Stress Part-1

Welcome to Medicine and Health with Dr. Paul Anderson. This is a show about opening up the often mysterious world of how doctors think. The goal: to empower the listener to gain access to the best healthcare possible.

Good day and welcome to Medicine Health with Dr. Paul Anderson. That's me, I'm Dr. Paul. And our topic today is stress. And I don't think there could be any time you'd be listening, maybe in the future, where we as humans don't have stress. If you're listening live, there seems to be a lot going on in the world. We have, you know, COVID and a pandemic, and we have election in the US and all sorts of things going on that are creating a lot of, you know, extra stress on top of everything that just goes on normally with us humans. So wanted to talk about that today. And the couple of angles wanted to come at that with. First is The idea, and we'll develop this a little bit, that stress is actually a normal part of human health and life and all of that sort of thing. So we, you know, we sometimes think of stress as an evil external sort of influence on us. And in reality, it's just a part of being alive. It's a part of, you know, our experience of being human. And we have a physiological response to stress that is supposed to both take care of the stress response, use it for whatever its purpose is, and then help us get over it. That doesn't always happen in that order. And so we want to talk about that as well. So big concepts we want to talk about are why do we have stress response? What's it do to us? Why do we feel the way that we feel when we get stressed or things from the outside stress us, as many people are feeling right now and things that are going on?

And then Excuse me.

Really, one of the things that are probably the best, where the rubber meets the road things, are going to be what are some things we can do about it, especially when we have this kind of add-on effect where we have all the normal life stress and then we have extra things, maybe illness, maybe the threat of illness, maybe things that we see constantly in the news. And you've We've got things like, you know, elections and political stuff going on, and just all manner of things that pile on. And that's not even to factor in all of our own individual stressors, meaning things that go on that are unique to us or our families or our circle of friends. Maybe we have a loved one who was recently diagnosed with, you know, an illness, or we have a tragedy in the family, or we have a loss of a job or any other thing. So there are seemingly Endless ways where humans can get stressed. Now, in all of the conversations I've ever had, especially with patients around the idea of stress, one of the things that becomes at issue sometimes— and so this is what I want to talk about first, about this being a normal experience for humans— is, um, Is it really normal? You know, is stress like supposed to be there? What, what's its purpose, etc.? But also, is stress just one of those things that's literally all in my mind? And I think that this comes from a few different places when people get concerned when you say, well, you know, I think that your health issue is somewhat related to the stress that you're having. I've had a lot of people come back and say, well, Do you— are you saying then, you know, I'm just making it up? It's just all in my mind. It's not real. And there's nothing further from the truth. Now, of course, we perceive most of the stressors that are external to us through our brain and through our senses, and then our body gets into the act. So yes, there is that aspect of stress where your brain has to process it. For example, a real simple stress, such as something you're afraid of, somebody chasing you, your Your brain processes that rather quickly. So there's an, uh, there is an aspect of what goes on in your mind, certainly, that's there. But it's not just an all-in-your-mind sort of phenomenon where if you were just, you know, a better person or you thought better or whatever, uh, you wouldn't have stress. No, that goes to part A of our question, which is Is it normal? And it certainly is normal. If you have no stress, you're actually dead. And dead bodies don't have a lot of stresses, at least that they perceive probably. But while we're alive, we get to have stressors. Now, just like we've talked about biologically with other things that we sometimes vilify, like inflammation, and we, you know, we take anti-inflammatory things to stop the inflammation because it hurts or creates problems. Certainly there is that issue, but just like biologically inflammation is necessary to trigger an immune response, and then it's supposed to go away later, stress is there to trigger particular activities inside of the mind and the body to help protect us. So if we go back to what would be, you know, a You know, self or human preservation reason for stress response? Well, if you, you know, go back to times when, you know, really not that long ago in human history, where we lived a little closer to nature and also closer to things in nature that might eat us, you know, like bears, tigers, and other animals and such. It was probably good to have a stress response that said, Hey, uh, let's not hang around while the bear is here because the bear will probably eat us, and, uh, maybe we should increase our biology so we can get away from the bear or the tiger or whatever it is that is threatening us, or maybe another human. Well, that's a normal response, and if we didn't have any alarm or alert response, we would probably Not appropriately respond to the outside threat, and then we would get eaten by the bear or the lion or killed by the attacker or whatever. So if we have this response, which has a number of levels, and it's automatic to a degree, once we know that we are alarmed and, you know, we have a threat. How does that work? So why would that be burned into our nervous system and our endocrine, our hormonal system, and our muscular system and cardiovascular system and every other part of your body? Why would that be so firmly burned in and entrenched that we would have it as just part of our existence and Many other animals have it as well. Well, what it does is when you perceive a threat, let's, let's just for the sake of keeping it easier, we could pick another human attacking you, lions, tigers, bears, giant snakes, whatever, you know, it is that you would least like to come in contact with you. We'll just pick bears because that's easy to remember. No one, you know, wants to get eaten up by a bear or mauled or killed or whatever. So you got You know, a bear. Bear comes around. Now intellectually, probably know interacting with a bear, not a great idea, probably going to get eaten. But your body actually responds way before you do intellectually. And what happens is your autonomic, the automatic nervous system goes into— we all heard about Fight, flight, or freeze. And fight or flight, or fight or flight or freeze, is the part of the nervous system that is activated when there's a threat. And we'll keep it to bears for the moment. So bear is in the neighborhood. We suddenly have this increase in biological activity, which actually allows us to do a lot of things to get away from the threat, the bear in this case. What are those things? Well, the autonomic nervous system, the automatic part of your nervous system, has 2 portions that are always working in concert. And they seem to oppose one another because one side goes in one direction neurologically and hormonally and stuff, and the other side goes in the other direction. But really what happens is when the bear is there, The sympathetic side grows and the parasympathetic side gets minimized so that we can utilize this sympathetic outflow of nervous system information that turns on everything in our body to get away from bears. So these 2 sides are supposed to then come back to normal. That's part of the normal stress response. And then sometimes the parasympathetic grows up and it minimizes sympathetic activity. So there's this always yin and yang going back and forth. Well, sympathetic nervous system activation, which creates what we call fight or flight or fight, flight, or freeze, does a bunch of things to us. One of the things is that it puts out neurological chemicals in our brain and our body that essentially make us in a position, physically speaking, to either run away or fight back or a little of both. So for example, with your eyes, either when the sympathetic neurochemicals are being released through particular nerves and everything, your eyes have 2 responses. One of them is that the lens in your eye that focuses things is actually changed to a focus of far away, and the pupils get really big. You think, why would that be? Well, the idea there is, is that if threat, a bear is coming, I want to run as far away as possible. I'm not curious about things up close. I'm focused on getting away. Big pupils are to collect as much light as possible so I can safely flee. Okay. We get to other parts of our body, such as the balance between the blood vessels and the digestive tract. They call them the 2 Tubular organs, right? Well, the same neurological chemicals that affect your eyeballs also affect the tubular organs, but in 2 different directions. So what happens is that the digestive tract actually gets sort of paralyzed and the blood vessels actually constrict. And you think, well, what does that do? Well, the blood flow to your digestive system is minimized. Your digestive activity is minimized. So you're not expending energy digesting and absorbing nutrients, you're putting your energy into your vascular system where your blood vessels constrict, your blood pressure goes up, and what's called perfusion increases. And so your perfusion of blood into your muscles improves and increases. Why would that be? If I'm going to run away, I'm going to burn up a lot of energy in my muscles. I need a lot of blood flow going there to deliver new new substrates for, you know, from calories and nutrients and oxygen, etc., so that I can run away or fight back and run away, whatever it is. Why don't I want to be digesting? It's because that's a waste of energy when I'm about to be killed. I would rather put it into my physical musculature, hence the blood flow improving to the exterior of the body. There's a number of other things that happen as well, but what you can see is that your body is physically put into a a physiological state where it is able to either fight back or flee or a little bit of both. Now, there's also changes that these same neurological chemicals that come from the threat to the sympathetic nervous system, the automatic response to the threat, and then out. There's biochemical changes that go on in your body that actually shift so that you can feed The processes that you are now feeding with all this extra blood. For example, there are biochemical changes that allow you to free up nutrient sources so that your muscles can operate at maximum so that you have reserve energy to run away and all of that. There are other things that go on too. For instance, your heart rate, your heartbeat will go faster. We already talked about the blood pressure going up and all of that. So the idea behind it is your body is immediately perceptive of the threat. The brain, through the nervous system, the neurochemicals, hormonal interface, a bunch of other stuff, sends all these messages out to the whole body to put you in a position So that you can either fight off the attack or run away. Now, it's— I used to teach this a lot to medical students, and it's always hard to go through this particular discussion without— I had a patient one time that actually was— they were in Alaska, they were running, and they were actually attacked by a bear. So real live, you know. Oh my gosh. sympathetic thing. And they didn't have the opportunity immediately to run away from the bear because the bear actually got a hold of them. Now obviously they were telling me the story, so they lived through it. But they literally fought with the bear, which not many people live through, and fought with the bear and would run a few feet away and get caught, and fought with the bear some more, and fought with the bear some more. Until finally the bear actually decided that this was not worth the energy to try and eat this person, and then they were able to run away. And they, they were extremely, extremely, you know, cut up, and, you know, they would have probably died had there not have been a ship there that had some medical help and other stuff going on. But literally, That is the intended purpose of this stress response that you have. And it, as the person described what was going on to me when the bear, you know, was trying to eat them and cut them up and all this stuff, they literally were utilizing all of this stuff I just told you about. So it's a very real thing. But the part about stress that then becomes something that we think is different, but it really isn't. is when we have a life event where there's no bear anymore. So we don't see a bear, we don't see a person with a knife coming at us, we, you know, we don't see a tiger or a giant snake or, you know, whatever, right? But we suddenly lose our job, or a close family member or friend gets a terminal diagnosis. Or we find out that, you know, we're going to have our home foreclosed on by the mortgage company, or we find out that we failed a course that was very important in school, or, you know, you fill in the blank, any number of human stressors that go on. When those things happen, your brain does not actually— because this is from the part of the brain that is not really thinking about the larger picture. This is from the part of the brain, the stress response, that is about very, very quick activity to save your life. So the upper parts of your brain can sit back and can muse about, well, okay, you know, my home is going into foreclosure, but no one is going to kill me. You know, I can separate those things. You know, intellectually. Your fight-or-flight system, the autonomic nervous system, can't. It doesn't know the difference. So whether it's a bear, or whether it's you losing your job, or whether it's you had a fight with your boss, or whether it's, you know, you're having trouble with some relationship in your life or any other characteristic of your life. It's exactly the same physiologic change as a bear coming. Now, sometimes we don't notice it as much because there are levels that happen. But what happens in modern society a lot is we are living in a pro-sympathetic state so much and for so long that we kind of disengage from the physical effects that it gives us. Now, if you just go back to the positive effects of being able to run away from a bear, okay, I'm shunting my blood into my skeletal muscles so I can run away or fight or do whatever I have to do. That's great if there's a bear there. There's no bear there. What does that do then when you shut off your digestive system, turn it down because you're prioritizing things? You're not going to digest and absorb. as well, or maybe much at all, as you would under normal neurological conditions. So when you're highly stressed, you actually decrease the normal functioning of your digestive tract, and that has a whole host of problems. But one of the things that we see with people, and it's why a lot of, you know, underlying functional or chronic illnesses sneak up on you, is Because most of the day they're living in a stress response. And so then they go to eat, the food goes in and the body kind of moves the food through mechanically, but there's not an appropriate amount of production of stomach acid and enzymes and all the other good things that help us digest it. So then you have a lot of other— we have trillions of bacteria and some fungus and virus and stuff that live in our GI tract.

Yeah.

Normally, well, the wrong groups of them will then be emboldened by all this poorly digested food. And in the beginning, you might get indigestion. Well, then after indigestion comes sort of a lot of maybe overgrowth of the wrong organisms or dysfunction of the digestive tract not working right, et cetera. And then you wind up with an overall digestive dysfunction.

Yeah.

Now you think, well, okay, symptomatically, maybe I'd have some constipation or diarrhea, or maybe just stomachaches, or I'd have other problems. Certainly you can get that sort of stuff. But think about it a little bit more. What are you also doing? You're largely unplugging the body being fed because you're not in the parasympathetic, calm, digesting side of things. You're in sympathetic stress mode. So you're not going to digest and absorb very well. That means you can become chronically nutrient deficient and also get all the dysfunction in your digestive tract from the poorly digested food. And it really winds up creating a big snowball effect in the rest of your life. So the issue here Is because we don't have a bear usually out here going to attack us, and yet the stress response is perceived pretty much the same way by the body, we can have downstream effects from the chronic stress response that just aren't going to go away. And if you take something as core as feeding your body and fueling your body through the digestive system, and you're messing that up, By having a chronic stress response when there's not a bear out there, that alone will start to degrade the nutrient status of your body. You do that, it degrades the way that the cells work. And when you degrade the way that the cells in your body work, you start to degrade the way that your organs work and a lot of other functional things. The other thing is That when you are under stress— now, I gave an external example of your eyes and how— excuse me— and how your eyes under stress are more focused far away and all that. But neurologically, when you're under stress, the inside of your brain's operation goes into a usually a hypervigilant type of a state. So in addition to the peripheral problems that the stress brings, such as higher blood pressure, higher heart rate, you know, more constricted blood vessels and stuff, which is great short-term, not great long-term. Neurological chemistry shifted over to hypervigilance and essentially a, a position of your brain that would be for getting away from a bear. Well, again, if there's no bear over here and there's no proximal threat to me and my life and limb, and yet my brain is still operating that way, I am just like my digestive system isn't going to work quite right. My cardiovascular system is going to be shifted in an unhealthy long-term way. My brain patterns and my brain processing gets shifted too, to more of a life or death, you know, yes or no type of a response. And when you're in that sort of response, just like you're, you know, when you're in fight or flight and you're running from a bear, you minimize digestion because you don't need it. If your neurological chemistry in your brain is heightening the alert and alarm response side of things, you're going to have a lot of other things that don't get balanced out. So you're going to have neurological responses, which can come out either as thought patterns or emotional sort of outlets or any number of other things. Where the body is in hyper-alert mode. You're making only what you perceive to be critical, high-level decisions and often overreacting to them. And the side of the brain that does more of the calming neurological activity is minimized, like digestion is minimized. Because if you're going to run from a bear, you want those sort of life or death sort of circuits running. You want really critical information, fast decisions, and all of that. But for normal processing, we don't always need to be working that way. It's just like we don't always need our heart rate to be real fast and our blood pressure to be increased all the time if there's no bears around. We don't need this sort of imbalance in our brain chemistry. Well, just like long-term, that can affect the way That, you know, we— our digestive system does and absorbing things, etc. The other thing that can be affected is the ability of our brain to be able to kind of come back to neutral and settle down. So one of the directions that the brain goes is actually into this kind of hypervigilant state. And we all have underlying kind of constitutional things about the way our brain works. So some people are very anxious to start with, and they get more anxious. Some people have a nervous depression that they will develop. Some people develop other problems. And so this just accentuates what's already there. It can also engender a lot of inappropriate sleep patterns, because sleep is a return to balance between the excitatory and inhibitory sides of your brain, and the fight or flight is about the excitatory side. It can engender, you know, as I mentioned, anxiety and other sort of, you know, kind of hyperactive things that go on. And a lot of people will go through the day and not realize that Well, they may realize it, may not realize where it's coming from, that they're presenting on the outside a fairly level-headed, calm person, but on the inside, they're literally right on the edge all of the time. And so their friends and family might notice a little bit, coworkers might notice it all, not notice it at all, because they are essentially kind of level-looking, but on the inside, they're sort of churning along with this stress response. So long-term, the fact that an external stressor that's not a bear and is not gonna kill you is perceived the same way as a bear or a tiger or something like that, or a person with a knife or a gun, same inputs, same perception, same physiologic change as losing your job or as trouble in your personal relationships or as financial trouble or as health problems Or as other things that go on in our lives. So all of those things become very real physiologic challenges that the body has, and they can lead to very real long-term physical issues. If you think about just— and there's many, many other parts— but think about just the things that we've discussed up to this point, you got some pretty core things that if you derail them long-term are just not going to work out right. You've got your digestion absorption of all your nutrients in your food. You have your hormonal metabolism. You have your cardiovascular system being thrown off. You have your brain function and your neurological function being thrown off. You have a lot of things that are just very, very unique. And don't end well if they keep going. Now, one of the reasons, if you're listening, you know, live or anytime around 2020 when I'm recording this, if you're listening in the future, we may have other problems going on. But one of the reasons I wanted to talk about this stress response thing and then talk about some solutions coming up was, you know, there's just— the year 2020 has been a wild ride by any stretch of the imagination. And we've got, you know, this worldwide, you know, concern over coronavirus, COVID-19. We've had a lot of other things go on throughout the year that are big stressors. It's in the US, it's a presidential election year, which is always a stressful event. This year is even more so. for, you know, a million reasons. You put all those things together and then you add on to it the fact that because of COVID there's a lot of people who have had to work from home. A lot of people lost their jobs. Many people with children are having to do homeschooling of one kind or another for their children, which they weren't doing before. And, you know, many, many other things that have just changed in the worlds of people. Because of the circumstances of this year. And so it's normally a tough problem and normally a situation where we have chronic stress-induced illness, meaning— not meaning all in your head, meaning this thing where your brain literally believes that a bear is attacking you, but it's not, it's some other stressor in your life. That normally is a big problem in human health. Well, the year 2020 has just escalated that to a much, much higher plane. And so while, you know, if you go back through the podcast history, you'll see I've done a whole series on stress and all that. I felt like it was really important just to, you know, circle back to this and talk about number one, legitimizing, because honestly speaking, more often than not in conversations with patients, the thing I hear back when you talk about a stress-related illness is they Believe that you're telling them that they're crazy, or it's all in their head, and if they were just a tougher person, they could get through it or whatever. And that's absolutely not the truth. So the reason I want to spend time on that is to show you that this is a this is a human physiologic response. It is totally normal. It's just it's misappropriated in cases where there's something that won't necessarily kill you right away. But it's the same biology and the same reaction as if something was going to. try and kill you. So I wanted to really make sure that we understand this is not, you know, you should just be better and then this will go away, or, oh, stress, it's all in your head. No, this is a real thing. And it is exactly the same as if someone was coming up to you and injecting you with particular drugs that changed your neurochemistry. It would be the exact same output and response, only your body's doing it to itself. So the first thing is it's legitimate. It's part of the human condition. It's normal. But by understanding it and understanding what it does, we can understand that we can do things that help to counteract this automatic stress response that we all get under. So what are some things that we can do even in a year like 2020, or maybe it's a year in the future and we're having even worse things going on, who knows? What are some things that we can do that help to reset things and deal with this normal physiologic response that gets overplayed because our brain, the part of our brain that responds, doesn't understand the difference between a bear or a person with a knife trying to kill us and every other stressor that we, you know, that is not going to kill us. And we certainly are living in a time where there's plenty of those stressors. So what can we do? Well, the first things to start with, and this is always, you know, sort of on the same level as people, you know, when you say stress-related illness, they think, oh, it's all in my mind and I'm just weak and whatever. No, we No, that's not the case. Well, kind of along the same lines, the first responses are the things that make the littlest difference in the beginning, but the biggest difference long-term. So the first responses that we have to do with stress have to do with the way our body is treated, the way our mind is treated, and what we do around that to try and train our body to go back away from the running from the bear physiology. So one of the things that becomes incredibly important is sleep and wake, sleep-wake cycles. People under chronic stress tend to get sleep disturbance. Now, that can go in 2 different directions. One is the person will sleep more. Okay, we see this in depression sometimes, other neuro-emotional things. But sometimes under stress, people will try it, you know, they'll literally want to hibernate. alternate, because that's their body's way of trying to deal with things. But more people, it seems, under stress don't sleep as well. How many of us have had the experience of something's going on in your life, you have a big change coming up, maybe you're moving, getting a new job, whatever, and it wakes you up at night thinking about it? Or you're, you know, you're concerned because— I've talked to a lot of people in the year 2020 about this. They're, you know, they were going along, they're healthy, things have been going pretty well. Then they found out they were exposed to somebody who had coronavirus, and now they're worried about getting it. They don't have it yet, but, you know, it wakes them up at night, and they're just thinking, oh gosh, you know, what if I, you know, what if, what if I got exposed to COVID? How's that going to work out? And all that. Any number of things can do that. The other thing is, That maybe you're not consciously waking up, but something now people, uh, through, you know, apps on their phone and, uh, Oura Rings and other devices can check is, you know, how much good quality sleep are you getting through the night? Used to be we would do that with patients who are chronically ill, and we would take machinery that was, you know, amazing to do and all this. And almost universally, they were not sleeping well at night and not having restorative sleep. Imagine that. Well, now you can get apps that hook up to your phone and do all of this stuff rather simply. And what most people find is more stress they're under, the more poor quality of sleep and the more poor quantity of sleep that they get. Well, imagine if sleep is there to help your brain and your body recharge, and you're not getting into the right levels of sleep and the depth and the length of the right levels of sleep, is your body going to be reset for the next day so that it can deal with the next stressors that come along? Not very well. No, not good. So sleep quality. Now, there are a number of things that can be done. We don't have time to get into real super depths here. But one thing that you can do, because if you're listening to me anywhere, you're probably on the internet. So you can look up on the internet, the phrase sleep hygiene. So instead of dental hygiene, it's like sleep hygiene. And there'll be, you know, a lot of different sites and all that. And as with everything on the internet, you know, read a few and kind of see where they're coming from. But there's a lot of really good advice around sleep hygiene out there. And you can look into that if you're, you know, most of us are having having some degree of trouble sleeping. But there's things like having digital sunset where electronics get shut off at a certain time. There's things about when proximity of eating before bed and a million other things that you can look up under sleep hygiene. So sleep and wake is important. The next thing is physically getting your body to re-signal its metabolism. Meaning if you move your body and your skeletal muscle and your body moves around, that starts to send chemical hormonal signals out to your body that we are in a repair and building metabolism. The converse is if you do nothing and sit and eat foods that would increase your blood sugar levels, that signals your body that we are going into a pro-inflammatory feeding metabolism. And you can kind of guess which one probably is better for the stress response. So physical movement and exercise. Now you don't have to start running marathons or being a bodybuilder or anything like that. Getting up and walking, you actually using your legs and the big muscles in your body, which is walking, triggers more of this metabolism than almost any other type of exercise. Now, if you already exercise, great, keep doing it. But a lot of people, when they get under stress, Because of these neurological signals that go on in the sort of derangement of your executive function, you'll get subliminal or maybe not so subliminal messages saying, instead of resting or instead of exercising, let's just sit and eat some donuts. That sounds better. And so why do we do that? Why do we comfort eat and not move? Because moving and eating more appropriately is better for us. We comfort eat and we not move because is that there is a biological chemical hit that we get that is both physical and neurological when we bump up our blood sugar levels and insulin's released and we get these inflammatory mediators that go out and they have a short-term neurological and chemical benefit. It's very much like an addiction, sort of a trigger. And so there's a short-term benefit the body perceives to that. A lot of times when we exercise, if we're used to exercising, we kind of feel good when we do it and we're drawn to doing exercise, but that can take a while to build up. So it's not a judgment. It's just saying, you know, because, you know, every day I have to have the same conversation with myself. We're gonna go out and get some work for the core muscles in and move, you know, because a lot of what I do is I write and I record educational material and I do podcasts and all this stuff. And so a lot of that doesn't involve me doing a lot of movement. You see me move my hands, but that doesn't really count so much. So it's the same thing. It's, you know, okay, yeah, that's important. And after a few days of doing it, then my brain actually has its own idea that says it'd be good to go out and, you know, do some stairs or get a walk in or do, you know, whatever it is you're going to do. But it takes time to turn the ship. The important part is if you start working on these things like sleeping better, look up sleep hygiene, move your body just a little bit more every day, super healthy. Now, we already talked about like the The inflammatory eating, less inflammatory eating. Generally speaking, you boil it down, eating nutrient-dense foods that don't make your blood sugar bounce up and down are less inflammatory, generally speaking. Now, this again, diet is an extremely personal thing. Some people go one way or the other. People have a lot of ideas about it. It's not really something we have time to get deeply into, but something that's kind of universal is you should minimize the amount of things that make your blood sugar bounce around, that easily raise your blood sugar. You should maximize things from the plant kingdom. Things from the plant kingdom have a lot of nutrients in them. They have a lot of phytochemicals in them, plant chemicals that are there that are immunomodulatory, and they're good for our brain and all this other stuff. Very, very good all the way around there. And you need certain amounts of clean protein and fat. So you don't want to eat stuff that's full of chemicals and stuff like that, but we need protein and fat to help our muscles and our brain and everything else. And we don't— what we don't need is a whole bunch of sugar and things that boost our blood sugar because it goes up and down. So the metabolism of eating, the more we shift towards that and get our muscles working a little, that actually helps to blunt the stress response. Because while we don't have time to get deeply into the biology of it, one of the reasons why we talk about not having foods that make your blood sugar go up and down a lot is when your blood sugar is going up and down, your peripheral stress response hormones have to get involved because they're also involved in blood sugar manipulation. So if you're already stressing your system and your peripheral stress response hormones are already stressed, then you don't want to be, you know, wagging the dog by the tail by throwing more blood sugar problems on top of it. So you can look up a real easy resource you can look up online if that's, you know, sort of foreign to you is the glycemic index, G-L-Y-C-E-M-I-C index, glycemic index. And it's just a sort of a ranking of foods As, you know, how much sugar are they going to contribute once your body breaks them down? The more sugar they contribute, the more insulin sugar activity you get, which is not what you want. So, for example, you know, like broccoli is a low glycemic index food, even though there's some plant sugars in there. And so you can eat all the broccoli you want, basically, it's not going to be too big of a problem. Eat a high High glycemic food, you're going to have more, you know, more of this dysregulation stuff going on. Then there's your brain part of it, the mind-body part, your thoughts and all of that. And because we're constantly bombarded in modern times with electronic access to news and also just information that's both good and bad 24/7. We're bombarded all of the time. Those signals from the bombardment from news and other information and people angry online and all that, those signals go right to the stress response area of the brain as well. So you have to look at doing things like putting yourself on an information diet and, you know, keeping up however you will, but not Being engaged in the news cycle 24/7. The other thing is the inputs that come from both electronic sources and human sources. You want to maximize positive things that are going on because your body's already thrown off in the other direction by all of the negative stuff around you. So your brain has to have inputs that are going to be Positive and helpful. The other thing is what you do sort of from the inside out. That other stuff is outside in. Inside out, you can develop whatever practice you prefer that would be helpful. For some people, they like to meditate. For some people, they like to have a mindfulness practice. Some people like to do prayer or prayer and meditation. Some people prefer other things. The thing that they all have in common is that they are a practice which comes from the inside of you and focuses you and, and your mental-emotional being on, on something, and then works its way outward through your thoughts and your actions, depending on which one's one of those things you like to do. Now, the other part about them is the more that we study these things like mindfulness or any of the others we talked about, the more that they bring the nervous system back away from the bear is attacking me stress response. And remember, part of the thing that we keep going back to here is underneath it all, the brain doesn't care whether it's a bear. A person with a knife coming after you, or the fact that you're worried about getting sick, or the fact that you're worried about losing your job, or the fact that you don't know how you're going to homeschool your kids and keep your job at the same time. It's all the same system. So these internal practices that we can do bring our nervous system back to more of a center place, and they actually have been shown to decrease the sympathetic outflow. And so they decrease things like our blood pressure, decrease the heart rate, they improve digestion. They oppose all that stuff that I talked about in the beginning, where our fight or flight system kicks in. And so I'm very— I try to be very open when I talk about those things, because some people like one more than the other. It doesn't, you know, really matter. It's whatever you do and whatever your interested in doing. But if you look any of them up, they all have research now that shows that they actually shift the system back more towards neutral. The other thing that a lot of people— I mean, it's been practiced for thousands of years, but more people are doing now, becoming more popular, I guess— is breathwork and breathing. Because one of the things that is a literal direct signaler to your brain And especially to parts of the brain that get involved in fight or flight is how you're breathing. So under normal circumstances, I have to give the really short version of this, but under normal circumstances, your brain has sensors that sense if you start to breathe faster. Okay, because it, it's probably because you're running. And as soon as your respiratory rate starts to go up, There starts to be signals that go back to your brain and say, we're probably going to need to upregulate the biology around breathing and oxygen turnover, probably going to have to upregulate some things about output to the muscles. So if you go and you do breathwork, and you— and there's a lot of people online that do this. It's very, very common now. and lots of people who do breathwork and that sort of thing. You can look that up easy. But part of the idea is just one very small slice of a big pie is a lot like meditation and other stuff. You change your position, body position, you change your breathing patterns, and you actually can shift your nervous system back to a more neutral place. You can look up— there's a doctor, a colleague of mine who's excellent at this and knows more about it than anyone I've ever met. Dr. Brad Lichtenstein. And so if you— Lichtenstein like the, uh, like the country slash prefect in Europe. Uh, Brad Lichtenstein, he's on Instagram and other places. He, he does tutorials on this, really, really great stuff around breathwork. And he does things for physicians where he explains all the neurobiology of this amazing, amazing stuff. There's a lot of people out there. So there's some people who aren't comfortable maybe saying they want to, you know, meditate or pray or do mindfulness, but breathwork they could get into. Well, it's all part of the same thing. So something you haven't heard me mention yet, which often they're the first thing that people look for, are not just drugs for anxiety and stuff, but, and stress, but what about nutrients and supplements and things? So what I would say is those things are important. And usually, you know, someone comes to me looking for advice around this. I'll tell them about all these base things, you know, the breathing, the eating, the moving of the body and all, you know, and meditation, etc. And then basic things that help to feed the stress system to kind of move it back. The B vitamins are burned up quickly in stress response. Magnesium is used up every day in your body. Magnesium always goes with vitamin B6. So B vitamins do a lot of double duty.

Yeah.

But magnesium is a huge one that gets burned up in the stress response, and then things like vitamin C because it's water soluble. Vitamin C does a zillion things in your body, but one of them is it actually feeds parts of your adrenal stress hormone system and parts in the brain as well. So because we don't make our own, vitamin C is another good one to have. So you see things like extra B complex, mag. Magnesium, vitamin C. And then there's a lot of different herbs. And I don't usually give advice on podcasts about herbs because they're kind of specific to people. And, you know, some people do better with some than others. But some people, just as examples, and you should really work with somebody who does herbal medicine for this, this is not medical advice, but herbs like ashwagandha, That's common in Indian Ayurvedic medicine. Rhodiola is another one. Some people use certain types of extracts from herb called schisandra, S-C-H, schisandra, and a number of other herbs you can kind of look up, stress-supportive herbs. There's also the more calming things they call nervines. You look at like lemon balm, it's very calming and Some people use valerian or kava if it's, you know, a little higher grade. A lot of different things there. But we're running out of time here. So what I want to just mention as we go along is, number one, stress response is real. It's normal. And it's not all in your head. Parts of the circuits are in your head, but it's not all in your head. It is important because it keeps us alive, but we need to remember that your brain doesn't care if it's a bear killing you or if it's all the other stressors— the election, COVID, losing your job, homeschooling your kids, whatever it is. It all reacts the same way. It has an intended purpose, but when it's unintended because Your body doesn't need to run away from the fact that you, you know, you have job stress or whatever. The unintended consequence is the normal stress response still is not a good direction for your body. You can turn the ship around by number one, knowing that this exists. Number two, doing those baseline things around sleep hygiene, low glycemic eating. Move your muscles in your body. Do some sort of mental physical practice, whether it's breathwork, mindfulness, prayer, meditation, whatever it is you're doing there, something. And then talking to others. Find some people who are supportive to you. Talk through your problems. And what you see is we all have problems. We all have the same things that we deal with. And we have that in common, and it doesn't make it better that you have as much stress as someone else, but it normalizes it a little bit more. But we are now out of time for today. It's been a lot of fun talking to you. I did want to say we're just at our first month with the book Cancer: The Journey from Diagnosis to Empowerment. A lot of information in here for cancer patients and families about the stuff we talked about today, because the mental emotional part does affect the physical part, the physical outcomes of cancer. So if you just look up my name and Cancer: The Journey, you'll find the book, Amazon, anywhere books are sold. And we'll be doing some more announcements about that as we go along, but we're out of time. This is Dr. Paul Anderson with Medicine Health with Dr. Paul, and I'll see you all on the radio next week.

You've been listening to Medicine and Health with your host, Dr. Paul Anderson.