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Operating in the RED (Rest-Exercise-Diet) Zone
A Stress Reduction and Management Protocol
It was the best of times, it was the worst of times.
-- A Tale of Two Cities, Charles Dickens
Chiropractic's centennial year is a joyous occasion in which every
chiropractor on the planet takes great pride. The profession has
survived and flourished in the face of tremendous adversity.
But there is a great enemy lurking in the background, just waiting
to destroy the chiropractor and his practice. It's not the
insurance industry with all its UROs and IMEs, nor health care
reform; it's not HMOs, PPOs, or UFOs for that matter. Chiropractic
has always found a way to survive in the past, and will continue to
do so.
The greatest threat to the chiropractic physician is chronic stress
left untreated. Physician stress is probably going to increase for
most solo practitioners as they become buried in increasing amounts
of paper work required by HMOs, PPOs, and other organizations they
must join to survive.1
Stress is defined as the sum of all nonspecific biological
phenomena elicited by adverse external influences, including damage
and defense. It may be localized, as in local adaption syndrome
(LAS), or systemic, as in general adaption syndrome (GAS).2
Negative stress or distress plays havoc on the body's systems. Just
a few examples:
- releases cortisone from the adrenal glands; if chronically
elevated, decreases the body's immune response.
- increases thyroid hormone into the blood stream; my cause
nervousness and insomnia.
- releases endorphins from the hypothalamus; chronic stress
depletes endorphin levels, which has been shown to exacerbate
migraines, backaches, and create arthritis type pain syndromes.
- decreases sex hormones;
- decreases digestion;
- releases sugar into the blood stream with an increase in
insulin levels; excessive demands on the pancreas for insulin
increases the likelihood of diabetes.
- increases blood cholesterol, mainly from the liver.
Stress causes a long-term activation of the sympathetic nervous
system's fight or flight response, which is not designed to be
activated for extended periods of time.
Stress manifests itself in many ways. Some signs and symptoms:
inability to sit still tightness in neck irritable
foot tapping blotchy skin depressed
pacing the floor twitches nervous
slumped posture tight throat anxious
drinking/smoking muscle aches angry
overeating rapid breathing confused
nagging poor sleeping self-doubt
change in grooming loss of appetite defensive
making mistakes irritable bowel excessive focus
swearing fatigue forgetfulness
Now that we have a better understanding of stress and its effects,
how can we deal with the harmful effects of chronic stress. One of
the major difficulties is that many physicians will not admit that
they have a problem. They are reluctant to seek help because of
some perceived associated stigma, or simply don't know where to
turn.1
There are many types of treatments for acute episodes of stress. I
have found rest, exercise, and diet to be the best treatment
protocol for myself and many of my patients.
Rest
How much rest do we need? Researchers have difficulty agreeing to
the amount and duration required to have us function at optimum
levels. Most research involving rest is done in the field of sleep
studies. Insomnia is frequently stress related. According to a
recent study "sleep deprivation is America's largest, deadliest,
and costliest health problem.3,4
When we sleep is very important. Most of our activity takes place
according to a circadian cycle, slightly longer than 24 hours.
Sleep normally occurs during the time of reduced physiological
functioning. REM sleep peaks during the early morning hours when
our body temperature is at its lowest.
If we work late hours and stay up half the night worrying, we are
likely to sleep but miss some of the rest needed from REM sleep.
Serotonin is a brain neurotransmitter that has been linked to sleep
deprivation and stress. When serotonin levels are low we are likely
to experience depression, fatigue, and frustration.
Resting does not necessarily mean you have to go to bed and sleep.
Resting is also learning to relax. There are a multitude of
relaxation techniques available to all of us: massage; meditation;
deep breathing exercises; biofeedback; and autogenic training.
The key to rest is making the time for it. Note that I did not say
finding the time. I can guarantee you the world will continue to
spin if you take a few minutes to "stop and smell the roses."
Exercise
Regular exercise provides an excellent outlet to relieve stress.
It also provides a quiet time for contemplation and reappraisal of
priorities. Exercise does not have to be vigorous to play a
beneficial role in stress reduction. According to the U.S. Center
for Disease Control and Prevention and the American College of
Sports Medicine, moderate activity "most days" of the week improves
physical health as effectively as vigorous prolonged exercise.5
Exercise seems to play a role in mental health as well. Regular
jogging seems to reduce the symptoms of anxiety and depression in
many patients. Runners experience a feeling of euphoria caused by
increased endorphin secretion. Concentrated aerobic exercise has
been shown to lessen stress by reducing blood pressure. However,
excessive exercise does not produce excessive relaxation or
excessive stress reduction. The key to exercise for stress
reduction is moderation.6
Diet
Proper nutrition is essential for maintaining emotional and
physical health. A diet high in fat is believed to be associated
with heart disease, high blood pressure, and possible certain types
of cancer. Stress also has been linked to these conditions.
Research suggests a high fat diet reduces the body's ability to
cope with stress by interfering with metabolism of hormones
released during stress (adrenaline, nonadrenaline, and cortisol).1
Failure to metabolize these hormones at a rapid pace causes
increase concentrations of fats and sugars in the blood and
depresses the auto-immune system. Much has been written about serum
cholesterol levels and fat intake: good cholesterol (high density
lipids) and bad cholesterol (low density lipids), and the role they
play in coronary heart disease. Current research is searching for a
link between HDL levls, type A personalities, and stress related
heart attacks.
The role of proper nutrition in stress management is based on
common sense. Pay close attention to your body's signals: eat
slowly and relax while you eat. Stop eating when you begin to feel
full. Avoid large meals in the evening and late night snacks. Limit
your caloric intake. Few adults over 40 need more than 1,800
calories a day. Under stressful conditions, eat less and be more
selective about the foods you choose. Increase water intake and
supplement your vitamin intake with C, pantothenic and folic acid,
and the B complexes.
Stress related illnesses are treatable. The key to beating stress
in knowing that stress is something we create, and therefore it is
something we control. Stress must be intellectualized not
internalized. Only then can treatment regimens like rest, exercise
and proper nutrition play key roles in maintaining positive
emotional health.
References
- American Medical News, March 15, 1993, p 3.
- Dorlands Illustrated Medical Dictionary, 1974, Philadelphia,
W.B. Saunders, p. 1482.
- Newsletter of the American Institute of Stress, 1993, No. 7, p. 1.
- Newsletter of the American Institute of Stress, 1993, No. 1, p. 2.
- Journal of Sports & Exercise Psych, 15(1), March 93.
- Hobson M, Rejeski J. Wake Forest University, 1992.
Carmen Gioia, DC
Clairton, Pennsylvania
DC
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