STRESS - What it's doing to you and what you can do

And that's me. I'm Dr. Paul. And today we're going to talk about something that's topical every single day. But if you're listening live and it's February 18th, 2021, I think the topic of stress and our body stress response and things that we can do about it's probably a really appropriate one. Literally with All of the— is everything going on. If you're listening live, I don't need to recount any of it. And if you're listening in the future, go back and look at the years 2020 and 2021, and you'll see what I mean. So today we could have easily had another question and answer around things around COVID and infections and things of that nature. And we will probably circle back to that and get plenty of questions about, you know, all of that. But I was really thinking about, you know, just looking at the— not just the questions, you know, that I get about whether it's COVID or other, you know, medical and health issues, but also just looking at, you know, where are we all are right now. And one thing I was reflecting on is this is the middle of February 2021. It's, you know, we're already a month and a half into a new year. This time last year, we literally had been hearing on the news stories about this coronavirus thing that was going on outside of North North America, at least at the time we believed it was outside of North America, and we were thinking, you know, oh well, you know, that's happened before, you know, we think back to like SARS, and so SARS-CoV-1 or SARS was a little bit more limited, but it certainly affected a lot of people, and then we had, you know, versions of other types of, say, influenzas go around, so I think a lot of us were just thinking, well, you know, this might be kind of like SARS was and hit certain cities and get kind of intense and they can contain it, etc. And then that didn't happen. So it wasn't very much longer after this time one year ago that we started to get inundated with concern over this new potentially pandemic-type virus and all of this that went on. And I know it was just about, just, just a little over a year ago, about a year and a week or 2 weeks when I started to get requests to do topics specific to the care of viral illness and COVID and all that. So I just bring that up to say it's been quite a year. It's almost hard to believe, depending on where you're at and what What way you like to think about things, that it's, it's been a year. And it's hard to believe the way that we were thinking, you know, just a little over a year ago and not really worried about all of these things that people are dealing with, such as, you know, should we, you know, when do we wear a mask? How many masks? Do we socially distance? Do we do all this other stuff? How do we do infection control? You know, those were maybe thoughts that people had, but they certainly weren't— weren't thoughts that were on everyone's mind like they are today. So I was just thinking in honor of it being just about a year, and with just what I see going on back and forth between people around a lot of sensitive topics and back and forth between people around a lot of, you know, issues related to both dealing with COVID but also dealing with maybe the loss of a job or the change of a job or working at home. Or the kids being home doing school, or on and on and on. You just, you could fill in probably 100 things. I thought, well, let's, let's just take a step back away from the acute topics at hand. And of course, you've got COVID, and then you've, you know, there's political things, and there's all kinds of other excitement in the world. I thought, well, what would be a good, let's say, healing pause that we could do? And that's not to say there isn't anything going on. It's not to say that it's not all important, but I think taking care of ourselves can be one of the more important things that we really need to do. So stress comes up and stress is a normal part of human existence. As a matter of fact, if your body doesn't have stress, you actually will die. Now there are two, probably a lot, but there's kind of two divisions of stress that we think about. One is what they call eustress. stress, which is just the normal stresses of life, whether they be, you know, physical or mental, emotional, or, you know, whatever going on. And that's kind of what keeps our body going, that keeps challenges going towards our body, etc. And then there's, of course, distress. So eustress and distress. Distress is the kind of thing that we experience a lot. Now you can experience it Mentally and emotionally by listening to or reading a news story. You can experience it by, you know, going outside or being in your house and having it be colder than you would like. You can experience it by some sort of trauma. You can experience it by not eating for too long of a period of time. You can experience it by some other person interacting with you in a way that is stressful. It just goes on and on and on, the actual causes of stress. So the first thing we'll talk about, we kind of divide this into 2 chunks. The first chunk is understanding stress and understanding how we're really set up to have stress and how our body is set up to use stress and, you know, to neutralize it and deal with it. And if it doesn't, it can create illness. So I want to understand that part. And then part 2, want to talk about what do we What do we do about it? What are some things other than pretending nothing's wrong that we can do about stress? So the first thing is stress response is natural. It's a healthy response. The body's set up for it. It's built into the way that our body works. And one of the important things to keep in mind is if stress is something that is built in, And stress is one of those things that the body has mechanisms for dealing with, then what that really means is that the, the body's use of the stress can either be optimized or non-optimized, and the outcome of optimizing or not optimizing our stress response will lead to either a healthier outcome from the stress or a less healthy outcome from the stress. And I think that that is a very critical thing to keep in mind. And there's this stigma around stress that a lot of people have, which is very reasonable, which is by saying, well, if you say something is caused by stress, then it must be all in my head. And meaning it doesn't— there's no value to that. That's not a real thing. It's not like a broken leg, right? It's just as real as a broken leg. It just happened to be a different problem. And your body, as a matter of fact, drew a lot more mechanics in your both head and peripheral body when you have a stress response than it does when you break your leg. Now, we don't want either one, especially broken legs, very painful, but your body actually does more work more constantly on the stress response. And I can't really think of— if you just watch, you know, the news and social media and all of this stuff, and just watch how people are responding to various things that are going on in the world, this is a very concentrated, high-stress time that now has been drug out over a fairly long period of time. And so, you know, I am old enough to have been around when wars have started and, you know, enduring wars and other things going on. And you, if you think back when things like that happen, you know, you go through it and it's sort of— there's sort of a crescendo of the sort of psychic stress of the world, and then it kind of goes down and there's little, you know, blips. And if you have a personal connection to the war, you know, it might be higher for you longer. In the case of what we'd had going on in 2020 and 2021, it's sort of like everybody is brought into this, and it has created actually this, you know, giant What, you know, one way you can look at it is a giant ball of stress that people are involved in because of, you know, a bad virus that's novel that we're not used to. And we have all this conflicting information about what it does and what it is. And then we have, you know, the rules change every month as to what you're supposed to do about it. And then we don't have treatments, then we have treatments, and then we have treatments that do work, and then these— work, you know, it's just all sort of a mess. And then if it touched your family, as many of the people that I talked to, you know, unfortunately, really, where it's touched their family, it can either be something that, you know, wasn't that big of a deal, or it was a huge deal and somebody passed away. So it's, it's things like that, that are just a good example. We could have had completely nothing, none of that going on the last year, and we'd still have stress. So the first thing to release is if you feel that having a stress-related problem is just all in your head, you need to let go of that idea. And, and I know that there is a stigma around it, but it is an inappropriate stigma because stress your body undergoes all of the time, whether you know it or not. And if you have stress-related physical or mental-emotional complaints, There's a portion of them that are operated through your brain, but not all of it. So it's really important to understand that for the purposes when we try and flip this on the other side and say, well, what could we do about that if that's going on for us? So as I mentioned at the top, stress can come from literally anything. You being surprised, happy or sad, is stressful. Pain, as we mentioned, fear, anxiety, infection, and inflammation. If you have been sick, that is a stress on your body. And one of the things about the stress response that's really important is, and this is why we want to keep our stress response system working, the stress response system in the body, especially the neurohormonal part of the stress response, is intimately tied to your immune response in your body. And so if your stress response is not well controlled because it's been beat on and beat on and beat on and it hasn't had a chance to recover, your immune system will actually not work as well as it is supposed to. So you've probably seen people who have— sometimes they call it the letdown effect, where, you know, they've maybe been exposed to something, or they've, you know, had a history of something, or maybe just out of the blue, and they've been under a huge amount of stress. And the stress goes on and on, and finally there's a release of the stress, you know, the situation changes greatly for some reason, and their body sort of lets down. And you'll see that a person commonly will get sick with something or have something diagnosed during that time, the letdown time. Right. Well, part of that is because the stress response that was going on can, can actually cover up some symptoms of disease. But the other thing is, is when the stress response is really, really heightened, it's burning itself out. And so when you go into the letdown, there's normally, if you look at, you know, stress on a curve of we're not too stressed here, and then we kind of raise up like a hill and we get a big bunch of stress, but a big bunch of stress hormone output. And then we kind of go down like a nice little hill back to normal. What happens in the letdown effect, which is very common, especially in modern life with, you know, chronic stress and stressors that never stop, is that when the letdown effect happens, you actually kind of keep going down and down and down. So it's not just sort of like a, you know, an upside-down bowl where it goes up and then back down. It actually keeps falling down off a cliff on the other end. So the letdown effect is a big thing that can happen too. Well, another thing that can happen if the stress is persistent, and, and I would say, you know, this last year has been an example of persistent stress, that persistent stress, like I say, burns the system out. And so people will say, well, why would the system burn out? Like, isn't it set up just to work forever? Well, yes, your stress response system is with you from the day you're born till the day you die. And that's good, but it is intended to operate in the background at a certain level, and that is intended to upregulate when we have a trauma or a stressful event, but then downregulate very quickly. So your stress response is never intended to go up and stay up for long periods of time. So when we talk about like the immune effects of burning out our stress response, it's very important to remember that the normal thing your stress response does is, is to kind of modulate your immunity and then take the neurohormonal controllers back down to the level so that then the immune system has its cycle that it can go through. If it's always really high, or if it crashes and falls off the cliff, the immune system will get confusing signals. And then we can develop things— we mentioned the letdown effect, where you may develop a disease during the letdown from stress. You also can get things like an unregulated immune response, like an autoimmune-type response, or you can get an unregulated immune response, something we talked about a lot with COVID The infamous, they call it the cytokine storm, that sort of a thing. Well, when that goes on, what happens is that the normal hormones that sort of modulate the inflammatory response are related to, or directly, these stress hormones. If they are not there in the right amount, you'll either get too much immune response or too little. You don't want either one. Well, a cytokine storm is actually Too much, and that can be part of the stress hormones being so burned out that they can't deal with that. So I think it's important just to remember that the stress response is not just all in your head. It is a physical thing that helps keep us alive, and it's meant to work in pulses. But you take somebody who's got a, you know, a really bad situation in their life. You fill in the blank, whatever it is, but it's there constantly. That person will eventually burn out their stress response system because there's no letdown, there's no break. This is a lot of where post-traumatic stress disorder, that sort of thing, comes from. So I do think it's important that we understand that stress is a normal response in the body. It's a physiological response. It's something built into the way we're made, in the way that the body works. And if you break it down, down into its, its constituents, the stress response, which does reach out and affect lots and lots of other things in your body, has a hormonal side that is sort of divided into 2 things. The stress response is largely a neurohormonal response. So one side is the adrenaline family. You've heard of adrenaline or epinephrine. Norepinephrine, dopamine, those are catecholamines. That's the sort of adrenaline side, the catecholamine side. Those are the things that we tend to feel more acutely, quickly. So if, you know, you think no one's behind you and someone says boo, you, you know, you jump, or you pull out from a red light, someone whizzes right by you and almost hits you, that feeling you get through your body are those catecholamines. Yeah. Hormones. The other side is a steroid response system. And the steroid response system, you know, sometimes we think of steroids and we think of, they must be bad. Steroids are part of our body too. Steroid hormones are based on a cholesterol molecule. That's how they got their name, sterols, from cholesterol. And so they include things like, you know, cortisol and Estrogen, testosterone, progesterone, vitamin D— it's actually a steroid hormone— a bunch of other things. Well, in the world of stress response, you have the manufacture of the corticoids, the cortisol family— cortisol and cortisone, and then there's some relatives also if we really want to break it down. But the steroid family, the cortisol-type hormones, are there for more of a long-term thing. So if you look at the way chemically, if you were to— I don't recommend you do this, but if you were to inject epinephrine, adrenaline, into yourself, you'd get a sudden increase in your heart rate and the output from your heart and all this stuff. If you injected, say, cortisol— also don't recommend that either— what you would notice generally, unless it was a lot of it, is that the effect would be much longer over a period of time. So the body's made this way to have sort of an acute punch of a stress response and then a kind of a slow burn to take care of the longer-term stress. Now, if we go back to why was the stress response, you know, why is it there in the physiology? Well, if you go back to more basic times, and you see this in the animal kingdom, Humans all over. The stress response has a large role in our maintaining life as, as a species. So if we go back hundreds of years or thousands of years, our bigger threats may not have been, you know, coronavirus or whatever else, and certainly the news— Our Bigger threats may have been a bear chasing us and eating us, or any other thing that may have done that. So if you think about that, and you, you know, you think about, well, what would be a good thing for my body if I had to run away from a bear? Well, good thing for your body if you had to run away from a bear, if you could magically do this, would be to have a 2-stage response where in the first part of the response Not only did your heart pump faster, but it pumped more blood through it to your organs. Your blood vessels would suddenly, as if by magic, shift their focus, and more blood would go into the muscles of your body. Your vision would magically shift so that you could see more and further away. And your lungs— I was going to leave the lungs out— would actually open up wider, and so you would move more air in and out. Well, think that would be like this magic combination. Well, this is what happens when the initial stress response occurs and your body is ready to— they call it fight, flight, flee. Sometimes freeze. Well, here's the thing. If there's a bear coming, all of that's really useful. If there's no actual thing going to kill you, you still get all that benefit or not in your body from phase 1 of the stress response. So if I come and I stress you, your body doesn't care. It doesn't know the difference. The parts of the brain that operate this don't really care whether there's a bear or a mean person, or I just scared you. It goes into the same response. And it does this by those chemicals being released, those catecholamines being released all the way, brain all the way through the body. And there are literal switches in your body that are there in case you gotta run away from a bear or something. And so it literally shuts down the blood flow to your internal organs, turns it on to your skeletal muscles so you can fight or run. It changes your eye apparatus so that you can see further away and get more light in. It changes your lungs to being able to move more air more quickly, because obviously, if you're gonna pound more out of your heart, you're gonna need more air, etc. So imagine if I'm doing that to you all the time, and there's no bear, and you're not going to die. Well, there's 2 things going to happen. One is you're going to probably develop some troubles physically, because the, you know, the cardiovascular system, the pulmonary system, and the blood vessel system aren't really meant to be shifted You know, like that without the big need for it. And then the other thing is you're going to constantly be poking at the slower burn part of the stress response, which is the cortisol side. And that, of course, is other hormones too, but we can think of it as the steroid side, the cortisol side. Well, that's then going to do all kinds of other problems. So we mentioned the immune stuff. So if I'm in this like acute stress response, I'm going to be borrowing all these things that normally help the immune system. So if I get exposed to something when I'm in this weird stress response, I'm more likely to have an abnormal reaction to the virus or bacteria, whatever it is I get exposed to. But then there's also other connections, obviously the organ connections to the heart and the brain and the eyes and the lungs and all stuff we talked about. But also the stress response In its kind of normal format shifts your blood sugar around. Whoops. Well, if I'm going to have to fight a bear or run away from a bear or something like that, I want to have as much fuel available to me as possible in my muscles, especially so that I can continue to run or fight or whatever. And not run out of fuel. Well, shifting blood sugar— so the initial stress response actually releases free fats into your blood and turns on mechanisms that release glucose sugar molecules, or things that can be converted to sugar molecules, into your blood. The longer-term side, the corticoid side, can dysregulate that. Now you think, well, it's— why would it do that? Well, if you truly are going to have to fight or flee or something like that, you need the extra fuel. But again, what if you're not running anywhere? What if there's nobody chasing you? What if no bear is going to kill you? You get all the same effects. So then it turns out that in addition to the body responding, the blood sugar response becomes accentuated. So you can wind up with long-term worse effect of, or worse control over your blood sugar. You're— in some people, their triglycerides will go up. All sorts of things can happen with chronic stress. So that's another, you know, place, and that's obviously not good for us long-term either. So as we think about all of these things, then we want to kind of Keep in mind, okay, if we're going to look at what can we do physically and mentally and emotionally to help out this situation with stress, where are my big areas that the stress response affects? Well, so we already— most of us have a pretty clear understanding If we're stressed, we do have a mental-emotional component because you feel it. Okay, that's the mental-emotional sort of feeling. We now see that the cardiovascular system and the lungs become affected. The shifting of blood around in the body, which is good if we need it to run away from bears, but not so good if we aren't running away from bears, that goes on. Okay. Also, our muscle is affected through all of these things that we've talked about, our blood sugar control, and to some degree, our control over fats in the blood and things of that nature. Our digestive system. So remember I said that if we're going to run from the bear, it's nice because we kind of shut down a lot of internal organ Perfusion of blood, especially your digestive system. So when you go into a sympathetic response to run away from a bear, your digestive system, the blood vessels shrink down basically. And so they're not, they're not prioritized for blood going in. And the blood is shunted outwards into the muscles. Okay, which is great. But what again, if there's no bear chasing you and you're just stressed? And you eat and you're trying to digest, if you are in a stressful milieu, in a stressful situation for your body, your digestive system can't do all of the business that it does. Because in addition to the blood flow not being in your digestive system to help you digest, you also have a shunting away from the parasympathetic nervous system that helps to operate all the organs of digestion and help you with secreting things like acid and enzymes and all of those good things to help you digest. So your body is just not in the business of needing to eat or digest. Well, you think about it, makes sense. If I'm going to run away from a bear, I'll eat later, right? I don't want to, you know, waste time right now eating if I'm running from a bear. But if there's no bear there and I decide to eat and I'm still under all this stress, I am not going to digest well. Then you have maldigestion. You don't break your food down all the way, so you don't get all the nutrients out of it. You can have symptoms from malabsorption and maldigestion, whether they're heartburn, reflux, stomach pain, bloating, gas, all of that stuff. A lot of that comes from just inappropriate breakdown of the food. And if you consider it, this can go on for years with people, right? So the digestive system is a big area that this goes on. There's another thing that happens in your brain. Obviously, we, you know, as I said, we feel stressed mentally and emotionally, but your brain has this— and you're actually— your whole nervous system has checkpoints for this, but your brain especially is very good at this. It has this ability to modulate away from stress responses. Not that it doesn't make you have the stress response, but it makes you think it's not going on. So there's a tolerance mechanism, whether it's in the central nervous system, you know, your brain and spinal cord, or peripheral nervous system, where maybe you feel pain, etc., where your body downregulates when there's a persistent stressor. So one is a real simple mechanism. There's, there's a lot of real complex ones, but one simple mechanism we can all think of is When you first sit down on a chair, you might notice it's hard or soft or something of that nature. But unless it's a terribly uncomfortable chair, you may notice after 10 or 15 minutes that you're, you're really not spending all your time thinking about the chair. Now, yes, if the chair is terribly uncomfortable or it's ice cold or something, you're going to think about the chair. But for most chairs, you stop thinking about it. Think about when you're in school, you think about You know, you've been in the chair for 30 minutes. You might think, I'd like to get out of here. I might want to go do something else. But you're not thinking about the pressure on your legs and your thighs sitting in the chair. Well, that's not because the pressure isn't there. It's because your nervous system, your sensory nervous system has said, oh, we're going to have this pressure on our legs and our thighs and, you know, our rear end. So we're going to downregulate how many signals we send out about that. Well, that's a normal decrease in tolerance loop that goes on in the body. Well, on a much bigger level, you do the same thing in your brain. So if, you know, we'll use just an example of, let's say somebody has, you know, a job that they really, you know, there's just big stress at the job and they have no control over the stress and they really hate it there. And they feel stuck and trapped. They will feel that way, and intellectually they will say, I don't like going to work, etc. But their brain will start to disassociate many of the signals from the body and the mind that are fighting against that feeling of being in a situation you can't control or not like or whatever, essentially to try and help you keep sane. Okay. The problem is, over time, your decrease in caring constantly about the situation and noticing what it does to your body doesn't change the way that your body reacts. This is why people in— and it, you could change the word job to whatever else you would like to say, a relationship you're in, or, you know, a situation outside of work, or a financial problem, or you lost your job, whatever it is. Right? Something kind of long and chronic. When it's going on, and especially if you don't feel you have control over it and you can't really do anything to get ahead of the problem, the physiologic changes are still going on. And that's why you see people over time, they will have shifts. You know, their, their blood sugar will get less stable. Their heart rate may be higher persistently. Their blood pressure may trend up. Their blood vessels may get— Uh-huh. You know, more resistance in them, so the blood pressure goes up. They may have chronic maldigestion, maybe all sorts of problems that go on, but they really have sort of, you know, they know they don't like the situation, but they're not conscious of everything they're feeling. So it's important to remember that that goes on, and this is the way that your, your central nervous system, but also peripheral nervous system, just tolerate over time to things that really aren't a great situation. So when we think about what we can do about this, so obviously it's got, you know, effects all over. Well, here's the first thing I would say is when we're thinking about what to do about stress, one of the things to consider is, does stress just affect a few things in my body or does it affect a lot of things in my body? Well, the answer is affects a lot of things in your body. And so So that would mean if I'm going to do a more integrated sort of whole body approach to dealing with stress, I'm probably going to want to involve as many parts of my body as possible. So if you've listened in the past and you've heard me talk about, you know, the basics with chronic illness and other things that go on with people, There's a sort of a mnemonic memory device that I use with people to try and have a place to start. And it works for this too. So turns out it works for most of things, how our body works. And it's, it's 3 things to remember, and then you can kind of work out from there. Food, muscle, and brain. What do I mean by that? If you can focus on these 3 areas and think about what the stress might have done or been doing. You can focus on things that you can do that you have control over that can oppose the stress. Now, what I will say is, there's a lot of people that this gets so far out of whack, and I would say, especially in, you know, the last year, where you might need some other help too. But you can always work on these things while you're figuring out who you can work with to work on the stress response. So under food, now keep in mind, remember the stress response disorders, your blood sugar to a certain degree, blood lipids, your fats, digestion, all this stuff. So the first thing is to remember, if we're going to eat— so food does have to do with eating— when you eat, you want to try and move your situation so that things are calm. That's hard to do, but removing outside stressors, not watching the news or having your phone in front of you and reading stuff while you're eating, having quiet when you eat. Now, it's not always possible, especially if you have little kids around, but as quiet as you can. Anything you can do to decrease outside stressors. There's some stressors you have no control over, but decrease all the rest of them. Okay? If you eat with other people and they like to have lively discussions about things and that becomes stressful, then it might be good if, especially if you eat with the same group of people all the time, to say, can we debate things, you know, any other time during the day other than while we're trying to eat? Okay? It literally makes that much difference. Standing up and eating, running and eating, eating while driving and talking on the phone. These are examples of things that don't feed into a positive parasympathetic activity. So as much as you can, calm your eating environment. Next thing is the timing in which you eat. Now, if you're one of those people, because this is a big deal now and people have discovered it, although it's as old as humans. If you're one of those people that does, you know, time-restricted window eating like intermittent fasting, and you eat between, you know, 11 AM and 8 PM or something of that nature, you know, then eat then and do what your body is used to. If you don't do that, then eating regularly is probably better for you. Okay, it's— that's up to you and your doctor what you want to do about that. The most important thing is though, people tend to take 2 tracks when they get under stress with food. One is they eat too much. So they stress eat, so eat all day. And usually when we stress eat, it's not the greatest stuff for us. Or they stop eating, right? One or the other. And either group does not understand the other group. You stress certain people, they can't eat. Stress other people, they can't stop eating. Those are Different neurological triggers that we don't have time to go into. Whichever one you are, you have to oppose the desire to do that. So for some people, it is setting a schedule to actually eat. For other people, it is looking and saying, I'm going to eat on a schedule, but I'm not going to graze constantly. Okay. The next thing is what you put in. So this is where just basic, like, what are the macronutrients that you're eating? Now, if you're already on a particular type of a diet plan for a health purpose, so some people might be on, say, a moderated carbohydrate diet for, you know, any number of things, or they might be, you know, some people with cancer might do a ketogenic diet, or some people might do whatever else, whatever you do, unless it's just, you know, some insane thing you want to do it. And you want to look at, am I getting enough quality protein and quality fat? And then slow burning carbohydrates. If you're eating carbohydrates, you want them to be slow burning. So we talked about this before. You can look up glycemic Index, and it's this range of foods. And what you want are the slower ones, the lower glycemic foods. Why? Because then your diet is not also triggering this weird insulin and blood sugar reaction that the stress hormones trigger. So the more regular you're eating and the more balanced that your diet intake is, the more you oppose the stress response changes to your blood sugar and your insulin and glucagon and all the other stuff that that affects, including your— Yeah. immune system. Now you're gonna get more nutrients the better you eat, the better you digest and absorb, the more will go into your blood. So that's gonna be a good place to start. Now muscle. So food, muscle, and brain. Muscle basically means that you kind of have 2 opportunities to have muscle help you out. But if you think about it, go back to the story of, you know, a bear chasing me What would normally happen if a bear is actually coming to chase me? I'm going to run far, far away if I can, right? Or if it's an attacker and I can't get away, I am going to fight, fight back. Well, the body under stress response is set up to do all of that stuff, right? Imagine under naturalistic sort of circumstances, if, if, you know, a tiger or a bear or some other threat is the thing This system is set up for, and then I run away. What's that going to do? That is actually going to burn up a lot of the stress hormones as we go through. It's going to use up all this stuff. Well, if you have a job where you're sitting and doing Zoom meetings, or you're in an office or somewhere and you can't go anywhere, and you're having stressors piled on you, you're not running from anything. Your body is not moving. So moving your body becomes terribly important, and you don't have to become, you know, a marathoner, and you don't have to, you know, do lift heavy weights or anything. You just have to move your muscles in your body. The more you are stressed, the more you can move your body, the better it will do to dampen these things. Now, the other benefit that happens from that is— we talked about this in other settings— is the more that we move our skeletal muscle, the muscles that move our body around, whether it's the legs, the core muscles, the upper extremity muscles, etc., the more we also will burn up excessive calories, we'll make sure our insulin levels become more levelized. The more you move your body, your insulin blood sugar becomes more regulated generally. And also your physiologic tone, the biochemistry of your body actually becomes more disease resistant. So, you know, muscle is medicine. The muscle and fat kind of have this seesaw relationship, like they're on a teeter-totter. The more the muscle works and has metabolism, the lower the fat metabolism goes. And the more muscle metabolism, the healthier the person usually is. Lower the fat metabolism, the healthier the person is too. So muscle is about movement. Now you might say, well, you know, I am stuck on Zoom meetings all day. There's a few things that you can do. One is before you plug in and do whatever you're going to do, you can, you know, even if it's a walk around your house or your building or whatever, or planning a little bit of time before you, you know, get to your computer and plug in, On any breaks that you have, simply standing up and sitting down, if that's all you can do, gets the bigger muscles in your legs and your core muscles working. If you— even if you can't leave wherever you're at, but you could stand up and sit down, that works. Some people now, they use, you know, they have stand-up workspaces or treadmills or other stuff that they use, you know. All of that's for these purposes. So just do as much as you can, or at least at the end of your workday. Take a quick lap somewhere, do something, do something physical. Very important. So food, muscle, and then the third one is brain. Brain, mind, think of it all together at this, at this point. The first thing that is crucial for stress response and will go out the window with a stress response is your sleep. And this is like eating. It's feast or famine. Some people, you know, don't eat. Some people eat everything. Some people, when they get under stress, sleep longer and more. Some Some people don't sleep at all. So you have to work on that. Now, there's a lot of things that we won't have time to go into, but you can look up online something called sleep hygiene. So you've heard of dental hygiene, you know, to protect your teeth and all that. Sleep hygiene, and there's literally hundreds and thousands probably of websites and info about it, but there's a lot of good university-based things that you can look up about sleep hygiene, a lot of research around this. And they're just, you know, it's sort of like common sense, grandma's helpful hints, really. Yeah. But there's a lot of them sometimes that we forget about when we're under stress. And so things such as having a digital sunset, meaning when you're in the hour or 2 before you're going to go to bed, you're actually not engaged in screen times and big lights and other stuff like that. You know, think about how things are now that that's not the normal thing people do. There's other sleep hygiene things such as if you're going to be involved in something, you know, that engages your mind, make it something that's at the very least pleasurable for you. So that might be reading, you know, a novel you like or something you're interested in, or, you know, if you are, you know, listening to a podcast or watching something, it's something that, you know, is uplifting and you really are into. It's not, you know, stress-producing things, which a lot of people do, such as the news, etc. So sleep is a big thing, getting your sleep regulated and sleeping enough. Centering, whatever practice you use— some people call it mindfulness, some people like to call, you know, meditation or prayer or some combination of all 3 of those, or whatever it is you do— that literally changes the switching between the parts of your autonomic nervous system. Autonomic nervous system is the 2-sided nervous system interchange that Upregulates into sympathetic when you are under stress, and you, you need to ebb and flow of this. Your body's made to use both of them, but you don't want to be kind of all on all the time. If you are, then you get stress-related disorders. So the autonomic nervous system can be brought back to the middle by these centering-type practices. So whatever it is that you do and you're into, or whatever you're drawn to if you're not into it, but you'd like to be, There is something for everybody you can look up online. If you want to start in the middle, you can look at mindfulness. There's actually a lot of research around mindfulness. Some people have a meditation practice or a prayer and meditation practice or whatever it is. Do that. Okay, just, you know, whatever you want to pick, just do something. Because in addition to sleep, you want a way to, you know, it's sort of like Like not— if you can avoid eating your food while you're under extreme amounts of stress and there's all this chaos going on, it's better for your digestion. Well, if you can have a time period during the day where, you know, you not only move your body a little bit, but then you kind of calm and center your mind, it's actually useful to get the nervous system kind of swung back into the middle. Then there's the concept with your mind of the, the thought patterns and messages. And I've got a couple of minutes left, but basically what I want to get into in this last little part here is thought patterns and messages can either bring our mind and our thinking back more towards the center, kind of like I was saying with mindfulness or meditation or prayer, whatever it is that you do, bringing yourself back to kind of the middle, your core of your autonomic nervous function. And it's broader than that, but let's just think of it that way. But thought patterns are bidirectional. So it could be what you're telling yourself Or it could be what something else is telling you, putting into your head. And for most people in real life, it's both. It's a two-way street. So what does that mean? Well, if we're talking about affecting our stress response, the part that becomes critically important is— and there is no way to, you know, there's no way to have a perfect diet. There's no way to have perfect fitness. There's no way to have perfect whatever. But to the degree that you can and be mindful of, actually, the more you can think about what you're telling yourself— those are the inside thoughts of this bidirectional thought thing we got going on— and the more you can think through and maybe rein in some of the more stress-inducing things that you may say to yourself. The more it will help. Now, one of the things is you have to think about what your triggers are for that. So, for example, for me, the universal, you know, 100% of the time availability of any media you want, any message you want, and all of that. If I get too involved in like the news of what's going on at the moment, and it could be any moment, but especially, you know, this last year, it's just. Just you know nutty all the stuff that you see. You can wind yourself down into a rabbit hole where the only messages going out are actually fight or flight stress messages. And so sometimes if that's your trigger, you have to limit the amount that that you do, and you have to tell yourself before you engage in looking at the news: Well, this is the news; it's not everything. The ones on the outside are just as important. Important. You know, what if you have really toxic, poisonous people that you may or may not have any control over what they say, but they're always saying things that are super negative and doomsday and horrible? You know, you may have to limit the amount of that that comes in, or you may have to put it into place and say, that's just that person talking. That doesn't have to affect me here. The other thing is, of course, Outside of the news, we can listen to and hear and participate in all kinds of things. And if they're real, real triggering, again, it just pushes our stress response up. Well, we're right on the cusp of needing to get off of the air for today. But what I want to remind you is that the stress response is part of our body. It's how we work. And unless you're actually running from a bear or some threat, the stress response will turn inward and mess you up, mess up the inside of you. If you keep in mind focusing on food, so what we're eating, when, how, not too much, not too little. Muscle, move around, make your body do a little bit of work, even if it's standing up and sitting down. And then brain, the messages that come from the inside and the outside. And of course, getting extra help if you need it, like we all do sometimes. All of those things together are things that you have control over that can help to move your stress response back to normal. But I am out of time for today and I've got to go. This is Dr. Paul Andersen with Medicine and Health with Dr. Paul, and I will see you all on the radio next week. And you can go to the podcast anytime you want.