And breathe! As I discussed in last week’s opinion piece on the causes of stress, I am going to be (gently) tackling how to manage stress.

Illness statistics paint a demoralising picture and the doubling in anti-depressant prescribing rates over the last 10 years suggests urgent action is needed. With the growing incidence of people ‘succumbing’ to our fast-paced world, we need to slow down in order not just to survive but thrive in it. Too many of us are living in a constant state of ‘fight or flight’ (sympathetic) nervous system activation. With the resultant constant circulating stress hormones, we’re exhausted, grumpy, and our bodies are wearing out faster than they should.

There are some really simple, quick and natural solutions, which I will describe below. Like the conventional prescription medication, compliance achieves the best results, but unlike medication, they have no side effects. All the following natural techniques ‘switch off’ the sympathetic nervous system and turn on the parasympathetic nervous system to allow us to ‘rest and repair’.

  • As I alluded to in the first sentence, breathing is an important first step. Yes, it is possible to be a ‘terrible’ breather. Encouraging breathing awareness is often all that is needed to improve breathing in our patients and ourselves. However, as an added bonus, teach your patients to imagine their abdomen as a balloon, with each inhalation filling up the balloon and each exhalation deflating the balloon.
  • Along with breathing is the closely related technique of meditation and mindfulness (meditation on the go). This powerful technique does not need to involve sitting cross-legged chanting ‘om’. The key to meditation is to find a technique and position that works for you. Thankfully, there is a multitude of great apps, books, websites, CDs/DVDs and a range of techniques to make this technique enjoyable. In addition, meditation has been shown in many studies to turn off ‘bad’ genes and turn on ‘good’ genes.
  • Avoid toxins as much as possible. This includes toxins in our food (e.g. pesticides and emulsifiers); medications (unless essential); recreational drugs (e.g. alcohol); our food wrapping (e.g. including the so-called ‘safe’ BPA-free alternatives); our hygiene products (e.g. parabens); our air (e.g. perfumes and tobacco); people (yes, we all know those toxic relationships); and in our water (e.g. chlorine). Testing for heavy metal (e.g. mercury) and chemical exposure is available, which can help inspire patients to reduce toxic load.
  • Exercise is not just about prescribing more for those who do too little. There are a significant number of people who exercise too much and then there are those that partake in exercise but then sit for the rest of the day, e.g. at a desk. The latest advances in gene testing can help us more accurately prescribe the type and amount of exercise that suits that individual.
  • As important as exercise is rest which more and more of us are getting less of. It seems to be that being ‘busy’ is almost considered a ‘badge of honour’ in modern life. The human body needs rest, and I don’t just mean sleep, although good quality sleep is important. Refreshing sleep requires a rise in the sleep hormone melatonin and a drop in the stress hormone cortisol. This pattern is often switched in those suffering stress. As well as being able to test for melatonin (and stress hormones) there are natural ways to increase melatonin. One of the best ways to do this is to lower your home lighting as much as possible in the two hours before bed or, even better, wear blue-light-filtering glasses.
  • Sunshine is good for lowering stress for a number of reasons, with one of the key reasons being that it the best way to attain our daily vitamin D requirements; studies have shown that vitamin D helps improve our mood. Obviously, moderation is key but around 30 minutes of sun (before 10am and after 4pm) in the summer and the same amount at midday in the winter is about right. Testing vitamin D is ideal as it helps determine if supplements are needed to achieve optimal levels (as opposed to barely adequate or toxic levels). The other benefit of being outside is that it usually means we are around nature, which also has been shown to reduce stress.
  • Social contact is important for our wellness and can be as simple as helping out at your child’s school or having meals with your family instead of in front of the television. A six-second hug has been shown to release oxytocin, which helps to elevate mood and reduce stress. The opposite of social time is alone time, with reading a book at home or walking on the beach as two examples. Alone time is also when we canplay or undertake hobbies and can involve anything from knitting to the dangerous hobby of ‘extreme ironing’ (definitely google that one!). Alone time can also be when we journal, think of or speak positive affirmations or visualisations.
  • Some less-obvious stress reduction techniques include warmth (e.g. a warm bath), music, and eating foods we aren’t intolerant or allergic to.
  • External techniques for reducing stress include mind body techniques such as neuro-linguistic programming (NLP), cognitive behavioural technique (CBT), emotional freedom technique (EFT) and HeartMath. Prescription supplements can also provide a benefit if prescribed by a suitably trained integrative health practitioner and, of course, prescription medication may be needed in some cases.
  • My final tip is the simple act of being gentle with yourself, because as humans, we are very prone to ‘beating ourselves up’ and being our own harshest critics. We are only human, we make mistakes – just pick yourself up and carry on. Saying sorry and being kind to others can also go a long way to reducing your stress and that of others around you.

Although the process of testing stress hormone levels can add stress, it can be a great way to show our patients and ourselves the need for stress management.

And again, breathe! As most English teachers would tell us, we need to put more pauses into our sentences (when speaking) and also, I argue, into our lives.

 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.

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