“It’s not the load that breaks you down, it’s how you carry it.”

-Lou Holtz


I think it is safe to assume we have all experienced stress, to varying degrees, in our lifetime. Here are two quick statistics about stress (taken directly from the Global Organization for Stress):


75% of adults reported experiencing moderate to high levels of stress in the past month and nearly half reported that their stress has increased in the past year.

– American Psychological Association


80% of workers feel stress on the job and nearly half say they need help in learning how to manage stress.  And 42% say their co-workers need such help

American Institute of Stress


So what is actually happening in our bodies, on a cellular level, when we are stressed. Here is a quick step by step breakdown of what happens when our body perceives something as stressful.

  1. The amygdala in the brain interprets sounds and images. When it deems something as dangerous or threatening, it immediately sends a signal to the hypothalamus in the brain.
  2. The hypothalamus releases a hormone called the corticotropin releasing hormone (CRH) which quickly makes its way to the pituitary gland.
  3. The pituitary gland then produces a hormone called the adrenocorticotropin hormone (ACTH), which travels to the adrenals.
  4. The adrenal glands, which sit on top of your kidneys, then produce cortisol the infamous stress hormone
  5. Cortisol triggers the fight flight and freeze response. This causes your heart rate, blood pressure, and blood sugar to increase in the body.

Short term, this stress response is crucial for survival. However, most of us experience chronic stress with little to no time for rest and relaxation. This chronic stress can cause adrenal dysfunction. In conventional medicine, there are two primary extremes of adrenal dysfunction: addison’s (severe adrenal failure- very low cortisol) and cushing’s disease (hyperactive adrenal function- too much cortisol). However, in functional medicine we believe there is a gray zone where your adrenals are not functioning optimally.

Cortisol should naturally start high in the morning and gradually drop down by bedtime. When there is adrenal dysfunction, cortisol levels spike at inappropriate times. For example, high cortisol at night can cause you to feel wired and tired, leading to interrupted sleep cycles.

So what can you do today to help your body effectively respond to stress:

  1. Listen to your body. If you had a very stressful day, you may need a low impact exercise such as yoga to help lower cortisol rather than a long endurance run.
  2. Keep your blood sugar stable. Low blood sugar increases cortisol so it is important to keep your blood sugar stable throughout the day. This can be accomplished by eating small frequent meals with protein and healthy fat.
  3. Schedule weekly self-care activities: I recommend 1 hour per week of self-care; get a massage, facial, acupuncture, yoga, epsom salt bath (even better with lavender), etc.
  4. Don’t forget to breathe: The simple act of slow, deep breathing can lower cortisol levels. If you are feeling stressed, take a step back and take 3-5 slow deep breaths (place your feet flat on the floor and sit up straight, slowly breath in through your nose, hold your breath for a couple seconds, and slowly breath out through your mouth, repeat for 3-5 cycles).
  5. Supplements: If you are still not feeling optimal (fatigue, brain fog, decreased focus, interrupted sleep, anxiety), you may need to add adaptogenic herbs. These supplements help balance out your hormones to help your body achieve homeostasis. For example, if you have low cortisol they help increase your cortisol and if you have high cortisol they help lower your cortisol. Here are 3 of my favorites:
    1. Ashwaghanda 400-500 mg twice a day (caution if you are allergic to nightshades or experiencing hot flashes- this may not be the best option for you)
    2. Rhodiola 250 mg twice a day
    3. Holy Basil roughly 500-600 mg twice a day

Ultimately, there is only so much we actually have control over. Wake up each day and do your best, remembering that you are only one person and at the end of the day you have to take care of yourself. Don’t forget your bodies basic needs: adequate sleep, water, movement, and a healthy diet.

In good health,

Kristin Oja, DNP, FNP, PT-C

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