Stress - Luca Pella


There is a lot of talk about stress … It seems to be at the origin of most modern diseases and probably plays an important role in the genesis of these dysfunctions in our body which can then evolve into real diseases.

Over the years of practice, however, I realize more and more often that people are not aware of the mechanisms that underlie stress and even less of those that link stress to their pain. I think as we become more aware of what a thing means, we can manage it better. When it comes to stress, it often happens that people, not understanding its mechanisms, think that the doctor or therapist who talks about their symptom as deriving from stress is actually saying that they are making it up. It is not so. Stress mechanisms have a very important impact on the body and are also the basis of its functioning.

To better understand them we need to observe how our body has evolved and how it tries to adapt to modern life.

The first thing we can notice is that our bodies are made to move. The very birth of nervous systems in evolutionary history took place just when multicellular organisms began to need a system that could coordinate the more complex movements and functions of various organs. This led to the creation of a coordination center that slowly developed more and more over the millions of years of life on earth because it allowed to obtain an advantage over other organisms that could not move and that could not control a more complex physiology.

In fact, if an environment becomes hostile, organisms that can move to go elsewhere will certainly have a better chance of survival than those that cannot move. If the muscular system can work in a coordinated way, the movements will be more effective and consequently the species that will best develop this possibility will be favored.

The ability to move therefore serves to attack (the prey) or to flee (so as not to become prey). The musculoskeletal system thus becomes an integral part of the survival response, but it needs adequate nourishment to be able to act efficiently. The Autonomous Nervous System manages the amount of blood that is distributed in the various parts of the body as needed.

Due to this particular function, in the history of medicine it was at one point divided into 2 parts: Parasympathetic and Orthosympathetic.

This division does not exactly reflect the reality of the body which is much more complex and grayscale; but it can be useful at the didactic level to understand the fundamental principles.

When we’re in a comfort zone and relaxed, much of our nervous system focuses on organ repair, digestion, and recovery. The heart has a fairly slow and controlled rhythm despite its physiological variability; breathing is slow and occurs through the nose.

On the contrary, in the moment of greatest danger, the organism has to fight for survival and can do it in two ways: Fight or Flee. Both actions require important changes in the distribution of nourishment as it will not be possible to continue to send blood to the digestive system in the same quantity: digestion will have to be reduced or suspended as an activity as that blood must be diverted to the periphery to the muscles of the limbs. and to the brain that will need to increase concentration in order to make the right decisions in the shortest possible time.

This reaction, however, does not normally last long as both the escape option and the combat option will have a limited duration in time to a few minutes (hours in the worst case); after which we either managed to survive, or we became dinner. In both situations, this reaction is bound to wear off in a short time and, if we survive, to restore the parasympathetic mode.

In order to best survive, the nervous systems have also evolved in other ways. The possibility of being able to carry on our progeny is in fact greater if we are able to implement these behaviors in a forecasting way: if we are able to grasp the signals that make us understand that there is a danger nearby (smells, footprints, sounds … ), I will be able to implement safety solutions in advance.

The brain has gotten better and better at detecting patterns and predicting what might happen. It is enough to catch the eye of a Lion at the zoo to change the heartbeat. Our brain knows that the lion is dangerous and the moment we meet its gaze, it knows that it must prepare the body for escape.

It is thanks to these prediction functions of the brain that we can perceive fear thanks just to a well-conceived soundtrack in a film.

Once we understand these mechanisms, we can better understand what happens when we are under stress.

Fortunately, in our modern society we are largely safe from dangers such as predators or immediate threats to our lives. Unfortunately, this cannot be said for everyone as many countries have war as their daily life and in others we are witnessing urban gang warfare; but in general most of us have a chance to be confident enough to survive the day and to make plans for the future and for our children.

This privileged condition has been possible thanks to numerous factors that have developed during the history of civilization, but they have been stable and widely available only for a few hundred years (in some countries only for a few decades). Evolutionary times are much longer and our body has not yet been able to adapt to this new reality substantially free of immediate dangers.

What happens is that we are constantly subjected to situations that are absolutely not dangerous, but somehow annoying; our brain sees in these stimuli a possible signal of danger and begins to analyze the situation in order to survive. In the same way we feel in danger thanks to the soundtrack of a film even if nothing actually threatens us, in the same way deadlines, office work, the relationship with the boss or family members, can generate (not always fortunately ) an activity of the nervous system that mimics the physiology that should serve us in case of real danger.

At this point it should be easier to understand how it is possible that stress leads to changes in heartbeat and blood pressure, impaired breathing that often collaborates in generating and maintaining states of anxiety and panic attacks, alterations in the digestive system including gastritis and reflux to to which the diaphragm can greatly contribute when its functionality is impaired; in addition there are also some reactions at the level of the musculature: prolonged stress increases the tone of the muscles throughout the body and therefore we will have the muscles more ready to take a shot for survival than ever, the neck and shoulders will become tense. due to various factors that can intervene, not least the tension in the masticatory muscles which are activated to bite the hypothetical enemy but in this case we cannot bite.

The immune system and the endocrine axes come into play and are kept active for a long time, sometimes creating a hyperactivation that can be the basis of various pain problems due to autoimmune diseases.

In short, seen from this widely simplified perspective, perhaps it is easier to understand what happens to our body and why we can encounter certain pathologies.

What can we do to counter these effects?

Simple but not very applicable answer: Radically change our life trying to return to a life condition more in contact with nature with different commitments and times marked by the sun and not by deadlines, natural light and physical activity outdoors as well as food true unprocessed and unrefined.

More complex and theoretically more feasible answer: learn to understand what is happening and counter it. One of the first things we can do is to put our nervous system in a position to carry out the tasks it is preparing for: it wants to escape or fight. Good. Regular physical activity is the first smart move we can make to be able to “vent” the Autonomous Nervous System and make it believe that its preparation has been used efficiently. Training breathing is another very important point that can help us stop the vicious circle and when we relax the diaphragm we can also improve some gastric symptoms as we remove a large mechanical component of these symptoms.

There are many other things that can be done to improve the situation, especially with regard to circadian rhythm regulation and sleep quality, things that require minimal effort but can give great results; for the moment, however, it would be sufficient to start introducing regular physical activity and good training with breathing exercises done in order to regulate the autonomic nervous system and make the diaphragm more elastic.

what techniques might be indicated in this case?

Quanto sei stressato?