Friday 17 August 2018

'They're marinating in cortisol' - Doctor shows how stress badly affects our bodies

Your heartrate rises. Your pupils dilate. Your breathing speeds up. These are familiar responses to intense pressure, but why? And how do we make sure that stress doesn't damage our health? Ailin Quinlan reports

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Are you "marinating" in cortisol?

That's the graphic mental image used by Dr Mark Rowe, a GP with 23 years' experience and an expert in lifestyle medicine, to describe what it's like to experience ongoing, chronic negative stress.

In itself, explains Rowe, stress is neither good nor bad. However, the way it impacts on us, he believes, depends on how much we are exposed to and how well we manage it.

"Experiencing a certain amount of stress can improve our performance," he explains, "but when we're under too much stress or when we don't have mechanisms in place to help us re-charge from stress, our stress turns into distress."

Human beings are hardwired for fear and anxiety, and when we're involved in a highly stressful incident, we quickly pass what Rowe calls the "tipping point" in our stress levels.

Within seconds, he explains, our body has geared up into what is termed the "fight or flight" response.

Here's how it happens - first, explains Rowe, the amygdala, a tiny almond-shaped gland based in the brain, which acts as the control centre for our emotions, emotional behaviour and motivations, sends an instant message to the hypothalamus, the memory and command centre of the brain. This activates the stress response, resulting in the release of adrenaline and cortisol from the adrenal glands, based on top of the kidneys.

The effects on the body of the release of both of these chemicals are virtually instantaneous.

"The heart begins beating faster," says Rowe. "The blood pressure goes up. The pupils dilate to let in more light, so that you are more aware of your environment."

Your breathing also speeds up in order to bring more oxygen into the system - to get you prepared for fight or flight - and blood is diverted towards your muscles, which tense and become ready for action. Meanwhile, your mind shoots into hyper-alert mode, focusing solely on the stressor and literally shutting down to everything else.

"Blood doesn't flow well to more than one part of the brain at a time so in an acutely stressful situation, the blood flow is diverted to the amygdala, which is the brain's panic button," Rowe explains.

This means blood is directed away from the pre-frontal cortex, which is the logical, decision-making part of the brain, he explains.

The outward manifestation of all of these changes in the body is quite interesting.

We're familiar with the sweaty palms, butterflies in the stomach and beating heart that usually accompany stress - but did you know that stress can also affect our ability to listen properly, and distort our perception of what people are saying?

Extremely stressed people often don't fully hear what is being said to them, explains businesswoman and management coach Mary Lou Nolan, who spent more than 20 years working in high-level corporate management roles before setting up her executive coaching and mentoring service Cor Consulting.

"When you're under stress, you end up going into survival mode," she explains, adding that when people reach extreme levels of stress, they "literally don't take in stuff."

Not only do they fail to take in the totality of what is being said, she explains, but they can often misinterpret it as well.

"They will only hear the negative," she says, adding that in her experience, a very stressed person will have a "distorted" perception of what is being said to them.

"They can lack the balanced view, or the balanced judgement," she explains.

Another reason for this is because, along with the release of high levels of the stress hormones cortisol and adrenaline as part of the body's plan to gear us up for the fight or flight reaction, our brains also release a neurotransmitter called Catecholamine, explains psychologist, coach and learning expert Dr Celine Mullins.

This impairs the cognitive function of the pre-frontal cortex, allowing the older limbic system, of which the emotion-led amygdala is a very important element, to dominate.

Because this logical, decision- making part of your brain - the pre-frontal cortex - has slowed down, it's harder for you to think straight, she explains.

"The brain goes into a form of shutdown and becomes less effective because of the high levels of adrenaline and cortisol in the rest of the body and our limbic system, which is the centre of the emotions, becomes very dominant.

"I've seen situations where stressed people cannot think straight," she says.

Clients have told Mullins that prior to going into an important meeting with a potential client or with a company executive more senior to them, or even when making a work presentation, they will report feelings of confusion and "going blank", and experience "an inability to think straight".

"This can be quite disturbing," says Mullins. "People say to me 'I just felt so stupid! I had prepared for the meeting but then I couldn't get my thoughts straight'."

In this situation, Mullins observes, people don't get their prepared message across with credibility, which can leave them feeling even more stressed.

And on top of all of that, adds Mary Lou Nolan, high levels of stress can also disrupt sleep, which has a domino effect in terms of reduced concentration and memory, further impacting on the person's ability to do his or her job.

"In turn, their self-belief is impacted.

"People can suffer a crisis of confidence.

"This cycle feeds the stress. I have seen people on that cycle who literally start to unravel," she says, adding that it can often take intervention of some sort to break the cycle.

High levels of stress, however, are not particularly uncommon in today's society.

"A lot of people are living with chronic negative stress, or as I would put it, they're marinating in cortisol," warns Rowe.

Here's the really interesting bit, though: the body actually has a built-in mechanism to help bring us back 'down' from levels of high stress.

Rowe refers to studies carried out by researchers at Harvard, which showed that along with the stress hormones, the body also produces another hormone, oxytocin, which 'nudges' us to break our cycle of stress by talking to someone.

"Oxytocin is a hormone which allows us to connect with one another. It encourages us to reach out to others," he says, adding that this is fundamentally as much a part of the body's stress response as is the release of adrenaline and cortisol.

The release of oxytocin motivates us to seek support and "tell someone how you feel," he explains.

In other words, when we experience the urge to talk to someone about a stressful incident, it's down to messages being sent by the body.

"Your body is actually priming you to do this by releasing oxytocin."

While adrenalin and cortisol push up the blood pressure, causing blood vessels to narrow, oxytocin allows the heart cells to heal and regenerate, he explains.

"It's an anti-inflammatory and it helps us to restore and recharge by taking us away from the fight or flight phase and on to the pause and plan stage.

"Oxytocin basically moves us back to take stock of the situation and starting thinking logically again! It's a built-in mechanism for resilience and human connection."

However, we can also teach ourselves to break a cycle of high stress, according to Mullins.

What we need to do, she explains, is interrupt what she terms 'the feed-back loop' between mind and body.

Experiencing symptoms such as sweaty palms in a stressful situation can make us even more nervous, she explains - and this in turn exacerbates the stress symptoms we're already experiencing.

Unless, that is, we know how to break the loop. But this takes preparation and practise, emphasises Mullins, who is CEO of Adaptas Training.

If you're prepared to put time and effort into practising how to break your personal 'feedback loop' she says, it will be an invaluable support during high-stress moments.

First, gain control over your breathing by taking deep breaths into your diaphragm so that your stomach expands rather than your chest.

This helps calm the body and enables you to regain control over your stress.

Next, it's important to control the rapid-fire series of stress-related negative thoughts that result from a difficult or upsetting situation. Practising this at times when you are not stressed really pays off, she advises.

"In my experience, it's not always possible to take control of these thoughts in a highly-stressful situation, unless you've already practised doing it. I recommend that you do the preparation when you're not in a stressful situation."

First, think about, and identify, the kind of thoughts, feelings and emotions you tend to have in stressful situations, she says.

"Once you have identified them you will be able to identify your personal feedback loop. When you know what to expect it's easier to take control."

These may be thoughts such as 'I can't do this job', or 'I'm not as good as my colleagues'.

Now think about all the reasons that prove the exact opposite to these thoughts. Make a list of the evidence which shows you can indeed, do your job, and that you are just as good as your colleagues.

"Examples might be 'I got this job and I'm able for this job' or 'I passed my exams in this so I do know what to do' or 'my colleagues often ask my advice before making a decision on something, which means they trust my judgement so I must know what I am talking about!'

"This is all about taking control. Everyone has a locus of control," Mullins explains.

For some people, their locus of control is internal. This means they recognise that they can control events that are happening in their lives, in terms of how they think and feel.

However, other people feel their locus of control is external - ie, that environment, circumstances and other people have more influence over their lives than they have. In other words, they believe they don't have much control over their lives.

"What people need to do is focus on their internal locus of control. If you can manage your internal locus of control, you can be more effective in your job and have healthier relationships, because you are attributing your own success to your efforts and abilities rather than to luck, fate or circumstance.

"We have to focus on developing an internal locus of control to the point where we take responsibility for how we feel and what we do," she explains.

Having an internal locus of control helps us cope more effectively with stressful situations by understanding that we can actually prepare for them by practising how to manage them, she explains.

"We all experience being uncomfortable or stressed in certain situations. Having an internal locus of control enables us take responsibility for how we feel now rather than waiting for something bad to happen. "I recommend preparing for stress. Stress is an inevitable part of life for most of us and there are ways to prepare for it!"

• Next week: Reframing stress: If we embrace it as a positive, can we stand to benefit?

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