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Depression

When is Stress Actually to Blame?

 

 

I feel like in the 20th century no one was talking about stress as an etiology for disease. Possibly I am guilty of generational egocentricity, having barely reached the drinking age by 2000. Thankfully, I had very few young friends discussing ailments and how they came about.

Still, I think it is more referenced, even over-diagnosed nowadays, especially by western doctors any time they cannot explain a symptom or its etiology, shrugging shoulders and throwing their arms up, citing the most probable suspect. “Might just be stress,” they say, which for its listener might feel an implication that their complaint is a fabrication of the mind, if not something that can only be resolved or improved once everything in life is good, or they achieve spiritual enlightenment, neither of which are in the cards for most of us this go around.

While I’m all for patients having agency over their own health, things happen that are out of our control—an accident, post-viral symptoms, genetic predispositions, or just life—when it helps to have a knowledgeable clinician to provide valuable insight and hopefully effective treatment.

In Chinese Medicine stress is said to have a drying effect on the body. This is why when people “stress eat” they crave “damp-causing foods,” such as cheese, bread, and sugar.

Unfortunately, such foods do not generate healthy fluids, nor is stress-induced dryness the kind that will drain pathogenic dampness. Instead, the drying effect of stress refers to the depletion of mucosal organ fluids, beneficial stomach fluids (anyone get acid reflux or diarrhea when over-stressed?), and/or those that lubricate our orifices, gyri and sulci of the brain. Although hydration is advisable, drinking water cannot replace these fluids.

In early stages or mild cases, the best way I know to restore such fluids is through rest, sleep, and the consumption of eggs, bone broths, or red meats. For the rest of us herbal medicine is necessary. Herbs such as ginseng or licorice for the gut, puerariae root for the head and neck, ophiopogonis for the intestines, atractylodes for the intestines, trichosanthis for the orifices, or rehmanniae for the brain and blood. Always consult a (real) herbalist before taking.

Although extensive periods of stress are never helpful, it is important clinically, to thoughtfully discern between when stress is, and when it is not the primary cause of a particular symptom. Almost everyone in modern society has at least moderate degrees of stress, yet everyone is walking around in enormously different stages of health or discomfort.

From our perspective, when stress directly brings up a symptom, it informs us that dryness is probably at its root of imbalance. The body couldn’t tolerate any further depletion of fluids. Then, and only then, is when stress is to blame—not to mention the fact that most disease is multi-factorial. Systemic dryness is likely only part of the picture, which is why many people “do all the right things”—exercise, meditation, good sleep hygiene—but still experience symptoms. Because it is almost never “just stress.”

 

Can It Be All Stress?

 

“It’s just stress,” is a diagnostic platitude commonly heard by patients when relaying either to friends or their doctor about some odd or non-immediately fatal symptom that lacks any conventional, empirical treatment.

It would be an over-simplification to label this stock response as wholly or always dismissive—in my opinion it is more often a result of the listeners’ lack of knowledge of physiological nuances, disease spectrums, and of course the entire internal paradigm of Chinese Medicine.

The mind is en vogue in the past generation, so much so that people jump at the opportunity to sound mentally acute even while being mentally lazy in its default citation as a scapegoat for everything, the way fat was in the 20th century or sugar is now. It makes them feel aware of the more mysterious, all while maintaining an orthodox adherence to conventional medicine’s present understanding of things. I picture people picturing themselves as if sipping a small cup of whiskey wearing Coke bottle glasses and a bowtie in their reply: “It’s (probably just stress),” then putting their cup back down and nodding their head as if they’d just cured HIV.

While no one could dispute that stress is an important variable in the etiology of most illnesses, it is also just that: One important variable. So why when we have curious symptoms that conventional medicine has no explanation or treatment for do they never say: “It’s just diet?” “It’s just your sleep hygiene?” Or: “It’s just your exercise routine that needs refinement or reduction, or simply needs to exist?”

Why when one person experiences incredible stress does it show up as digestive issues, while for another it does as insomnia, and another as hives all over their skin? “People are different,” idiots might shrug and say, which isn’t untrue, but is an egregious oversimplification. People are different, which means if we each consumed diets and partook in exercises suitable to our own individual constitutions, we’d likely be able to ward off the ill effects of short or even medium-term life stressors.

If stress causes you low back or neck pain we know there is “dampness trapped on the exterior layer of the body.” If stress causes stomach issues we know there are already stomach issues, since most or many people can endure stress without such symptoms. If stress causes headaches or migraines then there was likely already some dysregulation of cerebrovascular flow in particular neurological pathways

In this way stress can be invaluably informative, by tipping our internal scale and showing us where we are weak, where in our bodies we are retaining pathogenic fluids, so we can properly treat, instead of dismissing it. Because odd, inexplicable symptoms are never nothing. They are not “all in our minds” or insignificant. Instead, from a Chinese Medical perspective, sadly they are potential coming attractions—foreshadows of diagnoses to come.

I apologize if this sounds dark or ominous. My intention is the opposite, to offer optimism and agency to those of us who have been repeatedly implied to that we must resolve all of our internal turmoil in order to be free of a particular problem. While I am all for a daily practice of meditation, prayer, community, and anything else that reduces stress, we should be able to also rely on medical providers to step in with something more to offer during periods where our practice of psycho-emotional work and discipline just is not enough.

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