The story I’m about to tell you may sound familiar. It involves a health issue I see every day, but one that is seldom addressed. That issue is stress.

Bill and Sandy (whose names I’ve changed out of respect for their privacy) are a perfect example. In their early 60s, they had been my patients for more than 10 years. They had always been in good health. So, when they came to see me one day not long ago, I was a bit shocked to see them both looking older and far less robust than on their previous visit.

“How have you been?” I asked Sandy.

“You’ll be sorry you asked,” she replied. “We’re either too tired to do anything or too sick — it’s been one cold after another for months. And I keep gaining weight — mostly around my waist, or what used to be my waist. I’m sure the cookies don’t help, but I can’t stay away from them. Plus, my memory is just shot — some days I’m afraid it’s early Alzheimer’s. And Bill’s in even worse shape than I am.”

Clearly, it was time to sit down with Bill and Sandy for a heart-to-heart chat. So, after the examinations, we talked in my office. Before long, the real issue became apparent. Bill and Sandy were completely stressed out. In addition to worrying about the economy, fluctuating finances, and their grown children’s changing fortunes, they were concerned about the increasing number of health issues they were experiencing. No wonder they were suffering; their stress was completely out of control.

But when I mentioned the “S” word, Bill and Sandy both shook their heads. “No, it can’t be stress,” Bill told me. “We don’t have high-risk jobs, like air traffic controller or CEO of some big company. We’re just regular people.”

Obviously, it was time for my short course on stress. As I explained to Bill and Sandy, we all live with stress, whether it’s from worrying about a high-powered job or just ordinary concerns over money, jobs, children, politics, or future uncertainties. Stress is simply a fact of life today.

Too often, patients attempt to deal with a singular problem, like weight gain, without realizing that going on a diet isn’t going to fix the real source: accumulated stress. Sandy, for example, just wanted help ending her cookie craving so she could lose weight. But I had to be honest with her.

“I don’t think cookies are the real issue. You both need to learn how to manage the stress in your lives. I’m going to give you some homework. Follow these suggestions and come back in a few months. I’d like to know how you’re doing.”

I gave Bill and Sandy a hand-out with a half-dozen stress-reducing recommendations. Bill looked skeptical, but Sandy said she was willing to try making some changes.

A few months later, Sandy came in to tell me she had lost 15 pounds and hadn’t been sick since her previous visit. “But what I really wanted to tell you is that Bill is sold on de-stressing now, and he’s trying it, too!”

The Stress Hormone

Whenever someone complains of weight gain, carbohydrate and sweet cravings, irritability, fatigue, repeated colds, difficulty sleeping, high blood pressure, and memory problems, my stress detector shifts into high gear. Patients don’t complain of being stressed out; they have a laundry list of symptoms that might appear unrelated on the surface. But there is one thing that unites all these different symptoms — cortisol.

Our adrenal glands, which we discussed in an earlier issue, produce the hormone cortisol during stressful events. Cortisol mobilizes our bodies for fight or flight. For our earliest ancestors, cortisol was a life saver. But these days, the threats we face are complex and harder to escape than a hungry saber-tooth tiger. Fight or flight are not options, so the cortisol accumulates and erodes our health. Fortunately, there are some excellent stress management techniques available.

De-Stressing Solutions: Better Breathing

Deep breathing is an excellent way to banish stress, reduce cortisol, and eliminate toxins. But it’s important to do it correctly. Deep breathing does not mean hyperventilating or puffing up your chest like a pigeon. Breathing from your abdomen — sometimes called “belly breathing” — is the goal.

Most of us engage in shallow breathing throughout the day: the shoulders go up a bit and the upper chest expands a little. Shallow breathing will keep you alive, but it doesn’t provide much life-enriching oxygen. Belly breathing is just the opposite! In belly breathing, the abdomen expands, like a balloon being filled with air. (Put your hand on your tummy and try it right now! It may be a bit difficult at first, but you’ll get the hang of it.) Stretching the abdomen means the lungs have more space for oxygen. To exhale, simply contract the same abdominal muscles, forcing air out of the lungs.

Belly breathing helps calm the body and interrupts the cascade of cortisol before it can wreak havoc. Practice for a few minutes three, four, or five times a day, or whenever you feel overwhelmed by stress.

You Must Remember This PS

You may already be aware of phosphatidylserine (mercifully abbreviated to PS), a supplement often recommended for memory improvement. Interestingly, stress is one of memory’s worst enemies, so it makes sense that PS might play a role in stress management. And a number of studies have shown that it does.

Researchers have repeatedly found that PS supplements minimize stress by dampening cortisol production, whether the stress is due to excessive exercise, difficult mental tests, or emotional demands. A typical dosage is 100 mg, taken three times daily.

Tea Time for Stress Relief

Green tea (Camellia sinensis) has gotten plenty of attention recently for its health benefits, mostly in the weight-loss arena. But green tea also contains the amino acid L-theanine, which counteracts the tea’s caffeine. This is why green tea is soothing, even though it does contain some caffeine. I am not a caffeine drinker, but I do love to relax with a cup of organic green tea in the afternoon.

Studies have shown L-theanine has potent mood-lifting and stress-fighting abilities. In addition, L-theanine has been found to protect the brain from day-to-day damage. If you prefer, supplements of L-theanine are also available. I recommend a dosage of 50 to 200 mg per day.

A Stress-Fighting Duo

If you’re following my advice to take a quality multi-vitamin, good for you! But fighting stress may require a bit more. I’ve found B vitamins and magnesium to be two of the best de-stressing supplements available. In fact, a recent clinical trial found that a combination of B vitamins and minerals eased participants’ stress, improved their mental abilities, and increased energy.

The family nutrients known as B vitamin complex perform a wide range of tasks, including working closely with the nervous system. But since B vitamins are water-soluble, they can’t be stored in the body. Your multi-vitamin probably contains some B vitamins, but I recommend 100 mg daily of a separate B complex formula.

A good multivitamin should contain some magnesium. But you may need more; Americans are notoriously deficient in this vitally important mineral. Supplements are helpful for improving sleep, as well as relieving anxiety and depression. The recommended dosage is 500 mg, taken at night.

What, Me Worry?

We all worry, and too often we focus on things that are beyond our control. In other words, we stress ourselves out for no good reason. If you find that you’re worrying over the same things day after day, try setting aside a “worry time,” a five- to ten-minute daily session when you look at whatever is troubling you. If these thoughts intrude at any other time during the day, tell yourself they’ll have to wait for worry time.

Connect with Mother Nature

Whether it’s a strenuous mountain hike or a slow saunter through the park, spending time in nature can boost feelings of well-being, and simultaneously decrease stress, especially for people whose stress levels are the highest. More and more often, medical experts are recommending time in nature as an anti-stress remedy. These “green prescriptions” are designed to get people outdoors and to enjoy the true wonders of the world: trees, plants, flowers, fresh air, and sunshine. Just a 30-minute walk can help defuse stress significantly.

Of course, winter is just around the corner. But bad weather doesn’t have to keep you from reveling in nature. Travel books and magazines and botanical gardens are just a few winter options. Several patients have also reported that “garden therapy” — having green plants in their homes — is a helpful stand-in for nature during the winter, too.

Stress is truly in the eye of the beholder. You may not be able to change the circumstances of your life, but you can learn to deal with them in ways that cut down on cortisol production.

As always, I encourage patients to start with a basic healthy foundation, which means a whole foods (non-processed) diet; regular, moderate exercise; and sufficient sleep. Adding appropriate supplements and lifestyle changes to the foundation equips you for surviving today’s high-stress environment. Stress is always going to be with us, but now you have the tools to manage it, instead of letting it manage you.

Last Updated: August 16, 2018
Originally Published: October 24, 2011