STRESSRecovery - Understanding the role of stress in our lives

That which does not kill us makes us stronger - (Friedrich Nietzsche)
...provided we get enough recovery - (Wellness Garage)

When we hear the term stress, we think of the harm it does.

And in fact, chronic stress plays a central role in the development and progression of chronic disease and ill health.

Yet stress provides the signal to adapt to life’s challenges, increasing our fitness and allowing us to thrive.

This is the double-edge of of stress, the paradox that it can both protect and damage.

Balancing our stress with adequate recovery tilts the balance in favour of resilience and good health.

Stress is a response to perceived threats or challenges from our environment. 

We perceive that the stressor will harm us, and our brains mobilize a response to protect us.  

When we perceive a threat, our bodies respond by:

1. turning ON a complex adaptive physiological response that allows the body to cope and
   
2. then turning OFF the response once the stress has passed
   

This process is called allostasis – the ability to achieve stability through change.

From an evolutionary perspective, these challenges tended to be life-threatening hence the term “fight, flight or freeze.”  In the modern world, stressors are often more psychological than physical, are more frequent and last longer.  
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This evolutionary mismatch between our biology and our current environment is why chronic stress has become epidemic and is responsible for many symptoms and illnesses that we see in practice today.

The magnitude of our stress response always depends on our perception, which can be both instinctual and a conditioned response to previous experiences.  Beyond this immediate perception of threat, many other life factors determine our response:

• Environmental stressors - what is happening at home, the office and in our community
• Major life events - marriage, divorce, childbirth, death, moves, job loss, etc.
• Trauma, abuse - neglect, violence or psychological stress that has overwhelmed us in our past
• Individual differences - the genetic, epigenetic and developmental brain ‘wiring’ that makes us unique
• ​Lifestyle - individual behaviours - nutrition, exercise, sleep, relationships, sense of purpose and use of harmful substances

ALL of these factors can either amplify or abbreviate our perception of stress.

It is this net perception of stress which determines the extent of our physiological response.

The amygdala, deep in the temporal lobes of our brain, integrates our perception of the stressor and triggers our physiological response by signalling our hypothalamus.

In turn, the hypothalamus triggers the sympathetic nervous system, which then activates the inner part of the adrenal gland to release adrenaline resulting in:

• Increased heart rate
• Increased blood pressure
• Redistributing blood to the muscles
• Maximizing the production of glucose by the liver
• Increasing the release of free fatty acids from fat tissue

We feel this combination of physiological effects as an ‘adrenaline rush’.

The hypothalamus also releases the hormone CRH, which activates the pituitary gland to secrete adrenocorticotropic hormone (ACTH) that stimulates the adrenal gland’s outer part to produce cortisol.
Cortisol enables the body to maintain steady supplies of blood sugar for more prolonged stress.
Adequate and steady blood sugar levels help us cope with prolonged stressors and help the body to return to normal.
Cortisol does this by:

• Increasing production of glucose in the liver from the breakdown of glycogen
• Promoting gluconeogenesis
• A process that generates glucose from non-carbohydrate substrates - turning fats and proteins into glucose
• Counteracting insulin’s effect
• Increasing appetite
• Increasing food-seeking behaviour

Our physiological stress response is well suited for physical challenges where we will need immediate energy for muscular activity -  like running from a bear.  

Prolonged psychological stress drives the same response; however, the mobilization of energy has little purpose. 
Without activity, most of this mobilized energy turns into visceral fat - the metabolically unfavourable fat associated with insulin resistance.  
This phenomenon explains the belly fat accumulated in stressed-out executives and explains how stress can lead to metabolic dysfunction and Type II Diabetes.

Recovery
When the stressor passes, our bodies initiate a recovery response, activating the parasympathetic nervous system and turning off the production of adrenaline and cortisol.

With full recovery, our bodies make adjustments and adaptations that can make us stronger.

This whole process is called allostasis - the ability to achieve stability through change.

How things go wrong
When these acute responses are overused or inefficiently managed, instead of adaptation, allostatic overload results.

There are four patterns to the accumulation of allostatic overload:
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1. Repeated "hits" from multiple novel stressors​

 2.  Lack of adaptation to a single repetitive stressor

3.  Prolonged stress without recovery 

4.  An inadequate stress response that leads to compensatory hyperactivity of other systems - especially the inflammatory pathway 

With this understanding of the underlying physiology, it becomes clear that four factors determine our responses to potential stressors:

1. Pre-existing Allostatic Load - those underlying personal factors that accentuate or mitigate stress as well as concurrent stressors from which you have not fully recovered.
2. Perception and Mindset - how we frame situations, how we respond in the moment when we first perceive the stressor.
3. Managing the Stress Response - activating the recovery response.
4. Ability to Recover and Adapt - how quickly we can recover from stress will depend on our general health and lifestyle behaviours.

Achieving resilience and maintaining good health depends on balancing stress with adequate recovery. 

​Developing strategies that address these four factors can decrease the stress response and improve recovery:

1. Architect Your Life - to reduce or avoid predictable stressors and build in recovery time.
2. Change your Perception & Mindset - leverage mindfulness and cognitive tools to alter your perception of the stressor and immediately mitigate the response.
3. Active Stress Recovery - during the stress response, learn techniques to activate the parasympathetic nervous system and dampen the stress response.
4. Enhance Recovery - Leverage the other five pillars - nutrition, exercise, sleep, relationships and purpose to improve recovery.

The next five posts will detail these strategies and pull them all together as a healthy, lifestyle approach to improving stress tolerance.