What is stress, and what does it mean to us as people or more specifically what does it mean to the ayurvedic practitioner? It's one of those words that are much overused, or so casually, or so incorrectly that we actually lose the real meaning of the word and its significance. Stress is also commonly called anxiety, tension, etc.
Stressors which are events that provoke stress are in themselves not a bad thing as one may think by the commonly overused cliches that we often hear. They are a very necessary function of the psyche and the body to deal with different situations, both positive and negative. "Life stressors involve changes in your environment that your central nervous system must adapt to during the course of daily living. Stressors include either positive or negative life events ( e.g . death, divorce, new job, new house, new baby) that require you to adapt to these changes in your life. Stress results when pressures, challenges, or demands in life exceed your coping abilities. Stress can manifest itself in physical, emotional, or behavioral symptoms." 1
"Stress can come from any situation or thought that makes you feel frustrated, angry, or anxious. What is stressful to one person is not necessarily stressful to another." 2 Stress in everyday life isn't necessarily a bad thing; however, unchecked or negative stress can be a bad thing causing many conditions that we'll look at in this paper. A little stress can be a motivating thing to get your work done on the job for example. It can make you more aware in a situation that requires serious attention. It can also be used as a life saving safety mechanism e.g. in wartime, the soldier runs or just reacts without really thinking.
However, too much stress, or a strong response to stress, is harmful. It can set you up for general poor health as well as specific physical or psychological illness like infection, heart disease, or depression. "Persistent and unrelenting stress often leads to anxiety and unhealthy behaviors like overeating and abuse of alcohol or drugs." 3 Low emotional states or poor health conditions can cause stress as well.
"Anxiety is often accompanied by physical symptoms, including:
- Twitching or trembling Muscle tension, headaches
- Dry mouth, difficulty swallowing
- Abdominal pain (may be the only symptom of stress, especially in a child)" 4
These are some of the multitude of symptoms that can occur:
- lack of concentration
- sleeping problems
- irregular heartbeat
- Irritability (anger)
Almost all of these symptoms seem to point to a marked increase or imbalance in the vata dosha. However, all three doshas can play a role. Generally, vata individuals are likely to develop vata-aggravated stress reactions, such as anxiety or fearfulness, even phobias or anxiety neurosis. Pitta individuals increase in pitta during stressful situations and
typically react to stress in the form of anger. They may also suffer from hypertension, peptic ulcer, ulcerative colitis, and other pitta disorders. "Kapha individuals under stress can develop under active thyroid function, slow metabolism, and even increased blood sugar, leading to a prediabetic condition.
They tend to eat and eat and eat and become chubby." 5
From a physical point of view, ''the human body responds to stressors by activating the nervous system and specific hormones in the endocrine system The hypothalamus signals the adrenal glands to produce more of the hormones adrenaline and cortisol and release them into the blood stream These hormones speed up the heart rate, breathing rate, blood pressure and metabolism Blood vessels open wider to let more blood flow to large muscle groups. Putting our muscles on alert. Pupils dilate to improve vision. The liver releases some of its stored glucose to increase the body's energy. And sweat is produced to cool the body. All of these physical changes prepare a person to react quickly and effectively to handle the pressure of the moment." 6
"Cortisol also curbs functions that would be nonessential or detrimental in a fight-or flight situation. It alters immune system responses and suppresses the digestive system, the reproductive system and the growth processes." 7 Sushrut points out in the Sushruta Samhita that "a person with an uniformly healthy digestion, and whose bodily humors are in a state of equilibrium, and in whom the fundamental vital fluids course in their normal state and quantity, accompanied by the normal processes of secretion, organic function, and intellection, is said to be a healthy person." 8
''The natural reaction known as the stress response. Working properly, the body's stress response enhances a person's ability to perform well under pressure. But the stress response can also cause problems when it overreacts or fails to turn off and reset itself properly." 9
5 Vasant Lad, The Complete Book of Ayurvedic Home Remedies, (New York: Three Rivers Press 1998), 259
8 Kaviraj Kunjalal Bhishagratna, trans., Sushruta Samhita. 3rd ed. (India: Chowkhamba Sanskrit Series Office, 2005) 131
There are three phases of stress. PhaseIhas to due with the body's response to stress. Events can trigger this like divorce, finances, accidents, etc. Also, less tangible reasons might include worries, regrets, memories, etc. and how our mind interprets these mental processes.
Phase II is how we interpret the stressors and our ability to cope with them Our beliefs and values determine how we will likely view these stressors. If we view them as threats or pressures, or we're feeling over attached to things or outcomes then that could compromise our ability to cope.
Phase III "Reaction to stress might create or worsen physical, emotional, or behavioral symptoms.
- Physical -high blood pressure, heart disease, ulcers, strokes, rashes, migraine, tension headaches
- Emotional - anxiety, depression, anger, forgetfulness
- Behavioral - overeating, poor appetite, drug abuse, excessive smoking, irritability, social withdrawal, insonmia" 10
As previously mentioned that a little stress can be good in certain situations and then the body resets itself; however, the stress due to physical threats in previous eras doesn't apply to us nearly as much as it once did. The more psychological threats/stress apply to us much more often in the modern day world, especially in the western world, where man maybe more than anywhere seeks happiness and security outside of himself and in artificial ways. The thing about psychologically stressful situations more so than physically stressful situations is that the body tends to stay in the stressed mode for longer and longer periods of time. The stress with physical threats comes and goes rather quickly and the body resets, but the psychological can last for long periods of time. This can really start to breakdown the bodies systems ifstressed for an extended period of time.
Now, focusing on some of the major symptoms, problems, and diseases that stress can have on a person and how the ayurvedic system of medicine approaches these. Along with some of the different treatments, methods, and protocols that ayurveda suggests to help alleviate these problems. Ayurvedic methods of cure are very individualized for each patient so in a general paper regarding a particular topic more generalized methods must suffice.
One of the major problems that occur with too much stress for an extended period of time would be depression. Depression needless to say is a very big problem in our society. Depression may affect most people at some point in their life to a greater or lesser degree, but when it starts to become prolonged, or it starts to affect the ability to act and interact in normal life situations, then it becomes a problem that should be addressed. Depression is more on the emotional level than the physical level and is a very reactionary symptom of stress.
As Dr. David Frawley states, "depression follows stress, overwork, overexertion, and trauma, particularly adrenal fatigue. Itis generally a sign oflow Ojas and weak immune function. Depression is the most common kapha disorder." 11 Kaphas often suffer from low energy, a slower metabolism, weight gain, and attachment. These things can lead to depression. Vatas can also be affected by stress and depression. The vata type is usually more sensitive and may feel hurt more easily. ''Vata type depression is associated with feelings of abandonment, lack of love and nurturing in life. It can become severe or even suicidal" 12 Pitta depression is in large part due to a failure in their plans, a set back. The pitta type could take into consideration a sayingIheard a monk once say "if you want to make God laugh, tell him your plans for the future."
11 David Frawley, Ayurvedic Healing, 2 nd ed., (Twin Lakes, WI: Lotus Press, 2000) 324
12 Ibid. 324
With somebody that's so stressed as to fall into depression one of the hardest things is to get the patient to comply with any treatment. Dr. Frawley recommends that the first thing to be done is to initiate change and encourage activity of any kind to help restore some interest in life. A few of the general ayurvedic methods of treatment for depression would be a light stimulating diet that's well spiced with herbs that open the mind e.g. ginger and basil. There should be exposure to positive sights and sounds, like walking in nature.
There should be exposure to stimulating and positive aromas like camphor or tangerine. Exercise and pranayama are very good to bring in new fresh energy and prana. A good herb to take is calamus taken as a tea with ginger and honey. And, as with any good ayurvedic regiment keeping the apana going with a mild laxative e.g . triphala.
Tension is another big symptom of stress. Vagbhata wrote of tension in the Astanga Hridayam and said "that when vata getting inside the arteries/nerves present in the sides of the neck cause their stiffuess and then spreads to all parts of the body, constricts the shoulders, then makes the body bend forwards like a bow; produces bouts of convulsions, loss of movement of the eyes, move of yawnings, grinding of the teeth (rigidity of the jaw or lock jaw) vomiting of kapha (mucus), pain in the flanks, inability of speech, loss of movement of the lower jaw, back and head. This is called Anaryama (inward bending)." 13 This is obviously an extreme example of tension related symptoms; however, many people experience several of these on a regular basis. Headaches and neck stiffuess seem to be ubiquitous. Ayurveda would address tension with looking at a dosha balancing diet as should always be addressed, as well as nerviness sedatives and tonics such as Ashwaganda and jatamamsi and perhaps an analgesic like feverfew. Lifestyle issues are likely going to need to be addressed, what's making the person so tense and stressed, job, marriage, lack of rest, etc. Other of the five sense therapies like massage, shirodhara, and aromatherapy can be very helpful.
13 Board of scholars, trans., Astanga Hridayam. Vol 2 first ed. (India: Sri Satguru Publications), 129
Chronic fatigue is something else that is common that can be hrought on by stress. "Fatigue is physical and mental stress." 14 Fatigue is also called shrama and it's a condition of increased vata. An obvious treatment for fatigue would be a lot ofrest. A vata reducing diet one that is tonifing and strengthening. Sense therapies such as daily abhyanga ''removes fatigue and stress from work and life overall." 15 Morning rosemary baths are good as well.
A pitta type person suffering from stress may suffer from ulcerative colitis. This is actually a pitta/vata type condition in that it's a chronic inflammatory disease causing ulcerations. The cause or etiology of this disease is a ''vata- and pitta- vitiating lifestyle and dietary imbalances. Emotionally this condition occurs in individuals who are prone to worry and anxiety combined with intensity and I or anger." 16 The pathology of this disease is that pitta has relocated to the colon, from the small intestine. Vata has relocated from the large intestine to the small intestine and this combination of heat and dryness causes ulcerations in the mucosa! wall The doshas both relocate in the mind as well. This causes the anger and anxiety. Some of the treatments ayurveda would recommend are following a vata/pitta pacifying diet. '"friphala in the form of shita kshaya should be considered for the long-term care of the colon. Takra is also beneficial for normalizing digestion. With nutmeg and licorice added, absorption is improved and both vata and pitta are pacified." 17
Stress can produce sleeping problems and this is a major problem with many, many people. Many things can cause sleeping problems; however, this is just focused on the sleep that is troubled by stress and anxiety. In these cases it's usually a vata disturbance. A vata-vitiated lifestyle often leads to anxiety, worry, and overwhelm which in turn can disturb sleep. "Sleep disturbances are accompanied by fear, worry, and anxiety.
14 Vasant Lad, The Complete Book of Ayurvedic Home Remedies, (New York: Three Rivers Press 1998), 177 15 Swami Sada Shiva Tirtha, The Ayurvedic Encyclopedia, (Bayville, NY: Ayurveda Holistic Center Press), 207
16 Marc Halpern, Clinical Ayurveda Medicine, 5 th ed. (Grass valley, CA: California College of Ayurveda) 1-42
17 Ibid, 1-44
Sleep is restless, fitful, and light. Other systemic signs of vata disturbances are likely to be found." 18
Sleeping problems in particular to the vata type that we're discussing here, are really a problem that requires most if not all of the five sense therapies. Lifestyle is important to look at, what may be something that is disturbing or causing anxiety in the person.
Maybe a very disturbing work environment, a tyrannical boss, or an extremely chaotic or loud workplace. Too much coffee or caffeinated drinks. Too much TV before bedtime. A long fierce commute can be very unsettling. These are things to consider along with a myriad of other things in our vata-vitiated society.
Some of the things that may help a person with sleeping troubles are being quite after dark before bedtime. Rising with the sun and keeping a regular routine is helpful. Turn the TV off early, or never turn it on in the first place. Read a spiritual book to calm the nerves and uplift the soul, bathe in the peaceful vibrations of meditation before bed, or even twice a day if possible. Meditation works on all levels of a person physical, mental, spiritual. It also affects all three bodies physical, astral, and casual. On a practical physical level "p racticing meditation has been shown to induce some changes in the body, such as changes in the body's [fight or flight] response. The system responsible for this response is the autonomic nervous system (sometimes called the involuntary nervous system). It regulates many organs and muscles, including functions such as the heartbeat, sweating, breathing, and digestion, and does so automatically." 19
It's believed to slow the sympathetic nervous system, while boosting the parasympathetic nervous system, which slows the breathing and heart rate. Exercise, preferably a grounding or restorative hatha yoga routine may be helpful. A warm bath before bedtime is relaxing, perhaps with a little jatamamsi or lavender essential oil. A vata reducing diet needs to be kept.
18 Ibid, 6-39
19 National Center for Complementary and Alternative Medicine (NCCAM), Meditation for Health Purposes, Baime , Davidson, et al., February 2006, page 3
"Boiled milk builds ojas, promotes sleep (with warm nervine herbs). Boiled, it reduces Vayu and Kapha." 20 Anger is another problem that stress can produce, especially in the pitta type person. "Anger and hostility are signs of aggravated pitta in the nervous system. Pitta is necessary for right understanding and judgment, but when it gets disturbed or out of balance, it creates misunderstanding and wrong judgment, leading to anger and hostility. The aim is to bring pitta back to its normal constitutional function." 21 Many ifnot most people in our society create a tremendous amount of stress on themselves to keep up with everybody else, and even compare themselves to others to see if there up to standards with everybody else. People even create a false sort of desire for what others have; they have a tribal mentality to keep up, because somebody or some advertising has made them believe that they're less than others ifthey're without something. This can really create a lot of stress and anger in a person ifthey're so gullible as to follow this perverted rational Krishna in the Bhagavad Gita says, "brooding on sense objects causes attachment to them. Attachment breeds craving; craving breeds anger. Anger breeds delusion; delusion breeds loss of memory (of the Seit). Loss of right memory causes decay of the discriminating faculty. From decay of the discrimination, annihilation (of the spiritual life) follows." 22 This is a problem that can obviously run very deep, but from an Ayurvedic perspective we can view it as a primary pitta imbalance, as well as a case of prajnaparadha.
Some of the Ayurvedic methods to overcome this stress-induced anger would be to follow a pitta-pacifying diet, lay off the chili peppers, citrus and sour foods. Avoid alcohol and caffeinated drinks.
20 Swami Sada Shiva Tirtha, The Ayurvedic Encyclopedia, (Bayville, NY: Ayurveda Holistic Center Press), 146
21 Vasant Lad, The Complete Book of Ayurvedic Home Remedies, (New York: Three Rivers Press 1998), 124
22 Paramahansa Yogananda, trans., The Bhagavad Gita, (Los Angeles, CA: Self Realization Fellowship, 1995), 307
"Have a pitta pacifying drink. Into 1 cup of grape juice, add Ya teaspoon cumin, Ya teaspoon fennel, and a Ya teaspoon sandalwood powder. This cooling pitta pacifying drink will help to settle angry feelings and other pitta symptoms such as burning in the stomach." 23
A pitta in a hot climate should try to keep cool ifpossible; hot weather can really stress a pitta. Some lunar pranayama would be good. Avoid overheating exercise routines e.g . jogging at noon or hot yoga. As far as the deeper issues the best thing there is to do for prajnaparadha is meditation. A person with issues of stress and anger could immensely benefit by disconnecting with ahamkara (ego) little by little. Introspection while being quite is an excellent tool for anyone as well.
Heart disease is another area where stress has been known to cause or be a causative factor. In ayurveda and also "according to Oriental medicine, the heart, not the brain, is the seat of consciousness." 24 Dr. Frawley explains that what we feel in our hearts is who we truly are, not necessarily the passing thoughts that we think in our heads. He goes on to say that "heart diseases reflect deep-seated issues of identity, feeling, and consciousness." 25 Considering this train of thought, it's easy to see why emotions and stress, as well as the obvious physical reasons of overeating, eating the wrong foods, lack of exercise, etc. can cause trouble with the heart.
Allopathic medicine as well as Ayurvedic medicine sees that high stress can be a causative factor inheart disease as reported in the British Medical Journal (BMJ). "Both prevalence and incidence of angina increased with the perceiving of stress...high stress was associated with a
23 Vasant Lad, The Complete Book of Ayurvedic Home Remedies, (New York: Tbree Rivers Press 1998), 125
24 David Frawley, Ayurvedic Healing, 2 nd ed., (Twin Lakes, WI: Lotus Press, 2000) 209
25 Ibid, 209
higher rate of admissions related to cardiovascular disease." 26 In the Journal of the American Medical Association (JAMA) an article about stress research states that the authors looked at the behavior and biological mechanisms through which stress contributes to disease and weighed the results to whether stress plays a role is cardiovascular disease as well as others. "Those studies reveal that stress plays a role in triggering or worsening depression and cardiovascular disease." 27
General Ayurvedic treatment would emphasize extended rest. An extended retreat in a natural setting could due wonders, especially if the person has been a stressed out city dweller for a period of time. Meditation is great for calming the mind and emotions. A doshically appropriate diet is always important, but considering the vikruti, getting that under control first, while working toward the primary doshic routine. Certain herbs are great in different combinations, depending on the individual's particular problem and constitution; however, Arjuna is a tridoshic favorite for heart ailments mixed in combination with constitutionally correct herbs.
Stress can play a huge role in our lives, and for many, or even most it plays a role on occasion or even on a daily basis. As we've seen it contributes or even causes disease. It can cause simple things like occasional sleepless nights or chronic insomnia. Can contribute to angina, or to full-blown heart attacks. Stress can lead to ulcers, anger, depression, tension, chronic fatigue, as well as a myriad of other symptoms and diseases.
As we can see Ayurvedic medicine can actually play a major role in mitigating or even eliminating these kinds of problems.
26 Macleod, Smith, et al., ''Psychological Stress and Cardiovascular Disease" British Medicine Journal, May 2002 Available on the World Wide Web
To summarize some of the different treatments and approaches that ayurveda would take in an approach to help somebody suffering from too much stress in their life:
- • A constitutional balancing diet is always in the forefront of treatment. What is the person putting into their body three times a day, everyday? Is it correct for that individual?
- • How's the elimination? The apana needs to be moving everyday so toxins don't build up and overflow into the rasa and rakta dhatus and get carried into other weakened parts of the body. This can be easily addressed with herbal formulas as needed, such as mild laxatives like triphala, psyllium, flaxseed, etc.
- • With the proper herbs that are nervine sedatives and tonics like ashwaganda and jatamamsi, these can be of great value.
- • Meditation is a very important treatment, it actually a lifestyle, not so much a treatment, but it could be used as one in the beginning, working with a person new to ayurveda. Disconnecting from the ego, withdrawing from the senses, realizing that your not just this little body, but that you're part of the whole, and that behind all oflife's drama (lila) it's all okay. There's nothing better than this for stress relief.
- • A life routine especially for vatas, and occasionally we may want to be a little spontaneous if kapha gets a little too lazy.
- • Five sense therapies are very beneficial in the relief of stress and anxiety. Of course depending on the persons constitution the treatments will vary to some degree; however, getting out into nature and seeing the trees and sunlight does everybody good. Using some aromatherapy in a warm bath or diffuser is soothing. Paying attention to the environment that your in, is it well kempt or sloppy. Are the colors in your house good
for you, as well as the clothes you wear? Is your environment too noisy or restless? All of these things need to be addressed at some point. Of course taken slowly as to not overwhelm the patient, seeing they're already stressed.
- • Getting the right kind and amount of exercise for your constitution and level of health.
- • Monitor your thinking and introspection.
- • Get plenty ofrest.
All of these things, or depending on the individual a few of these things can and will make a difference to lessen stress.