Stress is caused by being ‘here,’ but wanting to be ‘there’
─Eckhart Tolle
The time to relax is when you don’t have time for it.
─Sydney J. Harris
TRADITIONAL CHINESE MEDICINE PERSPECTIVE
Pre-Data Note: throughout the writing some words that would normally be written in lower case, are in the article written in capital letters; for example Blood, Heart, Liver, etc. The reason for this is that in Chinese medical thought blood and the organs are entities and not just merely components of a body, and the article is written from the traditional Chinese medical perspective.
Stress is an inevitable part of life -it is desirable in fact. It becomes problematic when it exacerbates its initial genomic design. According to Traditional Chinese Medicine (TCM), stress alters the free flow of Qi within the body, resulting in stagnation, excessive internal Heat involving multiple organs, and poor Blood circulation. Stress in overweight or obese men of any origin or line of work is markedly deleterious, for it inevitably affects the production of a particular set of hormones that are essential for successful performance of daily activities, for coping, and for sexual function; and thus resulting in poor quality of life. Excessive and prolonged stress may impede the delicate balance in the body and trigger severe health problems that can lead to death.
The most common manifestation of stress includes, but are not limited to, sleeping disorders, anxiety, headaches, fatigue, indigestion, restlessness, hypertension, acne, poor or excessive appetite, decrease in sexual ability, sudden anger, impatience, a sense of doom, suicidal or murderous thoughts, and desire for sweets.
While stress is not exclusive to males, women and children experience it in a different way given the types of hormones that govern the body and in what quantity, and the level of understanding of their environment in the case of children. Women are more apt to dealing with stress successfully, but the need for treatment still exists.
Stress & Digestive Health
Stress tends to impede the flow of Qi, which would affect the function of the Spleen. Consequently, the transformation and transportation of digested food will be affected, and this will lead to an accumulation of internal dampness. In time, problems such as weight gain may develop, as well as fat around DAIMAI or Belt Vessel. Accumulation of fat in DAIMAI occurs in all who experience high levels of unrelenting stress, overweight or not, and this particular belt is not one to get rid off by weight loss, but only by directly treating the particular issue of stress.
Stress & Shoulder Tension
Shoulder tension is caused by factors ranging from continuous mechanical strain, lack of exercise, improper posture while working or sleeping, and emotional stress. When stress builds up and the Liver-Qi flow is impeded, the shoulder muscles tighten and become rigid. Tension in the shoulders leads to shoulder pain, neck pain, and headaches.
Treatment Principles
TCM is effective in relieving stress through acupuncture, herbal medicine, massage therapy, but most importantly, meditation and nutrition. It is important to note that treatments must be customized according to each unique body constitution, for the catalyst of all stress is the result of the autonomic nervous system working to compensate for an imbalance of Yin & Yang (homeostasis) in the body using the excitation of the sympathetic nervous system to fend off the attack. It should be noted that years of accumulated stress in the nervous system must be abated gradually, in the same manner that the stress accumulated.
•FCLVQi Free Course of Liver-Qi
In TCM, the Liver helps to regulate the emotions. When the flow of Liver-Qi is interrupted, emotional disturbances such as frustration, depression, anger, or mood swings may occur. Thus, it is important to ensure the smooth flow of Liver-Qi in the treatment of stress-related conditions. For millennia, TCM physicians have been prescribing Xiao Yao San herbal formula, for its stress-relieving properties.
Moreover, meditation and acupuncture treatments energize Qi circulation, particularly Liver-Qi in the case of stress.
• Eliminate Internal Heat or Fire
Late nights and irregular eating habits can put the body under intense stress. The untreated stagnation of Liver-Qi will generate internal fire, which may travel upwards to the UpperJiao region and disturb the sleeping process, suppress appetite, trigger a voracious appetite and desire for snacks, or cause other disharmonies. In these cases, treatments usually focus on clearing internal fire to restore balance. The herbal formula Tian Wang Bu Xin Wan is one of the ancient prescriptions that can supplement the Yin and remove internal fire to relieve stress.
• Calm the Mind ─Shen
When the Mind is relaxed, the body will return to its harmonious state.
• Nourish the Heart
In The Huang Di Nei Jing -The Emperor’s Inner Canon, the Heart is said to be the master of the ZangFu organs, the ruler of the mind or spirit -Shen, and the seat of consciousness and intelligence. The health of the Heart affects the Shen and can in turn lead to emotional disturbances such as anxiety, insomnia and palpitations. Therefore, it is important to maintain Heart health to sustain emotional balance. The physical Heart will not heal until the emotional Heart is in balance.
Bai Zi Ren is one important Chinese herb that nourishes the Heart. It is commonly used to treat insomnia accompanied by fidgeting and palpitations, night sweating, and constipation.
Heart tonifying formula Yang Xin Tang, and Shuan Zao Ren Tang are tonic formulas that nourish the Heart, soothe the nerves and calm the Mind.
Acupuncture and massages of the head, ears, and hand & foot reflexology help to enhance the function of the Heart.
• Replenish the Blood to the Heart
Various ingredients can be added into the daily diet to replenish the Blood to the Heart, and the Chinese formula Gui Pi Tang -Restore the Spleen Formula, is recommended.
• Exercise to Improve Qi and Blood Circulation
Exercise helps to unblock the flow of Qi and Blood and minimize the effects of stress on the Mind and body. Kundalini yoga, Qigong, walking, and other forms of exercise that focus on breathing and meditation also help to move Qi. These exercises help in calming the Mind and promoting relaxation. To move Qi, one has to move.
BIOMEDICAL PERSPECTIVE AND THE EFFECTIVENESS OF CHINESE MEDICINE
Often one finds one’s destiny just where one hides to avoid it.
─Chinese Proverb
Once we understand the meaning of stress: mental, emotional, environmental, and physical ─which also has to do with the physiological process of aging, we can deal with specific aspects of the presentation. The key to treating health problems related to stress is to first discern the problem, then to resolve the acute or chronic stress related imbalance of a particular organ or entire system. With chronic stress and aging, the restoration of a healthy homeostasis is most important, or in Chinese medicine, the balance of Yin & Yang. The assessment should focus on careful attention to systemic health, metabolic and hormonal balance, and inflammatory responses.
In the 1920s, the health researcher Hans Selye coined the term ‘stress’ to describe symptoms in patients that hindered health and healing- borrowing the term from his study of physics, meaning the force that produces strain on a physical body until it snaps. Stress was a non-specific tension caused by irregularities in homeostasis, thus the term stress hormone originated to create a measurement of the response. Later, the late Dr. John Wayne Mason, physiologist and researcher at the Walter Reed Army Institute of Research (WRAIR) noted that psychological and emotional stress alone could trigger this same measurable response, raising levels of adrenaline and cortisol.
Other studies showed that anticipation of anxiety could produce this stress response, and that the body and mind were very adaptive to stress. Extensive studies in Russia proved that specific herbal chemicals were effective to help the body adapt to stress, and the term adaptogenic was forged for these medicines. In recent decades, studies of chronic levels of stress, even chronic anticipation of a negative event, could create chronic stress responses that impact the health of the individual.
The term stress was also adopted during this century as a common term, referring to disturbance in the daily routine that was upsetting, as in “stressed out,” and most patients that try to deal with stress fail to see the complexity of the term, as well as the original non-specific nature intended by Dr. Hans Selye. The point of his study of stress, and coining of the term, was not to use it as a catch-all cause of diseases and symptoms that could not be easily explained by another specific cause, but to show that a more holistic view of health was needed, and that general health, diet, lifestyle and adaptability were important in treatment.
TELOMERES AND STRESS
In 2009, researchers showed how stress affects aging and disease by decreasing the function of an enzyme called telomerase, which protects the genetic chromosomes from degrading. The telomere, a repeated DNA strand at the end of the chromosomes, is a protective cap that prevents degradation and mutation of the genetic code. The telomere, a simple repeated genetic code, forms a nucleoprotein complex that protects healthy cells from degradation and is also required for cell replication.
The telomere complex is highly variable and controlled; and cancer cells almost always have longer telomeres on cancer cell genes to prevent cancer cell death and allow the tumor to grow. The subject of telomeres is thus complex and demands a normal homeostasis and modulation of controls to keep healthy. An allopathic drug or treatment to lengthen telomeres in general to prevent aging is likely to contribute to cancer. Subsequent study demonstrated how healthy diet and lifestyle, and real stress reduction in the body, could improve the telomerase metabolism and lengthen degraded telomeres, preventing the effects of aging and reducing cancer risk and premature mortality.
The telomere aspect is only one angle of the definition of the illness called stress. In recent years, a concerted effort to objectively define stress, and the tangible signs and effects, has revealed how we may integrate Chinese Medicine, in the form of diet, lifestyle, mind-body techniques, acupuncture, herbal and nutrient medicine, to better treat tangible physiological stress and its consequences.
To demonstrate how acupuncture could help alleviate the objective measurements of stress, researchers in 1998, at the Heart Disease Research Foundation of New York, found that acupuncture stimulation at the most common point used in clinical treatment, ZUSANLI ST36, increased telomere length in healthy individuals and decreased telomere length in people with cancer cells; where otherwise the length of the telomeres or genetic code would dramatically increase with cancer cell mutation, allowing the cancer cells, by the increase, to evade normal controls of programmed cell death, or apoptosis.
This study proved that acupuncture stimulation modulates the normal homeostatic mechanism in the body. People unfamiliar with acupuncture are reluctant to be stuck with needles, thinking of it as painful, and thus believe that acupressure may be less painful, not knowing that acupressure is just a different name for Shiatsu massage, which is a very rough and strong Japanese technique, and does not have much to do with acupuncture.
Researchers found that acupuncture stimulation at ZUSANLI ST36 could almost, in one treatment, double the length of telomeres in normal subjects depleted by stress. Acupressure is more painful than needle manipulation, and the research showed that it produced a significantly less effect on the telomere length. The study moreover showed that gentle manual massage at acupuncture points produces little to no measurable benefit. This research revealed that telomere length on the human chromosome is essentially the same in a healthy individual today as it was 5000 years ago.
Another study examined the telomeres in a preserved human trapped in ice in 3300 BC in the Italian Alps, now called the Otzi Caveman, who was discovered to have an array of tattoo points created by acupuncture techniques that used alchemical mineral elixir on stone needle points. This research also reviewed findings of mummified Egyptian sisters from about 900 BC, finding that telomere length was about the same as seen on healthy cells today.
Studies have demonstrated that Chinese herbal medicines also exert this modulatory effect on telomeres. In 2015, researchers at the Dongguei University College of Korean Medicine, and other university medical schools in South Korea, found that an active chemical in the herb Cordyceps Dong Chong Xia Cao, called cordyceptin, could shorten the abnormal telomeres on cancer cells by down-regulating gene expression of human telomerase reverse transcriptase (hTERT) and other transcription factors, as well as activating the anti-inflammatory pathways of PI3K/Akt cell signaling.
Such study showed how cordyceptin could be effective in the treatment of leukemia, helping to stop the spread of cancer by helping the body to induce cancer cell apoptosis. While these studies don’t tell the whole story of how acupuncture and herbal medicine alleviate the harmful effects of stress, these findings are truly remarkable, and should reassure everyone of the value of treatment with Traditional Chinese Medicine.
DEFINING STRESS
Most people think of stress in terms of a chronic emotional problem and use such terms as ‘stressed out’ to describe it. In truth, the term ‘stress’ has many meanings, and when physicians use the word stress with a patient, they are probably using it in a clinical sense to describe a mentally or emotionally disruptive influence, or distress. Mental and emotional stress are associated with an array of physiological factors. Understanding these factors helps to achieve an objective perspective about any mental or emotional stress that would be applicable to the specific health concern presented.
There are stress factors in the body that have little to do with mental and emotional stress, and when the term stress is used without a specific context, or that a vague psychological or emotional syndrome might be causing the physical or metabolic stress syndrome, or symptoms, it could confuse the fact that physiologically, stress may refer to a mechanical or a metabolic strain. For instance, stress on a joint may be mechanical, where an imbalance of muscular forces, and possibly poor body mechanics, places strain on the joint that causes mechanical deterioration.
In most instances, however, the term stress, as applied to chronic health problems, refers to metabolic stress, which overstrains the system in a variety of ways, especially with immune, hormonal, and nervous system dysfunctions. This is the most pernicious type of stress.
Metabolism is a term for the sum of chemical and physical changes occurring deep in the cells of body tissues, consisting of both anabolism and catabolism, the conversion of small molecules into larger ones, and the breakdown of larger molecules into smaller, as well as oxygen utilization, oxidation, energy utilization, synthesis and use of lipids, and uptake of food nutrients. Metabolic stress may have many negative health consequences. The key to dealing with this type of stress is understanding specifically what type of strain or imbalance is occurring, and what type of disorder is created that specifically relates to the health problem in question.
New patients seek a licensed acupuncturist because they were told, or have read, that acupuncture can reduce stress. In fact, many medical doctors over the years have lessened the practice of Complementary Medicine and the scope of acupuncture, or Traditional Chinese Medicine, by implying that “all it does is reduce stress and perhaps temporarily relieve pain.” While acupuncture helps to relieve the effects of emotional and mental stress, the real need of the patient, in most instances, is to cure precise metabolic and mechanical stresses to resolve the specific problems that they create. By taking a thorough and holistic approach to health, the factors that produce stress in the body can be identified and treated effectively.
Metabolic stress is defined in a number of ways in medical dictionaries. Steadman’s medical dictionary defines stress as: “reactions of the body to forces of a deteriorating nature, infections, and various abnormal states that tend to disturb its normal physiological equilibrium or homeostasis.” The same dictionary defines mental and emotional stress as: “a physical or psychological stimulus such as very high heat, public criticism, or another noxious agent or experience which, when impinging upon an individual, produces psychological strain or disequilibrium.”
While a standard medical practice may not be able to do anything about the noxious agents or experiences that are producing the imbalances that cause stress, a physician that treats the problem holistically can both take care of the homeostatic disequilibrium, or YinYang imbalance, and help make the patient more aware of the variety of factors that create physiological stress. The biomedical doctor does not have the time to spend, and in fact, is too expensive to engage properly in holistic therapy. The licensed acupuncturist and herbalist, who has a variety of effective tools and is affordable, often brings a wealth of scientific understanding to solve the individual puzzles of stress and holistic health imbalances.
Metabolic stress is defined medically as a deteriorating force, and the problems resulting are usually chronic and degenerative. It is imperative that the specific stressor be identified and resolved, and the effects of the metabolic stress treated. Too often, the stressor itself is no longer present in metabolic stress disorders, yet the disease of degenerative condition, and metabolic disequilibrium, persists.
A NEW PERSPECTIVE OF STRESS IN MODERN MEDICINE: PSYCHONEUROIMMUNOLOGY
For twenty years, the subject of psychoemotional stress has been heavily researched in modern medicine, especially in the realm of psychoneuroimmunology, a holistic perspective of health that explores the relationship between psychological factors, neurophysiological mechanisms, immune responses, and the hormonal, or endocrine functions.
The term mind-body approach is now becoming common in standard practice. Nevertheless, despite the bias against holistic medicine in standard practice, the sound research of decades makes this subject hard to reject. The same holistic connection between the psyche, the nervous system, and the whole physiology of the human organism, was a central facet of Traditional Chinese Medicine and Daoist physicians, and was well documented in texts dated to at least 400 BC. The challenge for humanity today is to advance their modern understanding of stress and apply it holistically and objectively to medical treatment to improve health.
For healthy aging, acupuncture reduces stress levels and lengthens healthy telomeres to counter the deleterious effect of stress.
OBJECTIVE SIGNS OF METABOLIC STRESS AND THEIR MEANING
Sudden need of cellular energy is usually generated by stress, above what a person can normally handle. The glycogen storage in the body that is accessible to the organs is primarily stored in the liver cells. Red blood cells and muscle cells store various amounts of glycogen to handle mechanical, or musculoskeletal stress. The brain stores glycogen and starch that can be converted to glucose energy within the brain when needed, by a localized process called glycogenesis.
Daily habits, physical and mental training, determine the amount of stored glycogen in the cells. When there is daily tension that one is not prepared to handle, or are physically and mentally incapable of handling, there is too much alpha-amylase secreted that is not utilized and will show up on the tests as indicator of stress. Cortisol is a steroid hormone produced by the adrenal gland, on top of the kidneys, and is well known to be released in the body in acute response to stress, but is also useful in the body to increase blood sugar, stimulate gluconeogenesis in the brain, suppress immune inflammatory responses that are in excess, and aid in fat, protein and carbohydrate metabolism.
ACUPUNCTURE AND STRESS REDUCTION
Numerous studies in recent years have proven how acupuncture reduces metabolic and psychological stress. A number of human studies done at the NIH show how acupuncture, even in simple and uniform choice of needle sites without stimulation, provide changes in the key biomarkers of stress, cortisol and IgA ─Immunoglobulin A.
When the stress is analyzed from a holistic and individualized perspective, the puzzle of what is causing the metabolic, physical or psychoemotional stress can be solved by treatments individually tailored to both resolving symptoms and treating the causes of the disorder. By designing treatment protocols, including acupuncture, herbal formulas, nutrition, meditation, and yoga or Qigong, the effect of each component will be enhanced for the benefit of the patient. The resolution of stress or its related disorders cannot be achieved by just buying a product off the shelf; therefore, consulting with a doctor of Chinese medicine or licensed acupuncturist and herbalist is essential to achieving a good outcome.
In 2015, experts at the Georgetown University Medical Center, in Washington D.C. conducted randomized controlled studies of the effects of electroacupuncture at just a single point, ZUSANLI ST36, mentioned above, and concluded that the rise in adrenal corticosteroid and ACTH induced by stress was prevented with a treatment of frequent electroacupuncture treatments at just that one point, ZUSANLI ST36, in a 10-day course, and that these effects were observed to continue for at least 4 days after the acupuncture stimulation was stopped.
Acupuncture may modulate stress chemicals in the body by restoring homeostatic mechanisms to better health, something that the current pharmaceutical approaches have not tried to accomplish. This does not mean that there is no place for pharmaceuticals in the treatment of stress related pathology, just that it is best to design a treatment protocol that integrates various approaches to achieve the ultimate patient outcome. Traditional Chinese Medicine is the benchmark for holistic medical care, with modern research now guiding its use. Many patients today realize the sound efficacy of Traditional Chinese Medicine and this holistic restorative approach.
HERBAL AND NUTRIENT MEDICINE IN STRESS REDUCTION
A significant part of the practice of the Acupuncture profession, or Traditional Chinese Medicine, involves integrating acupuncture needle stimulation with herbal formulas, diet, meditation, and nutrient medicine. Much research has come to light in the last few years concerning the efficacy of utilizing herbal formulas and nutrient chemicals in treating specific stress related disorders. This type of research is now proceeding with accelerated pace in the number, size and complexity of studies.
The results of such research clearly show how these benefits may treat chronic disease and cancer, as well as contribute to healthy aging or longevity. Scientific studies show that acupuncture and herbal formulas are proven to reduce a variety of the effects of stress, and also work by normalizing stress hormones in the adrenal-hypothalamus axis. A holistic protocol that is individualized to counter stress, combining acupuncture, herbal medicine, diet, meditation, and nutrient medicine, is able to provide the most effective outcome.
Most of the population still does not understand the science of nutritional medicine. The general notion is still stuck in the past, with the idea that nutritional deficiencies can be leveled with general supplementation with a multivitamin. While this is part of the story, it is a small part, and may be relegated to research from about 70 years ago. Most studies in recent years have clearly demonstrated how simple supplementation with multivitamins and mineral complexes do little to nothing to resolve health problems. Modern research reveals that specific nutrient chemicals may play an important role in specific physiological mechanisms and are becoming an important part of integrated approaches.
Oxidative stress is the key word that comes up in most studies of metabolic stress and disease pathomechanisms. Oxidative stress can be defined as the imbalance of oxidative tissue clearing need, versus the ability of the body to clear the oxidative free radicals that accumulate in this process. When the body is faced with tissue degeneration, inflammatory injury, cancerous growths, etc. there is a need to clear the old tissues and cells and replace them with new healthy growth.
Breaking down these unhealthy tissues and cells, and cellular components, is accomplished mainly via the oxidative metabolism, where oxygen compounds react with these tissues, cells and cellular components in a way that breaks them down to smaller components and allows the body to circulate them away. Antioxidants are a broad class of herbal and nutrient chemicals that help the body achieve this clearing of oxidative free radical accumulation and reduce this type of metabolic physiological stress.
The most intriguing arena of anti-stress research concerns the class of herbs called adaptogenic. This term implies that multiple synergistic chemicals in the plant helps the organism to adapt to a broad pattern of stressors. In the 1980s research in Russia confirmed that an array of Chinese herbs achieved remarkable adaptogenic effects, including Siberian ginseng ─Eleutherococcus or Acanthopanax senticosus, Rhodiola rosea, Ginseng and Withania senticosus.
Distinct chemicals in these herbs have proven to affect various stress-related pathways, to modulate stress hormones, to provide significant antioxidant effects, and to work synergistically to relieve physical and mental stress-induced fatigue. Further research showed that combinations of these herbs in formula, and combination of these herbs with probiotics, pharmaceuticals and nutrient chemicals, achieve even greater effects.
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-Above Article Written by Dr. Osorio, Gloria DAOM, L.Ac. 2015.
-Above Article Revised and Updated by Dr. Osorio, Gloria DAOM, L.Ac. 2021.
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