Stress! We all know what it is, what effect is has on our bodies and how it makes us feel, but are you also aware of all the various causes of stress? One of the most important things I learnt as an integrative GP is that stress has more causes than just the usual traffic jams, opening bills, and fighting with a loved one.

The less obvious stressors that act directly or indirectly to harm our health include the following:

  • Chemical stress. With 80,000 new chemicals released into the environment since the industrial revolution, we are living in a chemical soup. Many of these chemicals, such as mercury and pesticides, upset the delicate biochemical balance that keeps us healthy.
  • Sub-optimal temperatures, such as experienced by those working in cold stores.
  • Too much or too little exercise. I and many of my integrative medicine colleagues are also seeing an epidemic of ‘gym bunny’ patients who are exercising too much and don’t allow for activation of the ‘rest and repair’ (parasympathetic) nervous system.
  • Eating poor quality food creates stress in a variety of ways. The chemical effect of artificial additives such as monosodium glutamate (MSG) and the nutritional deficiencies that often result from these ‘food-like substances’ are a couple. (Please note, there are many hidden names for MSG!) Research shows that a whole-food diet is as effective as anti-depressants.
  • Eating food to which we are intolerant activates stress hormones and, conversely, stress is linked to a lower tolerance to many food substances.
  • Social isolation and its opposite of ‘too much socialising’. The effects of social isolation are as bad for your health as smoking.
  • Sleep problems, including shift work. Sleep is more important for weight management than exercise.
  • ‘Toxic’ relationships. (We all know how our body reacts when we see someone who stresses you out!)
  • Music can definitely be a great way to activate our ‘rest and repair’ nervous system, especially if it is our favourite tune, but excessive noise releases stress hormones.
  • Poor breathing patterns. When stressed out we often take shallow chest breaths, which makes us slightly acidic. It also makes it difficult to activate the ‘rest and repair’ nervous system, which only kicks in when we perform relaxing belly breaths.

We are also unlikely to be aware that our default stress levels are higher than they used to be back in the days of the caveman. Back then, we had the typical ‘fight or flight’ sympathetic nervous system reaction to being chased by a tiger, for example, which rapidly decreased once the threat passed.

Now we are exposed to stressors on a more regular basis, which causes our default stress levels to sit at a higher, more insidious baseline. Selye’s General Adaptation Syndrome (GAS) explains this well, with too many of us living in the final ‘Exhaustion’ stage. Chronic stress can lead to the very obvious conditions, such as depression, anxiety, tiredness and feeling overwhelmed. However, less obviously, chronic stress can lead on a microscopic level to ageing and disease from telomere shortening, altered gene expression, cell vulnerability and chronic inflammation.

With the World Health Organization (WHO) stating that stress is the health epidemic of the 21st century, we have to increase our awareness and manage ALL forms of our patients’ stress and also our own stress. As mentioned in last week’s column, the rate of suicide among physicians is the highest of any profession. In order to serve our patients (and our families) best, and also be in touch with stressors, we simply must remember the proverb ‘physician, heal thyself’.

There are many tools for dealing with stress, which I will cover next week, but in the interim for help with dealing with stress, please see either your GP, practice nurse, after-hours services (including 111) or contact the following organisations:

  • Lifeline:0800 543 354 (available 24/7)
  • Asian Helpline: 0800 862 342
  • Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7).
  • Need to talk? Free call or text 1737 (available 24/7)
  • Rural Support Trust: 0800 787 254
  • Whatsup: 0800 942 8787 (Monday-Friday, 1-10pm. Saturday-Sunday, 3-10pm)
  • Depression helpline: 0800 111 757 (24/7)
  • Samaritans: 0800 726 666.

Dr Tracy Chandler BSc (Hons) MBChB FRNZCGP FNZSCM, PGDipSEM, Cert Dermoscopy, Cert Homeopathy, MACNEM member, gained her degree in England and worked as a GP in Timaru before doing postgraduate training in sports, skin and integrative medicine. She specialised in integrative (wellness) medicine in line with her increasing interest in the impact of nutrition and environment on health and wellbeing.


Mental Health Awareness Week (MHAW), runs from 8–14 October 2018. This year’s theme is ‘Let nature in, strengthen your wellbeing – Mā te taiao kia whakapakari tōu oranga’.

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