Managing stress: Don’t just survive, thrive

Sandra Hardee, MD

Occupational Medicine

No matter what’s happening in the world, stress will always be part of our lives – affecting our health, productivity and happiness. Sandra Hardee, MD, shared tips on how to interrupt the stress cycle and build resilience during stressful times.

What is stress?

We often think of stress as bad and use it to label all things that feel overwhelming. But stress is a physiologic reaction to conditions that are good or bad.

“If you are driving home and need to swerve to avoid another car, it’s stress that’s causing you to react,” Dr. Hardee said. “We need that kind of stress in our lives. A little stress, nerves, or anxiety before an exam, game, or presentation actually helps us perform a little better.”

What happens to your body when you feel stressed?

Stressors and other threats that make you feel stressed will release cortisol, the main stress hormone. When cortisol is released it impacts every system and organ in your body.

“Everything in your body stands to attention,” Dr. Hardee said. “This is normal and your body can handle it until it is happening constantly and cortisol is being released all the time.”

What drives stress?

The stress response is driven by several things – some you can’t control and others you can. These stress instigators include:

• Genetics. Some individuals are just hardwired to feel more anxious. However, even those wired to be calm can lose that ability over time.
• Life experiences. Everything you go through and experience in life can lead to your ability to handle or not handle stress.
• Rumination. Talking about stress can make your stress greater, so follow the rule of three. If something stressful happens to you, tell three friends and then let it go. There is a calming effect that can occur by venting about stressful events, but after three times that calming effect goes away. After that, you are just increasing your stress response.

What is the difference between acute and chronic stress?

“Acute stress is to be expected,” Dr. Hardee said. “This is when you may experience nerves around a certain event or anxiety over a big decision.”

Some acute stress symptoms include:

• Anger, irritability, anxiety, depression
• Tension headache, back pain, jaw pain, strains/sprains
• Heartburn, diarrhea, constipation, irritable bowel syndrome
• Elevated blood pressure and heart rate, palpitations, chest pain
• Dizziness, shortness of breath

Chronic stress, or prolonged stress over time, impacts essentially every system and organ in your body with these possible symptoms:

• Impaired cognition, burnout, Alzheimer’s disease
• Decreased thyroid function
• Increase abdominal fat, obesity
• Persistent headaches, migraines
• Asthma
• Diabetes
• Hypertension, chest pain, heart disease, stroke
• Depression anxiety, suicide, violence, addiction
• Cancer
• Premature aging, premature death

“Even children and young people need to begin thinking about preventing chronic stress because it can begin when we’re young,” said Dr. Hardee.

What can you do to reduce stress?

When you are feeling the most amount of stress, lower your cortisol level with some of these stress-reducing activities:

• Exercise/physical activity – has the most impact on stress
• Stretch or get a massage – releases serotonin, the happy hormone
• Enjoy some humor – laughing will stop the release of cortisol
• Listen to music – it doesn’t have to be soothing, just music you like
• Complete a random act of kindness – has to be genuine and outside of what you normally do, such as giving a compliment
• Reconnect with people – social media, video chats and texting count, but face-to-face connection has the biggest effect
• Practice mindfulness – be present in the moment without judgment

Dr. Hardee said mindfulness is a very effective tool for reducing stress. An example of an easy mindfulness activity is to stop and note for 30–60 seconds what you see, hear, taste, smell and feel. Thinking of the present moment resets your brain and stops the cortisol cycle. Another example is to breathe deeply for one minute. The goal is to take six breaths in one minute, so 10 seconds per breath. Doing this can lower your cortisol for three hours.

There are also foods you can eat that can help you become calm and even lower cortisol. They include:

• Salmon – omega 3s decrease cortisol
• Spinach – magnesium decreases cortisol
• Oatmeal – releases serotonin
• Dark chocolate (in moderation) – releases endorphins
• Chamomile tea – mild sedative, which can help with sleep

It is important to remember that it is not a selfish choice to take care of yourself so you can manage and prevent stress.

“Prioritize rest and self-care,” Dr. Hardee said. “Replenish your spirit so you can serve others and be your best self.”