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Stress and What to Do About It

by Kirsten Hartvig(more info)

listed in stress, originally published in issue 279 - June 2022

What is It?

Stress is a response experienced when a threat is encountered. A stressor is a stimulus that causes stress. Sudden and severe stress generally produces an increased heart rate, increase in breathing, decrease in digestive activity, liver release of glucose for energy, and muscle tension.

It starts when a person encounters a threatening situation, initiating a semi-automatic assessment being made based on sensory input and processing, and on what happened the last time there was a similar situation. In the brain, it involves the amygdala, which is part of the limbic system, deep at the base of the brain, on top of the brain stem and behind the pituitary gland.

The amygdala plays a key role in how we assess and respond to environmental threats and challenges, by evaluating the emotional importance of sensory information and prompting appropriate responses. Its main job is to regulate emotions such as fear and aggression. It is also involved in tying emotional meaning to our memories, and in reward processing and decision-making.

Response to Stress

Courtesy: Wikipedia


Caption: In response to stress, the hypothalamus (H) releases the corticotrophin releasing factor (CRF) into the anterior pituitary (P), causing the release of adrenocorticotropic hormone (ACTH) into the blood flow. ACTH stimulates the generation of glucocorticoids (cortisol in humans and corticosterone in mice) in the cortex of the adrenal gland (A), which are then released into the blood.


The limbic system occupies the middle of the brain and is located within the cerebrum, immediately below the temporal lobes, buried under the cerebral cortex. It is a collection of structures, including the hippocampus, which oversees memory conversion, the hypothalamus which controls homeostasis, the thalamus which relays information, and the amygdala which is involved in processing emotion.

The limbic system was originally called the rhinencephalon – meaning the ‘smell-brain’ – because it was thought to be primarily involved with the sense of smell! It is now understood that the limbic system fulfils a lot more functions than previously believed. It is now known to be involved in the processing and regulation of emotions, and in the formation and storage of memories, in sexual arousal, and in learning.

The Quick Response to Stress

When a situation is perceived as being stressful, the amygdala activates the hypothalamus which then sends signals to the adrenal medulla by activating the sympathetic nervous system. This, in turn, increases the heart rate and blood pressure.

The adrenal medulla secretes a mixture of adrenaline and noradrenaline into the bloodstream, and adrenaline further stimulates the sympathetic nervous system and reduces activity in the parasympathetic nervous system. Noradrenaline also raises the level of physiological arousal, so the adrenal hormones combined get the body ready for a fight, flight, or frolic – which, interestingly, also includes ‘guarding’ in muscles.

This immediate fight or flight cascade starts before the visual centres have had a chance to work out what is actually happening!

A slower response is also activated via the hypothalamic pituitary axis in response to acute stressors, stimulating the adrenal cortex to produce steroid hormones such as cortisol which helps the body maintain blood sugar and, in principle, cope with prolonged stressors, and return to normal. This slower ‘follow-up’ response is often described as the body’s way of keeping the pedal down on the acute stress response until the body is out of danger.

But cortisol also suppresses the immune system, and prolonged stress causes cortisol dysfunction that can lead to a vicious circle of chronic inflammation, pain and psychological distress. The pain itself can trigger acute stress responses and sensitise fear-based memories.


Social Readjustment Rating Scale

Social Readjustment Rating Scale developed by Holmes and Rahe


Inflammation – Stress – Pain

Despite plenty of evidence of the relationship between chronic stress and pain, stress is rarely addressed in pain management and rehabilitation.

Although short-term stress may be adaptive, the response to pain or non-pain related stressors may intensity cortisol secretion and lead to an exaggerated stress response which creates ‘cortisol dysfunction’ inflammation and pain. It can also lead to high blood pressure, atheroma, heart attack, stomach ulcer, stroke, addiction, anxiety and depression, obesity, poor sleep and lack of exercise, insulin suppression, and type 2 diabetes.

Chronic low-grade inflammation is increasingly recognized as a silent killer, and widespread inflammation may cause autoimmune hypersensitivities, oxidative or free radial damage, and tissue degeneration. Cortisol can also facilitate fear-based memories for future survival and avoidance of danger.

The thought-provoking reflection is that the chronic activation of what is supposed to be a survival mechanism can profoundly impair health! Even so, there is a persistent delusion that we are designed to be able to cope with stress, and if we can’t, we are somehow weak…

The ‘general adaptation syndrome’ – alarm, resistance exhaustion – is an illustration of the role of chronic stress, where resistance is thought of as worthy while exhaustion is judged as weak. If we took the current state of knowledge about stress seriously, we would organise our world, and our lives differently, and stop rewarding people who stress out themselves and other, and then complain that our health care services can’t cope with the huge numbers of cases of chronic illnesses as the ones mentioned above.

Stress and Illness

One of the things that often surprise students of medicine is the realization that the symptoms and signs of illness are not actually caused by diseases but by the body’s attempts to restore normality in the face of unusual circumstances. In other words, when our reactions to changes in circumstances cause internal imbalance, we become ill in order to restore internal balance. There is therefore only one disease: imbalance.

If we find ourselves suffering imbalance, the first step in helping ourselves is to recognise where we are in the phases of stress, health and disease.

Phase 1: Coping with stress is not so difficult if the person affected is fit and well, and not usually prone to illness. Then stress may lead to an acute disease, starting suddenly after exposure to sudden unusual stress, such as an extreme climate, a minor accident, or exposure to someone else with the same conditions. Most acute infections, inflammations, and minor illnesses belong to this phase, and they give the sufferer a chance to rest, heal and convalesce.

Phase 2: But if there is no time to rest and recover, people who have been subjected to a period of physical, mental, emotional, or spiritual stress in various combinations, and who are tired and run-down, may experience false recovery. They are constantly tired and run-down, with repeated bouts of minor illness, and time off work. Instead of staying in the wheel of health where stress gives rise to an acute illness that leads to rest, detox and recovery, they enter a wheel of disease, where false recovery and continued stress leads to chronic illness with a slow insidious onset. The original cause may be in the past, or not very obvious, and treatment brings only temporary relief. Most chronic diseases – both physical and mental – fall into this category.

Phase 3: if the continued stress becomes unbearable, the person affected experiences an acute crisis, often with a background of chronic imbalance stretching back over many years. The person affected is in acute crisis, often with a background of chronic imbalance stretching back over many years. The disease involves failure of a major organ, system, or life strategy. The acute features are made worse by the poor general health of the person. Heart attack, stroke, cancer, kidney failure, liver failure, respiratory failure, and serious accidents and poisonings fall into this category.

What to do Next?

Having decided which category your stress-related illness falls into; you can start to do things that will helps you get well.

Firstly, you can accept that you are where you are, and start working towards a solution from there. We cannot change the past but, if we are alive, something is working, and it can often be helped to work better if we start to appreciate what is positive in our situation. Of course, it can be difficult not to worry when illness comes but, if you look at illness as nature’s way of giving you the opportunity to regain your health instead of as some sort of retribution or undeserved fate, you can turn your worries into positive steps which help to encourage the healing process.

Secondly, since health depends on balance between the natural forces, the treatment of any illness must create circumstances which maximise the beneficial effects of the fundamental natural forces. It must also remove any internal and external factors that produce continuing or additional stress and encourage the recovery of full vitality by allowing proper convalescence, however minor the illness.

In Phase 1 illness, the best way to achieve these objectives is to give the body complete peace and rest while making sure that any reaction to the healing process, such as fever, does not get out of hand. Since food requires digesting before its energy can be used, and since digestion requires energy, it is more efficient to allow the body to use its own energy reserves to fuel the healing process than to overload the digestion with food. In other words, it is best not to eat but focus on keeping an adequate intake of fluids. Illnesses in this phase don’t usually last very long, and almost everyone has some energy reserves stored in their fat.

From the body’s point of view, illnesses in Phase 2 result from circumstances similar to driving a car with the accelerator hard down and the clutch half engaged. We use tablets, treatments, and will power to keep ourselves going – despite feeling near enough worn out – and our body tries to keep the situation under control by releasing steroid hormones, as seen above, to damp down our inflammatory and immune reactions, and give us temporary relief. Once again, complete rest and relaxation are vital for real cure, which may take some weeks or even months in some cases. In addition, the depleted energy stores need refilling in a way which doesn’t demand too much work, a gentle, easily digestible diet of fresh fruit and vegetables will provide the vital energy needed.

Illnesses in Phase 3 occur when all available resources have been used up, without the basic problems being solved. The system becomes ‘insolvent’ and can’t manage even basic maintenance. Vitality is so compromised that additional problems like secondary infections may compound the crisis. Dealing with such conditions requires expert nursing and medical management around the clock. However, once some basic stability returns, anabolic diets and herbs can be used to speed up and improve the healing process and help maximise the potential for true recovery.

How often have you known that you should get more rest and more exercise, eat better food, drink or smoke less, in order to get well, and yet completely ignored your own advice?

For most of us, for most of our lives, not listening to our inner voice causes few problems. But, as time goes by, if you allow accumulated imbalance to persist, you put yourself at real risk of illness. This is because vitality always acts to regain a proper balance between the natural forces working within us – whatever the apparent cost – because it is the only way to sustain life in the long term.

We were born to be healthy. Whatever sort of mind or body nature has given you, it is always possible to live in a state of greater ease of body, mind, emotions, and spirit, by working with the natural forces, rather than against them. By understanding the fundamental process of illness, and recognising your own relationship to it, you can use simple methods to restore harmony when illness brings dis-ease.

Adrenal Support

Atrophy of the adrenal cortex is a common side effect of continual stress. Various nutrients, foods and herbs are useful in supporting and enhancing adrenal function.

Vitamins and Minerals

Potassium boosts energy and strength and enables nerves and muscles to function properly. It is also involved in regulation of blood sugar levels. Eating a diet rich in potassium helps the body to get rid of excess sodium, which in turn helps to prevent high blood pressure. Potassium deficiency produces a variety of symptoms, including tiredness, depression, constipation, palpitations, muscle weakness, and cramps.

Good sources of potassium include yeast extract, dried apricots and other dried fruits, wheatgerm, beans, peas, lentils, nuts, sweet potato, avocado, greens, cabbages, bananas and potatoes.

Magnesium is the second most abundant mineral in the body. It helps maintain healthy bones and teeth, and protects against epilepsy, hypertension, heart disease, osteoporosis, PMT, and mental disturbance. Magnesium assists vitamin B1 in releasing energy from carbs, alcohol and fats, and vitamin B6 in metabolising protein. Diarrhoea, diabetes, alcoholism and diuretic drugs can all cause deficiency. Symptoms of deficiency include muscle cramps and spasms.

Good sources of magnesium include nuts and seeds (especially brazil nuts), beans and greens.

Zinc is essential for growth, blood fat regulation and protein, carbohydrate and alcohol metabolism. It promotes wound healing, elimination of waste from working muscles, and insulin production. It also protects against prostate disease and mental disturbance. Symptoms of deficiency include skin problems, lowered immunity, loss of taste and smell, hair loss, white spots on the nails, tiredness and mental disturbance.

Good sources of zinc include wheatgerm, nuts and seeds, soya beans and lentils, beans and chickpeas.

Vitamin B5 (pantothenic acid) enables the body to utilise the energy contained in fats, carbs, proteins and alcohol. It aids antibody production, protects against allergy and hypertension, and maintains nervous system health. It is also involved in the conversion of cholesterol into steroid hormones and the detoxification of drugs. And it is closely associated with the adrenal glands and our ability to respond to stress, so it is also called the stress vitamin. Symptoms of deficiency include weakness, insomnia, cramps and allergy.

Good sources of vitamin B5 include broad beans, breakfast cereals, nuts and seeds, wheatgerm, and mushrooms.

Vitamin B6 (pyridoxine) is involved in protein metabolism, so the more protein you eat, the more vitamin B6 you need. It supports the nervous system and the immune system, and is used to treat nausea in pregnancy, and during radiotherapy. Deficiency may be linked to epilepsy, anaemia, and carpal tunnel syndrome. Pre-menstrual mood swings, acne, morning sickness, and post-natal depression may all be related to vitamin B6 deficiency. Other symptoms include cracks in the corners of the mouth and lips, migraine, depression, irritability, and tiredness.

Good sources of vitamin B6 include wheatgerm, tempeh, muesli, yeast extract, sesame seeds and walnuts.

Vitamin C plays a significant role in modulating neurotransmitter synthesis and release in the brain. It is also a co-factor for dopamine conversion tor noradrenaline, and its antioxidant properties in the brain include limiting ischaemic damage. Although it may seem illogical, there is a link between vitamin C and mood, but vitamin C deficiency is common among people with psychiatric disorders. Deficiency may be linked to fatigue, depression and anxiety. There is also evidence that vitamin C deficiency is related to adverse mood and cognitive impairment, melancholy and despondency.

Good sources of vitamin C are guava, blackcurrants, parsley, spring greens, peppers, brussels sprouts, curly kale, broccoli, watercress, orange, lemon and papaya.

Helpful Herbs

Adaptogens: the term adaptogen was invented by Soviet scientists in 1964. It defined herbs that increase the body’s resistance, vitality, and ability to cope with stress.

For a herb to be classified as an adaptogen, it must show a nonspecific activity that increases the body’s ability to resist physical, chemical, or biological noxious agents. It must also have a normalising influence, independent of the nature of the pathological state; and it must be innocuous, i.e. not influence normal body functions more than required.

Good examples of herbal adaptogens are ashwagandha (Withania somnifera), holy basil, aka tulsi (Ocimum sanctum), Korean ginseng (Panax ginseng), reishi mushrooms (Ganoderma lucidum), Rose root, aka arctic root (Rhodiola rosea), schizandra (Schisandra chinensis), and Siberian ginseng (Eleutherococcus senticosus).

Nerve relaxants are herbs that are useful during periods of stress. They relax the whole body, heart and mind.

Good examples of herbal nerve relaxants are California poppy (Eschscholzia californica), chamomile (Matricaria recutita), hops (Humulus lupulus), lavender (Lavandula spp), lemon balm (Melissa officinalis), Limeflowers (Tilia spp), motherwort (Leonurus cardiaca), oats (Avena sativa), passionflower (Passiflora incarnata), st John’s wort (Hypericum perforatum), skullcap (Scutellaria lateriflora and S altissima), valerian (Valeriana officinalis), vervain (Verbena officinalis), wild lettuce (Lactuca virosa), and wood betony (Stachys betonica).



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About Kirsten Hartvig

Kirsten Hartvig ND MNIMH DipPhyt is a Medical Herbalist and Registered Naturopath. She is Director of the Healing Garden and the Rachel Carson Centre at Emerson College UK in Sussex, comprising a complementary medicine library and a medicinal herb garden. You may contact Kirsten for private consultations, to join one of the monthly herb walks, sign up for workshops, or if you would like to visit the gardens:  The Healing Garden, Emerson College, Forest Row, East Sussex RH18 5JX; Tel: 07477 220707; If you want to support the Healing Garden, please visit Patreon: You can find out more about the Heartwood professional and foundation courses in Herbal Medicine on   Instagram @heartwoodbotanic  Watch Herb Hunters on YouTube;  Listen to the Herbal Medicine Show on UKHealthRadio. Watch Herb Hunters on YouTube. Kirsten may be contacted on Tel: 07477 220707;


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