Stress 101
By I. Michael Borkin N.M.D. (review bio) and William P. Stuppy, M.D.

CONCISE COURSE IN UNDERSTANDING AND MANAGING THE NATION'S NUMBER ONE KILLER

All living creatures respond to stress utilizing a system known as the "adrenal response," commonly referred to as the "fight/flight mechanism." This mechanism has been genetically embedded in animals for hundreds of millions of years. Fight/flight, a series of chemical events that prepare your body to respond to an attack, is our most important survival mechanism. It has been passed down, virtually unchanged from our early ancestors, to present-day man. What has changed is our environment and society. We have produced a culture of chronic stress. Instead of confronting the occasional saber-toothed tiger, we are now under attack 24 hours a day. Job pressures, noise and toxic pollution, dizzyingly rapid changes in the fabric of our society, and a barrage of invasive advertising and negative media messages charge at us.

This chronic stress causes our bodies to overproduce chemical and electrical messages, disrupting our natural ability to regain balance, or homeostasis. Our body keeps its hormone functions in a constant state of emergency. Left unresolved, chronic stress results in serious health conditions. Stress, in fact, is involved to some extent in all injury, illness, disability, and death. The good news is that new tools are available for testing, understanding, and treating the effects of chronic stress.

WHAT EXACTLY IS STRESS?
Stress is the sum total of all physical and mental input. The human body is unchanged for 50,000 years. The mechanism that was needed for survival 50,000 years ago is inappropriate for today's world. It is unlikely that our Pleistocene ancestors, having narrowly avoided being trampled by a raging mastodon, would turn to a companion and say, "Man, I am stressed out." We should be careful to distinguish between a serious stress problem and the fashionable use of the term stress, which trivializes its lethal consequences.

In the 1930s, Canadian researcher Hans Selye, Ph.D., first introduced the biological concept of stress. In his classic work, The Stress of Life, he used the term "general adaptation response" to explain that stress is a state that cannot be avoided because it is the body's adaptive response to any demand made of it. As such, appropriate responses to stress reflect the process of adaptation; however, prolonged or accumulated stress leads to maladaptation. Stress is communicated in the body by two primary vehicles: neurological impulses and chemical messengers. In response to external stressors perceived via the senses, nerve impulses travel at tremendous speed carrying data from our environment into the body where the information is processed. The brain then sends messages through nerve impulses to parts of the body in response.

The chemical messengers for communicating in the body are hormones (from the Greek--meaning "to arouse"), which are produced by the glands of the endocrine system. The hormonal system, while functioning at a much slower pace than the nervous system, works with the nervous system to maintain internal harmony and balance. The adrenal glands are the core of the endocrine stress response system. They produce about 40 hormones, responsible for many body functions. The adrenals are the shock absorbers of the body, and two of their most important hormones (adrenaline and cortisol) are responsible for the fight/flight response. Adrenaline provides the first burst of energy in a crisis situation.

Cortisol assists in this phase and then continues working for hours afterward. An analogy would be the firing of a gun: the initial trigger is adrenaline; the projectile continuing until it reaches the target is cortisol. Both are irreplaceable, but both are extremely damaging when misused.
When the body perceives stress, nerve impulses and chemical messengers immediately work together to respond. Stress activates specialized cells in the cerebral cortex (where thought takes place), which sends an impulse to the hypothalamus (the brain's main stress control center). The hypothalamus then stimulates the sympathetic nervous system (SNS) and activates the survival mode(the fight/flight mechanism).

The heart starts to pound, the senses become acute, and the body begins to sweat. Blood pressure increases as blood is directed to the brain and major organs, the body's survival centers. Hands and feet become cold and clammy as blood is diverted away from the extremities and redirected to the large muscles used for fighting or running.

(After the crisis, the homeostasis mechanism kicks in, seeking to recreate balance through the parasympathetic nervous system the function of which is summarized as "rest and digest.")

DESTRUCTIVE VS. CONSTRUCTIVE STRESS
Keep in mind that stress can be a constructive response (even a lifesaving one) to a threatening event. But what we're concerned with is what happens when stress accumulates. We need to look at our stress reaction and ask ourselves whether we're responding to stress appropriately. If we've lost our ability to adapt, we are experiencing destructive, or maladaptive, stress. When a healthy individual is subjected to prolonged, chronic stress, the adrenal glands initially increase hormone production (primarily cortisol) by enlarging in size. The abnormally high cortisol levels actually interfere with the adaptation process by preventing vasoconstriction (narrowing of the blood vessels).

When cortisol levels increase, the body turns off the immune system and growth and repair functions. (Why worry about the future when there is a more immediate danger?) Other functions, such as reproductive capabilities and tissue repair, also shut down or become diminished (thus, stress kills sexual desire and prevents recovery from illness). The large intestine can become paralyzed and the anal sphincter locked closed. As the body's ability to control inflammation decreases, and as digestion is inhibited, allergic reactions can result in a swelling of the intestines. This puts a person at risk for celiac disease, malabsorption syndrome, and a multitude of opportunistic invaders such as Candida, parasites, and other dangerous microorganisms.

If threshold stress continues and body reserves become depleted, the adrenals begin to falter. They no longer produce the necessary levels of stress hormones. If the stress continues, the adrenals become exhausted and the body goes into a forced state of recuperation. The body is then likely to convert sex hormones such as progesterone and testosterone to stress hormones. Symptoms of this phase include fibromyalgia, heart arrhythmia, increased urine flow, profuse sweating, night sweats, muscle spasms, migraine, anxiety, depression, tension headaches, memory laps, stiff neck and shoulders, asthma, irritable bowel, herpes outbreaks, psoriasis, eczema, low back syndrome, sciatica, erectile dysfunction, amenorrhea, hot flashes, hypertension, skin blotching, rashes, acne, and immune suppression.

A New Understanding of Panic Disorder
One of the most disabling psychological manifestations of chronic, inescapable stress is Panic Disorder. Previously, panic was restricted to psychiatric interpretation. Dr. Stuppy's research sheds new light on this disorder.

Acute stress produces the normal adrenal response, and subsequent homeostasis. Chronic stress can eventually result in the exhaustion of the adrenal system, and inability of the body to normalize; it remains in a state of "hypervigilance." This can ultimately lead to inescapable stress, and the failure of the adrenal and stress hormone system.

Holter Monitoring Provides "A Picture of Panic"

As levels of adrenaline fall, the body's opioid met-enkephalinis released in excess. Met-enkephalin is an endogenous opioid, meaning it is a naturally occurring substance that resembles an opiate narcotic (The familiar term "endorphin," which most people know is a "feel good" substance produced by the body, comes from "endogenoujs morphine.") The increase in metenkephalin produces excessive opiation; this is naturally followed by withdrawal. Chronic stress causes metenkephalin to repeatedly rise and fall seemingly spontaneously and at random, instead of as the appropriate response to certain situations, or without reference to regular cyclical hormonal variations.

Dr. Stuppy found that people with Panic Disorder were found to have large grossly visible deposits of met-enkephalin. Met-enkephalin affects not just the brain but the entire body. Panic is an acute opioid-withdrawal phenomenon, and is thus physiologically based-it is not just a psychological problem. The chaotic episodes known as panic can now be understood and treated effectively.

Using new digital tools, 24-hour non-invasive monitoring of autonomic function can now undergo a highly advanced form of analysis called Heart Rate Variability (HRV). Concurrent analysis of HRV and hormonal activity brings additional description of stressors and alternative approaches to therapy. In people with Panic Disorder, both neuronal and hormonal activity brings additional description of stressors and alternative approaches to therapy. In people with Panic Disorder, both neuronal and hormonal systems are characteristically dysfunctional and disarticulated. The better outcome we now see comes from addressing all these issues, to the best advantage, all at once.

Individuals suffering from panic can use non-invasive, ambulatory technology and natural treatments for recovery. Autonomic nervous system activity can be seen utilizing "user-friendly" tools for continuous ambulatory monitoring of heart rate and rhythm. Twenty-four hour recordings, in this highly specific method of analysis for panic disorder (called Holter monitoring) reveal the minute, beat-to-beat differences in heart rate and rhythm to a discrete, three-dimensional view of sympathetic and parasympathetic balance. The Holter test also measures the effects of stress, addiction, toxic exposure, and risk of sudden death. Recognition of characteristic circadian (24-hour) patterns leads to accurate assessment of disorders related to stress, indications for treatment, and maintenance of health and wellness. (For information on autonomic testing, see Dr. William Stuppy under "Contacts.")

A photograph from a polarizing microscope shows deposits of met- enkephalin to be "liquid crystals" in their natural form.

In this phase, the body shifts all its systems into the survival mode. All the body's reserves are directed for the purpose of trying to maintain homeostasis and all body energy is directed toward immediate survival. When one is in the survival mode, all the senses increase and become hypersensitive. This increases the volume of information entering the mind and causes it to reach maximum saturation before the sleep mode can help remove the stress, which it does by transferring date from active memory, the conscious mind, to the subconscious mind.When we experience this kind of "overload," the body and mind become temporarily detached and we feel spaced out. This is the result of the body's release of opioids that anesthetize us.

UNDERSTANDING LONG-TERM STRESS
It is only when stress continues that it causes damage. Experiencing long-term stress at threshold levels even affects the way cells develop and mature, causing premature cell death. When a significant number of cells' lives are compromised or shortened, the entire organism will suffer poor health or sometimes a shortened life span. While every system reacts to stress in its own way, most people aren't aware of when they're experiencing destructive or long-term stress. We may have felt an emotional stress manifest physiologically, say, in the solar plexus or between the shoulder blades. But how many of us realize when stress is responsible for sciatica or hot flashes?

Those of us who are suffering from long-term stress need help to change our stress response and recover. While it usually takes several months, complete recovery form adrenal exhaustion is possible. Whether or not we've reached a state of extreme or long-term stress, what we all need ultimately is a method of healthy adaptation--a method by which we prevent stressful situations from producing a destructive stress reaction syndrome.

There are many ways to relieve the mind of stress and interrupt the patterns set in neural pathways that are programmed to receive and send stress messages. Hypnotherapy, visualization, hatha yoga, Tai Chi or Qi Gong, and most meditation techniques are helpful in stopping habitual mental patterns that engender stress reactions. Any activity that allows you to relax your awareness instead of reacting to all stimulation will ultimately give you some recovery time. That might mean walking in nature, swimming, or a creative activity that is different from your normal routine and is satisfying to you.
Individual counseling, group stress management classes, or workshops can also help unearth the underlying messages that trigger stress responses. Many maladaptive patterns are conditioned responses learned when we were young, and which we believed were critical to acceptance and hence survival on the planet. It is up to the individual to reduce exposure to new stress and counter the damage done by accumulated stress. Sometimes support helps us to accomplish this.

Dietary supplements are a vital, indispensable means of supporting the adrenals and other body/mind activities. Hormone testing is now available to help determine how stress is affecting your body, and the exact supplements and amounts that are appropriate for you. (Please refer to the following sidebars for specific information.)

Our modern world compels us to deal with our stress in ways that are not genetically programmed; we have to take conscious action to avoid the devastating effect that chronic stress has on our well-being. Keeping our body in the emergency status of fight/flight is no more to conducive to our health than it would be for our Pleistocene ancestor to try to use our method of dealing with his contemporary stressors by trying to reason with that saber-toothed tiger: "Can we just sit down and talk about this?"
Authors:
Dr. I. Michael Borkin, N.M.D., has been in professional practice for 17 years. Dedicated full-time to endocrine research, he is CEO/Founder of the National Instititue of Endocrine Research. In addition he is Director of Research and Development for Sabre Sciences, one of the most progressive hormonal research labs in the country. A pioneer in transdermal delivery systems, his ideas have given birth to innovative therapies in naturopathic medicine, including NEST (Neuro Emotional Sensory Training) and Q2m (quantum Magnetic Manipulation). He is past president of the California State Naturopathic Medical Association, and an independent medical/nutritional consultant.

Dr. William P. Stuppy, M.D., F.C.A.P., F.A.C.G. has practiced medicine for over 20 years. His curriculum vitae features numerous academic appointments and dozens of publications in peer-review journals. Over the past decade he has focused his clinical and research skills on the understanding and treatment of stress and panic disorder. A pioneer in the use of non-invasive ambulatory testing, his findings and ideas resulted in the clear understanding of the relationships between psychiatric, somatic, autonomic, and endocrine aspects of stress, panic, and endogenous opioids. His clinic is located in Los Angeles, Ca.
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