Are you the right kind of stressed?
Roula Khalaf, Editor of the FT, selects her favourite stories in this weekly newsletter.
By any measure, the past year has been fraught. The findings of a study, led by the University of Nottingham and King’s College London, that people experienced “significantly more stress” in lockdown feels like an understatement. But while we know a good deal about the negatives of stress – heart disease, premature ageing and burnout, to name a few – a new argument in scientific thinking is gaining traction: not only might we be able to weather stress better, we may even be able to harness it for the good.
It’s a baggy term, stress. Loosely drawn, acute stress is a short-lived reaction triggering a “fight-or-flight” adrenaline and cortisol response. Chronic stress, “when we activate that fight-or-flight system for months on end”, is even more worrying, says Beth McGroarty, director of research at the Global Wellness Institute. “It causes raised inflammation, decreases the count of your body’s white blood cells that fight infection, disrupts the microbiome, and is associated with cell ageing and shortened telomeres [the protective caps at the end of each strand of DNA].” Long-term elevated cortisol levels also disrupt blood sugar levels and sleep cycles, and may make it easier to contract Covid-19 or suffer its more serious symptoms.
However, mindset studies suggest we can alchemise these hormone responses. “So much of the talk about stress is around how it is detrimental; but the most important thing to convey is that you have a lot of control over the response you have,” says Dr Kenneth R Pelletier, clinical professor of medicine and of psychiatry at the University of California San Francisco (UCSF). At its most simple level, he points to methods such as “reappraising” to make you feel more in control. “If you are in a stressful situation, look back and realise you’ve coped with similar, or worse things in the past,” he explains.
Harvard Business School associate professor Alison Wood Brooks also emphasises the power of reframing. When negotiating or giving a keynote speech, for example, repeating “I am excited” in the moments beforehand leads you away from feeling nervous and towards an “opportunity mindset” that improves performance.
In her book The Upside of Stress, Stanford psychologist and lecturer Kelly McGonigal references a study carried out in a Fortune 500 company. Employees were taught three steps to invoke a positive stress mindset: to notice and acknowledge the feeling of stress (switching the brain from an automatic response to a more measured one); to tie the feeling of stress to something of value – such as the fact that they might want a particular project to succeed; and purposefully to use the energy generated by their stress response to drive them toward their goal. “The intervention did not reduce stress: it transformed it,” says McGonigal. The employees were less anxious, healthier, more focused and better engaged.
The new focus is to engender brief doses of positive or “hormetic” stress. Such positive stressors could include vigorous breathing exercises, Wim Hof ice baths or fasting: short, sharp challenges that shake up and reset the body. “It is fascinating that in recent times we’ve seen people intuitively turning to hormetic stresses, wild swimming or cold showers,” McGroarty continues.
“It seems to do with creating a challenging situation that you can control where you can build resilience,” adds Pelletier. “You’re the initiator of the stressful experience and you know it will end.” A meta-review of 300 studies concludes that such manageable stressors can make beneficial changes to the immune system.
In a particularly exciting development, McGroarty continues: “UCSF has just undertaken the first human clinical trial to test whether they [positive stressors] could also have long-lasting impact”, or prove the idea of the “stress paradox” – the notion that brief, managed doses of hormetic stressors could profoundly reverse the ravages of chronic stress by repairing stress damage, rebuilding cells and enhancing neuroplasticity, and even fostering resilience to future stressful periods.
However, continues Pelletier, all things in moderation. “If you are under great pressure, and you add in too much intense exercise, it can be dangerous. You need to look at the whole pattern” of your physiology.
So before you all throw yourselves into an ice lake, a note of caution. A year or so ago, I felt shattered. I thought I was doing everything right: cold showers, intermittent fasting, high-intensity Peloton intervals; but a lattice of tests carried out by physician Dr Sabine Donnai of Viavi Clinic, including glucose, hormone and heart-rate variability (HRV), found that I was “stressing” my system in too many different ways. By failing to settle into the parasympathetic rest and digest state, I had got stuck in a constant adrenal surge.
Showing me a chart illustrating my nervous system’s failure, Donnai persuaded me to embrace meditation, advising me that it would make me feel both calmer and more in control. A year on, I can not only feel the benefits of more balanced introductions of hormetic stressors, but see them in my altered cortisol levels.
This resonates with Gideon Remfry, wellness director of KX members’ club. Before designing a client’s training plan, he tests their levels of cellular stress by looking at hydroperoxides (compounds containing a relatively large proportion of oxygen) in the blood. “There is a point at which it is detrimental to layer in further stressors like hard exercise,” he says. (Even, sadly, my much-loved Beyoncé-themed spin sessions.) “Modalities such as fasting can cause good effects, but need to be managed in line with the rest of your lifestyle. It’s about finding the sweet spot for each person.” Getting the balance wrong may even interfere with your waistline. “We see better fat-loss results putting some people on meditation plans than high-intensity training – some clients get thinner by sitting still.”
Happily, a new generation of wearables enable us better to understand what may work for us. For ongoing insights, Remfry has his clients wear the Oura Ring (see below, used by Bill Gates and Twitter founder Jack Dorsey), which gauges stress response – and suggests appropriate recovery behaviours – by tracking HRV. Two other excellent choices are wrist-based devices, the Whoop (also below; again focusing on HRV) and Fitbit Sense (which looks at electrodermal activity).
For those who have been stuck in chronic stress for months, extra help to reset may be the answer. Swiss clinic Clinique La Prairie has relaunched its flagship Revitalisation programme, designed to reduce cell inflammation and regulate cellular stress with treatments including microbiome recovery and anti‑inflammatory nutrient boosters. But there is a more accessible route to resetting that revolves around relationships. The love and social-bonding hormone oxytocin is also a stress hormone. “Stress can specifically trigger the need to seek out our friends, in what’s called the ‘tend and befriend’ response,” says McGonigal. “This drive to be with and to protect loved ones inhibits fear, and activates a state of bravery.” Rather wonderfully, it is cyclical – any time you choose to help others, you automatically activate this state. “Caring for others triggers the biology of courage and creates hope.”
Finishes Pelletier: “I may sound a bit Pollyanna-ish, but a stressful situation doesn’t have to be inherently bad. With the correct mindset you can choose to learn from it; always in negative circumstances you can find the opportunity for growth.”
Fitter Bits: five great gadgets to track your stress. By Fergus Scholes
What appears to be little more than a ring akin to a wedding band has three sensors on its inner surface: for heart rate and respiration; body temperature; and movement. Synced with the phone app, the data builds a picture of health trends. The app has three categories: sleep, activity and a readiness score that pulls in data to tell you how ready you are (or not) for a challenging day. $299, ouraring.com
This lightweight, no-frills strap tracks your heart rate 24/7. The app-based subscription (six months minimum) categorises data into sleep, recovery and strain, while a “coach” function gives a recommended bedtime for optimal performance – and a recommended exertion level too. It works well in tandem with other training devices such as a running watch or cycling computer. From $30 a month, whoop.com
This is the world’s first heart-rate monitor to incorporate both optical and ECG heart rate readings. At the touch of a button, the device instantly switches between the two, and it can be attached to wrist, arm or chest straps. It connects with third-party apps and running watches, or can be used with the Myzone app, which tailors the information to suit individual needs. £139.99, myzone.org
A battery life of 70 hours in full GPS mode (extending to 80 in sunny conditions thanks to a solar-charging lens) makes the Garmin Enduro a great proposition for runners, while Pulse Ox Blood oxygen saturation and heart-rate monitors means it doubles up for more day-to-day activity and health tracking. Other advanced running data includes VO2 Max, real-time elevation charts, built-in recovery adviser, cadence and navigation. £699.99, buy.garmin.com/uk
Polar Verity Sense
This arm-mounted optical heart-rate sensor offers an alternative to more restrictive chest-mounted versions. It has memory for up to 600 hours of data, so doesn’t need to be paired to a device to record a workout; but it can, of course, offer live heart-rate data via ANT+ or Bluetooth. It can also be mounted on goggles to read a pulse from your temple while swimming. £79.50, polar.com