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Stress. It can be everywhere and anywhere. And, it can occur in numerous forms: mental, emotional, physical, social, and environmental. We can’t avoid it, no matter what we do.

That’s not to say that some stress is not beneficial. In the short term, stress allows us to react quickly and appropriately to harm or danger. The problem is that if stress continues on a chronic basis, it can instead cause a variety of medical problems.

Stress causes the production of various hormones, especially cortisol and catecholamines such as epinephrine. These hormones help gear us up to fight stress in the short term. But if they continue to be produced in excess due to chronic stress, they instead cause wear and tear on our bodies and can damage every organ system.


Medical impact of stress

It is well established that chronic stress can cause an increased risk of heart disease, stroke, high blood pressure, diabetes, and acid reflux. It can worsen symptoms of asthma, cause disruption in digestion and elimination, and depress the immune system, leading to a predisposition for infection. It can lead to chronic musculoskeletal problems and cause or worsen pain. It can induce infertility, erectile dysfunction, and increase symptoms of PMS and menopause. It also can affect us mentally, causing anxiety, depression, and even panic attacks. Additionally, it can cause premature aging and decreased longevity. Finally, it can worsen any medical condition that we already suffer from.


Gender differences

Both men and women can be affected by stress, although each gender may deal with it differently. In women, hormones such as oxytocin and estrogen help prevent stress, but this may be lacking in post-menopausal women. Men do produce oxytocin but in smaller amounts and their primary hormone is testosterone, which may increase the effects of stress. Women’s brains are also wired differently than men; rather than a “fight or flight” response, women tend to negotiate and stress can affect them more as a result.


The best way to deal with stress

The best way to deal with stress is to avoid it, but we all know that may be difficult to accomplish. So the next best solution is to prevent it from affecting you adversely by taking actions that block the effects or decrease the production of cortisol and catecholamines. Here are 7 strategies you can use to help you deal with stress:

  1. Meditating daily is one of the best and easiest ways to do so, having a profound effect on preventing the harm of stress and being the most cost-effective method available.
  2. It also helps to maintain a good, balanced diet (avoid junk food). Comfort foods, like a bowl of warm oatmeal, boosts levels of serotonin, a calming brain chemical. Other foods can decrease the levels of cortisol and adrenaline. Complex carbs are the best, but fish, veggies, fruits, and nuts are all beneficial to counter stress.
  3. Exercise regularly, especially aerobically. Although it has long been thought that exercises reduce stress by the release of endorphins, it is now thought that a different neurotransmitter, norepinephrine, is better at helping the brain deal with stress.
  4. Another important step is psychological counseling, to either uncover the cause of the stress and/or find better ways to deal with it. An alternative method called Interactive Imagery (also called Active Imagination) may be even more powerful.
  5. Several medications, called anxiolytics (Valium, Xanax, Ativan), can help reduce the symptoms of stress but often have side effects. I, instead, recommend a Chinese herbal formula called Ding Xin Wan, which is very effective at relieving stress with minimal to no side effects.
  6. Acupuncture, which has a direct physiologic effect on the brain, can also be beneficial for anxiety and depression by rebalancing neurotransmitters such as serotonin and norepinephrine. The Chinese exercises, Tai Chi and QiGong, as well as yoga, can be beneficial and may provide long-lasting relief.
  7. There are also beneficial western herbs and supplements that can help you ‘chill out’, either in pill form, tea, or through aromatherapy. These include St. John’s wort, dill, sage, chamomile, red clover, rosemary, tarragon, kava, and valerian.

The bottom line is that stress occurs in everyone’s life and you can’t avoid it, but there are many actions you can take to deal with it more effectively and block its adverse effects on your body and mind.


  1. In my work with hundreds of burned out physicians, I have learned some important lessons about what I see as the first and most important tool to decrease your stress at work.

    Understand that there is a huge lesson from pain medicine to those of us wanting to lower our stress levels. In pain medicine and palliative care, we realize there are two things going on in our patient.
    1) The physical sensation of pain
    2) Our emotional reaction to that physical sensation = suffering
    Pain management is our attempt to separate the two, so that a patient can be in pain and not suffer.

    In burnout and job related stress the two simultaneous events are
    1) The repetitive tasks of your job
    2) Your feelings about these repetitive tasks = suffering
    When you are busy, behind AND in the throes of feelings like frustration or righteous indignation or homicidal fury – you are suffering. You are at least doubling the energy drain in that moment compared to if you were simply doing your job without all those feelings.

    Mindfulness is the tool to separate the two.
    – Notice you are having unsupportive thoughts or feelings
    – Make a fist and take a big breath in
    – Exhale, relax your hand and LET GO of the feelings
    – Refocus on what is right in front of you

    NOTE: Mindfulness is not Meditation. Meditation is one mindfulness technique. This breathing technique is just as powerful and you use it at work, when you need it most.

    My two cents,

    Dike Drummond MD


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