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Ways to Mitigate the Stress Response and Reduce Allostatic Load.

Taking care of yourself is incredibly important and even more so during this pandemic as the toll on physical and mental health can be significant.

I appreciate that many are struggling at this moment in time. Many of us may be feeling frustrated, angry, hopeless, trapped, unsafe, unsure, depressed, anxious or even numb. Many of us may be overeating and not nourishing ourselves well. Many may be time poor and attempting to juggle the demands of work, family and homeschooling. Many may be sleep deprived, exhausted and unable to move off the sofa, get out of bed and find the motivation to exercise. Many may have found comfort in consuming more than their fair share of alcohol, refined carbohydrates and sugar.

It is such a difficult and challenging time that I am going to reiterate the importance of being gentle with yourself and doing what you can. Even small steps can make a significant difference and the purpose of this post is not to give you a hard time for not coping or doing better, but to inform you and help you be on the lookout for signs and symptoms should you not feel so well or should your lab markers change over the next few months.

I have previously spoken about the concept of allostasis which is defined it as the "cumulative impact of progressive physiological ‘wear and tear’ on the brain and the body". Research continues to reiterate the fact that long-term stress exerts a "negative effect on health via continued activation of the hypothalamic pituitary adrenal axis (HPA) and the autonomic nervous system (ANS)", which is basically known as the stress response system.

Our body has an extraordinary ability to adjust and maintain homeostatic stability. However, when the exposure to stress becomes exaggerated and prolonged it results in the failure or dysregulation of these systems. The consequence is an increase in the release of primary stress mediators such as cortisol, epinephrine and norepinephrine, as well as heightened levels of inflammatory cytokines and oxidative stress.

This in turn alters the function and structure of specific cells and tissues and the cumulative outcome of the initial and therefore primary stressors can lead to secondary effects which can impact the metabolic system (insulin, glucose, total cholesterol, high density lipoprotein cholesterol, triglycerides, visceral fat depositing), cardiovascular system (systolic and diastolic blood pressure), the immune system (c-reactive protein (CRP), fibrinogen), gut and brain health.

From a healthcare perspective, the concern is that unless the primary and secondary factors, which place a burden on the body, are alleviated, the ensuing physiological dysregulations can result in "disordered, diseased, and deceased endpoints" and more serious and chronic conditions such as cardiovascular disease, hypertension, obesity, asthma, increased infection, depression, anxiety, metabolic syndrome, cancer and diabetes.

However, the good news is that the body and brain have a substantial capacity for adaptive plasticity and therefore the changes described above can be reversed with a reduction of allostatic load.

The list below, by no means exhaustive, highlights a number interventions that may be helpful.

-Mind-body medicine can be helpful and may include relaxation techniques, hypnosis, visual imagery, meditation, yoga, biofeedback, tai chi, qi gong, cognitive-behavioral therapies or group support - Engaging in a craft can be calming for many - Implementing some physical activity and small dietary changes can be helpful - Increasing social interaction, frequency and quality. Given the current circumstances, many of the above recommendations can be via a phone call or email, or platforms such as zoom and facetime. The requirement for social distancing needn't be a deterrent to maintaining connection and communication. - When the stay-at-home is lifted and it is safe to resume practice, acupuncture and massage can also be incredibly helpful.


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