Stress: A little is good but too much can be toxic

MARQUETTE – In the short term, stress can be a good thing. It can drive us to move, to respond and adapt, to change and grow as people. But when stress becomes a chronic condition, something that we carry with us, it becomes not only an unpleasant sensation, but can have serious consequences to our physical, social and psychological health.

“Without some challenge, we would sort of rot,” said Dr. Hannah Steinitz, a health psychologist at Marquette General Hospital, whose work involves helping medical patients meet their psychological needs. “We have to be doing some reaching and stretching in order to do any growing or even just staying in shape of any kind. I don’t just mean physical exercise shape, I mean mental shape, physiological readiness – we need to have stimuli that we respond to. So the issue isn’t stress or not stress, it’s optimal stress versus not optimal stress.

In human evolutionary history, stress was an adaptation against danger – what’s known as the “fight or flight response,” Steinitz said. Our bodies are meant to have that “fight or flight” stress response and then quickly recover.

“Our stress response was designed for basically early hominid lifestyle,” she said. “You’re walking through the forest or the prairie, the tiger jumps out at you – either you outfight or outrun it, or else the tiger genes live to tell the tale for that day. But it’s fast on, fast off and then on to the next thing. So our design spec(ification)s, if you will, are for perhaps multiple acute stressors over time, but a pattern of acute stress recovery.

Steinitz said chronic stress – where the body doesn’t recover but stays in that heightened stressed state – which afflicts so many people in modern society, is a byproduct of our social evolution and the fact that humans evolve much more quickly socially than we do on the genetic level.

“Chronic stress was presumably not what was going on in early evolutionary history, because that’s not how we evolved,” she said. “Socially we’ve evolved into a whole different situation: … that contemporary lifestyle seems to be a physical stress problem, and the reason for that is because we don’t have a chronic stress mechanism.”

The effects of stress on the body are numerous and have a whole slew of far-reaching implications for our health and quality of life.

“Chronically, being bathed in epinephrine (adrenaline) and (steroid hormone) cortisol and chronically having your blood pressure be up and having your heart rate be up and having your blood vessels be dilated and having your blood flow be preferentially sent out to the large muscles and away from the trunk creates very predictable and, I would think, obvious problems,” Steinitz said. “So that is why heart attack and stroke and coronary vessel disease are stress-exacerbated. That is why muscle tension is high in the stress response. Muscles being tense ready to spring is a good thing; muscles being chronically tense leads to aches and pains, tense muscles in the shoulders and neck, are contributors to chronic headache.

“We’re familiar with digestive diseases being stress-related – ulcers, heartburn, irritable bowel syndrome, poor digestion generally – and if you think about the functions that happen in the trunk of the body and if you are chronically, preferentially depriving them relative to the ‘fight or flight response’ organs, then you can imagine that digestive functions would be impaired, sexual functions are impaired; sexual dysfunction and diminished fertility are also chronic stress potential outcomes.

“Suppressed immunity and increased inflammatory responses are bodily manifestations of chronic stress that have wide-ranging implications for health. So chronic stress can have a number of well-documented health impacts.”

But stress has even more detrimental effects to health – secondary and tertiary factors – that aren’t readily apparent, Steinitz said.

“When people are stressed, some of the things they do to manage their stress then have physical consequences, such as overeating or undereating, alcohol or drug abuse, smoking, social behaviors – people who are crabby when they’re stressed and are disruptive to their relationships, people who get very withdrawn – so this has social consequences for the person,” she said. “If you’re trying to feel better and you’re using any of these coping techniques, then they have health impacts in an indirect way. And it can be very indirect. So, for example, if you’re chronically stressed out and you’re kind of a bear when you’re stressed, and you end up driving people away, and then you’re sort of a single, solitary person, social isolation and not having a partner has a physical health impact. So now we’re sort of way downstream in the causal chain, but it’s still related. It’s quite the stone-rippling-in-the-water effect of how stress can impact health.”

Luckily, there are ways to manage your stress, Steinitz said. In addition to learning how to control how stressed you get over daily things and reduce what stressors you can, there is a technique that can reduce stress on a physiological level. It’s easy to learn, can be learned about almost anyone and can be improved with practice. While stress triggers the response of our sympathetic nervous systems, the practice of meditation engages its converse – the parasympathetic nervous system.

“They’re like a toggle. It’s binary; it’s one or the other, on or off; there’s no rheostat,” Steinitz said. “So sympathetic arousal leads to the ‘fight or flight response’ kind of mechanisms.

Recovering equilibrium is a function of the parasympathetic activation. Stress makes you work out of the sympathetic branch, practices such as meditation evoke the activity of the parasympathetic branch, which then physically puts you into that equilibrium, homeostasis, recovery physical model.

Steinitz said she’s often reluctant to use the term “meditation” because of how often the practice is misunderstood and how many connotations it has in our society.

“I’m often hesitant to use, as I say, the ‘M’ word,” she said. “I don’t always talk about meditation right away with patients because it has so much baggage and there’s so many misconceptions.”

Steinitz said that some of the first research to be published on meditation’s effects came from Dr. Herbert Benson, a Harvard University cardiologist who, in the early 1970s, actually set out to disprove meditators’ claims that many in the scientific community thought were outlandish and impossible.

“To do Transcendental Meditation was all the rage and all these physical claims were made for it about things that at the time no one believed could be true, such as you can lower your blood pressure just by a practice such as this,” she said. “And no one in the West really thought that that was possible.

“Dr. Benson set out to debunk the claims of the meditators. And he studied skilled and practiced meditators and quickly realized that not only was he not going to be debunking it, but there was a whole lot of there, there. They were really onto something and they most certainly could control these things. And then he did the first really successful body of Western research demonstrating the effects of meditation and taking it out of a spiritual context and just saying if we just look at a simple, boiled-down version, where you just focus on your breath in and out and sit quietly doing that for 20, 30, 40 minutes – no spiritual or religious context for it at all, just the physical piece of it abstracted – what happens? And what happens is you get these physiological responses and they’re demonstrable and you show the lowering blood pressure and the improving physical symptoms over time. That was what was so exciting about that work.”

Steinitz teaches several types of meditation to her patients: progressive muscle relaxation, body scan, yogic breathing, mindfulness. She said that they’re techniques that can be learned from people like herself, through spiritual practices, through yoga, even self-learned through books.

“There are myriad ways to learn these skills,” she said. “Of course it’s beneficial for all of us and any of us. But in terms of what we do for patients, it’s depending on the patient’s needs. Patients who have difficulty with chronic tension and chronic pain, people who have problems with anxiety in particular, are people who are more likely to be taught relaxation techniques such as I just outlined…

The most important thing to begin these techniques, to use them to reduce stress and improve your life? A willingness to learn.

“The person has to be willing to do this practice,” Steinitz said. “Not everyone is motivated. It’s not at all difficult, but one does have to put in the time.”

Zach Jay can be reached at 906-486-4401.