Digestive problems
Restlessness
Fatigue
Irritated eyes
Emotions
Fear, feeling of emptiness, doubts
Irritability, anger
Hostility
Feeling unhappy for no apparent reason
Arrogance
Behavior
Excessive consumption of: alcohol, cigarettes, coffee
Uncontrolled eating (ravenous hunger)
Grinding of teeth
Inability to complete tasks
Mind
Forgetfulness
Trouble concentrating
Declining creativity
Loss of a sense of humor
Problems with decision making
A LACK OF SLEEP AS AN INDICATOR FOR STRESS
As a result of their everyday stress, about 15 to 20 percent of Americans suffer from sleep deprivation and insomnia.2 I have experienced this firsthand. During the four years of my internistic-cardiological training I had to work rotating shifts under great stress and never really had any time to recover or get enough sleep. Promptly, I contracted chronic sinusitis. All natural remedies—from Scotch hose treatments, saunas, and medicinal herbs to sole inhalations and exercise—were ineffective. At some stage, I had a surgery to widen my sinus cavities, which the ear, nose, and throat specialist had recommended. But the symptoms remained. I was at a loss. Eight months later, my time at the ICU was over and I transferred to the cardiac catheterization and ultrasound lab, a less stressful job with regular hours. My body was able to rest and recover, and the chronic sinusitis was gone within four weeks.
Irregular and insufficient sleep can also cause weight gain. A lack of sleep furthers insulin resistance via the hormonal cycles. The cells are unable to absorb glucose properly, and this in turn leads to a ravenous appetite, increased food intake, and weight gain. In addition, the immune system is weakened. On the other hand, the opposite extreme is also problematic: People who sleep for a very long time, i.e., more than nine hours a night, often suffer from health problems. Their tiredness is possibly a sign of a depressive mood or exhaustion. Therefore, it is necessary to find the right balance based on the individual daily routine. Not everyone has the genetic properties that enable them to manage with only four to five hours of sleep a night like Napoleon. I would recommend observing yourself attentively to figure out how many hours of sleep you need to feel well-rested. This may change somewhat with the seasons or when you are on vacation. Ayurveda recommends going to bed as early as possible, at 10 p.m. at the latest. If that’s not possible, a short siesta in the afternoon, or a powernap, can complete the need for sleep.
CONSTANT AVAILABILITY IS HARMFUL TO YOUR HEALTH
Sleep is the most delicate sensor of stress. But ensuring that stress doesn’t arise in the first place is becoming more and more difficult for all of us. In part, this is due to the fact that technology has made all of us available around the clock. Handling digital media is ultimately a big medical experiment, because it’s still not clear how it affects our health.
What is certain, however, is that the frequent use of screens causes increasing difficulty falling asleep and interrupted sleep phases—and consequently sleep deprivation. Among the causes here are not only the focused attention and muscular tension in general, but specifically the blue light emitted by the screens: It suppresses the sleep hormone melatonin. Newer models have a night mode that subdues the blue light. To reduce blue light as much as possible, you should use this mode during the day as well—it can be adjusted manually.
The digital network controls us. Having grown accustomed to quick response times, we’ve become increasingly impatient. Being forced to wait in front of a computer heightens blood pressure immediately, quickens the pulse, and leads to the release of stress hormones. A similar effect can be observed—and this is an intriguing comparison—when watching horror movies.
Because time always seems to be running out, we try to do multiple things at once—multitasking. This works quite well in predominantly automatized activities such as walking and talking, or driving and thinking. It does not work, however, when we are performing two or more demanding tasks at the same time; the brain is then forced to constantly switch back and forth between different activities. Multitasking, therefore, is a “multiswitching,” exhausting and damaging to the nerves. The psychologist Matthew Killingsworth and his colleagues developed an app for an interesting experiment to measure our psychological state in everyday life by using a smartphone. The participants of the experiment constantly registered what they were thinking and doing at any given time. The result was published in the professional journal Science in 2010. The title of the article, “A Wandering Mind Is an Unhappy Mind,” summarizes the findings: Whenever our thoughts drift, when we think of something other than what we are doing at the time, i.e., when we are multitasking, our brain exerts itself tremendously. As a result, we can become depressed and anxious.3
Anxieties and depressions are among the most common diseases around the world. Genetic and social factors as well as individual experiences are considered instrumental in whether we develop a depression or anxiety disorder. But using computers also contributes to this. According to a Japanese study of 25,000 office workers, the frequency of depressions rises after five hours of daily computer use.4 The constant interruption of our thoughts caused by working online has consequences: In one experiment, participants were asked to write a letter and check their email simultaneously—their ability to perform the first task was reduced by half.5, 6
We should, therefore, focus on what we’re doing at any given moment. But this also implies an act of letting go of certain things, which is not always so easily done. A simple measure to prevent stress consists of not using the smartphone while performing other tasks. For example, 90 percent of users are looking at their phones even when talking to someone else.7 We can observe a so-called “rule of three” here: When five or six people sit together, it’s enough for three of them to be involved in a conversation attentively to give the other three a reason to quickly check their text messages or email.
STRESS OCCURS WHEN WE HAVE NO CONTROL OVER THINGS
Stress is aggravated when we have no control over it or can’t see the purpose of it. This, for example, is why young parents rarely suffer from burn-out—despite sleep deprivation and permanent multitasking. Their exertion is compensated by the love for their child, they understand the purpose and meaning of their exertion. Mere sense of duty or pressure, however, are more burdensome.
Firdaus Dhabhar, a psychiatrist at Stanford University, is a neuroimmunologist and cancer researcher. He is concerned with looking at stress in a more differentiated manner. He has, for example, been able to show how short-term stress strengthens the body’s defenses because it causes an increase of white blood cells.8 A vaccination has a stronger effect when the body is exerted beforehand, for example by pedaling hard on a stationary bicycle.9 But maybe it’s not stress itself at all, but the relaxation after the exertion that has a positive effect. The fact that regular meditation fortifies this effect, as demonstrated by the American brain researcher Richard Davidson, is indicative for this as well.10
Like everything in nature, stress has two sides. Challenges have always advanced evolution: When flies or mice are put under stress, they live longer.11 Stress activates the brain. A research group at the University of Bochum was able to show that we retain memories better under slight stress. Cortisol, one of the stress hormones, activates those parts of the brain that are responsible for long-term memory.12
Artists, musicians, or competitive athletes have all reported how important a certain level
of tension is. A legendary example for this is Oliver Kahn, the former goalkeeper for FC Bayern Munich, who pushed himself to extraordinary performances by using aggression when he was under stress. A thrill can mean pleasure and fulfillment, otherwise there wouldn’t be people who sacrifice so much time and money to expose themselves to dangers—when free-climbing or base jumping, “danger freaks” feel fantastic. But if stress endures and the body gets no opportunity to relax, it facilitates forgetfulness, causes the ability to concentrate to dwindle, and increases the risk of dementia.
Fear of stress can be worse than stress itself. In an American study, thirty thousand people were asked how much tension they experience on a daily basis, how they deal with it, and whether they believe that it’s unhealthy. Eight years later, it became evident that among the people suffering from stress, 40 percent of those who believed that it was harmful died younger. The others, who didn’t attach too much importance to it, showed the lowest mortality risk of all comparison groups.13
In an experiment, researchers at Yale University conducted simulated job interviews in which the “staff manager” (an actor) put the participants under a lot of stress. Before that, one group was shown a movie that addressed the bad, health-damaging effects of stress. The other group was shown a movie which explained that stress promoted attentiveness and performance ability. In the second group, significantly lower levels of stress hormones in the blood were measured.14 So, it’s not always stress that’s unhealthy, but the belief that stress is unhealthy.
People who feel like they have control over their personal circumstances are less affected by stress. This is verified, among other studies, by the much-cited Interheart study, a large-scale experiment on the most important risk factors for heart attacks conducted in fifty-two countries in 2004: The risk for suffering a heart attack was shown to be increased by 30 percent in those participants who were under stress and had little or no control over it.15 A similar result was achieved by a British study among thirty thousand of the country’s civil servants.16
But it’s not just attitude—physical bearing also plays a part. In 2016, biologist Shwetha Nair and coworkers from the University of Auckland were able to show that a person’s sense of self-worth is diminished when they adopt a slumped posture for a prolonged period of time.17 It’s not for nothing that in yoga, erect standing positions such as the “warrior poses” are used for the purpose of increasing power and alertness. The fact that posture has an effect on the psyche also becomes apparent in laughter yoga. Even when people laugh without any humor and only grimace, their mood is improved. It follows that stretching your back after waking up and smiling at yourself in the mirror can have the same effect as medicine.
As a doctor who has worked in intensive care units and ambulances, I saw the effects of prolonged daily stress: Stress was almost always involved when younger people suffered from heart problems, hypertensive crises, or asthma attacks. During my night shifts, heart attack patients told me stories of family and marital problems or financial worries, all of which severely depressed them. It’s very rare for stress alone to cause an acute heart attack. But stress can cause heart attacks in the long run, and it also intensifies many additional adverse factors. If you’re under stress, you likely also exercise less, eat too quickly and less healthy, smoke and drink more, and suffer from sleep disorders.
Time and again it’s been confirmed in many conversations with patients that stress contributes to hypertension, asthma, irritable bowel syndrome and inflammations of the bowel, many skin disorders, head and back pain, as well as rheumatism and other autoimmune diseases and allergies, because stressed nerves communicate with the immune cells and disturb the signaling molecules and messenger cycles, i.e., our internal survival chemistry. A large-scale study from 2017 also proved that stress heightens the risk of cancer. Cancer of the pancreas, the large intestine, the esophagus, and the prostate occurs two to four times more often in people who have stated earlier that they were under a great amount of stress.18
Scientific research on stress began in the beginning of the twentieth century. Walter Cannon, physiologist at Harvard University, explained the body’s responses to stress as a “fight or flight reaction,” an immensely important survival strategy. When under threat, muscles tense, heartbeat and blood pressure increase, perception turns to tunnel vision, and the body tries to get rid of unnecessary weight—the contents of bladder and bowel—one is literally “scared shitless.”
This reflex enabled our primeval ancestors to either take flight or stand and fight. That way, one could escape the danger—or face it head on. But stress in the workplace or worries about the future don’t cease to exist after a sprint or a short battle. They have the tendency to become chronic, and therefore there is also no period of relaxation. Instead, we suffer from back pains, hypertension, heart attacks, and depressions.
Occasional “doses” of stress can potentially strengthen body and mind—you can experience personal growth after a difficult calamity because that’s when we develop resilience, the ability to withstand the blows of fate. This is a training effect similar to that achieved by exercise, Scotch hose treatments, or fasting, but on a psychological level. When you ask people about their life crises, interestingly it becomes obvious that it’s not those who have had no negative experiences at all who are doing the best, but those who have lived through a certain number of crises and trauma. That said, everyone has a tipping point, at which the initially increasing performance ability begins to decrease because the exertion is too great.
Stress hormones cause blood vessels to constrict, blood pressure to rise, and the hands to become cold, as well as the tip of the nose in some instances. My former boss in the cardiology department used to touch the tip of the nose of severely ill patients in the ICU: If it was cold, it meant that the situation was rather critical.
How Stress Affects the Body
Fosters depression, anxiety, and sleep disorders
Accelerates breathing
Heightens levels of blood sugar, insulin, and blood fats
Fosters blood clots
Heightens muscle tension and reduces bone density
Impairs memory and concentration
Narrows thoughts, causes headaches
Increases heart rate and blood pressure
Diminishes nutrient uptake and disrupts digestion
Impairs immune function
Aggravates obesity
Leads to infertility
At the naturopathic hospital in Essen, I used biodots for the first time; they are pea-sized dots that are stuck to the back of the hand. Via thermal sensors, they indicate body temperature and illustrate in which situations stress occurs. I remember one patient, a top executive with hypertension and a sleep disorder. I had expected that he would be tense due to his undoubtedly exhausting line of work—but the biodots revealed something else entirely: At work, his hands were being supplied with blood sufficiently, but at home his vessels constricted, possibly because he was suffering from a guilty conscience since he could only spend such little time with his family. The executive hadn’t expected this, either. A lot of the time, stress is misjudged the same way relaxation is misjudged: Many people believe, for instance, that they are relaxing when they watch television, but usually the opposite is the case.
We see then that a temporary strain activates the immune system. But this effect is quickly depleted if the stress persists. That’s why we are easy prey for viral infections when we are sleep-deprived and exhausted. Wound repair is also impaired and takes longer. This realization is slowly asserting itself among surgeons—some patients get to listen to CDs with relaxing music before an operation. Should you have to undergo surgery, you should perform a deep relaxation session every day of the week before the appointment.19 Meditation is best or, al
ternatively, there is autogenic training. Yoga exercises are ideal to stretch the fasciae and keep them supple. In addition, it would be helpful to fast for a couple of days beforehand (as long as you are not underweight). By the way, music in the OR, regardless of whether you are under general anesthesia or not, reduces fear. As a consequence, less pain medication is necessary.20, 21
To summarize the results of the numerous studies, the following risk factors for sickening stress emerge:
a heavy workload in conjunction with little decision-making power
marriage or relationship problems
arguments with family or friends
caring for a relative
experiences of violence and abuse as a child
symptoms of a disease (particularly pain)
sleep deprivation and not enough periods of rest
the feeling that the strain being experienced is meaningless
MIND-BODY MEDICINE: BRINGING BODY, MIND, AND SOUL IN HARMONY
What do we do with these findings? It’s hardly possible to lead a life without stress—this is the starting point from where many Eastern philosophies begin. As the Buddha said: Life is pain. Surely, one ought to reduce objective stress factors and make life easy, but usually that is not possible without fundamentally changing one’s coordinate system.
The Nature Cure Page 18