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Stress and The Holiday Meltdown Countdown

It's ba-a-a-ck! The holiday season that is. It's waiting - right around the corner. And depending on how you look at things it could be a time of great anticipation and merry-making or, it could be a time of never-ending to-do-to-get lists, burnt turkey dinners and "spirited family discussions".

Sure! Maybe for some of us, this is a nostalgic period and we are reminded of our childhood memories of decorating trees at home, the sound of jingling bells, Christmas carols and the familiar scents of freshly brewed peppermint hot chocolate.

The reality for most of us however, is that Christmas is often seen as a time of high stress and anxiety. As much as we hate to admit it, a good many of us tend to do the “holiday last minute shopping dash”, cram in as many projects as we can at work before we take time off and we force ourselves to be unnecessarily obligated to attend some of those awkward holiday gatherings.

It’s no wonder we’re so tired by New Year’s Day, burnt out, and craving a serious emotional and physical detox.

In my clinical practice I see many patients as early as the last week of November who come in for conditions that signal to me that their pre-holiday season cortisol levels are pretty much starting to peak and max out - in other words, they start coming in for conditions that are pretty much caused by the dreaded “S word": STRESS.

What are some common conditions caused by stress that usually afflict some of my patients? Well, this may be a pretty long list but it is by no means THE definitive list of stress-induced conditions; and, I might add, by no means is this strictly limited to Christmas stress! Stress can hit us at pretty much anytime in the year and when it does, sometimes clusters of physical symptoms (or emotional/mental) symptoms start to show up (such as those listed below):

  • Impatience and irritability (sometimes characterized by sudden emotional outbursts or emotional volatility)

  • Generalized anxiety (sometimes panic)

  • Depressive-like mood disturbances

  • Chronic fatigue and a feeling that is often described as being “burnt out”

  • Hormone imbalances resulting in conditions like period irregularities, painful periods, PMS, mood disorders, sleep disturbances, hair loss, sensitive skin or skin that is prone to cystic acne, etc.

  • Insomnia, frequent waking or vivid and anxiety-prone dreams

  • Immune System Deficiencies (catching colds easily, recurring bronchitis or the flu, etc.)

  • IBS (Irritable Bowel Syndrome)

  • Acne and breakouts

  • GERD and acid reflux

  • Loose stools or constipation

  • Digestive issues (flatulence, gas, intestinal discomfort, bloating and distension)

I could go on but I think that it is pretty clear that a large variety of issues flare up when “holiday (or chronic, year-long) madness” descends upon us and we start feeling the weight of the dwindling number of days that we have left on the calendar to get our proverbial act together before Christmas week.

So what conditions do I often treat with acupuncture at this time of year? Well, I figured a great place to start would be with some of the conditions that I have already treated so far in just these two past weeks alone (and it's not even quite the end of November yet is it?): emotional outbursts and volatility (including impatience and extreme irritability), insomnia and vivid dreams, hormonal imbalances resulting in missed or irregular periods and IBS symptoms like constipation, loose stools, flatulence and abdominal bloating and painful distension.

Emotional Volatility (‘I am so angry right now, I am seeing red and ready to punch a hole in the wall!’)

Patient “Andrea” came in to see me last week in tears, feeling like she was absolutely on the edge. She had been going through a series of stressful events at work and in her personal life; was about to catch a cold; and, earlier on the day that she booked in for her appointment to see me, she just “lost it” in a very anger-fueled, emotional outburst in public.

In situations like this, acupuncture is used to help soothe the liver to release “stuck and stagnant” emotions. In TCM (Note *TCM = Traditional Chinese Medicine) theory, the liver is the angry organ. It is usually associated with the emotion of anger and related to the element of wood. Wood cannot be restrained. It needs to be allowed to grow and flourish. Just as wood cannot be restrained, emotions cannot be restrained and contained (for too long anyway).

Emotions can be thought of as an ever-flowing stream of water. If the stream gets blocked, water tends to back up at the source of the blockage until one day, the blockage overflows and bursts, releasing a torrent of water that sweeps everything in its path away. This is essentially what happened with Andrea when the build-up of unexpressed frustrations and stresses in her life just reached a boiling point in a stressful situation in a public place. The emotional restraints that she put herself in just couldn’t hold things in anymore and the stagnant emotions from a bottled up liver burst through the self-composure that she had been forcing herself to hold during her anxiety-ridden last few weeks.

I treated Andrea’s liver channels to ease the stagnation of blocked up and stuffed in emotions and allow new and freer energy to flow through her body again. Liver channels points are often treated in the clinical setting with points between the first and second metatarsals (between the foot bones that are attached to the big and second toes) and are used to help“stuffed-in” anger and frustration find a safer and healthier outlet to be expressed.

She left feeling a lot less “rage-filled” and felt that she would not be so easily triggered by other people. Her frustrated liver energies were unblocked and allowed to flow more freely at this point. By the time the treatment was over, I heard her take and release a full and deep breath for the first time since the moment she came in for her appointment. Releasing stagnant and blocked up liver energy gave her the space to feel at ease and to breathe again (and thankfully, not need to take a swing at anyone nearby within a five foot radius!).

Insomnia (‘I can’t fall asleep because my mind just won’t stop and my dreams are crazy!’)

Patient “Marianne” came in two weeks ago with sleep issues; which she could easily identify as stemming mainly from stress. She was working a fairly fast paced job and was quite tired; feeling anxious for most of the day; with her mind constantly racing; and busy pretty much from the time she first wakes in the morning to the moment she goes to bed at night. In fact, it seemed to her that it was at this particular bedtime hour when her mind becomes the most active and as she puts it, “just goes bananas on me!”.

She has also been noticing that her dreams have been particularly colourful and quite anxiety-driven; leaving her feeling less energized in the morning and giving her a sense of heaviness (and even dread) before she even starts her day.

Now issues involving sleep almost always involve the Mind (or the spirit or “Shen” of the Heart according to TCM theory). The Heart and the Mind are pretty much interchangeable in TCM theory. Often it is said that when we have vexation of the mind, it is really vexation of the Heart that we are referring to in TCM diagnosis. When the spirit of the Heart is not settled at night, Heart fire burns and heats the Mind, making it near impossible to put a stop to mental activity.

Dreams are often seen as products of active Heart fire. When you look at it from a nervous system standpoint, the element of fire is very similar to electrical conductivity of the nervous system. When our sympathetic nervous system is overly stimulated, our heart rate goes up, our blood pressure rises and our mental alertness sharpens. Heart fire therefore is similar to a sudden burst of electrical activity in the nervous system - only this time, it happens at night when we should be sleeping; as opposed to in the daytime when we really need it to finish a project before a deadline or if we need to run after a bus so that we are not late for work.

Points on the Heart meridian were selected to treat stresses due to an overly stimulated Mind (or Heart) in this patient’s case. Heart meridian points are generally used to help ease a patient, like Marianne, into a more restful sleep with fewer vivid and overly active dreams by sedating and calming the “Shen” (or spirit) of the Heart. In other words, they are selected to calm one’s overly active mind. These points are often found on the crease of the wrist, right at the base of the palm in the area of the base of the palm (just next to the “outside” of the wrist, roughly underneath where the pinkie finger is located).

I have yet to see how Marianne is doing because she did leave on holiday the same week that she came in to see me. However, she is booked this coming week and I will check in to see what her sleep has been like while she was away (I’ll keep you posted!).

Hormonal Imbalances (‘My periods used to start like clockwork but lately they have been all over the map!’)

Patient “Pat” came to see me around two weeks ago for periods that were starting to get a little unpredictable. She had just come off birth control pills and was hoping to start a family soon but was finding it difficult to track her ovulation dates and times. She considers herself fairly calm and even-keeled despite work stress. Though she feels that she doesn’t suffer from the effects of work demands on her mentally, she did admit that she was starting to feel the stresses of not being able to predict when her periods would start and when she was supposed to ovulate.

She was tracking her ovulatory cycles with an ovulation kit but because she was not really able to know when to even start using it (because she didn’t know where the mid-point of each of her cycles was), she was starting to feel the frustrations of the situation weigh down on her even more. With the holidays coming up and with self-care time starting to take a backseat to holiday planning, she found that her periods were starting to space out over longer periods of time.

Pat was displaying symptoms of Kidney deficiency (and in this case, in particular, of Kidney Essence and Qi Deficiencies). Kidneys are often described in TCM theory as the “root of the body”. If you think of a tree and the strong, grounding root system at its base, you can imagine the importance of the role that the roots play in not only holding the tree in place but also of siphoning nutrients and minerals from the soil to nourish the entire tree from trunk, to branches, to the leaves that grow from its branches.

Pat’s daily stresses and pressure that she put on herself to regulate her cycles put a chronic strain on her kidneys, robbing them of essential Kidney Qi (the vital life force or energy that powers our bodies) and Kidney Essence (the primordial “DNA soup” from which the vital substances of the body is created from - like blood, body fluids, connective tissue, cellular material for eggs and sperm, etc). Kidney qi and essence is like the battery fluid that gets stored in the batteries (which are our Kidneys) and worry, stress and anxiety tend to deplete Kidney energy; making it harder for our bodies to create healthy amounts of blood or qi, highly intact eggs or healthy, mobile sperm.

Don’t forget, our adrenals also sit on top of our kidneys and every time they get a hit of stress, they release cortisol which is the body’s stress hormone. Cortisol is a hormone and tends to interrupt the natural signalling system of the endocrine systems of our bodies. This interrupts our body’s ability to effectively signal and let our reproductive organs and master glands of the endocrine system (like the pituitary or the hypothalamus) know when to ovulate, release progesterone or stimulate follicular growth.

Points on the kidney channel are often selected on our inside ankles to nourish and replenish any depleted kidney essence or qi that has been lost to stress, fatigue and anxiety. They are used quite often in cases where, as in Pat’s situation, fatigue and chronic stress, create an energy deficit of sorts and robs the Kidney of essential qi or essence. Boosting Pat’s Kidney qi created a nice energy burst for her resulting in elevated basal body temperature and as a nice side effect of ovulation in that cycle, an earlier and more timely start of her next period!

IBS (‘I ate breakfast - 7 hours ago! - and I’m still gassy, bloated and miserable!’)

IBS (Irritable Bowel Syndrome) is often classified as a disorder of the digestive system (oftentimes displaying a myriad of gut-related symptoms like gassiness, disrupted bowel frequency, abdominal distension and pain, loose stools and/or constipation, etc) in the absence of any underlying medical condition. Many of us can be or are “diagnosed” with IBS at any point in our lives. This often happens when we show several digestive and gut-related symptoms but no underlying physical cause is found. Stress is thought to be the main culprit behind the confusing and sometimes highly distressing pattern of digestive symptoms and patients who show IBS-like signs do tend to do better when they manage both their daily diet and manage perceived stress levels.

Patient “Lyla” was going through a long patch of chronic, generalized stress trying to manage the demands of returning to school, working several part-time jobs and managing personal life demands while all of this was happening. She started to notice increasingly disrupted patterns in evacuating her bowels and more regularly occurring episodes of abdominal distension and pain. She was showing increasingly longer periods of time (of several days sometimes) between full bowel movements and was starting to feel the after-effects of chronic, long-term constipation.

Abdominal distension was not such a huge problem for her before but over the last two weeks, they started to occur more often as a result of not having a full, colon-emptying bowel movement. The stress of managing her already overcrowded work schedule and the increasing demands of classes were compounding the increasing irregularity of her bowels. This new bodily function disruption was just one more thing adding to an already currently overwhelmed stress load and was creating a Spleen and Stomach Deficiency Syndrome - characterized by dwindling digestive fire (or digestive strength) and an impaired ability to produce enough energy to “push” her stools through the colon easily without straining and fatigue.

The Spleen and Stomach are often thought of as the “cookers” or the oven of the body according to TCM theory. Stomach fire is what makes the stove or the oven warm enough to “cook” and essentially break food that we eat, down into its basic essential nutrients. These basic essential nutrients are then siphoned off to the Spleen which (in some ways) “sorts” the minerals and nutrients out and “delivers” them to where they need to go in the body to fulfil basic bodily functions like repair damaged connective tissue or tendon, produce a certain neurotransmitter or elicit the signalling of a hormone and that corresponding hormone’s receptor.

In Lyla’s case, the oven was essentially “broken down” and it wasn’t heating things up enough to facilitate the breakdown of the nutrients needed to create a strong enough neural signal to create a corresponding muscle movement - in this case, not enough signal was elicited to cause colon muscles to contract, squeeze and move stool down the large intestinal tract to the rectum where the wastes are eliminated from the body.

Stress, as we have highlighted in the previous case with Pat, creates cortisol which acts as a hormone and endocrine disrupter; blocking signals so that certain bodily reactions do not occur (when they really should be). A muscular spasm within the colon walls is often referred to in TCM terms as the presence of strong or healthy “Stomach and/or Spleen qi”. When a patient like Lyla is stressed and cortisol levels are through the roof, perhaps they are also not eating well or often enough, and their sleep patterns are a little disrupted, there is oftentimes seen, a deficiency of Stomach and/or Spleen Qi and hence, the inability of the colon to “push” the stool easily out of the body where it and the toxins that it carries can be finally eliminated.

Stomach and Spleen meridian points were chosen to treat Lyla’s chronic and stubborn constipation. Acupuncture points on these two meridians are often chosen and needled in areas along the uppermost portion of the shin muscle (just under the knee), around 2-3 inches above the inner ankle bone and also sometimes right next to the base of the big toe (on the arch side of the foot). Points on these meridians were helpful for Lyla’s condition because they not only energized Stomach and Spleen Qi and increased colon smooth muscle contraction; they also produce tonic effects on her immune system and produce energizing effects on her body. After two treatments, her constipation had improved from moving her bowels once every 3-5 days to once every 1-2 days. The nice part of this was that as she moved more stool out of her body, her distention eased and because the bloating was not as bad anymore, her stress levels declined and she was handling everyday work and school tasks with minimal anxiety!

The takeaway lesson in dealing with stress:

So the bottom line from having gone through these clinical case studies really would be to find ways to manage stress before stress starts to manage you.

Its always helpful that when going through periods of time in life where you may be required to stretch yourself (and sometimes your resources) out a little more, to find ways to check in with yourself a few times during the day and to learn to “read” your body at those checkpoint times of the day. Notice whether you are tightening up anywhere or holding more tension than is necessary anywhere in the body (in the organs, in particular muscles of the body, etc). If it helps, ask yourself a couple of basic questions like whether you have had enough to eat or drink? Ask whether you really need to do this now or whether this task can wait. Ask whether you are reacting because you are tired and haven’t been sleeping well. Check-ins are ways of showing kindness and compassion to yourself when things start to pull you in different directions and you try to attend to all these things at the expense of your own personal health.

If your body is sending out signals of distress somewhere in the body, it will be easier to catch these signals during these checkpoint times of the day and respond to the situation by either prioritizing things that are truly critical and need to be done now (and then relegating those less critical tasks to some time later in the week) or by simply saying “no” to things if you really need to. Sometimes it is best to honour your body’s messages and to decline taking on more than you can manage.

Lastly, ask for help. It’s never a sign of weakness to do so. And sometimes, when we least expect it, people will be more than eager to step in and shoulder some of the burden. Most of the time we don’t see it but our loved ones around us do notice when we are “not quite ourselves” or when we are snappy and short-tempered when we are under stress. They are often waiting in the wings to help but sometimes don’t know when (or how) to approach and offer it. Its usually a huge relief when you are able to let them know what your needs are when things get crazy during the holidays and to start delegating tasks to friends and family who would be more than happy to help.

And if none of this helps, there is always acupuncture to fall back on (and your friendly neighbourhood acupunk is always up for it!). Until the next time, I hope this article finds you in good Christmas spirits!!

NOT THAT KIND (but man, I hear ya'! And I will raise you and Anderson a glass of moonshine on my meltdown days)

Happy Holidays!

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