Vee eee) eye le ee SS SS SS SSS SS ee Oe Ge UUUULULUULULUUUULUULELLL LE ‘4 Ceevewvvvved CHAPTER 9 SSS RMT Cela he A. INTRODUCTION Since the first bite ofthat forbidden fruit, the world has been a stressful place. From encounters with wild animals, to crazy drivers on the interstate, there has always been something in our environment to chal- lenge our ability to adapt and even survive. The stressors change, but the body’s response has not. Many ‘years ago, researchers discovered that the body has a predictable, physiological way to get us up to speed when the surroundings demand it. One of those researchers was a man from Montreal named Hans Selye. Even though he died in 1982, his work is still considered accurate and his terms are still used regular! Selye was an endocrinologist, which means he studied internal secretions. Insulin and adrenalin fall into this category, as well as many other hormores. He found that when a person's environment changes and external demands on us increase, the body secretes certain chemicals that have a profound effect on. many factors, such as heart rate and breathing. He called this the Fight or Flight response. His premise ‘was that we are preparing for either a fight or an escape. This works well for physical stressors such as the wild animal in front of us. The modern problem is that many, if not most, of our stressors are not physical. The lousy driver next to you sets off your Fight or Flight response, but you have to remain calm and controlled and drive. You arrive at the classroom and see every desk cleared and each classmate with a pencil in hand and you suddenly remember today’ test, Society and the setting require you to remain calm and collected, but your internal environment shifts into high gear. This can become a problem! One of Selye’s contributions to stress research is called the “General Adaptation Syndrome” (GAS) It suggests that everyone goes through three stages when stressed. The first stage is the alarm stage and wwe can think of that as the Fight or Flight response being set off. The second stage i the resistance stage. During this stage, our body is operating at an elevated level to match the environment. At some point, ‘we wear out and we reach third stage—exhaustion. While everyone goes through the three stages, there is considerable variation in the ability to “resist” Under pressure, some people seem to be able to hold up for long periods of time, while others are overwhelmed quickly. More stress than you can deal with can lead to many different illnesses that we will look at shortly. In 2005, the Center for Disease Control (CDC) said that 90% ofall physician visits were stress related. Other researchers have suggested that 90% ofall illnesses can be traced back to stress. Stress, whether physical, educational, social, or emotional, can make you sick. 107 re108 + LIFETIME FITNESS: God has Plans for You! B. DEFINITIONS ‘There are several terms that will help us study stress, Many of these originate with the work of Hans Selye and are still commonly used today. + Homeostasis—This is a state of equi- librium between the outside environ- ment and your internal environment. When your external environment is calm and quiet, your heart rate is lower, your breathing is slower, and so ‘on. You are in a state of homeostasis. ‘When the world around you speeds up, so does your internal environment. ‘When they match up—homeostasis. + Stress—"This is the disturbance of homeostasis. You are sound asleep until the evil alarm clock goes off. You are calmly daydreaming when the teacher asks you a question! + Stressors—These are the things that cause the disturbance. They can be as varied as the alarm clock, a flashing light in your car mirror, an unex- pected gift, or the neighborhood bully. They can be “good” things or “bad” things. + Adaptation—Human beings are one of the most gifted of God’s creatures in their ability to adapt to a changing environment. Trying to re-establish homeostasis is adaptation. « Eustress—“Good” stress is something like getting married, or receiving a refund from the bank in the ‘mail. Even though it is a positive moment in your life itis still stressful and it still activates the Fight ot Flight response. Sometimes, we equate eustress with a challenge. These can be very subjective. like to get up in front of class and talk. To me, teaching is eustress. My heart beats faster and I get excited. To some of my students, it would be their worst nightmare. I regularly have students who are taking speech class in their last, senior semester for this reason. To them, it is... + Distress—“Bad” stress is not seen as a challenge, but asa threat. It could be speaking in front of peo- ple, or shooting a free throw atthe end of a game, or taking tests. What bothers me may not bother you, and vice versa. Both eustress and distress increase the body’ activity level. «+ Cumulative Stress—Most of us do not have one, giant stressor. Often, when you ask someone why he or she is so stressed, he or she will not know, His or her life and the lives of those around him or her are not in danger. There are no obvious crises weighing him or her down. However, if you dig a litle deeper, there are an unusual number of litte things eating at him or her. He or she has a new job. © Adwo/Shutterstock.com i 3 5 g 5 2 “Chapter 9 Stress and Stress Management + 109 He or she moved rece ntly. He or she started attending a new church. Most of us suffer from these “little stressors all of the time, When there are too many of them close together, their effect is like a major stressor. Inverted U—When dealing with stress, there is a simple idea that this diagram describes, Think of stress as the horizontal component across the bottom. Per- formance is up and down on the left side of the graph. When stress is too low (bottom left), performance is also low. As stress increases (going toward the right), performance goes up. BUT! At some point, the stress gets to be too much and the performance starts to drop off. This looks like Selye’s idea of the GAS. The alarm stage increases your awareness/readiness; however, at some point, you become exhausted. ‘This is a.common sport phenomenon. If you are not focused, you miss important information (the ball was just hit to me) and you make errors, If you get too focused (swinging at bad pitches), you get tunnel vision and you “choke.” We all need some stress in our lives like the morning alarm clock. We function better with it. However, too much stress has just the opposite effect and perfor- mance goes downhill. ©Singkhar/Shutterstock.com ‘Type A Behavior—Years ago, two cardiologists discovered that their heart patients often had a unique personality. They were very deadline oriented and they were perfectionists. They often did two or more things at once. These people were high stress! The cardiologists wrote a book called “Type A Behavior and Your Heart.” Their basic message was that too much stress was bad for your heart and could make you sick. Personality—Additional research has suggested that other personality types/characteristics can cause illness. These include anger, hostility, and loneliness. All of these conditions increase stress levels and increase your risk of illnesses including heart disease © Daniela Barreto/Shutterstock.com110 « LIFETIME FITNESS: God has Plans for You! C. FIGHT OR FLIGHT Let’s look at what happens physically when the Fight or Flight response happens. Remember that these take place with eustress and distress. Remember also that these were discovered by an endocrinologist who was looking at the internal secretions of the body. Both the hormonal system and the nervous sys- tem are involved in making these changes. Moreover, keep in mind that the body is preparing itself for a PHYSICAL response to stress, whether it is necessary or not. + There will an increase in both heart rate and stroke volume, If you remember from the blood pres- sure chapter, these two affect cardiac output and blood pressure. All of these increase. This is logi- cal, because they allow for more blood flow, which increases oxygen delivery, to make more ATP, and so on, + Ifyou remember, shunting blood meant redirecting it elsewhere. During an emergency (Fight or Flight situation), blood is shunted to the muscles. This, in addition to more blood flow, means a sig- nificant increase in blood flow to the working muscle. * Blood is also shunted AWAY from functions that are not considered crisis related, like digestion. ‘These processes are put on temporary hold, while the emergency is dealt with. + When we studied muscle contrac- tion, we said each motor unit had its own electrical threshold, and once your nervous system reached that threshold, the muscle contracted maximally. The Fight or Flight response actually makes it easier to reach threshold and therefore causes more muscular activity with less effort, which is very handy ina physical emergency. * ‘The liver stores a good deal of your body's supply of glucose (sugar) in the form of glycogen. Glycogen is long chains of glucose molecules, and during Fight or Flight, they are bro- ken down and the sugar is dumped into the blood stream. This sugar is the fuel source for ATP production. Glucose is the first source of fuel, used anaerobically, so this is for the first few moments of the crisis. (The neighborhood bully that is fat but quick!) # Fat is stored as adipose tissue, and the body begins to break that down and dump it into the blood stream as another source of fuel for ATP E 8 g & § S g 2 § & ° Sergey Zaykov/Shutterstock.combee Chapter 9 Stress and Stress Management + 111 Production. Remember, this is not sprinting fuel, It is only used in the aerobic production of ATP, which is slower but lasts longer. We are now talking about a long-duration crisis. (Being chased by a bully that is also a cross country star!) To make the ATP aerobically, we need more fuel and more oxygen. To increase oxygen delivery, wwe increase both the rate and depth of respiration. Breathing faster and deeper moves more air in a given time period and allows more oxygen to come in contact with the walls of the alveoli and be absorbed into the blood stream. Two of the most important hormones released during Fight or Flight are adrenalin and noradrenalin. ‘They are also called epinephrine and norepinephrine, Together they are called the catecholamines. In the first few seconds of an emergency, the central nervous system can make many of the changes we have described above. Just moments later, the catecholamines it the blood stream and sustain these changes. When the crisis is over, the central nervous system can turn off its stimulation of the differ- ent systems, but the catecholamines remain in the blood stream for some time. This is why your heart, rate is still up 30 minutes after the argument is over! + Blood clotting is a fascinating balance of different substances in the blood stream. We talked about Vita- ‘min K earlier. People on a blood thinner have to limit their intake of green, leafy vegetables to avoid clots. People with hemophilia (a problem getting the blood to clot) may have a deficiency in Vitamin K. Stress shifts this balance toward easier clotting. This can be lifesaving in a physically dangerous emergency. + Finally, much research has shown that the immune system is suppressed when you are under stress. Catching a cold is of minimal importance when the lion is trying to catch you. The same applies to lesser stressors such as finals week or an annoying neighbor. EXCESS STRESS AND YOUR HEALTH If you look back on our Fight or Flight list of effects, you can probably do the next section by yourself. For instance, if your heart rate, stroke volume, cardiac output, and blood pressure go up and you did not physically need them to (as in the case of many of our stressors today) you have higher blood pressure and not demand. Ifyou are stressed like that regularly, your blood pressure eventually gets stuck at the higher rate and you have hypertension. If you could have used the higher cardiac function physically, say to run from the lion, it would have fatigued and gone back down. Here are some other chronic stress problems. + Ifyou regularly delay digestion by shunting the blood flow elsewhere, you will eventually begin to digest yourself. The stomach secretes hydrochloric acid to start the breakdown of protein. It also secretes a mucus coating to protect the stomach lining, but only for so long. This is not the only cause of ulcers, but itis a major player. Alternatively, As my mother used to say, “Go outside and play, you're giving me an ulcer” «+ The increased muscle tension associated with stress can surface as headaches. One of the popular pain killers used to have a commercial where something stressful would happen and a knot in a rope ‘superimposed on a person's neck would pull tighter giving the victim a “tension headache” Their ‘was, of course, their pill. We will have some other suggestions later. fat into the blood stream is great if you need it for fueling your escape, but if you don't 3 your stressor, you just have extra fat floating around in your blood vessels. This fat can in the walls of the coronary arteries and lead to atherosclerosis. This is not the of how stress is related to heart disease but itis part of the explanation.112 + LIFETIME FITNESS: God has Plans for You! «Similarly, dumping sugar (glucose) into the blood stream and then not using it raises the levels of blood sugar and the body has to respond. It releases insulin to drive it back into storage. ‘This swings the levels too low, and glucagon is secreted to raise it back up. Eventually, these large swings result in ult Onset Dia- the insulin/glucagon-regulating system losing effectiveness and may contribute to Adi betes (Diabetes Mellitus) + Iwas once at a traffic accident with injuries. ‘When the firemen came and took over, they were quizzing us about which car had which occupants. One lady didn't match any of 7 the damaged cars. She had gotten out of her car to help, looked at the mess, and passed out. The probable cause is hyperventilation, ‘When you breathe faster and deeper and use the extra oxygen, you are fine. When. you don't use it and you blow off too much carbon dioxide, the normal balance is dis- turbed and your body may respond by hav- ing you faint and taking over the rate and depth of respiration. The solution for this can be breathing in a paper bag so that you re-breathe the carbon dioxide you just blew into the bag. «The dangers of a weakened immune system from stress show up in college dorms during finals week. ‘No one is getting enough sleep, everyone is stressed about finals, a bug of some sort gets started, and, before you know it, you have an epidemic. Every so often the bug is a serious one and the school sends everyone home early. Don't get any ideas. ood clots are life savers unless you don't need them at that moment. A blood clot loose in the irculatory system can be deadly. We talked about embolisms and thrombosis in the discussion on attacks, They can also block blood flow to the lungs and other vital organs. Richard Nixon was prime example of stress and unneeded blood clotting when he was force to resign from office. At nis home in California, he developed phlebitis, which is formation of blood clots in the legs. He was “rushed to the Emergency Room! One study showed that people under stress have a 50% increase in “the risk ofa stroke. ‘© Ron Leishman/Shutterstock.com EALING WITH STRESS SUCCESSFULLY strokes, ulcers, diabetes mellitus, headaches, hypertension... the list is enough to give you have to have some stress in our lives to be functional, but how do we keep that under control? ‘we will approach stress from several different angles to maximize its benefits and minimize tial, Since the effects of stressors can be cumulative, let’s try to eliminate some of it first. STRESSORS very practical things to eliminate some of our stressors. These are techniques you have ‘may or may not practice. They take alittle work and some self-discipline, but, like it in the long run.i A . Making a LIST becomes essen- Chapter 9 Stress and Stress Management + 113 ‘Time management skills are one of the most useful stress reducers and one of the most elusive. At the end of the day, you wonder why you didn’t accomplish more. ‘You can't imagine where the time went. ‘That is exactly where you start. For a week, keep a log of what you were doing at 7 am, 7:30 am, and so on. Look for patterns. If you were texting half of the day, it will show up. If it was Mortal Combat for four hours every night, you at least know what you have to work on. It’s not that these need to be eliminated, but they need to fit into the amount of time that you have available for recreational activities. You then schedule fun into your schedule, making sure that the necessities get done as ‘well. (I write this knowing how poorly I do it!) © sibgat/Shutterstock.com tial as you age, but it has sev- eral advantages even when you are young. When you think of something that must be done, write it down! This keeps it from slipping up on you and from rumbling around in your sub- conscious making you stressed. Once you have a list of three or more things, you PRIORITIZE the list. What needs to be done first? What can wait? When you do this, you don't worry about items #2 through whatever, because you are working on priority #1. Sometimes, #4 works itself out before you have to deal with it, In addition, when you finish #1, you get to CROSS IT OUT! It is very stress relieving. ‘Now, on to #2. Did you ever have a stressor that you did not want to confront? Because of that, it grew in size until it was huge. Confront your stressors. Find out exactly what is involved and then you know how big the problem is. We had a student that was working to put herself through college and had an old 2 os i : 8 ' zg E "car to get to work. It developed a terrible screaming noise in the rear end, She agonized over it for a couple of weeks. It would probably be expensive, She would probably lose her job. Then, she would have to drop out of school and live in the immobilized car, She would soon be a bag lady with all of her belongings in a shopping cart. When we couldn't stand it any longer, we told her to go across the to the tire place, tell them she didn't have any money, but could they tell her what was wrong h the car and how much would it cost to fix it, When they put it up on the rack, they discovered hanger wedged in the wheel well and pulled it out. She had suffered for weeks because she4 + LIFETIME FITNESS: G NO—This can be the hardest word to say in the entire English language. If someone says that he or she is going to the movies on you need to do something important (stu you have to be able to say “no” If someone has a great new project that you would be perfect for, but you really don’t have time to add something w, You have to say “no.” It can be polite, but overloading yourself is stressful and you will end up doing several things poorly instead of a few things well. As freshman at a college in L.A., it was a car going to the beach. How could you pass that opportunity up? With great difficulty, but for good reason! CHANGING PERCEPTION Do you remember the example of the subjectivity of speaking in front of a crowd? One person’ percep- tion of the stressor is “no problem” and another per- sont is “life or death.” How can we take some of the perceived stress out of things we need to do? Here are some techniques to help. Several are very Biblical! 1. Worst Case Scenario—How often have you said, “If___ happens, I'll just die!” Alternatively, “When my Dad/Mom/Wife/Husband finds out they're going to kill me!” Really? Probably not. We set ourselves up mentally for the worst thing that COULD happen, when it is probably far from the worst thing that WILL happen. That is stressful! If an expensive fix on the rear end of the car is necessary, will you become a bag lady? Probably not. You might have to learn the local bus schedule and it © marekuliasz/Shutterstock.com cs might force you to be alittle early, 5 : i $ but bag lady? Confront the stressor and be realistic about its possible outcome. Then, deal with it. 2. Count Your Many Blessings—In psychological terms, this is known as the “glass half full, glass half empty” phenomenon, What are you focused on? When you get a half ofa glass of water, do you see the empty half or the full half? When you roll out of bed early for the day, are you grumbling about the early alarm or are you excited that you are alive for another day? Someone got your parking space? You have a car! Had to walk an extra block to class? You can walk! Stressed out about your major? You are in college and 90% of the world population would love to have that problem! 3. Peace That Passcth Understanding—That's Old English for an internal peace that makes no sense to the average person and can be found in Philippians 4:7. How can you be cheerful in a world that {is up to its neck in problems? Easy, There is a God, and He isin charge. If my life on this planet ends abruptly and traumatically, there is a next life that is positive and permanent, It takes a little faith, but it puts today in long-term perspective.Chapter 9 Stress and Stress Management + 5 * Asa Man Thinks in His Heart, So Is He! More Old English. You choose what kind of person you are going to be and you practice it every day by the way you think. Do you know someone that is sour? He or she chooses to be that way, and he or she reinforces it every day. Know someone that is always upbeat and cheerful? It’s a choice. Sometimes, you have to force the negative out of your head and replace it with positive thoughts. In sports, this is called thought stopping and centering. With practice, it gets easier and soon the positive side of you is the dominant side! Negativity is stressful. Don't choose it. Proverbs 23:7 by the way. LIVING WITH THE REMAINDER Inthe end, there will always be things that are stressful and unavoidable. You can eliminate some, improve your perception of some, but the rest can get to you. Here are some tested ways to deal with those stressors and not let them make you sick. + Relaxation Techniques—The idea here is that learning to relax your muscles and clear your mind can reverse the harmful effects of stress. This is called eliciting the relaxation response. Most of us do not know when we are tense and don't know how to reverse it. Here are several methods that have been tested and shown to be effective. They take practice and a time commitment in the beginning. You get better at it with repetition. 1. Breathing Techniques—Almost all of the relaxation techniques start with abdominal breath- ing. You slowly breathe in through your nose, pulling the air deeply into the lungs. Don't raise your shoulders. Push out your stomach, Hold your breath for a few seconds and then let it escape slowly from your mouth. Repeat several times. 2, Progressive Muscle Relaxation With this technique, you contract a muscle and then feel the change when you relax it. For instance, make a fst and squeeze tightly for a few seconds. Then, relax your hand and forearm and fee! the difference. The whole process “progresses” from one part ofthe body to the next, contracting and relaxing. With time, you can feel the relaxation quickly and often target where you “keep” your tension. 3. Biofeedback—Remember when we said that stress makes your body’ functions change? They have developed different ways to monitor these changes. An easy example would be a heart rate monitor tell- ing you when your rate was faster : or slower and, therefore, when you 7RN 116 + LIFETIME FITNESS: God has Plans for You! images are, the more relaxed you become. The more senses you can include (sounds, smells, feelings, textures, and sights), the more relaxed you become. You will have your own opinion of what your relaxing image should be. Practice helps you achieve the relaxation response more deeply and quickly. Meditation—It involves concen- trating on a single sound or image to the exclusion of everything else around you. It is commonly a sound, called a mantra. Again, practice improves your ability to focus, and the better the focus is, the more relaxed you are. Autogenic Training—Itis also concentration oriented and improves with practice. You are given suggestions related to different parts of the body and your job is to try to make the suggestions conne true, For example, your face is warm and relaxed. Your arms are heavy and calm. The better your concentration is, the better and quicker will be the response. « Bxercise—You knew this was coming! Numerous sources now recognize the importance of exer- cise to all aspects of health, including mental health, The exact mechanism through which exer. ise improves stress management is still debated, but the statistics clearly show that people who re regularly active suffer less from the effects of stress. It may be that the exercise actually utilizes the Fight or Flight response and the result isa lowering of the body's activation during recovery. It is also possible that the release of endorphins/encephalins during exercise is responsible, Remem- ber that this natural form of morphine improves mood, relaxes muscles, and decreases pain. ‘© mimagephotography/Shutterstock.com 2 ‘There is now a great deal being written about exercise and stress management, but a couple of the early writers are noted here. One is Thadeus Kostrabala, who wrote a book called “The Joy of Running” As ‘a psychiatrist in Southern California, hhe was often depressed and physically ‘After visiting a physician friend up, he was advised to start program. The results were ‘an improvement in his phys- but a significant improve- his mental health as well. Asa he began to incorporate his traditional approach early writer was Wil- wrote “Positive ise was that the 3 i g 3 8 8 5 & ° a om a aorChapter 9 Stress and Stress Management + 117 mae a tenes place and we all find some way to cope. Some will choose a negative addiction, such as a i rinking, drugs, or even mental illness. He proposed that a positive addiction such as exercise, aa ‘on, or yoga would be just as effective without the negative side effects. He had become a runner 'o deal with the pressure of writing, traveling, and lecturing. : + Do Something for Someone Else!—When you are busy and stressed and you think that you are about to go under, find someone with a problem and help him or her solve it, When you are feeling Kari for yourself, find someone with a problem and help him or her solve it. There is no science ‘ hind this, it JUST WORKS. When we go to Mexico to build little houses, we leave all sorts of prob- lems behind. In Mexico, we discover how small our problems really are. We come back to the hotel a organ and ee At the end of the week, we hand keys to someone that a jouse and the look on his or her face is worth more i purchase at the fanciest store in America. Saat ors + Nutrition—Eating right is as important to your mental health as it is to your physical health. We are a combination of mind, body, and spirit and to be truly healthy, each component must play its ; part. Specifically related to stress are a couple of nutritional issues we addressed earlier. Alcohol may sound like stress relief, but it solves nothing and usually creates additional stress. Sugar and caffeine should also be avoided when you are stressed. Sleep—A lack of sleep is one of the universal stressors. You function poorly, feel lousy, and your mood is fragile. You do and say things you regret. The body needs sleep to reset cortisol (brain chem- icals) levels and recover from yesterday. Numerous studies have shown improved brain function after sleep. One study showed that a 60-minute nap improved IQ test scores. Another study showed that an “all-nighter” (when you stay up all night cramming) lowered learning capacity by 40%! When you are working on time management skills, include sleep! ‘+ Humor—It would be hard to overestimate the power of the mind and your mood when it comes to __ Your health. A growing number of hospitals are including stress management and emotional state dealing with cancer and other serious illnesses. And with good reason! A study out of Nor- owed a 35% increase in the seven-year survival rate for people with a greater sense of humor. her similar study demonstrated a 70% decrease in cancer death rates. nous example of the power of er is the story of Norman Cous- Je was given little hope of sur- nd the hospital was giving him ‘to minimize the pain. He chose ontinue the mind numbing ns and found that laughter give him a period of time pain To the amazement of the physi- hhe recovered from his illness it on to research and lecture ‘mind’s ability to affect ‘one’s © Darren Whittinghamy/Shutterstock.com