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Stress is the "wear and tear" our bodies experience as we adjust to our continually changing environment; it has physical and emotional effects on us and can create positive or negative feelings. As a positive influence, stress can help compel us to action; it can result in a new awareness and an exciting new perspective. As a negative influence, it can result in feelings of distrust, rejection, anger, and depression, which in turn can lead to health problems such as headaches, upset stomach, rashes, insomnia, ulcers, high blood pressure, heart disease, and stroke. With the death of a loved one, the birth of a child, a job promotion, or a new relationship, we experience stress as we readjust our lives. In so adjusting to different circumstances, stress will help or hinder us depending on how we react to it.

Recent studies attribute 85% of all disease to stress-related factors. In America, 14 million people suffer from anxiety and 30% suffer from chronic to severe insomnia. There are many causative factors to the degenerative effects of stress on the nervous system. These can range from an unhealthy diet and lifestyle to insufficient sleep and exercise. Identifying appropriate lifestyle changes must and should be done on a case-by-case basis. There are, however, many stress-fighting and neuro-restorative herbs that can provide immediate relief and rejuvenation for the side effects of stress.

When the body is under stress, the nervous system responds by increasing sympathetic activity, which creates nervous restlessness, hyperactivity, anxiety, muscle tension, cardiovascular stress, and intestinal cramping, to name a few. IF the stress is prolonged, the adrenal and pituitary glands produce hormones, which provide emergency relief, at a price. This process produces chemical waste, which degenerates nerve cells and causes free radical damage systemically in the body. Certain botanical medicines, through a process call trophorestoration, can rejuvenate and restore the nerve cells from the damages of stress. The nervous system must first be relaxed and nerve centers sedated. The nerve tissues are then tonified with astringent and restorative herbs. This process is followed through resetting the nerves by stimulating and enhancing systemic circulation.

For thousands of years, people believed that stress made you sick. Up until the nineteenth century, the idea that the passions and emotions were intimately linked to disease held sway, and people were told by their doctors to go to spas or seaside resorts when they were ill. Gradually these ideas lost favor as more concrete causes and cures were found for illness after illness. But in the last decade, scientists like Dr. Esther Sternberg, director of the Integrative Neural Immune Program at NIH抯 National Institute of Mental Health (NIMH), have been rediscovering the links between the brain and the immune system. The Immune System and the Brain When you have an infection or something else that causes inflammation such as a burn or injury, many different kinds of cells from the immune system stream to the site. Dr. Sternberg likens them to soldiers moving into battle, each kind with its own specialized function. Some are like garbage collectors, ingesting invaders. Some make antibodies, the 揵ullets? to fight the infectious agents; others kill invaders directly. All these types of immune cells must coordinate their actions, and the way they do that is by sending each other signals in the form of molecules that they make in factories inside the cell. 揑t turns out that these molecules have many more effects than just being the walkie-talkie communicators between different kinds of immune cells,?Dr. Sternberg says. 揟hey can also go through the bloodstream to signal the brain or activate nerves nearby that signal the brain.? These immune molecules, Dr. Sternberg explains, cause the brain to change its functions. 揟hey can induce a whole set of behaviors that we call sickness behavior. . . . You lose the desire or the ability to move, you lose your appetite, you lose interest in sex.?Scientists can only speculate about the purpose of these sickness behaviors, but Dr. Sternberg suggests that they might help us conserve energy when we抮e sick so we can better use our energy to fight disease. These signaling molecules from the immune system can also activate the part of the brain that controls the stress response, the hypothalamus. Through a cascade of hormones released from the pituitary and adrenal glands, the hypothalamus causes blood levels of the hormone cortisol to rise. Cortisol is the major steroid hormone produced by our bodies to help us get through stressful situations. The related compound known as cortisone is widely used as an anti-inflammatory drug in creams to treat rashes and in nasal sprays to treat sinusitis and asthma. But it wasn抰 until very recently that scientists realized the brain also uses cortisol to suppress the immune system and tone down inflammation within the body.

 

Stress and the Immune System This complete communications cycle from the immune system to the brain and back again allows the immune system to talk to the brain, and the brain to then talk back and shut down the immune response when it抯 no longer needed. 揥hen you think about this cross-talk, this two-way street,?Dr. Sternberg explains, 搚ou can begin to understand the kinds of illnesses that might result if there is either too much or too little communication in either direction.? According to Dr. Sternberg, if you抮e chronically stressed, the part of the brain that controls the stress response is going to be constantly pumping out a lot of stress hormones. The immune cells are being bathed in molecules which are essentially telling them to stop fighting. And so in situations of chronic stress your immune cells are less able to respond to an invader like a bacteria or a virus. This theory holds up in studies looking at high-levels of shorter term stress or chronic stress: in caregivers like those taking care of relatives with Alzheimer抯, medical students undergoing exam stress, Army Rangers undergoing extremely grueling physical stress, and couples with marital stress. People in these situations, Dr. Sternberg says, show a prolonged healing time, a decreased ability of their immune systems to respond to vaccination, and an increased susceptibility to viral infections like the common cold.

 

Some Stress is Good People tend to talk about stress as if it抯 all bad. It抯 not. 揝ome stress is good for you,?Dr. Sternberg says. 揑 have to get my stress response to a certain optimal level so I can perform in front of an audience when I give a talk.?Otherwise, she may come across as lethargic and listless. But while some stress is good, too much is not good. 揑f you抮e too stressed, your performance falls off,?Dr. Sternberg says. 揟he objective should be not to get rid of stress completely because you can抰 get rid of stress — stress is life, life is stress. Rather, you need to be able to use your stress response optimally.? The key is to learn to move yourself to that optimal peak point so that you抮e not underperforming but you抮e also not so stressed that you抮e unable to perform. How much we抮e able to do that is the challenge, Dr. Sternberg admits. This may not be possible in all situations, or for all people, because just as with the animals Dr. Sternberg studies, some people may have a more sensitive stress response than others. 揃ut your goal should be to try to learn to control your stress to make it work for you,?Dr. Sternberg says. 揇on抰 just think of getting rid of your stress; think of turning it to your advantage.?

Controlling the Immune Response Problems between the brain and the immune system can go the other way, too. If for some reason you抮e unable to make enough of these brain stress hormones, you won抰 be able to turn off the immune cells once they抮e no longer needed. 揟here has to be an exit strategy for these battles that are being fought by the immune system, and the brain provides the exit strategy through stress hormones,?Dr. Sternberg says. 揑f your brain can抰 make enough of these hormones to turn the immune system off when it doesn抰 have to be active anymore, then it could go on unchecked and result in autoimmune diseases like rheumatoid arthritis, lupus, or other autoimmune diseases that people recognize as inflammation.? Dr. Sternberg says that there are several factors involved in these autoimmune conditions. There are many different effects that the brain and its nervous system can have on the immune system, depending on the kinds of nerve chemicals that are being made, where they抮e being made, what kind of nerves they come from, and whether they抮e in the bloodstream or not. Still, at least part of the problem in these diseases seems to involve the brain抯 hormonal stress response. 揝o if you have too much stress hormone shutting down the immune response, you can抰 fight off infection and you抮e more susceptible to infection,? Dr. Sternberg concludes. 揟oo little stress hormones and the immune response goes on unchecked and you could get an inflammatory disease.?

Pinpointing the Problems Why these miscommunications between the brain and the immune system come about is still largely unknown, and involves many genes and environmental factors. But by studying animals, scientists have finally been able to start understanding how the miscommunications occur. Dr. Sternberg first started publishing work on the links between the brain and the immune system back in 1989 studying rats with immune problems. 揑n many of these cases it抯 very hard to show the mechanism in humans,? Dr. Sternberg explains, 揵ut you can show the mechanism in animals because you can manipulate all the different parts of the system and you can begin to understand which parts affect which other parts.?It has taken 揳 good ten years?to gather enough evidence in human studies to show that the principles her lab uncovered in rats were also relevant to human beings. Drugs that have been tested in rats to correct brain/immune system problems have had unpredictable effects. That is because nothing happens in isolation when it comes to the brain and the immune system. Dr. Sternberg points out that our bodies are amazing machines which at every moment of the day are constantly responding to a myriad of different kinds of stimuli — chemical, psychological, and physical. 揟hese molecules act in many different ways in different parts of the system,?she says. Understanding how the brain and the immune system work together in these different diseases should help scientists develop new kinds of drugs to treat them that would never have occurred to them before.

Taking Control Now Dr. Sternberg thinks that one of the most hopeful aspects of this science is that it tells us it抯 not all in our genes. A growing number of studies show that, to some degree, you can use your mind to help treat your body. Support groups, stress relief, and meditation may, by altering stress hormone levels, all help the immune system. For example, women in support groups for their breast cancer have longer life spans than women without such psychological support. There are several components of stress to think about, including its duration, how strong it is, and how long it lasts. Every stress has some effect on the body, and you have to take into account the total additive effect on the body of all stressors when considering how to reduce stress. Perhaps the most productive way to think about stress is in terms of control. Dr. Sternberg shows a slide of an F-14 jet flying sideways by the deck of an aircraft carrier, its wings completely vertical. 揟he Navy Commander who flew that jet told me that he was the only one in the photo who was not stressed, and that抯 because he was the one in control. The officer sitting in the seat ten feet behind him was in the exact same physical situation but was not in control. Control is a very important part of whether or not we feel stressed. So if you can learn to feel that you抮e in control or actually take control of certain aspects of the situation that you抮e in, you can reduce your stress response.?Studies show that gaining a sense of control can help patients cope with their illness, if not help the illness itself. Until science has more solid answers, it can抰 hurt to participate in support groups and seek ways to relieve stress, Dr. Sternberg says. But what you need to remember is if you do these things and you抮e not successful in correcting whatever the underlying problem is, it抯 not your fault because there抯 a biology to the system. 揧ou need to know the benefits of the system,?she says, 揵ut its limitations as well.? In other words, try not to get too stressed about being stressed. — a report from The NIH Word on Health, October 2000

A Word to the Wise... Stress Control First try to identify the things in your life that cause you stress: marital problems, conflict at work, a death or illness in the family. Once you identify and understand how these stressors affect you, you can begin to figure out ways to change your environment and manage them. If there抯 a problem that can be solved, set about taking control and solving it. For example, you might decide to change jobs if problems at work are making you too stressed. But some chronic stressors can抰 be changed. For those, support groups, relaxation, meditation, and exercise are all tools you can use to manage your stress. If nothing you do seems to work for you, seek a health professional who can help. Also seek professional help if you find that you worry excessively about the small things in life. Keep in mind that chronic stress can be associated with mental conditions like depression and anxiety disorders as well as physical problems. Seek professional help if you have:   Difficulty sleeping   Changes in appetite   Panic attacks   Muscle tenseness and soreness   Frequent headaches   Gastrointestinal problems   Prolonged feelings of sadness or worthlessness

 

Medical Acupuncture in the Treatment of Chronic Stress-Related Illness

By Martha M. Grout

Stress related illness can be defined as any illness whose root cause can be attributed to chronic excessive release of stress-related neurotransmitters. Such illness can include common problems such as anxiety, depression, irritability, insomnia, hypertension, stroke, myocardial infarction, irritable bowel syndrome, as well as less clearly medically defined problems such as chronic fatigue syndrome, fibromyalgia, and even auto-immune diseases. The neurotransmitters and neuropeptides are the biochemical messengers through which information is transmitted or translated from the mind to the body and back.¹

Body-Mind Communication

Neurotransmitters include not only the commonly known stress molecules (epinephrine, norepinephrine, dopamine and corticosteroids), but also a host of others neuropeptides, short chains of amino acids present in both brain and body cells, with specific receptors on the cell membranes. Recent research shows that almost all communication between different parts of the body occurs by means of this psychosomatic network, a host of neurotransmitters, immunotransmitters, hormones and other chemical substances found in many different tissues in the body. Dr. Candace Pert calls these neuropeptides "molecules of emotion."² We have neuropeptide receptors all over our bodies, including the gastrointestinal tract; the white blood cells; the kidneys; and the pancreas, giving scientific validation to the ancient Chinese understanding that we feel emotions in all of our elemental organs, although the emperor organ, the heart, is the only one that consciously experiences the emotions. According to Dr. Ernest Rossi, a noted hypnotherapist and student of Milton Erickson, "The autonomic, endocrine, immune and neuropeptide systems are communication channels whereby mind may activate genes and the internal cellular machinery."³ Cholecystokinins in the GI tract, immunotransmitters in nerve cells and white blood cells, and insulin in the pancreas (the middle burner, the solar plexus chakra, the source of our power in relationships) all have receptor sites in the brain.

When we experience a particularly trying event, the memory is encoded by means of unique combinations of these chemical transmitters. If the memory is too painful for our conscious minds to deal with, it may be stored (and effectively buried) in particular places in our bodies. As long as the memory is still encoded in the body, it may try to bring itself to our attention by causing pain, dysfunction or imbalance in that place where it was stored.⁴ Consider, for instance, the patient with chronic neck and back pain, myofascail pain syndrome, myofascail pain syndrome, unresponsive to standard therapies and only partially responsive even to acupuncture. Needling a particular place on the neck brought to the surface memories of a five-year old being grabbed by the neck by his father, with the attendant feelings of "I didn't do anything! I am small and powerless! It's not fair." This patient had encoded that memory in the part of the body related to the upper burner, the lungs, whose associated emotion is grief, and which is concerned with structure and rules, justice and duty; and the heart, where that emotion is experienced. Once the memory was released and the father was forgiven, the physical pain was completely relieved.

How Can Acupuncture Help?

First, we can diagnose the medical illness, imbalance or problem that brings the patient to us. We are obligated to use our Western diagnostic skills and modalities, to determine whether we are dealing with a functional illness; with something that is surgically correctable; or even a life-threatening condition like pneumonia, sepsis, diabetic ketoacidosis or cancer.

Second, we can diagnose the energetic imbalance, using the system to which we best relate. We may use five-element diagnosis,⁵ French energetics⁶ or traditional Chinese medicine syndromes.⁷ In the end, if we diagnose correctly, we will all come to the same conclusions about the imbalance, although our plans of treatment may be different, depending on which system we are using.

Third, we treat the whole person: body, emotions, mind and spirit.

Treatment

If the disease or problem exists primarily on the emotional level, then our acupuncture treatment is directed at this emotional level, as well as the physical level. I find that the outer bladder line points are most helpful in this regard.⁸ I use BL42 (pohu) as well as the lung shu point BL13 (feishu) for patients with Valley fever or asthma, in which the root cause is likely to be an issue of enormous grief. Similarly, I use BL47 (hunman) and the liver shu point BL18 (ganshu) for patients with hepatitis, where the cause is rooted in emotions of anger or irritability. The gallbladder shu point BL19 (danshu) is combined with BL48 (yanggang) for patients with gallstones or cholecystitis, where is root issue is repressed anger and lack of courage to move on.

I also activate the fu organs themselves for their metaphorical functions. Issues of irritability may express themselves in the stomach as ulcers or gastritis, with the emotional issue revolving around "What is there that you cannot stomach?"⁹ The stomach mu point CV12 (zhongwan) and the shu point BL21 (weishu) are most helpful for treatment of these issues. I frequently use the small intestine mu point CV4 (guanyuan) or the shu point BL27 (xiaochangshu) for people who are unable to clarify the issue, "What is there that you cannot sort out?" and whose manifestations tend to be bloating or irritable bowel syndrome. The large intestine mu point, ST25 (tianshu) and shu point BL25 (dachangshu) are very useful for those patients who are unable to let go of that which no longer serves them. They tend to have issues of forgiveness, and manifestations of chronic constipation or colitis.

If the problem lies in the patient's fundamental mindset ("I am not worthy," "I am ugly," "I do not deserve the good things in life") as often occurs in cases of childhood neglect or abuse, it is important to work with the mindset as well. Abuse may not necessarily mean gross neglect; it may be as simple as Mom being preoccupied with a new baby, or Dad being chronically disappointed because we got Bs rather than As in school. The cerebral circulation pathways¹⁰ are particularly helpful for such core "mindset" issues of worthiness. These pathways are based on a combination of French energetics, anatomy and molecular biology.

The yin channels of the leg - tai yin spleen, shao yin kidney and jue yin liver - originate from cephalad points on the three leg yin meridians, and continue their influence deep into the brain, connecting eventually with the yang channels of the leg in the head, yang ming stomach, shao yang gall bladder and tai yang bladder, which run superficially over the head and face. The cerebral circulation pathways, arising from the cephalad points, influence the sensory organs associated with the three yin meridians, as well as the associated emotional states.

The kidney cerebral circulation is activated from KI27 and is focused on SI19 (tinggong) for the ear, or on BL10 (tianzhu) for the posterior pituitary gland across which the channel travels. The pituitary gland is the great controller of our endocrine organs, secreting vasopressin or anti-diuretic hormone, which regulates water balance, blood flow and urine flow. This pathway is useful in any ear problem as well as any endocrine problem, and is particularly useful for those patients whose primary issue is that of fear of change; fear of relationships; or fear of living in general.

The liver cerebral circulation is activated from LR14 (qimen), and is focused on GB1 (tongziliao) for the eye or on GB20 (fengchi) for the anterior pituitary gland. The anterior pituitary gland secretes luteinizing hormone, which is used in lactation; follicle stimulating hormone, which regulates the ovaries, and ACTH (adrenocorticotropic hormone), the precursor of beta endorphins and enkephalins.¹¹ Stress-like behavior, memory, attentiveness and learning are all mediated through the adrenal glands. This pathway is especially useful in people with attention deficit hyperactivity disorder, who clearly exhibit characteristics of liver wind (darting about and being unable to focus clearly). This pathway is also useful for our hypertensive chronically irritable patients, as well as those with refractory eye problems such as glaucoma and macular degeneration. This pathway is particularly useful in the treatment of those patients who are crippled by their irritability and anger, or who spin their wheels and never move forward.

The spleen cerebral circulation is activated by the highest point on the spleen meridian, SP20 (zhourong). It ascends through the pharynx to the maxillary sinuses and olfactory bulb. The focusing point is ST1 (chengqi) for the sinuses; BL1 (jingming) for the nose; and ST9 (renying) for the throat. The extra meridian point GV24.5 (yintang) can also be used for both olfactory and sinus problems. This may be very useful in treating chronic sinusitis that has been unresponsive to other less aggressive treatments. Since the spleen is charged with both logical thinking and intuitive thinking (through the nose), this pathway is also useful in treating patients with confusion and memory dysfunction, and those who have suppressed their intuition, who live "all in their heads" and are excessively logical. It is especially useful for those who get gridlock or stagnation on any level, those who have obsessive-compulsive disorder, and chronic worriers.

Conclusion

Medical acupuncture is extremely useful in the treatment of many chronic stress related illnesses, not only because of its effectiveness in treatment of the physical body, but also (and perhaps more importantly) because of its ability to penetrate the layers of defense and coping mechanisms which our patients exhibit. Once the defenses are penetrated, the patients have the opportunity of choosing to deal differently with their issues. Since, as we have demonstrated, the mind and the body are one inextricably connected entity which uses the emotions and their attendant neuropeptides as the vehicle for communication, it is clear that by treating the physical body, we can penetrate deeply into the emotions. By releasing the emotions, we can help our patients change their response to stress, and thereby enable them to heal that physical entity known as the body-mind.

References

1. Pert C, Dreher H, Ruff M. The psychosomatic network: foundations of mind-body medicine. Alternative Therapies July 1998;4(4):30-41.
2. Pert C. Molecules of Emotion. Simon & Schuster, 1999; ISBN: 0684846349.
3. Rossi E. The Psychobiology of Mind-Body Healing. New York: WW Norton, 1993, p. 189.
4. Greenwood, MT. Individuation, splits in Western consciousness from an acupuncture perspective. Medical Acupuncture Fall/Winter 2000;11(2):11-16.
5. Beinfield H, Korngold E. Between Heaven and Earth: A Guide to Chinese Medicine. New York: Ballantine Books, 1991.
6. Helms J. Acupuncture Energetics: A Clinical Approach for Physicians. Berkeley, CA: Medical Acupuncture Publishers, 1995.
7. Maciocia G. The Foundations of Chinese Medicine. New York: Churchill Livingstone, 1989.
8. Deadman P, Al-Khafaji M. A Manual of Acupuncture. Ann Arbor, MI: Journal of Chinese Medicine Publications, 1998.
9. Page CR. Frontiers of Health: From Healing to Wholeness. Essex, UK: CW Daniel Co, Ltd, 2000.
10. Helms J. Acupuncture Energetics: A Clinical Approach for Physicians. Berkeley, CA: Medical Acupuncture Publishers, 1995, pp. 432-440.
11. Rossi E. The Psychobiology of Mind-Body Healing. New York: WW Norton, 1993, p. 188.

 

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Last update：Tuesday, 24 April, 2007