How do you respond to stressful situations?

Ridding yourself of toxic stress must begin with changing your behaviour and tackling the cause, Dr Harry Barry tells Margaret Jennings.  

How do you respond to stressful situations? Do you become anxious or depressed, or do you rise to the occasion with frustration or anger?

When it comes to acute stressful events — short bouts that we need to address as part of life — most of us fall into one or the other camp, in how we manage our world, according to Dr Harry Barry, the Drogheda-based GP who specialises in this area and is the author of five books on the subject.

Depending on our response then, we will release a “hormone burst” to protect ourselves, of either adrenaline (we are fearful so need to flee), or noradrenaline (we are angry so we want to stay and fight).

But while acute stress is part of normal living the chronic version is far more insidious — it’s called toxic stress.

“Toxic stress is when chronic stress becomes so pervasive, so persistent that it begins to intrude in our physical and mental health and I maintain that it’s a much more damaging condition, much more subtle —it’s lurking behind many illnesses. Being tired but wired is a perfect description of it,” says Dr Barry.

At that stage we have begun pouring out glucocortisol, the hormone which is meant to sustain us during longer periods of stress, he says. “What happens with it, is that we, of course, get all these insidious symptoms like fatigue — which is one of the commonest —nightmares, teeth grinding, sleeplessness, irritable bowel, mouth ulcers, cold sores, increased infections and also we’re more likely to get conditions like heart disease and diabetes.

Part of the problem is that while our body wants to rest and recover at night time and normally does this by dropping its cortisol levels, it cannot do so when we are still pumping out the hormone 24/7.

This interferes with our immune system’s ability to do its job and so we become more prone to illness.

“We know for instance people who are depressed have much higher cortisol levels by night and that’s one of the reasons depression is associated with conditions such as heart disease,” says Dr Barry.

This all explains why we continually hear about the importance of a good sleep routine.

“What we don’t fully appreciate is that when we are asleep, the body is working away at full blast. And one of the areas that’s very active is our brain. It’s going through what happened during the day and re-organising our memories for the night. In other words, clearing our brain, so that when we wake up in the morning we are all set to go again.

“So for example, if I am very stressed during the day then my dreams are going to be very anxious dreams and I will be pouring out adrenaline and cortisol.

“It’s one of the reasons that people, for example, who are very stressed, very anxious, wake up in the morning and they already have the physical symptoms of anxiety before they even get out of bed.”

You can see how the “tired but wired” cycle perpetuates itself and as a result of this “hormone burst” which prevents our brain from switching off, we suffer both physical and psychological symptoms.

That was all very well when we were being chased by wild animals in the jungle back in the day. But nowadays those stresses are much more subtle, says Dr Barry: “They’re coming more from technology, from all the difficulties of modern life, like housing problems, mortgages, relationship problems and very much by — and I’m really hot on this — the increase in social media. That mix is hyping us more, making us more exposed to the risk of toxic stress, so that the more we go down that road, the more difficulties we get into and the more our bodies react to it and the more symptoms we have and so on.”

One of its extreme consequences is being linked to people who take their own lives, he suggests.

“We know from examining post mortems of people with suicide that their adrenal glands can be up to twice the normal size and that there are frequently high levels of cortisol present, prior to suicide.” It’s not surprising, he says, because many people with toxic stress feel trapped.

“If I’m under a long period of stress maybe I’m anxious all the time; maybe I get worn down and depressed and eventually I come to the stage where I can see no way out of it.... particularly because toxic stress implies that you are in some situation that you can’t see a way out of. You can see why it’s such an important subject.”

Our behaviour when we are in this state is what gets us into further trouble.

“If a person begins to notice they are not taking care of themselves – not exercising, or eating properly, staying up late surfing the internet, smoking or drinking more alcohol they have to ask themselves ‘why am I doing this?’. And they are doing it because they’re trying to calm themselves down, if they’re wired.

“It’s very important to have a serious look at your behaviours, your lifestyle, and for example to cut out the crap eating, the endless coffee, using alcohol as a crutch and to start doing practical things like exercising and if possible fitting in some short periods of mindfulness throughout the day.”

But while behaviours can change, the biggest mistake is that people avoid dealing with the stressor themselves, says Dr Barry.

“I could do all the lifestyle changes and that would be wonderful, but they won’t help me if I can’t re- interpret what’s happening to me — the stressors — in a different way. And go for help.

“It’s very much about learning techniques to deal with the stressor itself —that’s the real key. If I can re-shape how I look at the stressor, that in turn with bring down my stress levels. Sometimes I might not be able to change things, but I might be able to change how I look at it.” It’s about being able to pull back from the momentum of being immersed in the chronic stress and looking at what the triggers are; our beliefs around the triggers; how our beliefs influence our behaviour and the consequences of how we feel.

“That’s the real secret to how I help people,” he says.

It’s how he works with patients at his busy clinic in Drogheda. “I get them to understand themselves. And to learn ‘this is how I respond’ and ‘if I can learn a different way to respond and spot when I’m falling back into old ways, and challenge it, then, of course, I’m going to change myself’.

“Because we tend to focus on whatever illness comes up, whether it is depression, or anxiety or physical conditions, we are often missing the precursor, that period of prolonged toxic stress,” he adds.

But if we can stand back and look behind it, then the great thing then is that you can do something about it.

Re-prints of five re-edited versions of Dr Harry Barry’s books are being released as a series this month and next by Orion-Hachette publishers. They include Anxiety and Panic, this month and Toxic Stress, in October.


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