Managing Stress During the Holidays and Year Round

by Nieske Zabriskie, ND

As another holiday season approaches, many individuals feel increased levels of stress. It is likely with the current economy that many individuals are under increased pressure throughout the year. The addition of the holidays with increased expenses and busy schedules compounds the stress already present, making many individuals notice it to a more significant degree. Managing this stress and maintaining a balanced response is an important consideration to endure and enjoy the holiday season.

The stress response is a normal physiologic process that allows for adaptation under short-term stressful circumstances. Activation of the stress response, however, can result in adverse physiological effects. The stress response involves several systems in the body, including the sympathetic nervous system and the hypothalamus-pituitary-adrenal (HPA) axis. Effects due to the stress response can be related to either elevation of the stress-response hormones, or hormones below normal physiologic levels due to the inability to maintain high hormone output with activation.

Activation of the sympathetic nervous system increases the secretion of epinephrine (adrenaline) and norepinephrine from the adrenal gland. These hormones affect every body system causing reactions such as enhanced heart and respiratory rate, reduced intestinal motility, directing blood to muscles and away from organs, and more pronounced sweating. This is known as the fight-or-flight response.

The hypothalamus is an area in the brain that is responsive to several hormones, stress and the sleep-wake cycle. The HPA axis is a cascade of hormone activation in which the hypothalamus signals the pituitary gland, which in turn signals the adrenal gland to increase or decrease cortisol release. Cortisol is the primary stress hormone and acts throughout the body resulting in effects on blood sugar, stomach acid secretion, blood pressure, immune response, bone formation and cognition, among others.

Effects of Stress on the Body

Weight and Blood Sugar Metabolism

Many individuals notice weight gain during the holiday season.

Research indicates that glucocorticoids such as cortisol increase levels of leptin, a hormone which modulates appetite.¹ Additionally, stress-induced rises in cortisol increase the hormone ghrelin, which stimulates increased food intake and fat deposition.^2-3 Interestingly, a recent study showed that increased cortisol was associated with increased consumption of low-quality foods high in calories, sugar and fat.⁴ Researchers have also shown that in individuals with an increased body mass index (BMI), increased weight gain was associated with psychosocial stressors such as job-related demands, lack of decision authority, perceived constraints in life, strain in relations with family and difficulty paying bills.⁵

Stress also impacts blood sugar metabolism. Not only has increased daily cortisol secretion been shown to increase abdominal fat deposition, but it also results in suboptimal insulin efficiency.⁶ In fact, researchers have shown that psychosocial stress increases the likelihood of experiencing imbalanced blood sugar metabolism in women.⁷

Sleep and Cognition

Sleep quality is often affected by stress. Difficulty falling or staying asleep is associated with both activation of the HPA axis and the sympathetic nervous system. A viscous cycle is induced as sleep disturbances affect the HPA axis, which in turn can result in poor quality sleep. Research indicates that evening cortisol levels while awake correlate with the number of subsequent nocturnal awakenings that night. Increased HPA activity promotes sleep fragmentation, yet this same sleep fragmentation increases cortisol levels.⁸

An interesting study reported that an increased cortisol level over a 3-day period was associated with cognitive changes including executive functioning (which regulates other cognitive functions), processing speed, and visual-spatial memory. Over a 35-year follow-up period, the researchers showed that general cognitive ability at age 20 was a significant predictor of midlife cortisol levels.⁹ HPA axis dysregulation is associated with low cognitive performance in the elderly, showing changes in verbal fluency, visuospatial performance, and visual memory.¹⁰ In addition, mood changes are also associated with HPA axis dysregulation.¹¹

Cardiovascular and Digestive Health

Various studies suggest that psychosocial stress can impact cardiovascular and digestive health. For example, time urgency and impatience increase the likelihood of experiencing imbalanced blood pressure. Additionally, psychosocial stress can result in changes in the endothelium, which are the cells that line blood vessels and help regulate blood flow.¹² Psychosocial stress is also associated with imbalanced blood lipids¹³ and inflammatory changes.¹⁴

Abdominal discomfort and frequent changes in bowel movements is associated with exaggerated HPA axis responses and elevated cortisol levels.¹⁵ In addition, occasional refluxing of food and stomach acid is associated with psychosocial stress, vital exhaustion and changes in mood.¹⁶ Psychological stress may also impact the lining of the stomach and small intestine. Researchers propose that this may be due to shunting blood away from the digestive tract, increased stomach acid secretion and reduced buffering of stomach acid.¹⁷

Immune Function

Immune responses are suppressed by elevations in cortisol. Studies indicate that psychosocial stress is related to variations in white blood cell number and activity, as well as changes in cell-signaling molecules.¹⁸ In one study, researchers evaluated the relationship between perceived stress and upper respiratory health. The study showed that more negative life events correlated to a greater incidence of respiratory complaints, which also correlated to imbalanced white blood cell number and function.¹⁹

Natural Support for Stress

With the holiday season fast approaching, it is important to support the body to minimize the effects of increased stress this time of year. One way to determine the impact of this stressful season is the Adrenal Function Panel. This is a test performed at home using four saliva samples that can determine adrenal response and cortisol production.

Adaptogens are plants that produce a non-specific response, increasing the resistance to multiple types of stressors by modulating adrenal function. Some adaptogens include Ajuga turkestanica, Aralia mandshurica, Stemmacantha carthamoides (also known as Rhaponticum carthamoides), and Rhodiola rosea (found in AdaptaPhase®). Stemmacantha carthamoides and Ajuga turkestanica contain active constituents known as ecdysteriods. Research suggests that ecdysteriods exhibit stress-modulating, immune-supportive, and rebuilding activity, as well as antioxidant and free radical scavenging properties.²⁰ Animal models also demonstrate that Stemmacantha has calming activity and supports learning and memory.^21-22 Aralia mandshurica has historically been used to support mood and energy. More recent research indicates that this botanical also has immune-modulating activity.²³ Several studies support the historical use of Rhodiola for mood, enhancing sleep quality and energy. In one study, supplementation with Rhodiola showed enhanced physical and cognitive function. It also modulated factors such as energy, motivation, daytime sleepiness, libido, sleep quality and cognition, including concentration, memory, susceptibility to stress and irritability. In addition, treatment effectiveness was reported by 80 percent of patients as “good” or “very good” and physicians reported efficacy for 81 percent of patients.²⁴

Additional adaptogens such as ashwagandha (Withania somnifera), Magnolia officinalis, and Phellodendron amurense, (found in Cortisol Control) modulate cortisol levels. Ashwagandha has been shown using animal models to moderate the stress response with environmental stressors.²⁵ Furthermore, research indicates that ashwagandha exhibits mood balancing activity.²⁶ Magnolia officinalis and Phellodendron amurense have been studied regarding stress and weight management in women. These botanicals balanced levels of cortisol in the evening while the placebo group tended to have higher evening cortisol. Also, the placebo group gained weight while the group supplemented with Magnolia and Phellodendron maintained their current weight and reported lower perceived stress.²⁷

Nourishing the adrenal glands is also important to optimize function. The combination of vitamins, amino acids, adaptogenic botanicals, and adrenal concentrate found in CortiTrophin® was designed to support adrenal function and balance blood sugar metabolism. This supplement includes the adaptogenic botanicals Eleutherococcus senticosus, Rhodiola rosea, Bacopa monnieri, and Licorice root extract. Bacopa is of particular interest as multiple human studies indicate it has various supportive activities. Research shows that Bacopa helps balance blood sugar metabolism, supports insulin action, and reduces markers of oxidative stress.²⁸ Randomized, double-blind, placebo-controlled trials indicate that Bacopa supports mood balancing and cognitive function and memory in older adults.^29-30

CortiTrophin also contains vitamin B6, which is an important cofactor for the production of neurotransmitters and norepinephrine. Vitamin C supplementation has also been found to decrease subjective stress response and allow for a faster cortisol recovery compared to placebo in subjects under psychological stress.³¹ In one study, supplementation with a B complex and vitamin C showed significant improvements in reported stress and occasional fatigue, and enhanced cognitive performance.³² N-acetyl tyrosine is also included as tyrosine is used for the synthesis of norepinephrine, epinephrine, and dopamine, and individuals under psychosocial and physical stress supplemented with tyrosine showed enhanced memory and tracking.³³

Conclusion

The added stress of the holiday season is inevitable and even after the holidays, the stress of modern living continues. A number of vitamins, amino acids and adaptogenic herbs have been shown to modulate the stress response and support adrenal function, as well as target many of the related imbalances associated with stress.

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