Book Review – The Upside of Stress by Kelly McGonigal, PhD

the upside of stressStress is bad, right? It damages our body, causes depression, shortens our lives…the list goes on and on. We say things like, “All this stress is giving me an ulcer!” or, “This stress is killing me!” Your practitioner, if unable to pinpoint the source of your malady, may advise that you reduce your stress level. We have whole industries designed to decrease stress in our lives: yoga classes, meditation courses, massage therapy, breathing exercises, exercise, and lifestyle coaching.

Dr. Kelly McGonigal urges us to rethink the idea that “stress is bad” in her book, The Upside of Stress: Why Stress is Good for You and How to Get Good at It. Dr. McGonigal is a health psychologist who teaches at Stanford’s School of Medicine Health Improvement Center and the Stanford Center for Compassion and Altruism.

A Little History

Dr. Hans Selye, an endocrinologist, found that introducing any sort of unpleasant experience produced a loss of muscle tone, ulcers, immune breakdown, and ultimately death in his lab rats. Having already seen human patients who experienced similar breakdowns in their health, he drew from his observations and his rat experiments to define stress as any demand made on the body. Further, he felt that just about anything that happened to someone in life (good or bad) was toxic.

Dr. McGonigal argues that Dr. Selye’s definition is much too broad. She believes there is a huge difference between the body’s response to near-death experiences and electric shocks as the lab rats endured and the everyday stresses of living life in the modern world that humans commonly experience.

Fight or Flight

The classic description of the body’s response to stress is “fight or flight.” The body reacts to a stressor by stopping all non-essential processes, like digestion and fertility, and releases a flood of energy and oxygen needed to flee a dangerous situation or to fight for survival. Although this process has served human beings and other animals well throughout millennia in their survival efforts, “fight or flight” may not be always appropriate in modern life. It isn’t very effective to run away from a disagreement with your boss or an argument with your spouse, and it isn’t possible to fight for survival against past due bills or an IRS audit. Dr. McGonigal points out our stress responses have adapted over time and aren’t limited to this one “fight or flight” response. We have developed many more coping strategies.

A More Finely-Tuned Healthy Stress Response

Dr. McGonigal describes three types of stress responses in addition to “fight or flight,” which all serve to handle stress in such a way that may have a positive effect on the body:

  • Rise to the Challenge: Stress allows us to focus our attention, heightens our senses, increases motivation and mobilizes our energy. For example, this healthy stress response benefits an athlete who is about to compete.
  • Connect with Others: Stress activates the need to protect our tribe and dampens fear and increases courage.
  • Learn and Grow: Stress helps us integrate experiences and helps the brain learn.

The Main Stress Hormones

The hormones cortisol (also called hydrocortisone) and DHEA produced by the adrenal glands are considered the primary responders to stress. The outpouring of these hormones can affect the body positively rather than negatively. For example:

  • Research has shown that supplementing these stress hormones to enhance the stress response has been beneficial to those with post-traumatic stress disorder (PTSD) and panic attacks.
  • Psychiatrists have begun using these stress hormones before a therapy session and surgeons before surgery to improve outcomes.
  • Experiments designed to measure stress hormone responses find that those with the largest increase in DHEA are the most resilient under stress. DHEA can act as a neuro-steroid and helps your brain grow stronger after stressful events.

Other Stress-Related Hormones

While cortisol and DHEA are the main stress hormones, there several other hormones involved in the body’s stress response.

  • Adrenaline (also called epinephrine) pours out of the adrenal glands with cortisol and DHEA and serves to activate and focus our senses. The pupils of the eyes dilate to let in more light and hearing sharpens. The liver starts to dump fats and sugars into the bloodstream to provide more energy for the brain and the muscles.
  • The release of endorphins, testosterone, and dopamine, along with adrenaline, actually provides a feeling of exhilaration that many find enjoyable. This “adrenaline rush” is the feeling thrill-seekers are after when they skydive or ride roller-coasters.
  • Oxytocin is produced by the pituitary gland. Oxytocin increases our ability to bond with others and during times of stress, it allows our courage to dampen our fear. Interestingly, heart tissue contains many receptors for oxytocin which allow for regeneration and repair. Many believe that stress will give you a heart attack; however, the outpouring of oxytocin may strengthen your heart.

Changing Our Mindset about Stress

Early in her career, Dr. McGonigal, like many, believed that stress produces negative effects in the body. Then she came across a study that she just couldn’t reconcile with her belief system. This study documented that people who were exposed to stressors had different outcomes dependent upon their mindset about stress. If people believed stress was bad and produced unhealthy effects, it was so. If people believed stress was a part of life and a challenge to meet, they were healthier and even had enhanced life spans when compared to those with low levels of stress.

After this, Dr. McGonigal turned her career around. She no longer teaches fear of stress and stress management. She sums up her change in mindset in the introduction of her book: “The latest science shows that stress can make you smarter, stronger and more successful. It helps you learn and grow. It can even inspire courage and compassion.” Science shows that mindset is malleable; The Upside of Stress shares the tools to change one’s mindset to take advantage of the little-known benefits of healthy stress.

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy
Edited by Michelle Violi, PharmD – Women’s International Pharmacy
© Women’s International Pharmacy
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