How to ward off the effects of Stress

The inauguration is coming up next week, and I’ve heard more than a few comments about how grey Barack Obama’s hair has become over the past four years. Truth be told, Obama has fared pretty well so far in comparison to former presidents— take a look at these before-and-after photos of Bush and Clinton:

presidents stress JPG
…Ouch. Clearly, the stress of the job takes a toll. In the case of U.S. presidents, there is some suggestion that most of the damage is cosmetic: when their life expectancy is measured against non-presidents, they actually do reasonably well. It may be that they are able to compensate for the impact of stress by having their health constantly monitored, being fed a better-than-average diet in the White House, or via the advantages of wealth after leaving office. That’s lucky for them, because the data on stress and health are quite clear: stress kills.

Stress: Your Body’s Response

There are two physiologic systems that coordinate the body’s response to stress: the autonomic nervous system, which reacts almost immediately, and the hormonal system, which creates longer-term changes to adapt to stress. The autonomic nervous system is the thing that causes the “fight or flight” reaction: when a lion is chasing you, your pupils dilate, your heart speeds up in anticipation of needing to either run or fight, your digestive system shuts down because you need blood flow elsewhere—changes take place all over your body to prime you for survival. During this process, a number of hormones are released, among them adrenaline and cortisol. These hormones tell our organs what their role should be in the battle.

Winning the Battle, Losing the War

The problem comes when the battle continues… day after day. Depending on how you respond to sitting in traffic when you are late for work, you can induce the same hormone release that one gets from being chased by a lion. That last point is important: our body’s stress response occurs when our perception of events don’t meet our expectations, and we don’t manage our reaction to the disappointment. The same traffic jam can have widely divergent effects on the bodies of the people sitting in it. If we react as though we are being chased by a lion all day, every day, eventually those adaptations start to work against us. When we are unable to mitigate our bodies’ stress response, we become at risk for long-term health consequences.

How Stress Kills

The image of an overweight man becoming red with anger, and then clutching his chest, is almost a cliche– but for good reason: a Harvard Medical School study of 1,623 heart attack survivors found that those people who got angry during emotional conflicts had more than double the risk of heart attack as those people who remained calm.1 But that’s not all: elevated levels of cortisol over time induce nearly all of the changes that we associate with aging:

  • impaired immune system function,2
  • worsening blood sugar control,3
  • osteoporosis,4
  • reduced muscle mass, sagging skin5
  • increased visceral body fat,6
  • impaired memory and learning. 7

In other words, stress makes you old—fast. So what can we do about it? You’ve heard the answers before:

  • Get lots of sleep (Wow, it hadn’t occurred to me to not be exhausted, thanks!)
  • Meditate/ Do yoga
  • Eat well
  • Some supplements, such as ashwaghanda, may help lower cortisol levels.

It is certainly true that meditation and yoga are effective in reversing the physiologic changes of stress. The problem is, the vast majority of us become frustrated trying to meditate, and are either unwilling or unable to incorporate yoga into our daily routine.

So is it hopeless? No. The question is:
WHY does meditation work, and is there a shortcut to that process?

What do yoga, meditation, Kabbalah—essentially all forms of higher spirituality—have in common? One answer is, they all encourage us to focus on our heart (rather than our mind) as a source of significant influence in our spiritual awareness. But that is not only true of spiritual practices: nearly all languages have expressions that suggest your heart “knows” something that your mind (brain) does not. In Japanese there are actually two separate words for the heart: shinzu is the physical organ, while kokoro refers to “the mind of the heart.” It turns out that there is a physiologic and anatomic basis for the focus of so many cultural meditative practices on our “heart” as the source of our spirituality. Decades ago, Western medicine thought that all control of your physiology emanated from the brain, while the heart simply followed orders. But that view has changed dramatically over time. It is now clear that the heart has its own nerve center, releases it’s own hormones, and actually sends communication back to the brain (and out to the rest of the body) in many different ways.

[expandsub1 title=”Click here for an overview of the various ways your heart communicates with your brain and body.” trigclass=”references”] Neurologically: via nerve impulses, the heart relays information to the medulla (brainstem), but some of those impulses are transmitted to the cerebral cortex8

Biochemically: In 1983, the heart was reclassified as part of the hormonal system when it was discovered that the heart secretes atrial natriuretic peptide(ANF), which exerts effects on the kidneys, adrenal glands, and many areas of the brain. Most importantly for this discussion, ANF affects the release of the stress hormone hormone cortisol.9-12

Biophysically: When the heart beats, it sends a pressure wave through the arteries that travels much more quickly than the blood itself. When that pressure wave reaches brain cells, there is evidence of changes in the brain’s electrical activity.

Energetically: This is where many of you roll your eyes and call me a hippie. But the fact is that the heart’s electromagnetic field is by far the most powerful produced in the body; it’s about 5000 times stronger than the one produced by the brain. The heart’s field not only permeates every cell, but can actually be measured eight feet away by magnetometers. Thus, it is quite literally true that people near you can be impacted by your “heart’s energy.” So mull that one over. So-called “hippie” talk of people having an “aura” or “feeling someone’s energy” are quite rooted in physiology. Though it is probably true that most people aren’t sensitive enough to detect that “consciously”, it would not be at all surprising if it can be felt at a subconscious level.13 [/expandsub1]

The obvious question is: If the heart is able to send all of these messages to the brain and rest of the body—is there a way to measure and change the messages being sent? The answer is Yes. Altering those messages is what meditation, yoga, kabbalah and other spiritual practices are doing. And the success of your efforts to meditate can actually be measured in something called Heart Rate Variability (HRV).

What is Heart Rate Variability?

Let’s say someone takes your pulse and tells you your heart rate is 70 beats per minute. That is an average: for part of that minute your heart may have been beating at 73 beats per minute; for part of it, 67 bpm—in fact it may NEVER have been beating at exactly 70bpm. The reality is, your heart rate changes slightly in between every single beat, even when you are asleep. HRV explained JPG Years ago we thought that a steady heartbeat was a sign of good health—but we now know that the loss of naturally occurring heart rate variability is actually a sign of disease and a strong predictor of future health problems. Because your HRV declines as you get older (i.e. your heart rate becomes more steady as you get older) HRV is actually a way to measure your physiologic age. [expandsub1 title=” For more on measuring your Physiologic Age, click here.” trigclass=”references”] The biomarker testing we do at Evolved Science is based, in part, on the fact that our organ systems all lose flexibility with age:

  • Pulmonary Function testing shows that our lungs become less elastic as you age.
  • Aortic Augmentation Pressure shows us that our blood vessels become less elastic.
  • Cutometer testing shows that our skin loses elasticity.

By measuring these values in various organ systems, we can tell our patients their overall physiologic age (PhysioAge), standardized against thousands of other people. Our autonomic nervous system is no different: It too loses the ability to adapt to change. HRV is a measure of the flexibility of our heart’s connection to our nervous system. As we get older, that connection becomes more rigid: we lose Heart Rate Variability. [/expandsub1] In case you think this is just something that “alternative” doctors believe in, here is a 2010 article from the American Journal of Cardiology:

The findings that aging is associated with a progressive decrease in heart rate variability (HRV), an index of autonomic function, suggests that longevity might depend on preservation of autonomic function. We assessed the relation between autonomic function and longevity by a study of HRV in 344 healthy subjects, 10 to 99 years old. …In conclusion, healthy longevity depends on preservation of autonomic function: in particular, HRV–parasympathetic function. Persistently high HRV in the elderly (is) predictive of longevity.

Am J Cardiol 2010;105:1181–1185. Relation of High Heart Rate Variability to Healthy Longevity.

So what does all this have to do with stress and meditation? That elusive “feeling” or state that people are trying to reach when they meditate is not relaxation—it is restored heart rate variability. Here is a recording of HRV in someone feeling frustration vs. the same person feeling profound appreciation:

HRV frustration v appreciationJPG
Image from: http://www.heartmathstore.com/cgibin/category.cgi?category=sciencebehind

Note that in both graphs, the heart rate varies between about 60 and 85 beats per minute over the course of 5 minutes. However, in the bottom graph there is a regular, sine-wave variation with a transition from one extreme to the other roughly every 5-6 seconds. In the upper graph, by contrast, there are very few complete transitions between extremes.

Improved HRV is NOT “relaxation”
To be clear, this state of improved HRV is not the same as relaxation: From: http://www.heartmathstore.com/cgibin/category.cgi?category=sciencebehind That sine-wave pattern of heart rate variation is what is achieved through meditation– when you are doing it right. The rest of the time you are simply breathing deeply and wondering “Am I meditating yet?” And therein lies the problem: It may take months of practice meditating to know when you are “in the zone”—and most people give up long before that.

If You Can’t Be A Swami, Be A Technophile
We need a device that helps us get into the meditative state quickly, and lets us know when we are “in the zone.” Hopefully you know that I’m not here to waste your time: There is, in fact, just such a device! It is called the EmWave2. (By the way: I get exactly zero dollars if you buy an EmWave. I just think it’s a useful product.) The EmWave2 measures your Heart Rate Variability, and has a simple colored light that changes from red to blue to green as you enter the “coherent” (optimal HRV) state. It comes with a computer program that helps you “meditate” to get there; I found that within five minutes of first using it I had gotten the hang of getting myself into “coherence.” Here is what it looks like: Your thumb rests over a sensor that measures your HRV.

EmWave: the red light at upper left of the device indicates poor HRV
EmWave: the red light at upper left of the device indicates poor HRV

The green light on the bottom indicates power. The red light at the top indicates poor HRV. When you get “in the zone,” that red light becomes green, like this:

EmWave indicating good HRV: the light at upper left is now green.
EmWave indicating good HRV: the light at upper left is now green.

Using this, I could see how when my mind wandered, I quickly lost my HRV rhythm and faded back to red. It quickly trains you to stay in the zone. (You’ll notice on the computer screen in the above image, my actual HRV over time was extremely erratic; that’s because someone was holding a camera waiting for me to get the light to turn green… it’s hard to meditate under pressure!) This, in my opinion, is a device that condenses months of training in meditation into minutes. It is exceedingly useful. My practice has essentially five components: Diet, Exercise, Stress Reduction, Hormone Replacement Therapy, and Supplements. Of those, Stress Reduction has always been the most “amorphous” and difficult to achieve. The EmWave is a wonderful tool in that regard, and I encourage you to give it a try!

[expandsub1 title=”Show me the REFERENCES” trigclass=”references”]

Much of the above information was adapted from the book The Heartmath Solution, by Childre and Martin.

1. Circulation. 1995 Oct 1;92(7):1720-5. Triggering of acute myocardial infarction onset by episodes of anger. Determinants of Myocardial Infarction Onset Study Investigators.

2. Hiemke C et al. Circadian variations in antigen-specific proliferation of human T lymphocytes and correlation to cortisol production. Psychoneuroendocrinology. 1995;20(3):335-42.

3. De Feo et al. Contribution of cortisol to glucose counterregulation in humans. Am J Physiol. 1989 Jul;257(1 Pt 1):E35-42.

4. Manolagas SC, Anderson DC, Lindsay R. Adrenal steroids and the development of osteoporosis in oophorectomised women. Lancet. 1979 Sep 22;2(8143):597-600.

5. Berne, R. Physiology (3rd ed.). St Louis: Mosby, 1993

6. Mårin P at al. Cortisol secretion in relation to body fat distribution in obese premenopausal women. Metabolism. 1992 Aug;41(8):882-6.

7. Kerr DS et al. Chronic stress-induced acceleration of electrophysiologic and morphometric biomarkers of hippocampal aging. J Neurosci. 1991 May;11(5):1316-24.

8. Int J Psychophysiol. 1986 Nov;4(3):183-95. Cardiac-related cortical inhibition during a fixed foreperiod reaction time task.

9. Cantin M, Genest J. The heart as an endocrine gland. Scientific American 1986;254(2):76-81

10. Life Sci. 1992;50(24):1835-42. Atrial natriuretic factor inhibits the CRH-stimulated secretion of ACTH and cortisol in man. Kellner M, Wiedemann K, Holsboer F.

11. Kentsch M. Effects of atrial natriuretic factor on anterior pituitary hormone secretion in normal man. Clin Investig. 1992 Jul;70(7):549-55.

12. Vollmar AM. A possible linkage of atrial natriuretic peptide to the immune system. Am J Hypertens. 1990 May;3(5 Pt 1):408-11. 13. McCraty R, et al. The electricity of touch: Detection and measurement of cardiac energy exchange between people. In: Pribram K, ed. Brain and Values: Is a Biological Science of Values Possible? Mahwah, NJ: Lawrence Erlbaum Associates,1998;31(3):593-601 [/expandsub1]

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