In a hyper productive world, busyness often feels like a prerequisite for existence. Layer that with constant digital connection, personal relationships, and the occasional global crises and there is no question why we are all so very stressed. You might even say that stress is a word so ubiquitous in our conversations that it has nearly lost its meaning.
What is stress? A feeling, yes. A physical reaction, yes. A dizzying state of being? That too. To help us unpack the concept of stress and how it can deeply affect our health, we had an insightful conversation with Dr. Sarah Oreck, MD, MS, Columbia University-trained psychiatrist focusing on women’s mental wellness. Read on for her wise perspective on what causes our stress, and how to manage it as we move through life.
To start simply, what is stress?
“‘Stress’ is our body and mind’s response to internal or external pressures. I often find that stress originates from new or unknown conditions that threaten our sense of security and control. If we want to get biological, stress rings our brain’s alarm system—the amygdala—leading to the often talked about ‘fight, flight or freeze responses’ and away from the ‘rest and digest response.’
“Once the amygdala processes the threat it sends a distress signal to the brain’s command center—the hypothalamus. The hypothalamus then sends a signal to the rest of the body via the nervous system that results in the release of hormones and physiological responses required to fight or flee to safety. The main hormone involved in the initial stress response is called epinephrine (or adrenaline) and some other players include corticotropin-releasing hormone, adrenocorticotropic hormone and cortisol.
“This mechanism which is mostly outside of our conscious control evolved as survival mechanisms, allowing mammals to react quickly to life-threatening situations. Unfortunately, for many, this reaction is not reserved for life-threatening events and can seem to be set off by anything like work pressures, relationship conflicts, or dealing with a screaming toddler,” Dr. Oreck says.
"Stress originates from new or unknown conditions that threaten our sense of security and control."
How can stress manifest in the body and the mind?
“Stress manifests differently for everyone but I like to talk about stress as hijacking our nervous system, which connects our brain to every part of our body. Stress can shape shift and look like a lot of different issues in your body including muscle tension, aches and pains, headaches, fatigue, nausea, indigestion, digestive problems including bloating, constipation or diarrhea, shallow breathing, sweating, and heart palpitations.
“Similarly, stress can manifest in many different types of behaviors including anger, irritability, withdrawal, indecision, rigidity, sadness, change in eating habits, insomnia, sexual dysfunction and increase in substance use,” Dr. Oreck explains.
What are some unexpected symptoms of stress that one might not identify initially?
“Many people are surprised about the strong mind-body connection and how stress can manifest in physical ways despite it being something you feel ‘emotionally’ or ‘in your mind.’ Another very unexpected symptom of stress for many is the ‘freeze’ response–or what many describe as being disconnected about the stress–which can include symptoms of brain fog, indecision or avoidance.
“Another symptom that I see quite commonly is anger or mom rage associated with stress that is difficult for many to identify initially—partially because women in our society are not typically taught or allowed to identify with feelings of anger,” Dr. Oreck says.
"Women in our society are not typically taught or allowed to identify with feelings of anger."
What does stress do to our reproductive health and hormone equilibrium?
“We don’t completely understand the implications of stress on reproductive health. For example, we see that some individuals can conceive in the most challenging of times including famine and war. We have a growing body of evidence that points towards the fact that the hormones released during the stress response, including glucocorticoids (like cortisol), inhibit the body’s main reproductive hormone called gonadotropin releasing hormone (GnRH). This inhibition has been found to suppress sperm count, ovulation and sexual activity,” Dr. Oreck explains.
What are the long term effects of chronic stress?
“Every organ system is impacted by stress and stress hijacks the nervous system which connects our mind to every organ system. Persistent surges of stress hormones can damage blood vessels and arteries leading to cardiovascular issues including risk of heart attacks or strokes.
“Elevated cortisol levels have been linked to weight gain and obesity as well as inhibition of reproductive hormones and decreased fertility. Chronic stress can even suppress our immune response. Moreover, chronic stress can wreak havoc on mental health and lead to the development of anxiety, depression and post traumatic stress disorder (PTSD), in which the brain’s alarm system basically never turns off after a traumatic experience,” Dr. Oreck says.
How can you manage stress in the triggering moment? Any specific tools?
“My favorite stress management tool is simple, free and always available—your breath. Breathing exercises particularly coherent breathing or mindful breathing can help regulate your nervous system and bring back the balance between the sympathetic or ‘the fight or flight’ part and the parasympathetic or the ‘rest and digest’ part.
“Mindfulness-based work, including meditation and guided imagery, can also be extremely helpful as well as somatic-based interventions focused on identifying and understanding different sensations in one's own body. My disclaimer is that these should be practiced during times of low stress first so they can be easily recruited during times of acute stress,” Dr Oreck advises.
My favorite stress management tool is simple, free and always available—your breath.
How can you manage stress to maintain an ongoing balance?
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Start to notice when you're feeling stressed.
"Cultivating awareness of your body and noticing your stress response is the first step in managing stress. Notice what your body feels like. What are you feeling? What sets off your stress reactions?"
- Make room to de-stress.
"Are you taking on too much? Could you release some control over the
situation or need for perfection? Can you hand over or share some of the responsibility with someone else?"
- Lean on your crew.
"Supportive relationships are crucial in navigating life’s many stressors."
- Make time to nourish yourself.
"A healthful diet and water can improve your mood and stress response. People talk a lot about getting ‘hangry’ but I find that if you haven’t taken care of your needs, like grabbing a bite to eat, small pressures can easily snowball and become overwhelming."
- But seriously—get some sleep.
"Sleep can be a game changer when it comes to resilience around stress. Improving sleep habits like decreasing caffeine use in the afternoon or reducing exposure to electronics in the 30 minutes to one hour before bed can improve quality of sleep."
- Cut the caffeine and alcohol, especially before bedtime.
"Keep track of how much alcohol and caffeine you’re using. Although caffeine may help you get up in the morning and give you a burst of energy, do know that it can sometimes increase anxiety. Many people use alcohol to cope with stress, which may be helpful initially, but alcohol can increase the feeling of anxiety and interfere with sleep which only worsens stress long term."
- Show up for you.
"Practice self-care and feel free to take time-outs from stressful situations."
- Remember to go easy on yourself.
"Be kind to yourself! You’re not alone, we are living through extremely stressful times and we are all in the middle of a global pandemic."
- When in doubt—ask for help.
"If you’re finding that despite lifestyle changes you continue to feel overwhelmed by stress, don’t be afraid to seek professional help and speak to your doctor about how you’re feeling."
Have any additional questions for our experts? Ask away on social or drop us an email. Plus, shop our new Women’s Multi for every day hormone support.
Written by Jessica Lopez. Jessica Lopez is a freelance writer, digital content creator, and new mother. She has covered all lifestyle topics ranging from bridal to beauty for publications including Brides Magazine, Byrdie, THE/THIRTY, and more. Walking wide-eyed into motherhood has inspired her to connect with other parents through her writing and shared experience. You can follow more of her journey @Jessica.H.Lopez.
This article is for informational purposes only. It is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and we recommend that you always consult with your healthcare provider. To the extent that this article features the advice of physicians or medical practitioners, the views expressed are the views of the cited expert and do not necessarily represent the views of Perelel.
