this point all the nonspecific symptoms disappear and the body deals directly with the stressor.

In the wilds, where we evolved, our challenges were usually brief in duration, the source of the threat or demand was clear, and there was a well-defined physical response. Following this brief encounter the chemicals of stress are quickly cleared from the system and the system goes into the recovery phase (relaxation).

But most of our stressors today are not Type I stressors. Instead, they are vague, impalpable, continuous, and they cannot be countered by such natural physical responses as tensing your neck, raising your blood pressure, or sending your gut into a knot.

As a result, the body continues in the alarm state, consuming a great deal of energy, and producing very uncomfortable symptoms and dysfunction. And most importantly, there are no recovery periods, no relaxation.

Type II Stressr
This is the state of stress, a state that produces an ongoing state of imbalance, with oversecretion of stress hormones, damage to the cells of the body (including brain cells), and glandular exhaustion, while diverting energy from useful application, and reassigning it to useless tension, anxiety, and unrest (see “behaviors” in the chart above).

The flow of stress chemicals is now continuous. This does not help resolve the non-physical demands we face, and the chronic presence of stress chemicals produces:

impaired cognitive performancer
Suppressed thyroid functionr
Blood sugar imbalancesr
Decreased bone density and distorted immune and inflammatory responses

This gives rise to all the symptoms above, and in addition, slow wound healing, allergies, increased abdominal fat, heart disease, allergies, anxiety, depression, and innumerable other conditions that have now been shown by published studies to follow chronic stress.

Most of us now recognize that each of us must learn to be responsible for his or her own health and wellness. That means we who are physicians have as one of our primary jobs to encourage our patients to change their behaviors so as to prevent illness and to reverse it when it occurs – through making wise choices. And physician or not, it is equally as wise to make the same changes in our own lives.