Our thoughts are the main source of stress for most of us, says Bouvé clinical instructor Erin Sharaf, so we can reduce stress by changing our internal narrative. Photo by Casey Bayer.

The American Psychological Association recently released a study reporting that one in five Americans is extremely stressed. We asked Erin Sharaf, a clinical instructor in the Bouvé College of Health Sciences and a former primary-care provider, to expound on the concept of stress from a physiological perspective and what we can do to reduce stress in our own lives.

What is the clinical definition of stress?

Dr. Walter Cannon was the first to coin the term “Fight or Flight Response” in the early 20th century. This response of the sympathetic nervous system was activated in response to perceived threats to physical or emotional security.

How does chronic stress affect the body and mind?

Chronic stress affects just about every organ system of the body in a negative way. The fight-or-flight response is designed to save us from a physically life-threatening situation. Cortisol and other stress hormones flood the body, causing increased heart rate, muscle tension and levels of glucose. Other systems are down-regulated, including digestion, reproduction, immunity and growth. Our body can’t tell the difference from an actual physical threat and a perceived threat that is created entirely in the mind. When we think stressful thoughts, we are in the same physiologic state as if we were being chased by a predator. The problem is that there is no fight or run to release the tension; we are sitting in our offices, in traffic or on the couch. Over time, this can lead to profound physical and mental impairment and can exacerbate problems such as hypertension, diabetes, obesity, insomnia, muscle pain, headaches, anxiety and infertility. Chronic stress puts our mind on a perpetual state of high alert, which negatively affects mood, concentration and memory.

What are some suggestions for managing or reducing stress?

Most of our thoughts happen to be negative, which triggers the stress response. We all have thoughts that play through the mind as “stories” all day long. The first and most important step in breaking this cycle is recognizing that a thought is simply an internally generated idea. It is not necessarily a truth and it is transient. Stepping back and identifying that a particular thought is a hypothetical threat scenario (and not an actual threat) decreases the effect on physiology. Most of us feel helpless in the face of stress because we feel it is created externally. When we learn that we have lots of control over our internal processes, stress can be markedly reduced. We can choose another thought in any given moment or choose not to hold on to and ruminate over our negative thoughts. The best way I have found to do this is through a regular mindfulness practice. A growing body of literature supports mindfulness as a vital component of stress reduction and true mental and physical wellness. Our minds need to be exercised to function optimally just as our bodies do, and mindfulness is an ideal way to do this.