Understanding Stress
Where it comes from – How to deal with it

By David Spero RN

Adapted from Diabetes: Sugar-Coated Crisis – Who Gets It, Who Profits, and How to Stop It by David Spero RN (New Society Publishers 2006). Please feel free to download, re-post, and disseminate this article, as long as you keep this source information.

Say you’re walking down the street, and you bump into a hungry, man-eating lion. (Don’t you hate it when that happens?) Here’s how your body would respond. Your adrenal glands would pump out a number of hormones. Chief among these is cortisol, which tells your liver and your muscle cells to pour all their stored sugar (glucose) into your bloodstream. They do this so that your leg and arm muscles can use the glucose as fuel for running away, fighting, or maybe climbing a tree or a fire escape.

At the same time, your other cells would become "insulin-resistant." We need a hormone called insulin to get glucose into our cells to be used as fuel. In a crisis situation, most of your cells resist insulin, so the muscles involved in fighting or fleeing will have more energy. Your blood pressure and heart rate would go way up, to get your blood pumping to the muscles. This reaction is called "stress."

None of us would be here without stress. In nature, the stress response is vital to survival. The antelope senses the lion (a threat) and runs. It either gets away or the lion eats it. In running, the antelope uses up the extra sugar and restores its hormonal balance. The whole thing is over in ten minutes, and the antelope can rest.

But in our society, threat isn’t usually physical. There’s no fighting or fleeing; you just sit there and worry. And the stress isn’t over in ten minutes; modern stresses often act on us 24/7, week after week. Over time, insulin resistance builds up. It is a major cause of Type 2 diabetes, heart disease, overweight and many chronic illnesses.

How does stress cause illness? Since, under stress, most of your cells become insulin-resistant, some of that extra glucose stays in the blood and causes damage to nerves and blood vessels. The rest of it gets converted to abdominal fat, and your LDL ("bad cholesterol") level goes up. This is a combination likely to cause all kinds of problems.

What is Stress Exactly?

We have an image of stress as a very busy thing. The phones are ringing, we’re racing around town; we’ve got deadlines, high noise levels and not enough time. All the little crises of life add up to this feeling we call "stress." But this is a mild form of stress, akin to a roller-coaster ride, a reaction that many bodies actually enjoy.

Real stress is something quite different. It’s a constant feeling of danger and powerlessness – like living with the threat of violence, job stresses beyond control, economic insecurity, dealing everyday with racism, sexism, or other prejudices, caring for a demented parent, feeling hopeless or useless, lonely, unloved or uncared for. Stresses like these can wear you down, make you fat, and predispose you to illness.

Stress occurs when the threats we face exceed what we think we can control. It’s when all your energy goes into just coping, "trying to keep your head above water," an image that captures the feeling of stress very well.

Now pay attention. If stress occurs when you perceive threats greater than your power to control them, then the less power you have, the more stress you will have. Let’s say that hungry lion is still on the corner, but this time you’re not walking; you’re riding in an Abrams tank. You wouldn’t be stressed at all. You might have a "cute lion" story to tell at work. When you have the power to cope, there’s no stress.

Access to money, a source of power, reduces stress. Say my company is sending my job to Bangladesh. If I had a million dollars in the bank, I wouldn’t worry much. It might hurt emotionally, but it wouldn’t affect my health. And if I knew I could get another job easily, it would be even less stressful. But if I had twelve cents to my name, and knew getting another job would be very difficult, and had a family depending on my income, worrying about job loss might keep me up all night and keep my blood sugars up too, even if the actual move never happens. My body would be screaming, "Run! Fight! Climb a tree or something!" but I couldn’t. My body would pay the price with long-term health problems.

Another way stress hurts us is by depressing the immune system, the body’s natural repair and defense program. Stress doesn’t care about long-term health, because there will be no long-term unless we survive the immediate crisis. Repair can wait until the crisis is over.

But for people with less power – less money, less education, less social support, less self-confidence, a minority skin color or body type – the crisis is never over. The economic, emotional, and sometimes physical threats are always there. The immune system stays suppressed. So over time, chronic stress is like endlessly deferring maintenance on your car. Like your car, your body will tend to break down.

Coping with Stress

Since stress is a symptom of lack of power, the best way to reduce stress is to increase your power. Power can be personal – self-confidence, self-esteem, knowledge, money, political influence. Or it can be social – the support of other people: friends, families, professionals.

Here’s a useful formula showing how stress relates to power and how to change the equation:

If you want to reduce stress (and believe me, you do), this formula shows several ways to do it. We may be able to reduce the threats we face – for example, getting disability payments to avoid poverty, or moving to a safer neighborhood to avoid violence. You may be able to reduce your perception of threat – for example, realizing that if your husband yells at you, it’s not the end of the world. You’re still alive and you’re still a good person.

We can also reduce stress by increasing our sense of control. If you’re a young man in a neighborhood where the police harass young men, you may be able to learn skills for avoiding the cops or dealing with them. If you have diabetes and are deathly afraid of complications, learning to control your blood sugars through diet, exercise, relaxation and/or medications will give you a sense of control and reduce stress.

Other people are a major source of power. Strengthening connections with family, friends, neighbors, your congregation, or other people who share your problems (as in a support group) will reduce your stress and help you cope.

Self-confidence is a major element of power and perceived control. You can build self-confidence by accomplishing small goals, by learning more skills or by seeing people like you gain more control. If they can do it, you can too.

We can combine all four of these strategies by joining with other people to change threatening situations – for example, organizing for youth employment programs or cleaning up toxic pollution in our communities. Gaining power is not just for individuals. If we increase the strength of our community, we help everyone in the community, including ourselves.

For a more personal approach, relaxation, meditation, and prayer are powerful ways of reducing stress. They reduce perceived threat and make you feel more in control. Perhaps you can get some relaxation tapes, go to meditation or yoga class, join a church you believe in, or just take some time every day to sit and breathe.

The least healthy way to deal with stress is also the easiest way – by eating fats and sugars. Like cigarettes, these "comfort" foods make us feel more in control, less stressed. But the positive feelings won’t last long. In a very short time, you’ll feel worse than before, and you’ll need to do them again and again, leading to increased abdominal fat and insulin resistance.

Get Active -- The Indispensable Step

The healthiest way to deal with stress is the way the animals do, with physical activity. Stress tries to help us survive the only way it knows how, by getting us to move. If you don’t exercise, most of the glucose your body puts out will turn into abdominal fat. That’s why stress and inactivity are a lethal combination. Getting active lowers insulin resistance and sugar levels, while helping our hearts, minds, and spirits.

So get out and run or swim or bike or walk your dog. Consider exercise that makes you stronger and tougher – kick-boxing, weight-lifting, martial arts. You’ll wind up feeling more confident and therefore less stressed. Get active in your life, too. In an unhealthy environment, taking the path of least resistance will make you sick. You’ll do better if you decide what to eat, what to do, what’s important to you, instead of letting a sick culture make you into a passive consumer.

For more information, read my books Diabetes: Sugar-Coated Crisis, or The Art of Getting Well or Robert Sapolsky’s book Why Zebras Don’t Get Ulcers.