The Stress Response
Feeling stressed is never a pleasant state. Your body reacts by releasing adrenalin into the bloodstream to increase the heart rate, raise the blood pressure, speed up the breathing and heighten blood sugar levels; you get those butterflies in the stomach and your palms start to feel sweaty as your body prepares you to fight or flee. In a situation of acute danger this reaction can save your life, enabling you to perform tasks possibly beyond your normal strength: to run faster than you have ever run before or to strike out at an opponent with more force than you believed possible as you ride the adrenalin surge.
However, if this state becomes chronic it can become damaging rather than life-saving. Chronic stress suppresses the appetite and the immune system, heightens sensitivity to pain, disturbs sleep patterns and leaves you feeling exhausted and anxious. Muscles become permanently tensed, ready for action which they are not needed for, and energy is burned at such a rate that fatigue becomes a regular companion.
Stress has a negative impact on any illness and fibromyalgia is no exception. Our muscles already feel tight and sore and we certainly don't want to waste any of our precious energy stores. Heightening our sensitivity to pain even further and giving ourselves even less chance of falling asleep are also not on our agendas. But how can stress be avoided? It is all very well for people to say "Relax," "Take it easy," and "Don't worry," when we know we have a list of tasks that need to be done—and pain and fatigue are constantly nagging at us, reducing our ability to handle further demands. When you live in constant pain things can become overwhelming quite quickly; I know that towards the end of the day when I am feeling tired and my muscles are sore, I snap much more easily. Those close to me know not to ask me to make decisions or to do lots of tasks in the evening, as my reaction is not always amicable!
People with fibromyalgia are often labeled as "type A" people who are generally not renowned for their laid-back approach to life; but is there any underlying physiological reason for this? Interestingly, research suggests that there is a disturbance in the stress hormone system. Basically, there are three main hormones involved in the stress response which work in a feedback loop where the last hormone in the chain acts to stop the release of the first hormone. This makes sure that the stress response is switched off and not left on continuously once stimulated. Researchers have observed that the first hormone in the chain, called CRH (corticotrophin releasing hormone), and the second hormone, called ACTH (adrenal cortical stimulating hormone), tend to be released at elevated levels in response to stress in individuals with fibromyalgia compared to controls. The third hormone, cortisol, appears to be released in significantly lower amounts in response to stress, whereas its level at rest seems to be higher in individuals with fibromyalgia compared to controls. These findings could indicate high chronic stress levels, meaning that the levels of cortisol stay at a higher level when at rest, making you more responsive to stress; in addition, diminished amounts of cortisol released in response to ACTH mean that there is less of the third hormone to shut the stress system down. It is not clear whether these disturbances result from having long-standing fibromyalgia or are part of the underlying cause.
Whatever the reason, we need to learn how to cope effectively in stressful situations to insure that we do not aggravate our symptoms further. We all react to stress in different ways and are stressed by different things. A messy house will have some people climbing the walls whereas others, like myself, will have the inbred ability to simply not see the mess and walk calmly by. The key is to identify your own particular stressors and to develop a strategy to cope with them before they become overwhelming. Obviously it is not possible to prepare for every situation as we are not in control of what happens in the world around us, but we can learn to control our response to stress. There are various techniques which we can learn to use to combat stress and to alter our response to it. Have a look at the list below and see what most appeals to you.
- Cognitive behavioral therapy: a helpful technique in tackling negative ways of thinking to enable you to respond more positively to stressful situations.
- Meditation: very useful to slow you down, clear the mind and help you to relax when things start to become overwhelming.
- Exercise: a great way to get rid of all the stressful emotions; also during exercise the body releases endorphins, the body's natural painkillers.
- Rest: taking a rest before you become exhausted can prevent you from becoming over fatigued, a state in which you are more likely to become stressed.
- Relaxation: learning to relax each muscle group can make your rest periods much more productive, allowing you to release the tension from your body.
- Distraction: distracting your mind with perhaps a movie or your favorite music can help to calm you down and give you a break from thinking about the stressful situation.
- Getting away: if the situation does become overwhelming it can be helpful to get away for a few days and have a change of scenery to help you relax and come up with a solution if one is needed.
- Laughter: this can be one of the best stress releases as it can instantly relax you and cause the release of endorphins.
I often find an evening with one of my best friends, when we can laugh and chat, to be one of the best stress busters. It tends to put things into perspective and calm me down. My other favorite technique is spending some time outside in the countryside, I find that fresh air and beautiful surroundings always work their magic, making me breathe more slowly as I stop to admire the views. I try to go for a walk each day somewhere green to clear my mind and enjoy the exercise. If I am struggling to walk I will take my wheelchair out for a spin to ensure I am not stuck indoors all day. Finding what works best for you is well worth the effort. Stress can affect all the symptoms of fibromyalgia so it is imperative to find healthy responses to keep stress at bay whenever possible.
Ten Easy Ways to De-Stress
Everyone needs time to relax—but relaxation is especially important for FM patients, who may be thrown into a flare by excessive stress. Try one of these tips the next time your tension level is on the rise.
- Be aware of your body. "Just as one’s mental attitudes affect his body, so also his bodily postures affect his mind," writes Sri Kriyananda in Yoga Postures for Higher Awareness. "Slumped shoulders and a bent spine can actually, to some extent, induce moodiness. Tensed stomach muscles can—again, to some extent—induce mental anxiety…. As physical tensions can induce, as well as reinforce, mental tensions, so physical relaxation can bring serenity to a worried mind."
- Listen to music that makes you feel calm and peaceful. Try setting aside a period of time just to listen to that music while doing nothing else—then try listening to that music while you’re doing other tasks.
- Slow down. Even if you’re running late, don’t allow yourself to rush—which will only make you feel tenser. "Begin each activity, such as driving, speaking at a meeting, or walking onto your commuter train, with one gentle inhalation, followed by a calm exhalation," suggests Judith Lasater in Living Your Yoga: Finding the Spiritual in Everyday Life.
- Take a warm bath. Focus on how the water eases the pain in your muscles, and the sensation of tension draining out of your body.
- Breathe. Deep breathing can reduce stress and increase relaxation. Try taking a deep breath, and then releasing it twice as slowly as you inhaled. "Change the breathing, and one’s mental state may be changed, too," writes Kriyananda. He adds that deep breathing practice will eventually relax any muscular restrictions that exist in the area of the diaphragm and the upper part of the chest.
- Participate in activities that leave you with a sense of relaxation and peacefulness. Some people may go for a walk, join in an aquatics class, or go to the gym for a light workout, releasing endorphins with their physical activity and thus improving their mood. Some physical activities have a built-in relaxation response, such as yoga or tai chi.
- Pray or meditate. Studies have shown that mindfulness meditation can reduce pain, and that prayer can effect healing. Both prayer and meditation are also practices in relaxation, a sort of time-out in the middle of our hectic lives.
- Rediscover your hobbies. Before you were diagnosed with FM, what activities did you enjoy? Think of creative ways you can bring those activities back into your life. Maybe working in the garden makes your back ache—but if you plant flowers in pots, and work at a table of comfortable height, you may be able to garden once again.
- Dean L. Mondell and Patty Wright, authors of the recently-released Living with Fibromyalgia, advocate "deep relaxation," a multi-step technique that induces a sense of tension-free calm. Start the process with deep breathing from your diaphragm and progressive muscle relaxation, focusing your attention on different muscle groups successively. Inductions—oral suggestions to enter a peaceful state—can be used to enter deep relaxation. It’s a sort of self-hypnosis, the authors say. "Deep mental relaxation can also help control pain," they write. "Pain can also be utilized as motivation to drive the relaxation state deeper; deeper states are more detached from your bodily sensations and more attuned to your inner state of gentle calm."
- Choose a relaxing practice—and practice it! "Repeated practice is one of the most basic principles of most spiritual and meditative paths," writes Richard Carlson in Don’t Sweat the Small Stuff… and it’s all small stuff. "In other words, whatever you practice most is what you will become." If you want to be a more relaxed, less stressed person—practice relaxing and reducing your stress.
