As we head into the holidays, W&M News spoke with Dr. Elizabeth De Falcon to learn about ways relieve stress and practice self-care over winter break, to strengthen our collective immune systems. Dr. De Falcon is a practicing physician with William & Mary’s Health Services. She is a licensed pediatrician and Fellow of the American Academy of Pediatrics.
I want to start off with a more technical question, because I think it will help frame this conversation. How do you, as a physician, define stress?
In the simplest terms, stress is just your body's reaction to any change that requires response. So, it could be anything: a mental strain, a physical strain or even an emotional strain. Honestly, it's different for every person. What stresses me out may not stress you out, but if we’re talking about physiology, then our stress response would be mostly the same.
What do you mean by “stress response”?
Without going into the specific names of all the different parts of your brain, it's just that your brain perceives stress or danger or threat. Then it sends out a signal from what is essentially the command center of your brain to the rest of your body, through the nervous system. Then the nervous system starts acting on a fight or flight response and all these different neurotransmitters and hormones get released. All these different substances start flowing through your body just to get you prepared to respond to that stressor.
Ok. That sounds really intense.
A lot of times, you're not even aware of it. Most of the time the threat comes and goes, and as the threat goes away, the stress response decreases. Think of a car whizzing past you on the street. It’s stressful for a second, but the feeling is very short-lived. It’s important to understand that not all stress is bad. It serves an important biological purpose. The stress response has been vital to our survival and evolution. When the saber-toothed tigers were hunting us down, our bodies learned how to respond to that.
Right, but we don’t have prehistoric predators hunting us down anymore, hopefully, so how is stress helpful today?
If you translate that to now, let’s say you're taking a test and you feel a little bit stressed. You're supposed to have a certain level of stress, because it’s your body’s way of motivating you to focus on something important. After the test is done, there’s this sigh of relief because that stress is gone and your body just goes back to a kind of homeostasis where it's feeling ok.
But sometimes that stress hangs around for a little while. That’s when you start running into problems. You may find that even though the threat is gone, you’re not feeling better. You may be experiencing increased heart rate and breathing or generally feeling edgy all the time. That’s a sign that you're bumping over into a low-level, acute stress or chronic stress state.
That’s when we start to think about cortisol. You’ve probably heard about cortisol as a stress hormone. In the moment, it actually helps your body boost its immune system and decrease inflammation, but if it's there for a long time, then you start to get into different problems.
What kinds of problems?
I always tell people to seek medical help if they start seeing signs of chronic stress. Some of the red flags would be that you feel in a low mood all the time. You may stop hanging out with your friends or your family. You're just kind of retreating and not interested in the things you used to be interested in. You may be sleeping too much or too little. Some people experience physical symptoms. They have an upset stomach or heartburn or headaches, because their blood pressure is up. They might feel a knot in their chest. All of those things could be signs that you're experiencing anxiety, so you would definitely want to see your doctor at that point.
This gets us to what I really wanted us to discuss. What are some ways we can better manage stress in our daily lives to boost our immune systems and hopefully avoid some of those outcomes?
It comes down to the basics of general healthy living. For example, if you’ve not been on a good sleep schedule over the semester, you really need to prioritize getting on a healthy sleep schedule — and make it a realistic schedule that you can keep doing once we get back on campus. If you were not addressing your dietary needs during the semester, start to incorporate healthy, nutrient-dense types of foods into your diet.
Also, exercise is super important. Just from a perspective of improving your cardiovascular health and improving your circulation, regular exercise will help get all those immune cells pumped around your body. You don't want to smoke and try to minimize your alcohol intake.
Then, of course, what we’ve all been focused on over these last nine month is taking steps to minimize infections. So, being very diligent about washing your hands, keeping your distance from pretty much anyone who doesn't live in your house, and wearing a mask if you have to go out and about.
How will we know if what we’re doing is working?
When you have a healthy immune system, when it's functional, you don't even know it's there. It's protecting you from things that are trying to kill you, viruses and bacterial infections, but you aren’t even aware of it.
But just like a car runs out of gas when left idling, if you are not fully addressing the things that boost your immune system, eventually that car will run out of gas and then that leads to a whole host of problems. You might start noticing that you're getting more colds or struggling to get over minor illnesses. That’s really just because when your stress response is revved up all the time, it has the opposite effect on your health and it starts down-regulating your immune system.
So, what is something I could do right now that would help lower my stress? I’m at a desk, so I’m not about to hop out on a long run, but what is simple enough for someone to do right when they’re reading this?
This is something I always recommend to my patients: practice gratitude. It’s such a simple, easy thing that anyone can do. It doesn't have to be complicated. Just get a little notebook, or even make mental notes, and focus on three things that you're grateful for in a day. No matter how crummy the day is, there's always something that we can find that we can be grateful for.
Studies show that if you practice gratitude, there are positive changes in your brain that actually change your outlook on things. Along those lines, the Wellness Center has all kinds of wonderful mindfulness, meditation and exercise resources available online. They make it really easy to access, so I’d also recommend trying out some of those offerings.