Holiday season brings with it a plethora of fun memories, loving gifts–bought or homemade, Christmas music, store specials, inspiring concerts, mouthwatering cookies and candies…and stress. Learning how to recognize stress and de-stress our lives will benefit us healthwise and ensure a much more pleasant, relaxed Christmas.
Life is full of surprises, some planned and hoped for, and some that knock us off our feet. How we deal with life has much to do with our general health, and specifically our cardiovascular system.
We are all familiar with stress. Some of it is good—exhilarating, “I work better under pressure”. Our body’s initial response to stress will help us do better, especially if we meet the saber-tooth tiger (think of who that could be in your life) in the jungle (“it’s a jungle out there”). The immediate adrenalin and sympathetic nervous system activation gets the muscles working better, sharpens mental abilities and drive and the heart pumps harder and blood pressure goes up to keep up with the increased demands of the body. Non-vital systems of the body slow down or shut down during this time, permitting all the resources of the body to get through the challenging experience. What a wonderful body we have!
This scenario works great when a critical deadline comes up tomorrow, or you are playing in a ball game, or an injury or accident occurs. In fact, it could be life saving.
However, we now live in a world where the stresses may not be of short duration. Financial, emotional or toxic exposures may persist, and not permit the body to get its much needed rest or peace. Nutrient deficiencies or sleep deprivation or toxin build-up that interfere with basic body processes, if not corrected, will cause chronic stress in our bodies. Infections the body cannot clear, or hormone dysregulation in the body, will interfere with proper functioning and be a stressor on the body. The list is almost endless.
We are wise when we learn to recognize that there are both stressors over which we have control, and those over which we have no control.
In and Out of Control
So, what does the body do with chronic stresses, and specifically, how does it impact my heart and blood vessels? There are two systems that are activated in stress. One is the sympathetic nervous system—nerves coming from the spinal cord that go directly to organs of the body. This system is counteracted by the parasympathetic nervous system, which, for the most part, does the opposite. It is the parasympathetic system that functions during rest, and does much of the repair needed from the sympathetic discharge. The other system is release of epinephrine (adrenalin) and norepinephrine from the adrenal gland. Let’s talk about each part and its direct impact on the cardiovascular system.
In the state of emergency, accident or injury, or escaping or fighting a perilous situation, bleeding may take place. Adrenaline from the adrenal gland increases the ability of platelets to aggregate, or come together to assist in the clot formation to stop the bleeding. If there is long term adrenaline release, there is an increased likelihood of clots forming inside the blood vessel walls. These clots partially block the flow of blood inside the blood vessels. If this occurs in the heart, or coronary arteries, this may manifest as angina (chest pain) with exercise, or even a heart attack. If this occurs in the peripheral limbs, pain (claudication) is felt in the muscle that needs more blood for energy production, but can’t get it.
Stress and the Heart
Upon stimulation of the sympathetic nervous system, the nerves that go to the heart activate processes that increase the blood pressure and heart rate, thus supplying more blood to the tissue. The muscle is a high-demand organ for energy, so this demand can be better met. However, higher blood pressure and heart rate long term may cause more turbulence inside the blood vessels. This turbulence will cause more vessel wall tension and possibly damage the wall. This prompts a repair process to be started which releases inflammatory substances from the local wall and platelet aggregation with more inflammatory substances released. The wall of the blood vessel thickens and a clot may form inside the vessel lumen. This is called atherosclerosis.
In the stressed state, aldosterone is produced and released from the adrenal gland which tells the kidney to retain salt (sodium) and water, in case bleeding has taken place. In the absence of bleeding, this increases total fluid volume in the blood stream, thus contributing to higher blood pressure.
Stress and Weight Gain
Stressed individuals have a tendency to eat more, thus putting on more weight. More weight means more blood vessels need to be made, which lengthens the distance of the vessels, thus requiring more blood pressure to reach the new distance. Stressed people tend to exercise less, also contributing to weight gain. Smoking is more common among people who are stressed. The toxins in cigarettes are some of the most inflammatory substances the body can receive. The greater the inflammation that is inside the blood vessels, the greater the chance of atherosclerotic plaque building up and occluding the blood vessel lumen.
Many other organs of the body are also affected to increase survival in the stressed state. The pupils dilate to see clearer. The spleen releases stored red blood cells in case bleeding has taken place. Airways to the lungs dilate. Liver breaks down the storage form of glucose and fat cells breakdown, all to supply the body with immediate energy in the form of glucose.
There are other organ systems that reduce their function: these are the non-critical body functions of the body. These include: bladder relaxation and sphincter contraction increased, digestive juices and enzymes diminished, kidney flow and urine production diminished, gall bladder relaxation, salivary and eye tears decreased, skin hair stands up and increased sweating.
The body is able to maintain a heightened state of stress for months, or even years. It is not healthy, but a maintenance level is maintained. At some point in time, though, after the adrenal gland has enlarged as much as it can, it starts to fail. Hormone levels drop, life-sustaining support wanes, and the body goes into a state of exhaustion. Low levels of cortisol and DHEA or seen, the immune system becomes compromised, and stomach or intestinal bleeding may result. With the anti-inflammatory systems of the body reduced, inflammation increases, causing further blood vessel and organ breakdown.
Much of this can be avoided, reduced, or even eliminated by recognizing its potentially harmful effects, knowing there are things to bring about health, and taking action, step by step.
Treatment Options
Now that we recognize the effects of stress on our heart, blood vessel systems and body, let us review some treatment options. First, we must be able to identify the cause(s) of what is putting stress on us. Sometimes these are created by our own selves. We may have a hard time saying “no,” when we do not have time, or someone else should do it. When we do things for others who should do it, we may be depriving them of growth that they should experience. I am often reminded of the Serenity Prayer:
God grant me the serenity
To accept the things I cannot change,
Courage to change the things I can,
And the wisdom to know the difference.
Our stress will never end if we try to change things that we cannot change. Even within what we can change, we must carefully choose where to spend our time and energy, and be sure we spend time in the ‘weightier matters.’ Stephen Covey addresses this concept in his book The Seven Habits of Highly Effective People. He differentiates between tasks that are urgent and not urgent, and between important and not important. Our most important matters usually revolve around the building of relationships, which are too often sacrificed on the altar of cell phones and computers, by interruptive calls, mail and trivia.
Getting Centered
This Christmas season, try playing a little game with yourself to focus on the truly meaningful gifts of Christmas. One year, during med school, my wife and I brought home boxes by the dozens—of all shapes and sizes—as our only Christmas presents for our 3 small sons. We obtained them for free, and our little boys played with them for months. They received no other presents, and my wife and I gave each other nothing but our love and support. But our children loved their Christmas that year. Never did we feel that we had shortchanged them! In fact, their creative skills were enhanced as they designed towns, trains, and toys to play in.
One of my patients remarked that she was overwhelmed with the “pressure” of getting everything done—a telling word—until she took the time to visit an art exhibit featuring paintings of the Savior.
In a few moments of gazing upon the miracle of His birth and His life, her perspective and her peace were restored. Now, taking a deep breath, she realized that she could truly honor the Christmas spirit.