• Madalyn Otto

Did You Know You Can TURN OFF Stress??

Understandably, the onset of COVID-19 has been nothing short of a wrecking ball on society, and to top it off, it's also a contentious election year. Some may be trying to shut thoughts about the coming fall and winter out of their heads simply so that they can emotionally survive the current pandemic-related life changes at-hand. Nonetheless, a season change is upon us and the tension is palpable. The last two weeks in my practice have been rife with patients' struggles to stay above water in a state of uncertainty: Kids are going back to school in some way, shape or form depending on the stool district. Parents are trying to work their schedules around kids' modified school schedules. Angst runs deep as we absorb policy decisions made so close to the election. We are all wondering how the heck we are going to re-vamp our holiday rituals while also staying safe. And we all should be thinking about how we can protect our immune systems during the cold-weather cold/flu/COVID season.


Just as the pandemic has been a wrecking ball on the economy, these very real and intense experiences are acting as a wrecking ball on our autonomic nervous systems. Every one of us knows intimately what it feels like to be in a "fight-or-flight state". I bet it happened to you this week. Maybe you were driving your car and some irresponsible driver veered in front of you on the highway. Maybe your boss called you into his or her office to have an unplanned discussion about your work on project. Maybe the stock market trembled again... Maybe you were calmly reading your book on the couch when an enormous bee buzzed into your periphery. In those quick-stress moments, stress hormones are dumped into your blood stream. Your blood vessels constrict, your airway opens up, your brain becomes alarmed, blood pressure rises, your muscles prepare for rapid movement, your heart beats rapidly.

Our bodies are pretty impeccably designed to perceive a potential life-threat and to immediately flip a switch to activate what is called the "sympathetic response". The sympathetic response, or "fight-or-flight" response, is the body's alarm system that is kicked-off when even the possibility of a threat emerges. It's like having an alarm system in your home that goes off even when a twig blows onto the front porch. In the days where we were prey as well as predators, this system came in handy. We wouldn't have wanted our bodies to only engage in "fight-or-flight" after the lion was fully visualized. That would have resulted in the loss of precious time to escape. Instead, the body would rev-up when certain sounds were heard, or the outline of wildcat ears were perceived in the distance among the vegetation. Your system needed to perk up and be ready to run on a moment's notice. The problem is, we don't experience any longer those same types of stresses that we were originally designed for. What I mean by that is, the threats we face nowadays aren't effectively resolved by running from it or brawling (except maybe in the case of the buzzing bee if you happen to be allergic). But our bodies never developed an alternate stress reaction for these newfangled threats. Whether you are faced with a grizzly bear or a stock market crash, your body only has one general mechanism for reacting when the stress response system is engaged.

The rapid life changes and immediate uncertainties propagated by the COVID-19 pandemic are indeed perceived as stresses in our brains. And our brains are responding by signalling to our hormone systems to kick out stress hormones like cortisol, epinephrine and norepinephrine. The problem is that this stress has been going on for 6 months straight at this point. It hasn't let up. By now, the hungry predator should have either caught us or given up and wandered off to chase different prey. But in this case, it's kind of like being stalked by a known predator for months on end, but the predator is invisible, so you can't run from it and there's nothing to physically fight. Your body is simply engaged in "fight-or-flight" without resolution or solution. This is a big problem.

When the sympathetic system is chronically engaged, it causes a myriad of negative effects on the body. Stress is harsh when experienced in excess and over long periods. It has the tendency to break down body tissues, age the body, impair the immune system response, wreak havoc on the cardiovascular system, knock every single hormone out of balance, impair digestion, impair sleep and carve a perpetual mode of anxiety into the circuitry of the brain. So what do we do?

The only "weapon" we have to combat the emotional distress from a pandemic-economy is to learn how to turn ON the "parasympathetic response". The fight-or-flight component of the autonomic nervous system has an opposite just like every other system in the body - an "antidote" to act as its control. The parasympathetic response allows us to activate the exact opposite physiology of the fight-or-flight (sympathetic) state. Think of the autonomic nervous system as being on a dimmer switch rather than a flip switch. You are either in a sympathetic state or a parasympathetic state, and you can push yourself pretty far in one direction or another, but it's almost impossible to be exactly in the middle between the two.

The parasympathetic state is one of calm, rest, relaxation & digestion. Blood flow shifts towards your deep-acting organs, your digestive tract and your lymphatic system. Your mind feels safe, satiated and the body feels adequately warm. We should spend most of our time in the parasympathetic state and only experience short bursts of sympathetic response when there is an acute crisis or problem to remove. I think you can guess that that has not been the case for most people in 2020.

We will fare better during this tumultuous time if we utilize all of the tools we have to engage the parasympathetic state on our internal dimmer switch. This naturally turns the dimmer switch away from the sympathetic state into a state of rest and relaxation. How can we do this?

Make a true effort to reduce incoming stress: We can't control that there's a pandemic, but we can "say NO" to fear-mongering that makes our anxiety about it worse without having any benefit to us. Does it benefit you or truly change your behavior for the better to watch the news all day long? Exposure to the media certainly can trigger anxiety and increase heart rates. There is some evidence that it may do even more damage in terms of making us more susceptible to stress disorders down the road. So how can you reduce the inflow but still stay informed? Avoiding TV news (which tends to be purposely entertaining and shocking), unsubscribing to redundant news sources and simplifying your information diet to short snippets of fact-only news can be helpful in reducing anxiety about the things outside your control. I will fully admit that my husband and I initiated a moratorium on disaster-talk in the house when we realized we were just venting angrily to each other about the exact same shared opinion day after day. It was completely unproductive and made both of us frustrated and prone to insomnia.

Get enough sleep: This is crucial. I know that many of you are overwhelmed with the day-to-day right now, especially those of you who are parents of young kids. And it is tempting to slash sleep in order to get everything done. I promise you, sacrificing sleep is not the way to survive this. Something else in the picture needs to shift so that you can muster up 7 hours minimum of sleep on a regular basis. Studies clearly show that health and autonomic regulation are dependent on adequate sleep each night. In fact, healthy social interactions and interpretation of social signals may even be dependent on adequate sleep! Having wind-down time and bed-time rituals are extremely helpful for both kids and adults, as is sticking to a designated bed-time. It's important for this time before bed to be screen-free so your brain has a chance to quiet down. Reading, playing solitary games, sharing bed-time stories are helpful pre-bed activities. If you are finding that your mind remains overactive, incorporating a meditation, total body relaxation or visualization exercise will engage the parasympathetic state, calm your mind and slow your heart rate for bed. A high-quality supplement that contains L-theanine or Lavendula can go far in helping to quiet the mind as well. Simply adding 3-6mg of melatonin can support an easier time falling asleep if in the context of a healthy nighttime routine. If a more aggressive sleep aid is necessary, this is the time to reach out to your functional medicine doctor or primary provider for more support. You need to sleep! Remember, supplement quality is essential for efficacy and safety.

Use anti-anxiety herbs and nutrients: This is a good time to visit with your naturopath or functional medicine doctor and get your natural medicine cabinet up-to-date. Along with the band-aids and Arnica ointment, your medicine cabinet should cover emotional health. I already mentioned these two: concentrated Lavendula (common name: Lavender) is a botanical medicine I use a lot in practice for patients to use as-needed for anxiety along with L-theanine, an amino acid that promotes the activity of certain relaxing neurochemicals in the brain. The increase in intensity of our patients' anxiety at this point in time has caused us to load our medicinary shelves with these go-to's as well as other anxiety-curbing herbal formulas that contain combinations relaxing herbs known as nervines like Passiflora incarnata, Scutellaria lateriflora, Eschscholzia californica and Verbena hastata. We are also utilizing our adaptogen herbs which are herbs that promote tolerance and resilience against chronic stress. In my practice, I utilize combinations of Rhodiola rosea, Schisandra berry, Glycyrrhiza glabra, Panax ginseng and Eleutherococcus. The effect of herbal adaptogens is pretty remarkable because there is no pharmaceutical equivalent. Pharmaceutical drugs can blunt the stress and anxiety response (and certain drugs do this very well), but they do not enhance the body's ability to modulate itself in the face of stress over the long-term. Herbs can be quite powerful that way. I have already personally stocked up on my own adaptogen/nervine protocol to get me through this winter - which includes a set of two formulas that I use together twice daily - HPA Axis Day-time Maintenance by Gaia Herbs and Emotional Balance by Gaia Herbs. Please note that you will have better results when the right combination is picked for your subjective description of your stress experience as well as your lab history, so I recommend talking to your natural doc about a plan. Contact our office if you feel you need to add anxiety-support to your regimen.

Keep your blood sugar stable: Highs and lows of blood sugar makes the stress response worse. You might have noticed this before: when you or your kiddo goes too long without food, it can be a nightmare. A big part of blood sugar stability is making sure you are not consuming simple carbs. Avoid foods that contain added sugars and sweeteners, and avoid bread and pasta products as these quickly become simple sugars once consumed and can cause your blood sugar to roller coaster, taxing your stress response system further and perpetuating the sympathetic nervous system response. Instead, reach for protein-containing foods like beans, nuts, animal foods if you are a meat-eater or complex carbohydrate foods like beans, fresh whole fruit, whole grains. High-protein foods and complex carbohydrate-rich foods have a blood-sugar stabilizing effect and do not ramp up the sympathetic response.

Practice Gratitude For Ordinary Things: In addition to having physical health benefits, practicing gratitude will increase an individual's experiences of joy and pleasure, improve their sleep, promotes feelings of optimism and reduces feelings of loneliness, despair and isolation. If there was a supplement or medication that did all of that, we would all be taking it. Gratitude may be difficult to express for some people. I won't go into great depth here about those challenges, I will only suggest that every single person will benefit mentally and emotionally from a consistent gratitude practice. Consider implementing a gratitude practice into your daily routine.

Take Care of Your Existing Health Issues: I'm a little bit of a broken record here, but I can't help it. It's hard to be rational and calm when you are in pain, when you can't sleep, when your stomach is upset all the time. It's also anxiety-provoking to have some of the risk-factors for severe COVID-19 disease like an elevated weight-to-height ratio (BMI), heart disease, and diabetes. Exercising agency over these issues, strengthening your treatment plan and reinforcing healthy lifestyle behaviors gives you some control back and reduces your risk for disease severity.


Use BioFeedback: You may think you're able to tell when you're revved up, but you may be so used to operating within a stressed state that what you're actually recognizing is a super stressed state. Many of us have been operating in a revved up state most since COVID began and this stressed state has become normal for us. We tighten our necks and shoulders, we take shallow breaths and often hold our breath by accident. We are actively worrying about something while we perform a mundane task. Having awareness of the body language and physical sensations that are associated with a sympathetic state is the first and necessary step toward addressing stress physiology. You can actually change your "fight-or-flight" physiology in real-time simply by teaching yourself how to turn the dimmer to the parasympathetic state. That means you can literally turn off anxiety and turn on relaxation. And it doesn't take long to see great results. I have been using my Inner Balance tool A LOT lately to help me re-engage my parasympathetic state during the day. Biofeedback is a way to use technology to give you instantaneous feedback about what is happening inside your body. To keep the dimmer towards relaxation-mode, you need to learn what it feels like to be in that mode just as much as you need to know how to recognize the fight-or-flight signs of your body. If you haven't read my blog post on this recently, I recommend it. Getting a personal biofeedback device may be a powerful addition to your toolkit.

We are living in unprecedented times, but we have so many tools to tap into to protect ourselves, our friends, families and communities against suffering. Let's be sure to accept what we cannot control, but step in and make changes to the things we can control that will make our lives and the lives of people we care about better through this challenging time.

In Health,

Dr. Otto




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