Stress and Anxiety Issues
Stress is often called a silent killer; it has a reputation for sneaking up on us unawares and causing significant health problems. Stress along with its health effects and mechanisms, is such a broad topic, we'll only be able to brush the surface in this short page. Hopefully, you will still gain a better understanding of what stress is, how it can affect your health, and how massage along with other techniques can help you manage stress.
What is Stress?
Let's start by looking at homeostasis. Homeostasis is the ideal balance of the body's internal environment and is the process (sometimes called Allostasis) by which that environment is regulated and kept stable. Small changes to this internal environment such as heart rate, blood pressure, temperature, or PH balance can have huge implications for our health and wellbeing if they aren't returned to normal quickly. Your system is constantly being tweaked and adjusted to maintain optimal function and keep you alive.
A stressor is anything that knocks homeostasis off balance. For most animals this is a sudden short-term physical crisis. So for example, if you were a Deer being chased by a Tiger, that would be stressful. However chasing and trying to catch a Deer is also stressful. So both the Tiger and the Deer are experiencing stress during this event.
The stress is only short-term because either the Deer escapes from the Tiger and shortly forgets about the whole experience, or it becomes lunch. For the Tiger, it either relaxes in the sun with a full belly or saunters off on the look out for other prey.
Either way, shortly after the experience, homeostasis is restored and the experience forgotten. Can you imagine a Deer constantly mulling over the day it got chased by a Tiger and worrying about when it's going to happen again? Well that's exactly what we Humans do.
Our amazing brains with our wonderful cognitive capabilities have unfortunately given us the ability to imagine we are being chased by a Tiger whilst we're lying comfortably in our beds. We've all heard the expression "I was scared at the thought of." Well we can literally scare ourselves to death with just our thoughts.
What this means is we can experience stress just from our thoughts; our body acts as if it's actually being chased by a Tiger when we aren't. This is what we call psychological stress. Psychological stress is at the root of chronic stress because it's that thought process that is continually activating the stress response throughout the day. Stressful situations such as moving house, work place disputes, and arguments with spouses can be both sudden short-term stressors and psychological stressors. The event itself may be perceived as an immediate threat. However, we often go on to worry and replay the events after the situation has ended: Sometimes for just a few minutes, other times for years.
Chronic stress isn't constant stress, but more like a roller coaster ride. We become stressed, and our sympathetic nervous system is activated (the stress response). Shortly afterwards our parasympathetic nervous system is activated to return homeostasis to normal levels. Then, just when the grass stops rustling, BAAAM another stressful situation or thought comes along and the process starts again. This cycle can be continuous for someone who is experiencing a high level of chronic stress.
What happens when we're stressed?
Whether it's an actual physical stressor or psychological stressor, our body reacts in pretty much the same way; the Sympathetic Nervous System (SNS) is triggered. The Hypothalamus (a part of the brain that's in charge of the stress response) is activated by the Cortex (another part of the brain) in response to a stressor. It signals the Pituitary gland to release what are commonly called the "stress hormones." The Pituitary gland further signals the peripheral endocrine glands to release or inhibit secretion of other hormones; this is known as the Endocrine Axis.
These hormones enable the body to very quickly make temporary changes that are geared to keeping you alive in a life-threatening situation. This includes shutting off long-term body functions, and diverting resources to systems required to keep you alive right now.
- Get energy. Hormones release glucose from storage sites into the blood
- Increase heart rate, blood pressure, and breathing rate
- Inhibit digestions, growth, tissue repair, and reproduction
- Activate the immune system
- Dampen pain perception
- Increase glucose and oxygen to the brain
- Increase blood flow to the hindbrain responsible for reflex actions
- Enhance short-term learning, memory, and memory recall
You can see how these changes would help in a life-threatening situation but maybe not so when lying in bed worried about a project at work tomorrow.
In a life or death situation, you want quick energy and oxygen pumped to your muscles to run like the wind. Anything already in your stomach won't provide energy quickly so digestion is switched off. You can grow, repair, do maintenance and reproduce later, if there is a later. Increased cognitive ability from extra glucose and oxygen is perfect for thinking fast on your feet. Dampening pain perception and activating the immune system will help with emergency injuries whilst on the run.
If you're experiencing chronic psychological stress, then shutting down your digestive system daily won't be much fun. Your sex drive and fertility will suffer. Your ability to recover from disease and illnesses will be impaired; simple problems that your body would normally correct and fix are left to run rampant around your system. Heightened immune function can trigger autoimmune disease flare ups.
Once a particular stressor has left the building, the Parasympathetic Nervous System (PNS) is activated to restore homeostasis. Different hormones are released by the endocrine system to deactivate the stress hormones. Normal balance, and function is restored.
- Energy from the blood is returned to storage sites
- Blood pressure, heart rate and breathing are normalised
- Digestion is switched back on (along with hunger!)
- Growth, repair and maintenance functions are returned to normal
There are many health problems associated with chronic stress; some are mere irritations whilst others can seriously affect your health and quality of life. It has been suggested that chronic stress negatively affects every system in the body over time.
Below are a few of the health issues that have been associated with chronic stress. There is a growing body of evidence that suggests many of these issues can be halted and even reversed when stress is managed or removed.
- Anxiety and worry
- Depression or unhappiness
- Insomnia and sleeping problems
- loss of memory and confusion
- Digestive problems such as IBS and ulcers
- Insulin resistance
- Loss of sex drive
- Skin conditions such as acne and eczema
- Heart disease
- Autoimmune diseases
- Physical aches and pains
- Muscular tension
We've seen that stress can exacerbate existing health problems and cause health issues itself. There's a wide variety of techniques and treatments that can be incorporated into a successful stress management program, and a growing body of research is showing touch therapy such as massage to be one of those effective treatments. Massage has been shown to stimulate the parasympathetic nervous system and decrease feelings of stress, anxiety, and depression.
A study in 2005 showed that following massage therapy, levels of Cortisol are decreased and levels of Dopamine and Serotonin are increased. Cortisol is one of the main stress hormones we discussed earlier, Dopamine and Serotonin are often called our feel-good hormones. However, other studies have suggested that any change in Cortisol levels within the body is very small and not statistically significant. Scientific research is still trying to understand the mechanisms by which massage therapy and other touch therapies have a positive effect on stress levels for so many people.
Touch is far more than just a way of sensing our surroundings; it's a primeval method of communication and social interaction. Take, for example, holding hands with a loved one; so much can be communicated in that simple act of touching. A simple squeeze or stroke of the hand or fingers can communicate so much emotion, and can make us feel safe, loved and cared for. Similarly, a hug can elicit many feelings within us. It could be friendly, supportive, loving, caring, or make us feel anxious and fearful depending on the situation, context, and person hugging us.
Massage taps into these primeval neural pathways. Massage gives us the opportunity to switch off for a while whilst being cared for by another. I think John Jeremiah Sullivan puts it brilliantly in his article My Multiday Massage-a-Thon in The New York Times. "Maybe that's what massage is to a lot of people, those who don't have chronic pain or migraines - it's enforced meditation for those of us too distracted to meditate. You're paying someone to meditate you. It's not anything they're doing, necessarily. It's that they open a little window. They give you an excuse to lie there in silence and pay a deeper attention to the fact that you exist."
How To Make Stress Your Friend
A very interesting Tedx Talk by Kelly McGonigal where she discusses the results of some interesting studies that point towards a new way of viewing and dealing with Stress.
Here are some ideas and techniques on my website which are appropriate for reducing stress and anxiety.
Other techniques that may help reduce stress:
- Breathing techniques
- Guided Imagery such a BodyScans
- Yoga, TaiChi, QiGong
- Walking (especially in nature)
- Tending a garden
- Listening to music
- Reducing caffeine and alcohol
- Eating a balanced and natural diet
- Talking to someone
Recommended Reading & Research
Why Zebras Don't Get Ulcers - Robert Sapolsky
Stress and Health: Biological and Psychological Interactions - William R. Lovallo
The Rough Guide to Mindfulness - Albert Tobler, Susann Herrmann
Managing Stress with Qigong - Gordon Faulkner
Research Papers and Articles
Physiological adjustments to stress measures following massage therapy: a review of the literature.
Moraska A, Pollini RA, Boulanger K, Brooks MZ, Teitlebaum L.
Evid Based Complement Alternat Med. 2010 Dec;7(4):409-18. doi: 10.1093/ecam/nen029.
A randomised study of the effects of massage therapy compared to guided relaxation on well-being and stress perception among older adults.
Patricia A. Sharpe, Harriet G. Williams, Michelle L. Granner, James R. Hussey
Complementary Therapies in Medicine, Volume 15, Issue 3, September 2007, Pages 157-163
Physiological responses to touch massage in healthy volunteers.
Lindgren L, Rundgren S, Winsö O, Lehtipalo S, Wiklund U, Karlsson M, Stenlund H, Jacobsson C, Brulin C.
Auton Neurosci. 2010 Dec 8;158(1-2):105-10. doi: 10.1016/j.autneu.2010.06.011.
Feasibility and effect of chair massage offered to nurses during work hours on stress-related symptoms: a pilot study.
Engen DJ, Wahner-Roedler DL, Vincent A, Chon TY, Cha SS, Luedtke CA, Loehrer LL, Dion LJ, Rodgers NJ, Bauer BA.
Complement Ther Clin Pract. 2012 Nov;18(4):212-5. doi: 10.1016/j.ctcp.2012.06.002. Epub 2012 Jul 17.
Does massage therapy reduce cortisol? A comprehensive quantitative review.
Christopher A. Moyer, Lacey Seefeldt, Eric S. Mann, Lauren M. Jackley
Journal of Bodywork and Movement Therapies, Volume 15, Issue 1, January 2011, Pages 3-14
Cortisol decreases and serotonin and dopamine increase following massage therapy.
Field T, Hernandez-Reif M, Diego M, Schanberg S, Kuhn C.
Int J Neurosci. 2005 Oct;115(10):1397-413.
Effects of Swedish massage on blood pressure.
Moa Aourell, Martina Skoog, J. Carleson
Complementary Therapies in Clinical Practice, Volume 11, Issue 4, November 2005, Pages 242-246
Massage increases oxytocin and reduces adrenocorticotropin hormone in humans.
Morhenn V, Beavin LE, Zak PJ.
Altern Ther Health Med. 2012 Nov-Dec;18(6):11-8.
Effect of massage therapy on stress levels and quality of life in brain tumor patients--observations from a pilot study.
Support Care Cancer. 2011 May;19(5):711-5. doi: 10.1007/s00520-010-1032-5. Epub 2010 Nov 3.
Exploring effects of therapeutic massage and patient teaching in the practice of diaphragmatic breathing on blood pressure, stress, and anxiety in hypertensive African-American women: an intervention study.
J Natl Black Nurses Assoc. 2010 Jul;21(1):17-24.