You can read it here: Economic Crisis, Unemployment Take Emotional Toll.

Or you can listen to it here.

The video is short but makes a dramatic point about the effects of the fight/flight response in everyday human life.  It’s well worth the five minute viewing.  Here’s the link:

http://killerstress.stanford.edu/about-robert-sapolsky

(For some reason I had difficulty watching the video in my web browser.  I downloaded the video with realplayer and it worked fine.)

This post covers the relationship between the 3^rd and 4^th posts. That is, the relationship between some of the stress reduction techniques and the biology of the stress model.

Once more, I need to repeat that this is a tremendous simplification of a highly complex process. In addition, microbiology and neurophysiology are not my strongest points. I welcome all corrections to any of those processes in these posts. References are available at the end of the post for anyone wanting further details. As always, none of the information in this post is intended to replace diagnosis and treatment by a licensed professional. This is for informational/educational purposes only.

During normal times, the body is in a general state of alertness and homeostasis. Even then, "muscle is never completely relaxed-it is in a state of continuous but variable contraction." ( The Nature of the World and of Man, p. 487)

When we need to move or perform some task, we don’t use the whole muscle with all its force for each movement. This is a good thing. Otherwise, you’d smash your teeth and spill the tea into your lap each time you raised the cup to your lips.

Muscles, like the biceps for instance, are separated into smaller groupings or layers by the fascia. The fascia, according to David A. Winter , are sheaths that "enclose the muscles, separating them into layers and groups and ultimately connecting them to the tendons at either end." (p. 166)

A single muscle, then, can have a number of different layers or groupings (motor units).

These layers or units are called into action through a sequence known as "The Size Principle." Winter writes that according to this principle, "the smallest unit is recruited first and the largest unit last. In this manner…movements can be achieved in finely graded steps." (p. 167) The first muscle groups or motor units involved will be the last ones released back to a relaxed state. This allows you to raise a cup gently to your lips and sip, without spilling the tea or splitting your lips.

After getting a drink and returning the cup to the saucer, the task is done. A cortisol message informs the hypothalamus. The hypothalamus then sends out corticotropin-releasing hormone (CRH) to the muscles involved in the task. (This is an oversimplification because there are a number of sub-routines or minor tasks included in the larger goal of taking a sip and placing the cup down. It is the general point that we are interested in.) The muscles in the arm begin to relax, with the largest motor units turned off first and the smallest ones last.

So much for normal daily life.

Now, recall that when we detect a threat, the fight/flight/freeze response starts. The brain initiates a complex series of biological processes that prepares us for the danger.

One way that the body is prepared is an increased tone or readiness of the skeletal muscles. However, in anxiety, there is no clearly identified external threat. Without a specific threat, it is not possible to plan a reaction.

The muscles are tensed, but there is no action to take. A wrong move might get us killed. Yet we have to be prepared to make any move. So long as we believe a threat might be present, the muscles will remain at the ready. CRH is not sent to the muscles to tell them to stand down.

All dressed up in our shiniest battle gear, and no place to go.

To counter this situation, you can give your muscles a direction. Get up and go into the next room. Better yet, go out for a vigorous walk around the block, play catch with one of your children, go for a walk on the beach with a friend, etc. If for some reason you cannot get out, you can do progressive muscle relaxation right where you are sitting.

The point is to give the muscles a useful, conscious goal and to carry it out to completion. Once that is accomplished, the brain, in turn, will send out CRH so that the muscles can go back to their resting point.

It is tempting to sit in the same spot and mull over the worries and anxieties. There has to be a solution to all this worry, stress and anxiety. If only I think harder, longer, I will come up with an answer. That is the wrong response.

You will only generate an increasing level of threat perception and the body will continue to get tense. Remember that the brain calls on increasingly large groups of muscle as the demands of the task get greater (the size principle). As the muscle groups involved become larger and more widespread, the more uncomfortable the body becomes, the more difficult it is to breathe, and so on.

The brain is receiving feedback that the body is under stress and this increases the sense of anxiety/panic. Some people start taking their pulse at this point and get further freaked out because their heart rate is well above normal and they feel short of breath.

All this seems to confirm that one should be anxious. Even if there is no external threat, the brain has in fact found something frightening. It has identified that something is wrong with the body itself. Again, though, I have no idea why my pulse should be 102 and I feel dizzy. That alone makes me anxious. This is now a completely self-fulfilling circle of thought.

Breathing with the diaphragm is so easy that babies do it. However, that simplicity is often an objection to breathing in that fashion. After I tell people about it during a session, I often hear doubt in their voice. "How’s that going to help with dealing with my boss?" It seems too simple to be of any help with real problems, panic and anxiety.

Remember that as the perceived stress/threat grows, more and larger muscle groups are called into service. As my pectoral, trapezius, intercostal, deltoid, and other chest/back/shoulder muscles tighten, they press in against very important items: my ribcage and the lungs. As pressure builds against the ribcage and lungs, it becomes more difficult to take a deep breath.

By the same principle, as the stress/threat level increases, so does the tension in the muscles of my neck. Underneath and around the neck muscles are my throat, spinal cord, major arteries and veins. Pressure on the throat makes it more difficult to breathe. Constricting the arteries causes problems getting blood to the brain.

Understandably, having difficulty breathing is very upsetting to people. It increases the anxiety level. People often start to hyperventilate to compensate for the pressures on the ribcage and throat.

The way out of this is to use the stomach muscles to push out the abdomen and allow the diaphragm to drop, expanding the lungs fully. Pulling the abdominal muscles in pushes the diaphragm up and pushes air out of the lungs. The muscles of the rib cage and shoulders are not used. problems associated with hyperventilating are avoided.

While I was researching this post, I came across a very interesting article that uses a number of the above principles. The article, A quiet hand for microneurosurgery , is by and for neurosurgeons performing microneurosurgery. You don’t want your neurosurgeon to have a shaking hand. The authors found that the following variables are associated with worsened tremors:

Long-term factors include health and age. Intermediate factors are skill, alcohol, nicotine, and caffeine. Short-term factors, which occur during surgery, include limb support, direction of movement, physical fatigue,and anxiety. (p. 542) (I have italicized the elements shared between their article and our discussion.)

The neurosurgeons note that with increasing involvement of more muscle groups, the tremor worsens:

We also became familiar with the size principle of motor unit recruitment; that is, the smallest motor units are recruited first….one should recruit the least number of motor units to perform a task because each contracting muscle fiber adds to the tremor. (p. 542)

For anxiety, the increasing involvement of more and larger muscle groups adds to the anxiety and physical problems associated with anxiety.

These authors found that fatigue was nearly impossible to eliminate in neurosurgeons given their demanding schedule and hours. So they devised a work-around solution. Use only the most energy and movement required for the task-the "quiet hand technique."

Furthermore, avoid alcohol, caffeine and nicotine. Reduce or eliminate anxious thoughts. Focus on the present task. Exercise: " An exercise specific to the quiet hand technique involves taping the four fingers together or placing them together on a tabletop and stretching the thumb in all directions." (p. 543) Finally, they stress the role of breathing. Proper breathing control plays a role in microsuturing:

3) Flex the thumb so that its tip holds the needle holder to the first finger.

4) Inhale with thumb flexion.

5) Position the needle.

6) Extend the thumb .

7) Exhale with thumb extension to ensure smooth rotation. (p. 542)

As you see, many of the principles for stress/anxiety reduction are the same in both our lives and in the practice of neurosurgery. If the principles help physicians working inside a patient’s brain, it would seem like reasonable that the same principles would help with stressful situations in other areas of life.

This post has covered why diaphragmatic breathing, progressive muscle relaxation, light exercise and other factors work to reduce stress and anxiety. Another post will handle good sleep and diet in more depth. A separate post will deal with ways to turn down the dial on anxious thoughts so that the thinking/emotional aspect of anxiety is covered.

The following are references for people who would like more detail on the topics in this post; again they are listed in no particular order.

emedicinehealth.com

Wikipedia-action potential

mcgraw-hill.com Animation: Myofilament Contraction

Mechanism of Tension Generation in Muscle An Analysis of the Forward and Reverse Rate Constants — Davis and Epstein

GetBodySmart.com-action potentials

Wikipedia-muscle contraction

A quiet hand for microneurosurgery: twiddle your thumb

GetBodySmart.com-Skeletal Muscle Fiber Contraction Physiology

By necessity, this discussion of the biological aspects of anxiety will be limited to a simplified overview. If you would like a thorough discussion, allow me to direct you to “Neuroendocrine pharmacology of stress,” or “The Neuroendocrinology of Stress” or “The Neuropsychology of Anxiety: Reprise.” These are quite technical and not written for a general audience; van der Kolk is a little bit more accessible. For our purposes, it will be enough to get a general understanding of the mechanisms involved in anxiety and how we think and feel when they kick in.

It all starts when a real or perceived threat is sensed. According to Chrousos, the brain’s reaction is to activate the stress system. Oversimplifying things, the hypothalamic-pituitary-adrenal (HPA) axis is engaged. This is undeniably a good thing when the situation is truly threatening.

One result of the HPA kicking into gear is that hormones are sent out to the adrenal glands. The adrenal glands respond by releasing epinephrine, norepinephrine and cortisol. These act to bring on the fight/flight response

This is perfect because we are now poised to react to the threat.

Blood pressure and heart rate increases, reaction time improves, blood flows more heavily into the brain and skeletal muscles. The body breaks down its stores of energy to power the muscles and brain.

The immune system gets a booster shot (just in case we get wounded or harmed). As another precaution, the body’s internal painkillers (endogenous opioids) are released. This would help us to keep running or fighting even if injured.

Reproduction is not going to help us either fight or run away so the sex drive gets shut down. Having dinner or completing digestion of my last snack is not a priority in times of high level, immediate threats. So, the corticotropin-releasing hormone (CRH) element of the stress system decreases appetite and sometimes leads to the colon emptying its contents. Again, if we might not live to see tomorrow, it is not a clear priority to continue growing and, accordingly, the growth hormones are shut down.

This is great. We are suddenly on full alert and completely ready for action. We can focus more acutely on the threat and begin to deal with it effectively.

Bring on the lions and tigers and bears. I won’t even say “Oh, my!”

In the normal run of events, I slay the dragon and the threat is gone. According to Chrousos, when the threat ends, the hormone cortisol notifies the hypothalamus. The hypothalamus, in turn, shuts off the corticotropin-releasing hormone (CRH). The body begins to return to a more normal state.

But wait. Suppose there is no victory of this sort. Imagine that the threat is a looming foreclosure; an unpleasant boss; any kind of ongoing and for the most part unavoidable stressor. I can’t break out my sword and vanquish the soaring adjustable rate mortgage, the raging boss or whatever else.

More complicated, perhaps, are the instances when we ourselves are part of the stress. Let’s say that my interests in high school were exclusively girls and hand-held video games (the latter did not exist, really, at that time). Both of these are fine pursuits. But years later it would be difficult to put those talents on a resume detailing my job skills. In a tight job market, my lack of training and education and low self-esteem is part of the chronic stress of unemployment or low paying jobs.

van der Kolk writes that: “chronic and persistent stress inhibits the effectiveness of the stress response and induces desensitization.” If you think that doesn’t sound good, you’re right. And chronic stress and anxiety are what we’ll delve into in the next post. I’ll also cover how anxiety and panic attacks can result from the fight/flight response in a later post.

References for this post include (in no particular order): The Anxious Brain; NIH Backgrounder—Stress; emedicine; Why Zebras Don’t Get Ulcers; Neuroendocrine pharmacology of stress; The Neuropsychology of Anxiety: Reprise; Wikipedia; mentalhealth.about.com; The Neuroendocrinology of Stress.