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Understandingthestressresponse
Chronicactivationofthissurvivalmechanismimpairshealth.
Fortwoyearsinarow,theannualstresssurveycommissionedbytheAmericanPsychologicalAssociationhasfoundthatabout25%of
Americansareexperiencinghighlevelsofstress(ratingtheirstresslevelas8ormoreona10-pointscale),whileanother50%reportmoderate
levelsofstress(ascoreof4to7).Perhapsnotsurprising,givencontinuingeconomicinstabilityinthiscountryandabroad,concernsabout
money,work,andtheeconomyrankasthetopsourcesofstressforAmericans.
Stressisunpleasant,evenwhenitistransient.Astressfulsituationwhethersomethingenvironmental,suchasaloomingworkdeadline,or
psychological,suchaspersistentworryaboutlosingajobcantriggeracascadeofstresshormonesthatproducewell-orchestrated
physiologicalchanges.Astressfulincidentcanmaketheheartpoundandbreathingquicken.Musclestenseandbeadsofsweatappear.
Thiscombinationofreactionstostressisalsoknownasthe" ght-or- ight"responsebecauseitevolvedasasurvivalmechanism,enabling
peopleandothermammalstoreactquicklytolife-threateningsituations.Thecarefullyorchestratedyetnear-instantaneoussequenceof
hormonalchangesandphysiologicalresponseshelpssomeoneto ghtthethreato or eetosafety.Unfortunately,thebodycanalsooverreact
tostressorsthatarenotlife-threatening,suchastra cjams,workpressure,andfamilydi culties.
Overtheyears,researchershavelearnednotonlyhowandwhythesereactionsoccur,buthavealsogainedinsightintothelong-terme ects
stresshasonphysicalandpsychologicalhealth.Overtime,repeatedactivationofthestressresponsetakesatollonthebody.Researchsuggests
thatprolongedstresscontributestohighbloodpressure,promotestheformationofartery-cloggingdeposits,andcausesbrainchangesthat
maycontributetoanxiety,depression,andaddiction.Morepreliminaryresearchsuggeststhatchronicstressmayalsocontributetoobesity,
boththroughdirectmechanisms(causingpeopletoeatmore)orindirectly(decreasingsleepandexercise).

Soundingthealarm
Thestressresponsebeginsinthebrain(seeillustration).Whensomeoneconfrontsanoncomingcarorotherdanger,theeyesorears(orboth)
sendtheinformationtotheamygdala,anareaofthebrainthatcontributestoemotionalprocessing.Theamygdalainterpretstheimagesand
sounds.Whenitperceivesdanger,itinstantlysendsadistresssignaltothehypothalamus.

Commandcenter

Whensomeoneexperiencesastressfulevent,theamygdala,anareaofthebrainthatcontributestoemotionalprocessing,sendsadistress
signaltothehypothalamus.Thisareaofthebrainfunctionslikeacommandcenter,communicatingwiththerestofthebodythroughthe
nervoussystemsothatthepersonhastheenergyto ghtor ee.

Thehypothalamusisabitlikeacommandcenter.Thisareaofthebraincommunicateswiththerestofthebodythroughtheautonomicnervous
system,whichcontrolssuchinvoluntarybodyfunctionsasbreathing,bloodpressure,heartbeat,andthedilationorconstrictionofkeyblood
vesselsandsmallairwaysinthelungscalledbronchioles.Theautonomicnervoussystemhastwocomponents,thesympatheticnervoussystem

andtheparasympatheticnervoussystem.Thesympatheticnervoussystemfunctionslikeagaspedalinacar.Ittriggersthe ght-or- ight

response,providingthebodywithaburstofenergysothatitcanrespondtoperceiveddangers.Theparasympatheticnervoussystemactslikea
brake.Itpromotesthe"restanddigest"responsethatcalmsthebodydownafterthedangerhaspassed.
Aftertheamygdalasendsadistresssignal,thehypothalamusactivatesthesympatheticnervoussystembysendingsignalsthroughthe
autonomicnervestotheadrenalglands.Theseglandsrespondbypumpingthehormoneepinephrine(alsoknownasadrenaline)intothe
bloodstream.Asepinephrinecirculatesthroughthebody,itbringsonanumberofphysiologicalchanges.Theheartbeatsfasterthannormal,
pushingbloodtothemuscles,heart,andothervitalorgans.Pulserateandbloodpressuregoup.Thepersonundergoingthesechangesalso
startstobreathemorerapidly.Smallairwaysinthelungsopenwide.Thisway,thelungscantakeinasmuchoxygenaspossiblewitheach
breath.Extraoxygenissenttothebrain,increasingalertness.Sight,hearing,andothersensesbecomesharper.Meanwhile,epinephrinetriggers
thereleaseofbloodsugar(glucose)andfatsfromtemporarystoragesitesinthebody.Thesenutrients oodintothebloodstream,supplying
energytoallpartsofthebody.
Allofthesechangeshappensoquicklythatpeoplearen'tawareofthem.Infact,thewiringissoe cientthattheamygdalaandhypothalamus
startthiscascadeevenbeforethebrain'svisualcentershavehadachancetofullyprocesswhatishappening.That'swhypeopleareabletojump
outofthepathofanoncomingcarevenbeforetheythinkaboutwhattheyaredoing.
Astheinitialsurgeofepinephrinesubsides,thehypothalamusactivatesthesecondcomponentofthestressresponsesystemknownasthe
HPAaxis.Thisnetworkconsistsofthehypothalamus,thepituitarygland,andtheadrenalglands.
TheHPAaxisreliesonaseriesofhormonalsignalstokeepthesympatheticnervoussystemthe"gaspedal"presseddown.Ifthebrain
continuestoperceivesomethingasdangerous,thehypothalamusreleasescorticotropin-releasinghormone(CRH),whichtravelstothepituitary
gland,triggeringthereleaseofadrenocorticotropichormone(ACTH).Thishormonetravelstotheadrenalglands,promptingthemtorelease
cortisol.Thebodythusstaysrevvedupandonhighalert.Whenthethreatpasses,cortisollevelsfall.Theparasympatheticnervoussystemthe
"brake"thendampensthestressresponse.

Techniquestocounterstress
The ndingsofthenationalsurveymentionedearliersupportwhatmentalhealthcliniciansexperienceintheirownpracticesmanypeople
areunableto ndawaytoputthebrakesonstress.Chroniclow-levelstresskeepstheHPAaxisactivated,muchlikeamotorthatisidlingtoo
highfortoolong.Afterawhile,thishasane ectonthebodythatcontributestothehealthproblemsassociatedwithchronicstress.
Persistentepinephrinesurgescandamagebloodvesselsandarteries,increasingbloodpressureandraisingriskofheartattacksorstrokes.
Elevatedcortisollevelscreatephysiologicalchangesthathelptoreplenishthebody'senergystoresthataredepletedduringthestressresponse.
Buttheyinadvertentlycontributetothebuildupoffattissueandtoweightgain.Forexample,cortisolincreasesappetite,sothatpeoplewill
wanttoeatmoretoobtainextraenergy.Italsoincreasesstorageofunusednutrientsasfat.
Fortunately,peoplecanlearntechniquestocounterthestressresponse.
Relaxationresponse.Dr.HerbertBenson,directoremeritusoftheBenson-HenryInstituteforMindBodyMedicineatMassachusettsGeneral
Hospital,hasdevotedmuchofhiscareertolearninghowpeoplecancounterthestressresponsebyusingacombinationofapproachesthat
elicittherelaxationresponse.Theseincludedeepabdominalbreathing,focusonasoothingword(suchaspeaceorcalm),visualizationof
tranquilscenes,repetitiveprayer,yoga,andtaichi.
Mostoftheresearchusingobjectivemeasurestoevaluatehowe ectivetherelaxationresponseisatcounteringstresshavebeenconductedin
peoplewithhypertensionandotherformsofheartdisease.Thoseresultssuggestthetechniquemaybeworthtryingalthoughformost
peopleitisnotacure-all.Forexample,researchersatMassachusettsGeneralHospitalconductedadouble-blind,randomizedcontrolledtrialof
122patientswithhypertension,ages55andolder,inwhichhalfwereassignedtorelaxationresponsetrainingandtheotherhalftoacontrol
groupthatreceivedinformationaboutbloodpressurecontrol.Aftereightweeks,34ofthepeoplewhopracticedtherelaxationresponsea
littlemorethanhalfhadachievedasystolicbloodpressurereductionofmorethan5mmHg,andwerethereforeeligibleforthenextphaseof
thestudy,inwhichtheycouldreducelevelsofbloodpressuremedicationtheyweretaking.Duringthatsecondphase,50%wereableto
eliminateatleastonebloodpressuremedicationsigni cantlymorethaninthecontrolgroup,whereonly19%eliminatedtheirmedication.
Physicalactivity.Peoplecanuseexercisetosti ethebuildupofstressinseveralways.Exercise,suchastakingabriskwalkshortlyafterfeeling
stressed,notonlydeepensbreathingbutalsohelpsrelievemuscletension.Movementtherapiessuchasyoga,taichi,andqigongcombine uid
movementswithdeepbreathingandmentalfocus,allofwhichcaninducecalm.
Socialsupport.Con dants,friends,acquaintances,co-workers,relatives,spouses,andcompanionsallprovidealife-enhancingsocialnetand
mayincreaselongevity.It'snotclearwhy,butthebu eringtheoryholdsthatpeoplewhoenjoycloserelationshipswithfamilyandfriends
receiveemotionalsupportthatindirectlyhelpstosustainthemattimesofstressandcrisis.
Updated:March18,2016
Originallypublished:March2011

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