Stress is the silent killer of the 21st century. Most people in America today find themselves experiencing some form of stress on a regular basis. Stress is the biological reaction one experiences during times of either real or imagined danger. The stress response kicks the body into high gear so as to either flee or fight. Internally, the body releases the stress hormones cortisol and adrenaline, and the blood pressure and pulse rate rise getting the body ready for extreme physical activity. A few hundred years ago, this response was invaluable because it prepared a person to flee an attacking lion or prepare for harsh environmental conditions. Yet, most Americans no longer face these life threatening situations. Our stress comes from everyday activities. Our jobs, finances, driving and dealing with negative social interactions are some of the many daily stresses we face. And while stress can help us accomplish many of our daily tasks, it also has very harmful consequences to our health.

Too much daily stress has been linked to a myriad diseases, most of which are considered diseases of affluence (common only in the First World). These include heart disease, hypertension, autoimmune disorders, asthma, diabetes, depression, anxiety and gastrointestinal problems such as IBS and GERD. Elevated levels of cortisol and adrenaline have been associated with systemic inflammation as well as an increased immune response in the body. This inflammation over long periods of time has been linked to may autoimmune diseases such as fibromyalgia, asthma and IBS. The elevated pulse rate and blood pressure related to stress can put a lot of strain on the cardiovascular system causing hearth disease and hypertension. Chronic stress causes the stress system to overact, thus making one more sensitive to new stresses, creating a vicious cycle.

In Chinese Medicine too much stress causes the natural flow of qi, or energy, in the body to get stuck or stagnate. In a natural state, the body's qi and blood are supposed to flow freely though the twelve primary channels. It is the responsibility of the Liver Organ system to regulate this flow. As this system gets damaged by a stressful lifestyle it no longer functions to smoothly regulate the flow of qi, and disease occurs. Liver Qi stagnation is associated with headaches, hypertension, anger, irritability, red face and eyes, pain, painful periods, PMS, and migraines to name a few. Furthermore, when the energy in the body isn't flowing properly, there are effects on other organs systems as well. The primary system to be affected by Liver Qi Stagnation is the Spleen/Stomach or digestive system. This organ system is thought to create the energy in the body, and when the Liver overacts, it most frequently causes the digestive system to become weak because it can no longer function to make the qi in the body (stuck qi means no qi). In terms of Western Medicine, this can be seen when stress or emotions such as anger or irritability have an effect on digestion, such as in IBS or GERD. Chinese Medicine does a terrific job to sooth the liver and calm the spirit to treat imbalances in the energy. Both acupuncture and herbs can help by regulating hormones and neurotransmitters to help one feel more calm, joyful and relaxed.

Yet wouldn't it be better if you could manage stress BEFORE it becomes a problem? While most Americans experience stress regularly, very few actively try to counteract this stress. Some even feel stress is a good thing because it is a sign that they are successful and hard-working. Most people just accept it as a regular part of life. However, there are ways to manage, deal with or eliminate stress in order to live a calm and healthy life. All of these are things one can do at home, some of which are simple to incorporate into one's daily life.

One of the best ways to deal with stress is through the practices of mindfulness and meditation. As you might know from reading though my website, I am a Buddhist, and thus mindfulness and meditation are a major part of my spiritual life. However, one doesn't need to be a Buddhist, or even spiritual to practice meditation or mindfulness. Meditation has been shown to have an effect on the autonomic nervous system. Meditation can help to reduce headaches, lower blood pressure and help one sleep. Furthermore, meditation and mindfulness are a great way to re-train the mind and body to react to stressful situations in a more healthy way. Mindfulness can help one become more aware of negative emotions and learn to properly manage such things as anger and irritability. Also, the self knowledge one gains while meditating and practicing mindfulness can help one become more aware of what stressors one is experiencing day to day, thereby helping one to make the lifestyle changes necessary to reduce or eliminate these stressors.

I think the biggest problem is that many people don't know how to meditate, or think that it is a new age "fru-fru" thing to do. Many people try meditating and have trouble sitting still and give up before really trying. Honestly, meditation is not difficult, and in many ways is completely misunderstood. One of the biggest misnomers about meditation is that one is supposed to sit there in a very specific pose and turn off one's brain. Many people think that meditating is chanting,"OM" over and over. My kids used to do this when I talked to them about meditating because they had seen it so many times in their morning cartoons. There are many forms of meditation, including guided imagery meditation, concentration meditation, mindfulness meditation, insight meditation, plus many others. And if sitting for long periods of time is difficult for you there are walking meditation or qi gong, which involve meditation in movement. There are as many forms of meditation out there as there are different personality types, and therefore, chances are there is a type that will suit everyone.

If you are a beginner to meditation, a good place to start is with sitting meditation. Get a comfortable cushion or chair and sit either cross-legged or with your feet flat on the floor. Make sure you are comfortable in whatever posture you assume. Hold your hands in a relaxed state in your lap. Close your eyes or keep them low. Take three or four deep breaths to relax the body, then simply breath naturally. Focus your attention on the breath, notice how it feels as the air flows out of the nose. Observe your chest, abdomen and shoulders as you inhale and exhale. Do not try to control your breath in any way. As you sit, you will find your mind wandering. When this happens, simply label the thought, "thinking," "planning," "worrying," etc., and bring yourself back to the breath. Maintain this meditation practice for 3-5 minutes to start, then as you gain mastery, try to sit for longer periods. Try to practice every day. It helps some people to create a peaceful corner or room to use as their meditation space. Set aside a specific time every day for your practice, and build it into your daily routine. This will ensure you continue your practice. Everyone has 3-5 minutes in their day to spare, so there is no excuse! Studies have demonstrated that even a few minutes a day of meditation has been beneficial for lowering blood pressure, helping anxiety and depression, improving blood circulation, and lowering blood cortisol levels.

The pause one takes before reacting to emotions is mindfulness. Mindfulness is awareness of the present moment. It is meditation in action. It is a great way to deal with stress as it arises. A perfect example of mindfulness in action during a stressful situation is while driving. If you are late to work and someone cuts you off, you may be inclined to have a fight or flight reaction to the situation. You feel anger at the other driver for being so inconsiderate, and anxious because you are already running late. Your stress levels rise, and perhaps you even find yourself leaning toward road rage. But as we all know, not only can this be dangerous, it is also causing lasting damage to your body every time you allow yourself to fall back into that stress pattern. When one practices mindfulness, the goal is to see when one begins to feel angry, stressed, irritable or anxious, and to calmly breath through the situation. Between the emotion and the reaction there is a pause when one evaluates the situation and CHOOSES how to react. One can go chasing after that rude driver, screaming and yelling, but this will do no one any good, and will only make the situation worse. Yet with mindfulness, one learns to see these emotions as they arise, stop and breath before reacting.

Yet mindfulness needs to be developed. It is easy to be reactive, and it take training and discipline to be aware of one's feelings and experiences, and mindfully go through life only reacting when necessary. Meditation can be carried through to the rest of the day through mindfulness. As you do the dishes, clean the house, make dinner or do your work try to be present. Don't get lost in thoughts about the past or worries about the future. Just focus on the task at hand. If you are washing the dishes feel the scrub brush in your hand, be aware of the texture of the bubbles. Try not to think about what you could be doing, just do the dishes. If you find your mind it wandering, just gently bring it back to the present moment, the same way you would do during meditation. As you develop this skill, you will find that stress becomes easier to manage because you no longer react to the stressor. You can pause in the present moment, and see that your emotions, feeling and experiences are not you, and you don't need to have a physical reaction to them.

Another really important piece of the stress management puzzle is regular exercise. A regular exercise routine has been shown to have many beneficial effects on stress. It is thought to reduce fatigue, increase mental alertness, and enhance mental cognition in general. Physical activity increases endorphins in the body. These are the feel good chemicals released in the brain to help us cope with pain. Acupuncture, massage, deep breathing and meditation also have an endorphin releasing affect. Exercise also aids in sleep, which is another key component in managing stress. If you are not regularly active, aim to exercise a minimum of one hour three times per week. If you are saying to yourself, "I don't have time to spend a whole hour at the gym!" start with what you can commit to, even if that is only 10 minutes before you get ready in the morning. Find a video or app that gets you moving. It is also important to build exercise into your day. Make sure to take the stairs at work. park farther away and walk to the store. If you live in a city try biking or walking to work. Get a pedometer and aim for 10,000 steps throughout your day. If you find motivation is an issue, try to find a physical activity that you really enjoy, such as dancing, gardening or playing team sports. Exercise doesn't have to be at the gym on the treadmill if you find that to be monotonous or boring. Also, get a buddy to go with you! This will not only make the experience more fun, but it will also keep you from giving up because you won't just be giving up on yourself, you will be giving up on your workout buddy as well. While the exercise may seem challenging at first, the more you do the easier it will become. Before you know it you will feel more calm, energized, and happy.

Lastly, I would like to discuss sleep. Many, if not most, Americans are sleep deprived. I cannot tell you how many patients I have seen who claim they get a good amount of sleep per night, and then when probed admit to sleeping an average of 5-6 hours. This is not enough, people! Most adults need anywhere from 7-10 hours per night. Most would do best getting between 8 1/2-9 hours per night. Unfortunately, sometimes the reason people aren't sleeping is the stress itself. Stress and sleep are intricately linked. One affects the other and visa versa. The perception of a stressful life often keeps one lying awake at night worrying about life's difficulties. Yet lack of sleep also effects one's perception of life as stressful. It impairs our ability to have a healthy outlook on our situation, causing a kind of tunnel vision. Maintaining a good sleeping routine is two-fold.

Firstly, make sure you aren't staying awake on purpose. Many people find themselves staying up late to finish projects or get ready for the next day. Try to plan ahead if this is you. Do a few things over the weekend to prepare yourself for the work week. Also, recognize that lack of sleep makes you less productive during the day. It would be much easier to get things accomplished if you were mentally focused and relaxed. You will most likely get MORE done in less time if you've had a good night's sleep.

Some people are staying up to relax after a stressful day. They are stuck in front of the TV trying to find some "ME" time after the kids go to bed. It is all to easy to get sucked into the latest show and find you are up far too late. If this is you, try to curb your late night TV binge. Limit yourself to one episode of your favorite show, and turn it off. If you find you loose track of time, set a timer on your watch or phone. MY iphone has a new setting that keeps track of my sleep through my watch and will let me know when it is time for bed. With proper sleep, you may find that you no longer need that de-stress TV binge-time at the end of the day.

The second thing you need to do to maintain a good sleep routine is more important if you are having trouble with insomnia. Many people suffer from sleepless nights. Some people find they are waking a lot, others simply can't fall asleep. There are many reasons for sleeplessness. Stress and worry are major components. In order to help you fall asleep in-spite of stress, it is important to develop a sleep regime or ritual. The body works well with a schedule, and often when we build a schedule into our day the body starts to follow it despite the brains urging to do otherwise. Go to sleep at the same time every day. Any parent will know that a set bedtime makes sleep easier. What works for babies also works for adults. Have a pre-bedtime routine that is relaxing. Take a bath with lavender essential oils, give yourself a five to ten minute massage, or do a five minute meditation. DO NOT watch TV that is going to impact your sleep, such as scary, intense or dramatic shows. Try listening to some relaxing music instead for half an hour before bed. If you find you are still lying awake, herbs such as Chamomile, Lavender, Hops, Passionflower, and Valerian can help. Either take a tincture at night, or buy leaf tea, and drink a warm cuppa' before bed. There are also some new apps on the market to help you sleep. One new app I heard about recently says random words every few seconds. The random words interrupt our chattering monkey minds. Instead of thinking and worrying, your brain is forced to stop and relax. There are also many guided sleep meditations available online which may help. If all else fails, try to nap. Even if you aren't getting your sleep at night, you can make up for it later. Try to sleep for 20 minutes or less to avoid grogginess when you wake. I recently read about a style of napping where one naps three times per day for 10 minutes. This is supposed to help reset the circadian rhythm, and help one to feel refreshed. Try it! It may help.

If all else fails, and you just can't seem to get your stress under control, acupuncture and herbs can really help. Acupuncture releases endorphins and stimulates the release of serotonin in the brain. Both of which are "feel-good" chemicals. It also helps balance the bodies sex hormones, which can also be a factor in stress. There are specific acu-points to treat stress and any side-effects of that stress. As most can attest, acupuncture leaves most people feeling calm and relaxed. Furthermore, there are also many herbal prescriptions that are used to treat stress, anxiety, depression and their related diseases. Each formula is specific to how you are manifesting stress, so it is best to see a professional rather than self prescribing the herbs. In Chinese medicine, we would treat a person with anxiety, shortness of breath and heart palpitations due to stress very differently than someone with headache, anger, hypertension and red eyes due to stress. So it is best not to go to Whole Foods and buy the herbal formula in the stress or anxiety section. While this may help some, it will not be formulated to your specific symptoms, and will thus not be as effective as the formula you get from your DOM. Finally, remember, life is short, try not to stress so much that your forget to enjoy it!