Stress and the sympathetic nervous system

People talk about adrenal fatigue: what is it that they mean? And how can we address it?

When we are relaxed, or less stressed, we make more sex hormones and thyroid hormone.

When we are in a crisis, or more stressed, we make more adrenaline and cortisol.

The pain conference I went to at Swedish Hospital took this a step further. They said that chronic pain and PTSD patients are in a high sympathetic nervous system state. The sympathetic nervous system is the fight or flight state. It’s great for emergencies: increases heart rate, dilates air passages in the lungs, dilates pupils, reduces gut mobility, increases blood glucose, and tightens the fascia in the muscles so that you can fight or run. But…. what if you are in a sympathetic nervous system state all the time? Fatigue, decreased sex drive, insomnia and agitated or anxious. And remember the tightened fascia? Muscle pain.

When we are relaxed, the parasympathetic system is in charge. Digesting food, resting, sexual arousal, salivation, lacrimation, urination, and defecation. So saliva, tears, urine, and bowel movements, not to mention digesting food and interest in sex. And muscles relax.

If the sympathetic nervous system is in overdrive, how do we shut it off? I had an interesting conversation with a person with PTSD last week, where he said that he finds that all his muscles are tight when he is watching television. He can consciously relax them.

“Do they stay relaxed?” I asked.

“I don’t know.” he replies, “but my normal is the hyperalert state.”

“Maybe the hyperalert state, the sympathetic state, is what you are used to, rather than being your normal.”

He sat and stared at me. A different idea….

So HOW do we switch over from the sympathetic to the parasympathetic state?

Swedish taught a breathing technique.

Twenty minutes. Six breaths per minute, either 5 seconds in and 5 seconds out, or 6 in and 4 out. Your preference. And they said that after 15 minutes, people switch from the sympathetic to the parasympathetic state.

Does this work for everyone? Is it always at 15 minutes? I don’t know yet. But now I am thinking hard about different ways to switch the sympathetic to parasympathetic.

Slow walking outside.
Rocking: a rocking chair or glider.
Breathing exercises.
Massage: but not for people who fear being touched. One study of a one hour massage showed cortisol dropping by 50% on average in blood levels. That is huge.
Playing: (one site says especially with children and animals. But it also says we are intelligently designed).
Yoga, tai chi, and chi kung.
Whatever relaxes YOU: knitting, singing, working on cars, carving, puttering, soduku, jigsaw puzzles, word searches, making bean pictures or macaroni pictures, coloring…..and I’ll bet the stupid pet photos and videos help too….

My patient took my diagrams and notes written on the exam table paper home. He is thinking about the parasympathetic state: about getting to know it and deliberately exploring it.

More ideas:

I like this picture of Princess Mittens. She looks as if she has her head all turned around. Isn’t that how we get with too much sympathetic and not enough parasympathetic nervous system action?

12 thoughts on “Stress and the sympathetic nervous system

  1. I watch my young grandsons playing video games, and they might as well be on the scariest Disney RIDE!! What are we doing to them??? It is not my call with them, but I have insisted on at least expressing my beliefs and gathered information to their parents. I myself have mostly recovered from and can actually teach about PTSD to my clients. But apparently, I did not heal in time to prevent the serious thyroid damage I am dealing with now….bummer.
    As usual, thanks so much for this informational and thought provoking post. I really appreciate you.

    • drkottaway says:

      Thank you…. good question…. my son and I argued for years about “screen time”. He got to take over in high school as long as his grades were good and he took over the dishes: with increased power comes increased responsibility. Just like Spiderman.

      • OK I may use this but will unfortunately have to choose a different Super Hero. These two (10 and 13) have moved on to guys like Dead Pool. Who IS that anyway. I guess I better Google Dead Pool. That should throw my search engine also…

        • drkottaway says:

          …well, they’ll still respect Spiderman’s words… I don’t remember Dead Pool’s… not a favorite of mine!

          • Described as”A fast-talking mercenary with a morbid sense of humor who is subjected to a rogue experiment that leaves him with accelerated healing powers and a quest for revenge.” The only saying of his I liked is “That’s just my common Sense tingling.” So rare it’s a Super Power. (I actually laughed at this…hmmm.)

          • drkottaway says:

            I like that too! We could use more common sense…

  2. My husband seems to be regularly in the hyperalert state and says that watching TV calms him down. That doesn’t seem to be true for me though. So we find ourselves at odds about what to do in the evenings.

    • drkottaway says:

      Trade off? Take turns? Some nights do separate things? I don’t know….when my partner was being househusband he was itching to get out at night and I was by then not wanting to be anywhere but home. We traded off….

  3. shoreacres says:

    This really is interesting. One of my theories about the increasingly virulent social media scene has been that people get addicted to their own adrenaline, and keep creating situations that restore that “hyper” state. Could there be some truth to that?

    • drkottaway says:

      The linked paper at the bottom talks about how reinforcement changes the brain. I would think of it more as a feedback loop that reinforces itself. I keep Facebook to ten minutes a day…..self protection!

      • Susanne says:

        I deactivated my FB account in September in anticipation of too much information re: the US election and have not gone back. It definitely cranks up my stress and irritation levels.

        This morning on the radio station I listen to (CBC in Canada) a family doc was talking about this same subject – deep breathing for stress release – and the different ways people can activate their parasympathetic system. Fascinating connection you made about tight muscles/chronic pain and the sympathetic system in hyper alert. I have a knitting project at work that is a never ending scarf and I pull it out and knit a few rows in the staff lunch room when I get overwhelmed. It works!

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