Joel M. Evans, MD, board-certified OB/GYN, international lecturer, director of The Center for Functional Medicine in Ridgefield, CT, Chief of Medical Affairs for the Institute for Functional Medicine.
We’re learning more and more about the intertwined effects of stress and inflammation and why living with high levels of both can put every aspect of your health at risk. Here’s what you need to know.
In short-term situations, both stress and inflammation are part of our self-preservation arsenal. When facing an imminent danger, acute stress sets off the fight-or-flight reaction, the well-known sympathetic nervous system response to keep you alive.
Say you’re walking on the street and see a stranger who could be a threat. The neurotransmitters epinephrine (you know it as adrenaline) and norepinephrine surge so you can take action. You experience an increased flow of blood throughout your body, and your heart rate and blood pressure both rise to face a possible challenge.
Acute inflammation is your immune system responding to a health threat. Get a splinter stuck in your foot, and it rushes inflammatory cells to the affected area. In the absence of tweezers, your body will work to drive out the splinter. Problems start when these protective mechanisms become chronic. They kick in or persist when there’s no threat. One example of chronic inflammation is an autoimmune disease, like rheumatoid arthritis, in which your immune system attacks your body.
Chronic stress means living in a state of anxiety even when there’s no imminent danger. Once you pass that stranger on the street, your fight-or-flight response is supposed to turn off. But when you’re under chronic stress, that first worry just gets replaced by another one—maybe another stranger will cross your path, you think, and you worry about what’s around every corner. This pattern can escalate to catastrophizing, such as wondering what would happen to your family if you have an encounter that you don’t survive.
This kind of thinking sets us apart from the animal kingdom, where true fight-or-fight circumstances do occur at any time. Picture a herd of gazelles grazing in the Serengeti. The threat in the form of a lion comes into view and they scatter. Whether that lion captures one of them or they all escape, once the predator is gone, the gazelles go right back to grazing and don’t think about it again until a lion again appears. The human mind doesn’t react this way in chronic stress mode. Instead it thinks, “I got away this time, but what happens next time?”
Beyond making us live in a state of perpetual fear and causing damage to the psyche, chronic stress leads to chronic inflammation. It’s difficult to tease out the exact mechanisms at work, but we know that the two are interrelated. Stress causes the immune system to act up. One explanation is that chronic stress leads to the release of pro-inflammatory chemicals that affect every organ system, interferes with the immune system’s ability to regulate itself, and sets you up for a whole host of diseases.
We know that over 75 percent of diseases are related to the one-two punch of stress and inflammation. They include diabetes, high blood pressure, heart disease, fatty liver disease, chronic kidney disease and even depression. Chronic stress decreases the production of serotonin and has direct and indirect effects on mental well-being. Some studies suggest that stress is one of the triggers for autoimmune diseases and even cancers.
Our world is more challenging than ever before because stressors are everywhere. When I first started working with patients on stress management 30 years ago, the average person’s stress came from having a difficult relationship with a spouse or their boss, and they could take steps to work on the problem relationship as well as learn stress-reduction techniques. But now we have many pervasive stressors that are beyond our control—political divisions, threats to our climate, COVID—and we’re exposed to them nonstop from all the media we consume. Because so much illness is stress-related, we need to diminish the amount of stress we’re under to diminish inflammation and prevent or heal chronic disease.
Improve circumstances within your control. When I work with people living in a war zone, I can’t tell them that the war will go away if they meditate, but I can show them that mind/body techniques can allow them to temporarily take their mind off their tragic circumstances. For others, these skills help them to identify and manage the stressors that are within their control and control thoughts so their circumstances don’t continually bedevil them.
Identify the aspects of your life that you can work on. Most people don’t explore what these are or don’t address them because they’re stymied by an inner voice that talks them out of making the effort or convinces them that nothing will work, so they don’t even try. Overcome this resistance with the help of the next step.
Train your mind to relax. You want to achieve the relaxation response, activating your parasympathetic nervous system to change both your physical and emotional reactions to stress—the opposite of the fight-or-flight response. The way to do this is by regularly practicing meditation techniques or mind-body skills. Most people know about focused breathing, inhaling through the nose and exhaling through the mouth. Another very effective exercise is to focus on the flame of a lit candle, watching it as it dances in front of you.
No matter what technique you use, the idea is to be totally present, to focus your attention on what you’re doing and not on your worries or even your pressing to-do list. If thoughts intrude, acknowledge them and let them float by without reacting to them. You’re not diminishing the importance of valid concerns, but you’re not letting them be intrusive or dominate your conscious thinking in these meditative moments.
Start with just one minute of your chosen technique and, over time, increase to two, then five, and then 10 minutes, maybe twice a day. As your practice becomes a habit, something magical happens. Your body changes physiologically and you become less reactive to worries. Those fears start to get replaced with trust and hope. Pessimism gets replaced by optimism. There’s no science to explain it, but there is “biologic plausibility,” the concept that we don’t have to wait for proof to take steps we think will help us. When you train your muscles, you realize it’s working in everyday moments: Grocery bags don’t feel as heavy as they used to. You can train the worry “muscles” of your mind in the same way, and you’ll soon notice that you’re less reactive to problem situations.
Decrease social isolation. Not having a social network is itself a stressor and releases the same chemical messengers as stress. Reach out to loved ones or people in your community to connect with others.
Fight inflammation with diet and exercise. Eat more anti-inflammatory and high-antioxidant foods—fatty fish, walnuts, berries, garlic, ginger, tea, and cherries—and avoid processed foods and added sugars.
Exercise is a great inflammation and stress reducer.
Bring any warning signs of disease to the attention of your doctor. Keep a minor health problem from worsening by addressing it as soon as possible. A functional medicine practitioner, in particular, will work with you to identify how stress is negatively affecting you and design a course of action to help you with stress management. Find practitioners near you at https://www.ifm.org/find-a-practitioner/.
Siberian ginseng may improve memory, thinking ability, and resistance to stress. Take 2 to 3 grams of dried root daily or 2 to 4 milliliters (mL) of a tincture two to three times daily.
Rhodiola rosea can relieve feelings of stress, anxiety, anger, confusion, and depression in people under severe stress. Look for a product standardized to contain 2 to 3 percent of rosavin and 0.8 percent salidroside rhodiola. Take 200 to 400 milligrams (mg) daily, ideally in a formula that combines rhodiola and Siberian ginseng.
Ashwagandha. This gentle, balancing adaptogen can lower levels of the stress hormone cortisol. Take 1 dropperful of a tincture (about 40 drops or one teaspoon) three times a day in a shot of water or take a 500 mg capsule twice daily.
Tulsi. This gentle adaptogen is useful for insomnia and mild anxiety. Take 1 to 2 tablespoons of tulsi tincture in a 12-ounce cup of water.
Herbs can interact with medications or medical conditions, so talk to your physician before trying these or any other supplements.