Stress and Burnout
Updated: Dec 15, 2021
Why We Need To Chill Out To Avoid Burning Up
-From the Desk of Dr. Brkich
Stress is becoming an increasingly ubiquitous phenomenon in our lives these days, especially with the pandemic. Preparing for and celebrating holidays often results in many of us burning the candle at both ends. We can find ourselves grappling with so much stress that burning out can feel inevitable. It is essential that we pause and catch our breath because stress can take a toll on our health. Stress of any kind, no matter what its cause, can have negative consequences, not only on our mental health, but our physical health as well.
Everyone has their own unique ways of managing their stress. Coffee, alcohol, sleeping pills, anxiety, and antidepressant drugs are go-to stress relievers for many. For others it may be serotonin precursurs such as 5-HTP, GABA, CBD, adrenal adaptogens, nervines and essential oils such as valerian, passion flower, lavender, and lemon balm, to name a few. For still others it may be CBT, homeopathics, acupuncture, yoga, reflexology, therapeutic breathing, tapping, reiki, health spas, and other specialized modalities, all of which can help to take the edge off stress.
Although a certain amount of healthy stress can be good for us, most of us would agree that the less negative stress we have in our lives, the better. Therefore, it is always good to manage and minimize stress. Stress can be so insidious and chronic that we may not always recognize that we are stressed. Stress can result in a diverse array of symptoms such as heartburn, acid reflux, irritable bowel syndrome, bloating, stomach pain, digestive discomfort, constipation, diarrhea, hormonal imbalances, menopausal symptoms, skin eruptions such as acne, eczema, hives, and angioedema, allergic or sensitivity reactions, insomnia, anxiety, panic attacks, depression, memory loss, and the list goes on. It is not always obvious that these symptoms may have any connection to stress.
Stress management strategies, even though they can help a lot, unfortunately, cannot fully reverse all of the negative consequences of chronic stress. We may feel better from relaxation therapies or taking something that relaxes us, which may make us feel better, but it may not be enough to address the deeper damage caused by prolonged unrelenting stress. Correction of nutritional deficiencies and healthy eating are not only important, but essential, because stress causes depletion of various vitamins, minerals, amino acids, and antioxidants, but even that may not be sufficient to clean the slate after stress.
No long-term consequences of chronic stress can rival its negative impact on our gut microbiome. During stress, blood supply and nerve input to the digestive organs are diverted away from the “rest and digest” parasympathetic division of the autonomic nervous system to the “fight or flight” sympathetic nervous system. Digestion of food comes screeching to a virtual halt or snail-pace when we are under stress. The brain and nervous system are revved into overdrive under the influence of the stress hormones. Undesirable, opportunistic bacteria in our intestinal tract flourish and multiply in response to stress hormones. At the same time, beneficial bacteria, especially important health promoting bacteria, referred to as keystone strains, are lost. A similar scenario happens with antibiotics, except that, antibiotics kill everything, both bad and good bacteria, indiscriminately. Stress does not kill bad bacteria, but rather, the opposite. Stress promotes the growth of bad bacteria while at the same time killing good bacteria. The resulting imbalance between the good and bad bacteria, called dysbiosis, is the origin of a multitude of health problems, physical as well as mental and emotional.
It is an oversimplification to refer to bacteria as good or bad. Whether a bacteria is good or bad depends on the context. A good bacteria can turn into a bad bacteria in a state of dysbiosis. Any bacteria can become bad if it grows in larger than normal amounts in its normal habitat causing infection and/or inflammation. Any bacteria can also become bad if it goes from its normal habitat to a place where it is not supposed to be found. E. coli, for example, is a bacteria that is a normal inhabitant of the intestinal tract of every one of us. We all have E. coli and it performs many useful functions and plays an important role in keeping us healthy when it is found in normal amounts. However, if E. coli overgrows to larger than normal amounts in the colon, it can become a pathogen, capable of causing disease, and even death. Inflammatory compounds produced by E. Coli and other gram-negative bacteria in a state of dysbiosis can damage the intestinal lining. Among the most inflammatory toxic compounds of all are the lipopolysaccharides (LPS). When there are insufficient numbers of beneficial bacteria, whose job is to continually repair the gut lining, the LPS can cause pathologic intestinal hyperpermeability, commonly referred to as “leaky gut”, which allows inflammatory toxins from the intestines to enter the bloodstream and into systemic circulation. LPS is the primary driver of inflammation, everywhere, wherever it travels in the body, including the brain and nervous system.
On a positive note, the good news is that it is possible to reverse inflammation, including LPS induced inflammation, by correcting dysbiosis and restoring normal intestinal permeability. The body has an innate ability to heal itself if provided with the necessary building blocks and the removal of obstacles to healing. Because stress itself can be a huge obstacle to healing, it is always helpful to engage in as many stress-reduction modalities as we can, to help in preventing and mitigating progression of deleterious consequences.
Once we understand how living in a prolonged and relentless state of fight or flight can lead to a disruption of our gut microbiome, we can begin to appreciate how balancing the gut microbiome can lead to healing of the various chronic, inflammatory, degenerative conditions initiated by and perpetuated by dysbiosis. The same applies to mental and emotional conditions associated with inflammatory changes in the brain, which too, we are learning, have their origin in gut dysbiosis. An overwhelming body of scientific research is beginning to unravel how it is the microbiome, not the brain, not the adrenal glands, and not our hormones, that orchestrates our mental and emotional state. The microbiome determines and controls whether we are happy, motivated, energetic, sad, gloomy, melancholy, irritable, quarrelsome, anxious, depressed, angry, foggy brained, forgetful, always tired, always wired, impulsive, restless, compulsive, rational, irrational, addicted, withdrawn, calm, cool, collected, thoughtful, cautious, or reckless.
We can change our mental/emotional state from one end of the spectrum to the other, from a state of extreme anxiety, panic, or debilitating depression, to a state of happiness, calmness, and contentment, by restoring the ecological balance in our gut microbiome. It is the microbiome, not the brain, that provides the bulk of the hormones and neurotransmitters that we need to keep us happy and calm, which should always be our default state. Mind and/or mood-altering pharmaceutical drugs, and even natural precursor supplements, cannot replicate the multiplicity of positive beneficial effects of a healthy, balanced microbiome on the brain and nervous system. Antidepressants such as selective serotonin reuptake inhibitors (SSRI’s) work by inhibiting the normal recycling of serotonin in the brain, causing more serotonin to build up and hang around, rather than being recycled in the usual fashion. To me, this is analogous to plugging drains and storm sewers to retain more rainwater for the lawn so that the grass doesn’t dry out. Plugging the drains and storm sewers cannot possibly have the same effect on the grass as a natural, predictable, steady rainfall, minus the extremes of drought or flooding.
5-hydroxytryptophan (5-HTP), a natural precursor of serotonin, can bring up serotonin in the brain, with positive effects on mood, if the serotonin is low. Similarly, supplementing gamma amino butyric acid (GABA), can have a calming effect on the racing brain of someone whose gut microbiome isn’t producing enough GABA. But what happens when you stop taking neurotransmitter precursors such as 5-HTP or GABA? Serotonin and GABA drop back to baseline and you end up right back to where you started. The microbiome in the gut, surprisingly, makes over 90% of the serotonin in the entire body. A healthy, balanced microbiome can make all the serotonin that is needed to make the brain happy and calm, without significant negative side-effects, and with a host of positive, beneficial side effects. If the serotonin in the brain is low, it is because of the absence or insufficiency of intestinal bacteria whose job is to make it inside the gut. It makes more sense, to me, to focus on cultivating a healthy microbiome that can make all the serotonin and GABA that we need for normal brain and nervous system functioning, instead of propping them up artificially and indefinitely, too often with unimpressive or marginal results. I am not opposed to hormone and neurotransmitter replacement, when necessary, if done correctly, while at the same time working on the long-term correction of the underlying problem, namely the dysbiotic microbiome. We should not allow ourselves to be fooled by short-term, band-aid solutions, whether natural or pharmaceutical, that can easily deceive us into believing that we have corrected the problem by eliminating its symptoms, but not the cause.
Specialized stool tests are available for testing the gut microbiome. These specialized tests are different from stool tests that are commonly ordered by conventional doctors, such as Fecal Immunochemical Test (FIT) or occult blood, or ova and parasites (O&P), or stool cultures for pathogenic bacteria. If you would like to learn more about microbiome testing and targeted treatment options based on the test results, please contact us for more information.
Thank you for your continued support and faith in us, which keeps us motivated and loving what we do.
We would like to wish everyone a very joyful holiday season and a happy, healthy, and much less stressful New Year.
Larry, Gaetana, and Anne.