Saturday, January 22, 2011


Someone emailed me asking about the roots of stress, chronic anxiety and depression. This person shared their personal struggle and wondered about links to "nutritional deficiencies, infections, inflammation, etc." Although the email felt personal, it had a long recipient list. I've decided to reply here.

I admire the writer's determination to understand the causes for his feelings and perhaps affect change. Psychological pain is serious. If it was more visible, more evident, I think society would show more compassion. But it's a quiet thing, except inside the head of the sufferer. As I've seen, people who take it on, who try to do something about it, show great fortitude.

Unfortunately, I don't know what more to say. Therapy, whether nutritional, behavioral, or drug-related, should be based on assessment. And assessment involves scrutinizing the whole individual - their mental and physical health, personal and family histories, resources, support network, as well as diet and lifestyle. In my opinion, that assessment is best made by a professional. But I can make a few comments about stress...

Stress is not benign. The American Psychological Association (APA) says that "chronic stress can result in serious health conditions including anxiety, insomnia, muscle pain, high blood pressure and a weakened immune system ... and major illnesses, such as heart disease, depression and obesity."1 And there's a feedback loop. In an attempt to mitigate the effects of stress, some people adopt unhealthy habits such as smoking, taking drugs, abusing alcohol, and overeating/undereating/eccentric eating. Those habits can damage health which adds to a person's stress load.

The APA conducts annual surveys on stress - how people perceive stress, how they manage it, sources of stress, and its overall impact on their lives. Here's their 2010 report:

Stress In America (pdf), American Psychological Association, November 2010

The survey was conducted last August. It's a small sample, but it's still informative. (Click to enlarge charts.)

People experience more or less stress depending on where they live, their health status, gender, age group, and other factors which the report discussed in more depth.

One point the report made which may be pertinent to the writer, "As the aftershocks of the Great Recession continue to be felt across the country, money, work, and the economy remain the most oft-cited sources of stress for Americans." I understand that Portugal has undertaken some painful austerity measures ... public sector wage cuts and tax increases. Their unemployment rate has been and remains higher than here. So this statement may be applicable.

Role Of Diet

It's important, of course, to consume adequate nutrients, the macronutrients (carbohydrate, fat, protein) and micronutrients (vitamins, minerals), as well as fiber and fluid. I'm tempted to discuss specific nutrients, but that would have me following a reductionist approach, which, as I'm coming to understand, is limited and possibly inferior compared to looking at the diet as a whole:
"The reductionist approach has traditionally been and continues today as the dominant approach in nutrition research. This means that parts of diet rather than the whole, or single food components rather than food habits, are studied. Even though much progress has been made with this approach, the relationship between diet and health is not yet fully understood. With the recognition about the whole being more than the sum of its parts, the limitations on the applicability of the reductionist approach, and the growing knowledge about parts of diet, another epistemological approach, such as holism, and new research strategies, such as transdisciplinarity, are needed to reveal more about the relationship between diet and health."
- Transcending Reductionism In Nutrition Research, American Journal of Clinical Nutrition, 2003
I'd venture that most people, at least most people reading this, know a lot about how to eat healthfully. That might mean an apple instead of apple pie, a bowl of soup instead of a bowl of ice cream, lightly dressed salad instead of stuffed crust pizza, a cup of tea instead of a quart of iced coffee. But they may be stymied in their efforts. (I'm not trying to convert anyone with that food contrast list. It's just an example to show that knowledge of healthful food choices doesn't rest with the few. There are no secrets.)

What hinders people from turning knowledge into behavior? Money, access, time, energy, family and peer pressure, confidence, habit, stress, illness, addiction, disability (mental or physical). You could probably name more. It's not enough to educate people about good nutrition. You have to address the barriers that impede their efforts. And you have to respect that each person is unique. No one diet is best for everyone.

Stress Is What Happens When We Fight Against The Moment We Are In Wishing It Was A Different Moment

A psychotherapist I follow and respect, Dr. Dan Gottlieb, says:
"The question is not how do we avoid these predictable unexpected events, the question is how we cope with them. ... Michael Baime M.D. is a colleague and friend of mine who is both a physician and a meditation researcher and teacher. He explains that stress is what happens when we fight against the moment we are in wishing it was a different moment (I immediately thought about a traffic jam)."
Dr. Gottlieb was in a near fatal traffic accident early in his career that left him paralyzed from the neck down. He's recently been experiencing "violent spasms":
"Every time they happened, I would suffer, become distressed and start telling myself stories about what they meant. I felt frightened, despair, self-pity -- but mostly fear of the future. After about 36 hours, I just gave up and gave in and allowed my body to do what it needed to do. I still suffered with the spasms, but I was no longer fighting with my body and I fell compassionate for myself and my body. Still felt pain and elevated blood pressure and difficulty breathing and all that goes with this stuff, but I didn't feel stress I felt kindness."

"Michael and those meditation folks think this stuff is teachable. What do you think?"
What causes you to feel stress? What do you do when you feel stressed?
1 Understanding Chronic Stress, American Psychological Association.


Perovskia said...

Ahh, a topic after my own heart. I don't know that one can root stress. Stress has been alive since the dawn of man; doesn't matter if you're a caveman or a suit on Wall St.

I do believe (for the most part) mental dis-ease is manifested in physical dis-ease. That comes with a lot of controversy as not everyone believes that (I'm talking from the basic cold to say, cancer).

The tables were interesting. And wow, 2008 was a bad year (not surprising). I'm glad to see most causes of and physical symptoms of stress have gone down. I also like the drastic difference between the ways men and women cope with stress. I'm interested to see how these tables compare to those done in say, Italy (who have a very "laissez faire" attitude compared to us.

So, we can eat as healthy as we want, but I think stress trumps all and will have some effect on our bodies regardless of how well we eat.

I like Dr. Gottlieb's theory about not fighting stress,though. Something I'm still trying to condition myself to do when I have an attack.

Anonymous said...

Some of your posts have been causing me to feel stress! I can't eat eggs anymore. It's disgusting what's done to chickens to get eggs. Debeaking, stuffing thousands in a barn full of excrement and filth, tossing male chicks alive into food grinders. There was another one about milk. That's it, no more milk.

Bix said...

2008, interesting point. It was an election year in the US, the Presidential election. A shame they don't have "politics" as a cause of stress in that first graph. Maybe "relationships" covers it.

Speaking of that, people were responding to items on the survey. How different would this be if respondents offered their own causes.

Bix said...

To Anonymous ... I just got to their chapter on fish. For crying out loud...

manu said...

Actually Bix's posts, if anything, lower my stress because they are fascinating to read. I can't say I agree with the 'sugar, flour and refined carbs are not evil' theory, in my case I find a diet high in sweet potatoes, fruits and beans etc to be great as soon as I eat processed sugar/dairy/flour I start crashing and sweating and voraciously wanting more etc... but this blog as helped me a great deal in finding a good diet for me that I can follow forever, and no I haven't stopped eating meat or fish, but I do consume much less and I try to find out where it comes from

Bix said...

Thanks, manu.

I love sweet potatoes. I came across this list yesterday:

... and was amazed how many there are. I've only had about 5. And regularly eat just one or two types since that's all I can find in stores. I'd love to try more.