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Stress and Distress

Sixty years ago in medical school, I was told that 75% of all the patients I would see would be there because of stress. But not one word was said about treating that stress! Indeed, even the major cascade of stress was not significantly taught. In the late 70s Joseph Califano, Secretary of HEW, emphasized that the only way we would decrease disease was to prevent it. But there has been minimal attention to preventing disease. And shortly after Califano’s statement, Dr. John Knowles wrote that “Ninety-nine percent of people are born healthy and become unhealthy because of human misbehavior.” The human misbehavior that Knowles was emphasizing was the responsibility of the individual. I will emphasize also the misbehavior of society in the broader sense, as well as the individual!

In order to understand personal responsibilities, I start with emotions, as they provide the foundation for the stressors that most people know and consider the “cause” of their distress. Basically, there is only one major emotional stress—fear. And there are only five significant fears:

 Death

 Invalidism

 Poverty

 Abandonment—loss of love

 Existential issues—purpose, meaning, why, justice, and God

Our reactions to fear are:

 Anxiety

 Anger

 Guilt

 Depression

 And dozens of synonyms for each of these!

All of these are associated with a remarkable cascade of chemical reactions which result in mental, emotional, and physical stress. The basic chemical reaction is the release of adrenalin, which raises blood pressure and pulse, and leads to the release of cortisol and sugar, which leads to the release of insulin and DHEA, dehydroepiandrosterone, to help bring down the blood cortisol. Incidentally, blood cholesterol is increased by virtually all stressors. This basic reaction may result from mental experiences of anxiety, anger, guilt, or depression or the stress response may be induced by:

 Caffeine

 Tobacco/nicotine

 Sugar

 Alcohol

 Inadequate oxygen

 Excess carbon dioxide

 Excess heat or cold

 Inactivity

 Physical pressures/injuries

 Toxins, of which there are a few “natural” and over 550,000 human-made ones

 Nuclear energy/radiation

Essentially, a stress response is one which doubles the blood level of adrenalin or epinephrine. Simple examples in one not previously exposed:

 One cigarette

 One cup of coffee

 8 ounces of “pop”

 5 teaspoons of sugar

 One ounce of alcohol, one beer, or one glass of wine

 Being totally inactive

The great stress researcher, Hans Selye, emphasized the fact that we accommodate to repeated stress, so that with the same small stress, within a short period of time, perhaps a week of daily exposure, minimal adrenalin is released. But every time we adapt to a stressor, we decrease our tolerance to new stressors. Thus, we begin the process of maladaptation, which leads to virtually every known disease, degeneration, exhaustion, and death. Stress is thus additive or cumulative. Our genetic inheritance and our social environment are also inherent foundations upon which our stress reactions occur. And, of course, I believe that most genetic influences are significantly present because of karmic unfinished business. In other words, all significant illnesses are the result of unfinished psychological problems from a previous life!

Thus a baby born healthy and lovingly nurtured has far more resistance to unavoidable stressors than one born unhealthy. In the healthy situation, assuming reasonably good nutrition and moderate physical activity, a child continues to be healthy into young adulthood. Beginning at puberty, one of the most important hormonal regulators of stress, DHEA, begins to increase and reaches a peak production at age 25. Adolescent jocks may reach that peak in the mid-teens, emphasizing the additional benefits of increased physical exercise. By age 25 the healthy male has a blood level of DHEA between 750 and 1250 nanograms per deciliter. A healthy female has blood levels of 500 to 980 nanograms per deciliter. By age 30 the average person has lost 10% of his DHEA and by age 80 the average person has lost 80 to 90% of his peak DHEA. Thus, the simplest measurement of stress reserves is a blood test of free DHEA. The only lab I trust for this critical hormone test is Nichols in Capistrano, California. I have no financial interest in the lab, but extensive research has shown that five major labs give results that are 50 to 300% different on the same blood. Most DHEA is attached to a sulfur molecule and DHEA-S is not a reliable test of DHEA availability! Actually DHEA deficiency is only the tip of the iceberg of adrenal fatigue, which I will address later.

Cumulative total life stress is the reason for the gradually declining DHEA levels and the slow maladaptation that leads to virtually all illnesses, other than some accidents. Here is an excellent time to evaluate your Total Life Stress. One point represents essentially a doubling of cortisone or adrenalin output in response to the stressor: