How to Know When Stress Becomes Chronic

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When Stress Becomes Chronic

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About the Show
On this episode, Chuck Gaidica is joined by Dr. Kristyn Gregory, medical director of behavioral health for Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan. Together, they discuss stress and what to do if it becomes prolonged.
In this episode of A Healthier Michigan Podcast, we explore:
    • Common types of stress
    • When stress becomes chronic
    • Its impact on one’s physical health
    • Ways to manage chronic stress

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Transcript
Chuck Gaidica:
Frazzled, anxious, tense, do you feel surrounded by stress? This is A Healthier Michigan podcast, episode 129. And coming up we discuss chronic stress and the impact it has on our health.
Welcome to A Healthier Michigan podcast. It’s a podcast dedicated to navigating how we can improve our health and wellbeing through small, healthy habits we can start implementing right now. I’m your host, Chuck Gaidica, and every other week we’ll sit down with a certified expert and we discuss topics that cover nutrition, fitness, and a lot more. And on this part one of a two-part series, it’s all related to chronic stress and we’re looking into common types of stress and what happens to our health when short-lived stress turns long-lasting. With us today is Medical Director of Behavioral Health for Blue Cross Blue Shield of Michigan, Dr. Kristyn Gregory. Good to see you, doctor.
Dr. Kristyn Gregory:
Good to see you too, Chuck.
Chuck Gaidica:
Yeah, thanks so much. And I know you’ve had so much experience in dealing with kids and adults, and this seems to be a pervasive issue. And it’s the stats that blow my mind. I mean, when I read some of these statistics, according to the American Psychological Association, more than a quarter of US adults say that they’re so stressed, they can’t function. This isn’t a quarter of people who are stressed. This is a quarter of the population of America. Does that seem to relate to what you are seeing, not just anecdotally, but clinically?
Dr. Kristyn Gregory:
Yeah, very much so. Especially in the post-pandemic, it seems to be a chronic thing.
Chuck Gaidica:
Well, the adults that have reported stress had an impact on health. 76% report that they’ve had at least one symptom in the last month because they’ve had things like headaches, fatigue, feeling anxious, nervous, feeling depressed or sad. And I know there’s a lot going on in the world, and it seems like we’ve got so much to unpack out of this box because parts of it can include, well, you’re getting all this news that really doesn’t affect your personal life. I mean, some sad thing, we may be sad about a tragedy somewhere else in the world. Does it really affect you? And I know anecdotally in my own family, there are kids, my late mom was like this. She would say, “The news scares me,” and I was part of the news. And I would say, “Well then, mom, turn it off.” I had to say, “Well, yeah, sorry, just don’t watch it if it scares you.” Is that part of it that we’ve got so many inputs now from various parts of the world in lightning speed that things that didn’t used to stress us are now stressors?
Dr. Kristyn Gregory:
Well, yeah, exactly. I mean, there’s different kinds of stress and some of the things that we expect to go away over time seem to be hanging on and continuing to activate us.
Chuck Gaidica:
So for those that say, the 76% that say in the past month that they’ve experienced sadness or a headache or fatigue or something, there would be a lot of people, I think, who would just want to say, “Shake it off, snowflake. I mean, just get with the program, you’ll get past it. You’ll be fine.” How much value is there in just saying, “Pull yourself up by your bootstraps,” or is there?
Dr. Kristyn Gregory:
I don’t think that there is, because there’s certain things that we can’t just avoid, because stress from environmental things or work stress, we might not be able to avoid because it’s our livelihood or it’s where we live and work.
Chuck Gaidica:
So when we have stress, and I remember a previous episode we had, I think it was with Dr. DeFranco, and he talked about even going back to ancient times, this idea that we were wired, that we were ready to get stressed because here comes the bear out of the woods and now we’ve got to fight or flight. So we’re kind of wired to have stress. When does stress become chronic? What does that mean?
Dr. Kristyn Gregory:
It’s when we don’t have that come down, relaxation period in between, when we’re constantly so keyed up and we’re in a constant state of that fight or flight, like, “Oh, watch the bear.” And then that can cause chronic stress and all the physical symptoms that go along with it. Headaches, irritability, GI things. A lot of times we get so accustomed to it that it begins to feel normal. That’s just kind of how we go on our day-to-day lives is this heightened autonomic response, this fight or flight constantly.
Chuck Gaidica:
And it’s not just the world and its events that are affecting us, including the pandemic. It could be your job, it could be your family life. Because we’ve got two kids that just had two new babies end of last year. Well, there’s some stress there. I mean, it just is.
Dr. Kristyn Gregory:
Yeah. If you’re having financial issues or if you have an illness, I mean, those things might not go away.
Chuck Gaidica:
So you mentioned a few kinds of stress. How are they different from one another? Because you also mentioned symptoms that to me, are vastly different. I’m going to have stress and I get a headache. That’s one thing. But that same stress or slightly different stress may give me gastro issues. So can you help us understand the common types of stress and then how they relate to symptoms?
Dr. Kristyn Gregory:
Sure. You can have stress from your emotions. So say, you are dealing with difficult emotions like anger, sadness, or frustration. There can be environmental stress, which I mentioned, is where you live and work, relationship stress, and that can be your partners, your family, and there can also be work stress. And a lot of times all these stressors kind of go together. And work stress can stress your relationships, relationships can stress your work, and kind of vice versa, but they can all cause the same type of symptoms physically. So even though it might be work stress versus relationship stress, you can still have that difficulty sleeping because you keep overthinking and replaying a certain scenario through your head. You might have problems thinking or remembering appointments because you have so much on your plate. That can lead to a sense of fatigue, feeling a loss of control. Everything becomes circular at a point. The difficulty sleeping leads to fogginess throughout the day, lower energy, further problems thinking, along with that continued focus on whatever your stressor is.
Chuck Gaidica:
This is really interesting. I have a friend who just shared with me that he was having trouble sleeping, and it’s because his mind starts going, and it sounds like some of that stress was good stress, right? He’s got ideas or business ideas. It didn’t sound like it was stress to me, but it was stress to him. And he’s having trouble figuring out what the hack, as he described, it needs to be. Should I write these things down and throw them in a box and then go to sleep? But for a lot of people, this rumination or this idea of trying to go to sleep and the record keeps playing in your head is a real deal, and I just heard about it. What do we do for that in particular? How do we calm our minds at bedtime so that we can healthfully get that night’s rest, which may help us tomorrow with whatever new stress is coming.
Dr. Kristyn Gregory:
In the long term, developing healthier habits can work as well as creating new coping skills. And some of that might be throwing it in a box until the morning. Some of it might be meditation, healthy sleep habits overall, meaning you don’t watch the news, which could create more stress right before you go to bed, or you don’t check that last work email right before bed, as well as meditation. Meditation doesn’t have to be some big thing where you sit in your corner cross-legged and chant. It can be as simple as reciting a poem in your mind quietly. Your mind can’t do two things at once. So you can’t be reciting something like that, a prayer, a poem, a chant, and also worrying at the same time, as your mind will not do two things at once. So if you focus successfully on one thing that doesn’t have a lot of emotional impact, let’s say, that will help you get the other out of your head.
Chuck Gaidica:
It seems too, that sometimes in today’s world, for all of us, young and older alike, we have trouble unplugging. I can’t wait now for spring to spring so I can get out and goof around in the yard, and I just picture carrying a bag of bark mulch. That’s stress for a minute, but I can throw it off in the yard and then I’m like, “Whew, man, I’m done being stressed. I carried it out to the back 40 and I’m working.”
Dr. Kristyn Gregory:
Right. And exercise definitely, yeah, can help too.
Chuck Gaidica:
Does it? Yeah.
Dr. Kristyn Gregory:
Yeah. Exercise can really reduce your chronic stress overall, and it’s putting those fight or flight chemicals to good use, exercising and getting that cardiac output.
Chuck Gaidica:
So if you’re having trouble throwing off the maybe even multiple stressors, as you mentioned, you just had a baby, you’re trying to manage the job, you’ve got financial issues, and all of a sudden you’re carrying all this weight, when does it start to turn from everyday stress to chronic? And what should you be watching out for yourself or a loved one within your circle of influence that you say, “Eh, something’s up. It’s not just I’m having trouble today.”
Dr. Kristyn Gregory:
Well, because if it’s so prolonged like that, it can have an overall impact on your health. So if it’s always one thing, then the next, if you feel like you’re stressed and just on edge, your shoulders are up every day for weeks at a time, that can be chronic stress and it can cause health problems. It can affect your heart, it can cause high blood pressure, it can cause depression, acne.
Chuck Gaidica:
Really?
Dr. Kristyn Gregory:
Yeah.
Chuck Gaidica:
Wow.
Dr. Kristyn Gregory:
My daughter, she’s a teenager, so when she’s stressed out, I’ll notice it, she might get acne. I’ve noticed it when I was that age too, it’s due to stress.
Chuck Gaidica:
And I saw that with my wife last year. We moved, and the move, I think, created enough stress that she may have had something going on with an eczema, but it seemed like it just blew up. And the only thing that was different was this idea, we got to pack, we got to go, we got to get the truck. And I think that that had a lot to do with it. I saw it happen right before my eyes. There was no other explanation. There was an explanation medically, but this seemed to be a flare that was being caused by some input somehow.
Dr. Kristyn Gregory:
And that can be the role of cortisol. So cortisol is a stress hormone. So when we’re under stress, our body produces this hormone, cortisol, in higher levels. And unbridled cortisol levels can affect how our bodies metabolize sugars. It can lead to worsening of diabetes, it can lead to worsening of other conditions we have, like eczema, irritable bowel. You’ve heard the term nervous stomach. I mean, that’s due to stress.
Chuck Gaidica:
And then there are some of us, I mean, I have a friend, I won’t name him, but I have a friend who likes to eat cookies just in case he’s getting stressed, me. So that’s my trigger. I don’t have a physical response, but if something goes too right or too wrong, I know I’m apt, maybe cortisol is happening. Can that drive your appetite too?
Dr. Kristyn Gregory:
Yeah. So cortisol can increase your appetite. It’s like a steroid hormone. So sometimes if we’re prescribed steroid hormones from our doctor for various conditions, that can increase the appetite. But if you have higher cortisol levels, because stress can also change your appetite.
Chuck Gaidica:
So if you’re a person that’s feeling stressed and it seems like this has been continuing, there are certain things that come to mind, including how to remove those stressors from life, how to, as you’ve put it, calm your mind, how do you unplug. But also there are things from the outside, this idea of exercise. In Michigan, now when the weather starts to break, maybe we get out more. That’s got to be helpful that we can just go out and get fresh air and go for a walk more.
Dr. Kristyn Gregory:
Yeah, exactly. Thinking about something else, deep breathing. We talked about meditation, deep breathing, going for a walk, exercise. But also little things like hugs. And if you think about that, sometimes when you’re stressed and that physical touch, sometimes just getting a really deep hug from someone can relieve that stress for just a minute. Give us a chance to breathe.
Chuck Gaidica:
Well, and that’s really interesting because that idea, the cuddle hormone, that we all kind of give off.
Dr. Kristyn Gregory:
Oxytocin.
Chuck Gaidica:
Right, right. We give a hug and we give somebody something and we feel good about it as well. And I think, wow, we’ve come through this season where, holy cow, don’t touch people, don’t get close. We got to social distance. That alone then, based on what you’re saying, could be a stressor in some people’s lives.
Dr. Kristyn Gregory:
Yeah, exactly. Because we’re social creatures, we crave that physical contact. And you’re right, it’s been two years where don’t touch anybody, don’t be within six feet. So I think that that’s had an impact on the world’s mental health.
Chuck Gaidica:
And the other thing that pops to mind is I think about this idea of maybe not touching people and the loneliness, because we’ve heard these statistics, how lonely people can feel, even those that have, I may have four people in my house and I may still feel lonely. This has got nothing to do with the absence necessarily of people. But that idea of being in connection in community with others seems to be important too. Whether it’s at a workplace, which now a lot of people have gone back to, or maybe a church or synagogue or something, that just being around people can be helpful.
Dr. Kristyn Gregory:
It’s that feeling of connection of community that we’re missing, and that’s causing increased anxiety and stress. Because again, a lot of this is, as Dr. DeFranco has said before, this is evolutionary, right? We’ve evolved to be creatures that crave that. We have a social connectedness. So when that’s missing, we go back to the caveman day, so to speak.
Chuck Gaidica:
Are there things that we can not just do ourselves, but if we need to get the help, and I want to come to this here in a minute, finding professional help, like someone from you, but I know I will de-stress if I pay somebody to give me a massage. I don’t do it often. I probably should do it more than I do. But every once in a while when I do it, I think, man, I don’t know what it costs. Was it 50 bucks or 60 bucks? It’s definitely not for everybody, but there are certain things I think you can do where you can employ the help of others and then walk away saying, “Man, if that just gets me to swing from one branch to the next and I feel good for a month, that was worth every penny.”
Dr. Kristyn Gregory:
Yeah. And it can be things like yoga, it could be having a personal trainer or two, a massage, maybe an exercise group even, a hobby can reduce stress, if it’s a hobby that you like. A hobby shouldn’t necessarily cause stress. But maybe it’s golfing.
Chuck Gaidica:
I’m told that can cause a lot of stress, golf. I’m just told. I’m not a golfer.
Dr. Kristyn Gregory:
I’m not either, so. I think that that would cause me more stress. But there’s things we can do that are free too. So practicing gratitude can also reduce your stress level. So instead of focusing on all the things that are wrong, if we focus on the things that are right too. And it can be little things. It can be I woke up this morning and I was grateful to have my little puppy dog next to me snoring. Grateful it’s not snowing.
Chuck Gaidica:
Or grateful that it is because you like it, right? I mean, it’s so contextual because everybody’s so different. What works for one person may not work for another.
Dr. Kristyn Gregory:
Yeah. Somebody could be very ungrateful that it’s not snowing.
Chuck Gaidica:
Yeah. I read a great quote once that relates to so many of the things, so much of the wisdom you’re giving us today. I think the author is Anne Lamott. I don’t know if you’ve ever seen it. It goes something like, “You can unplug for a day and everything will be all right tomorrow.” In other words, you really can unplug the vacuum and put it in the closet, and when you come back and plug it back in, it’ll still work. Don’t worry. It will still work. And then you relate that to the human context. I’ve heard so many people, and I know I’ve done this too, “Oh, I can’t unplug. I mean, I am too busy. I’ve got too much stuff.” No, you really can. And if you just unplug for the minute, deep breathing for the hour, for the day, when you plug the cord back in, it’ll work. You’ll be fine. And I think so many times, I’ll just speak for me, I sometimes gloss over that. Like, “Oh, I just can’t stop. I’ve got to keep going.” You hear that sometimes?
Dr. Kristyn Gregory:
Yeah, I do that sometimes, Chuck. I went to a conference a couple weeks ago, and it was outside of San Diego. There was absolutely, the internet did not work there. And initially when I got there, I was like, “I still have to do all this work.” And it caused a lot of anxiety on my part until I was like, “I’m going to go with it, and what’s going to get done is going to get done, and what’s not going to get done is not going to get done. And this is going to be an opportunity.”
Chuck Gaidica:
And was it? Is that the way it worked out then?
Dr. Kristyn Gregory:
It was, yeah. I went for a walk, I petted the horses, and just eventually was able to forget about my internet connection and phone connection problems. And you know what? The calls waited for me, the emails waited for me until I got back the next day.
Chuck Gaidica:
Pretty wild how that works when you just let it work that way. So whether it’s anxiety, maybe it’s sadness, maybe we’ve gone to full-blown depression, let’s double back on this idea of chronic stress, trying to manage it on our own. Sometimes, again, based on the context of where you are in life or whatever, you can do it. You can unplug and go pet the horses and you’ll be okay. But for others, maybe they’re having trouble. But when we’re trying to manage it on our own, give us these points again, where we see the turns in our own life or those around us where we need to start to consider seeking help from a mental health professional.
Dr. Kristyn Gregory:
So if we try those things that we can do on our own, and we find that we’re still having significant symptoms, decreased energy, feeling loss of control, helplessness and depression, maybe we’ll start having panic attacks or you feel like you can’t go out of the house, or your heart’s racing out of your chest, then that’s the time to consider maybe some professional treatment for that. And that can be things like therapy.
One of the approaches we use is cognitive behavioral therapy, and that really helps us identify these negative thought patterns, these all or nothing type thinking. If I don’t complete all this, something horrible is going to befall, I have to keep going. The inability to unplug. And we can work with a therapist to change these thoughts to more realistic, helpful ones. And therapists can also help with mindfulness and meditation because those help with chronic stress as well. And then there’s also the types of stress when they become chronic, and they might become an anxiety disorder or depressive disorder because that can happen with chronic stress. Then it might be something that we talk to our family doctor or a psychiatrist about anxiety or depression medications.
Chuck Gaidica:
That’s interesting because all that you’ve just said is so healthful and such a positive thing to consider, and yet going to visit a doctor even via telehealth, for some is going to cause anxiety. Maybe they’ve never done it, or maybe it’s just they can’t unplug. They’re like, “Oh my gosh. It’s another thing.”
Dr. Kristyn Gregory:
Yeah, it’s another appointment.
Chuck Gaidica:
But you’re raising this to a level of concern where I think that’s part of the answer is we have to assign high value to our health because we can’t take care of ourselves sometimes the way we need to without someone else helping us, or a crutch, or we just need a cane for a minute after we twisted that ankle and then we’re done. We’re okay.
Dr. Kristyn Gregory:
Yeah, exactly. And brain health is body health. It’s the control center of everything else that’s going on, the steps that you take, the thoughts that you have. So if the brain is stressed out and struggling, then we need to help the brain so it can manage all the other parts of us as a whole. And that’s why stress affects so many different body systems because it is the control center. So it’s very important we take care of that.
Chuck Gaidica:
Well, we’ve covered so much great stuff. You want to give us a few takeaways here to kind of wrap it up of some of the important things to consider as we’re navigating our way into the world?
Dr. Kristyn Gregory:
Sure. So stressful situations can become chronic. They can become chronic emotional, environmental, relationship, or work stress, and they can have a big impact on various physical symptoms. There’s different coping mechanisms that we can try, such as walking, exercise, meditation, hugs, being with friends. But sometimes when distress becomes overwhelming, it’s good to see a health professional and they can offer additional treatments which can help reduce stress and get everybody back to, let’s say, homeostasis, where all the systems are working well under a healthy brain.
Chuck Gaidica:
Well, that’s good stuff. Dr. Gregory. I don’t know if you noticed, I relaxed my shoulders while I was talking to you, so I feel good. I’m de-stressed now.
Dr. Kristyn Gregory:
I need to do that, I think.
Chuck Gaidica:
Well, it’s good to see you. Thanks so much for the advice and all the good stuff today.
Dr. Kristyn Gregory:
Thanks, Chuck.
Chuck Gaidica:
All right, take good care. That’s Dr. Kristyn Gregory. She’s provided us with a ton of good stuff. This is part one of a two-part series that deals with the impact of stress on our health. Next time we’ll be focusing on how stress impacts our eating. We talked about that a little bit today, but we’re going to dig deeper into that specifically and what we can all do to better approach food when dealing with stress.
Thanks for listening. We’re glad you’ve been here today for A Healthier Michigan podcast. It’s brought to you by Blue Cross Blue Shield of Michigan. If you like the show, you want to know more, you can go online. You can check us out at ahealthiermichigan.org/podcast. We’ve got, what are we now? We’re episode 129, so we’ve got a ton of great stuff in the library that you can partake in and take it with you as you’re going for some of these healthful walks. Leave us reviews or ratings on Apple Podcast or Spotify. And you can also follow us, by the way, Facebook, on Instagram, Twitter. Get all the old episodes, whatever episode you need, take it with you on your smartphone, your tablet, and be sure to subscribe to us on Apple Podcast, Spotify, or your favorite podcast app. I’m Chuck Gaidica. Be well.

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