Practitioners can help patients manage stress with a combination of lifestyle changes and supplements.
American life is demanding enough: work, kids, deadlines, family responsibilities, economic worries and societal pressures are enough to make even the calmest among us feel like we are slowly unraveling. Add in a global pandemic with a heaping uncertainty about the future, and that is a surefire recipe for increased anxiety and stress.
“Even before the pandemic, Americans had developed a culture of constant pressure. This could be due to our digital culture, where we’re always being reminded of what everyone else is doing and what we’re not doing. This creates a perpetual sense of ‘I don’t have enough.’ We’ve developed into a culture where worrying about everything and trying to constantly achieve more keeps our pressure levels heightened,” said Dr. Chris Shade, founder and CEO, Quicksilver Scientific, a manufacturer based in Colorado.
Some stress is normal, of course, and can be healthy and makes us aware of danger. But too much stress can wreak havoc on the immune system and cause physical symptoms due to excess cortisol. Cortisol is more commonly known as one’s fight-or-flight hormone. This alarm system is necessary but can get out of control when the body is experiencing an overabundance of stress.
“Stress is good for us as long as it is short-term and ‘homeostatic,’ which means you are present and aware. When it is chronic or ‘allostatic,’ which means disconnected and in stress overload, it is the No. 1 public health enemy,” said Laurel Mellin, PhD, a psychologist based in California who focuses on EBT—emotional brain training for emotional and behavioral health, obesity and stress overload.
Regardless of the etiology of stress, very few of us are immune from it, and some of us can experience detrimental physical effects.
“Chronic stress can manifest as physical symptoms, as well as lead to a multitude of health conditions. High blood pressure, gastrointestinal disturbances and sleep difficulties to name a few, are ways in which chronic stress may affect a person physically. Stress in general favors processes that support short-term mobilization for emergency situations, rather than processes that support long-term well-being like digesting food and absorbing nutrients,” said Katherine Cole, R&D manager for ChildLife Essentials, a California-based manufacturer.
Stress: Our Frenemy
Our bodies respond to stress by activating stress hormones like adrenaline, which is a good thing. But when your body is in a prolonged fight or flight state, physical problems are pretty much inevitable, said Melissa Davis, national service and education director for Elixinol, a manufacturer headquartered in Colorado. “These include everything from heart disease and digestive issues to problems with weight control and sleep patterns. Stress also can suppress your immune system, as well as your digestive and reproductive systems, too. Of course, chronic stress can greatly affect our brain health,” she said.
“Stress can help keep us safe by making us aware of danger, it can push us to try harder and reach goals that we would not get to if we stayed in our comfort zone,” added Jason Edwards, CEO of Rebel Herbs, a manufacturer based in Indiana.
But stress can become unmanageable and dominate our well-being. “When we wake up with a feeling of stress or go to sleep with that same feeling, it has crossed the line from productive to destructive,” he said.
Dr. Shade said that an autonomic nervous system controls everything “in the background,” such as heart rate, breath rate and blood flow to our organs.
“The autonomic nervous system has two sides, the sympathetic and the parasympathetic, which act as sort of a yin and yang. Sympathetic is the heightened response, which is also referred to in its more extreme sense as fight or flight. When that feeling of danger activates, we go into this fight or flight dominance. After the danger has passed, we come back into parasympathetic. Parasympathetic is when we settle down and start using our energy to clean up and regenerate the body. It’s loosely called ‘rest and digest,’ but more accurately includes rest, digest, repair, regenerate and detoxify,” said Dr. Shade.
He added that when someone is chronically in a sympathetic state, they are continually taking resources away from regeneration, and all of their energy is going into survival instead of digestion and detoxification.
Conventional Ways to Manage Stress
There is no question that the world is in crisis. Certain stressors, such as the effects of the pandemic, are lingering, and an end date is unknown at this point.
As stress of this magnitude is a life disruptor, it is human nature to want to immediately feel better and address the symptoms versus the root cause.
Some people self-medicate and end up with bad habits, such as overeating, which can lead to other health problems, or an overindulgence of drugs and alcohol.
“Today, pharmaceuticals from opioids to antidepressants also are used to target stress, despite the substantial downside many of these medicines present and the risk of addiction they pose,” said Davis.
For many people, stress management can mean acquiring a pharmaceutical prescription for anti-anxiety medication from a practitioner. “General practitioners have more pressure to see more patients each day and the time they have to look at and speak with each patient is shorter and shorter,” said Edwards. Plus, a prescription can seem like a quick solution to a long-term problem.
“The natural approach and products in the marketplace for stress don’t often enter the conversation because the practitioner has no firm understanding or education on them. So, they go with the devil they know rather than the angel they don’t understand,” said Edwards. Dr. Shade noted that pharmaceuticals may help in the short term but do not help the body to become more adaptive in the long term. “In fact, you’d find yourself becoming more reliant on interventional chemical interventions to calm things down,” he said.
Dr. Mellin said that conventional ways of reducing stress are ineffective in today’s world. Not only are most health epidemics today (diabetes, obesity, anxiety, depression) rooted in stress overload in the brain and body, but some research has shown that conventional ways may be counterproductive. Cognitive processing (eg., CBT, mindfulness, positive psychology) are effective at low stress, but in moderate to high stress, the thinking brain is negatively impacted by stress chemicals and these methods are not effective. Using them may give people a false sense of security, as when they really need the methods, they are not effective,” she said.
Natural Ways to Manage Stress
Though people have found relief in a bottle, often stress relief is right in front of you, easy to access and costs nothing.
For example, the power of getting outside and exercising should never be underestimated, as exercise has been proven time and time again to be a great stress reliever. Other tried-and-true methods of relaxation are yoga, tai chi and meditation, which Dr. Shade said can help shift the body from a sympathetic to a parasympathetic state.
Aromatherapy, soft music, and adequate sleep are other potential stress reducers.
“Americans are beginning to look beyond treating symptom after symptom and are considering healthy lifestyle changes to relax and mitigate the level of stress in their lives,” said Cole.
Certain herbs and ingredients have a reputation of helping to manage and reduce stress. Edwards thinks of ashwagandha and holy basil as superstars in the management of stress. Holy basil, also known as tulsi, is known to “…lower cortisol and help control COX-2 expression in the body. It is used every day by nearly everybody in India and is revered as a plant and medicine,” explained Edwards.
Davis agreed that ashwagandha is a phenomenal adaptogen that seems to be useful in shortening the initial fight or flight response stage. Another herb that has been shown to help improve stress levels is curcumin, the active ingredient in turmeric. “It’s also an incredibly powerful antioxidant and promotes anti-inflammatory responses, those kinds of things that help protect our cells,” she said.
Dr. Mellin teaches her patients emotional brain training, as it is based on how the stress brain (“emotional brain”) naturally processes stress at all stress levels—even stress overload. “People learn the five-point system of stress (five levels) and the emotional technique for each. If they have stress from a traumatic event or a triggered overreaction or addictive drive (food, alcohol, gambling, etc.), they use the same tools to rewire these drives. They learn to stop judging themselves and take responsibility for rewiring faulty circuits. We call it the ‘Stress Vaccine’ because the overall goal is to raise the brain’s emotional set point for lasting results,” she said.
Supplements to Help Address Stress
Along with other stress management techniques, practitioners often recommend a variety of herbal supplements to help reduce stress.
Rebel Herbs manufactures both Holy Basil and Ashwagandha as a single herb capsule and as single herb drink powders.
“We use a special process that pulls out all the beneficial compounds from the herbs using a dual extraction process. This improves the bioavailability and overall effectiveness of the herbs we extract,” said Edwards.
Quicksilver Scientific manufactures several lines that support stress relief. One is the CBD (cannabidiol) line, which include Quicksilver Scientific Nanoemulsified Full Spectrum Hemp Extract as well as the Broad Spectrum formulation. The THC is removed in its Broad Spectrum Hemp Extract CBD. With added botanical extracts and neurotransmitters added to the CBD, the company also manufactures CBD Synergies AX Calming Formula and CBD Synergies-SP, a sleep formula. And for those consumers who prefer not to use cannabinoids, the company has several other products, including LipoCalm, made with GABA, passionflower, skullcap and chamomile, to support sleep and daytime anxiety.
ChildLife Essentials manufactures products specifically for children. “Fortunately, in general, young children do not experience the same level of chronic stress as adults. Children do experience occasional stress which commonly results in gastrointestinal disturbances. Among our offerings, we’ve created products that support the gastrointestinal system, which the body deprioritizes during times of stress. ChildLife Clinicals Digestive Health offers digestive support in ready-to-mix powder form,” said Cole.
She added that the products contain a blend of key digestive enzymes that target lipids, proteins and carbohydrates to offer wide-ranging digestive support.
Genexa Stress Relief is a homeopathic remedy that addresses symptoms associated with stress: fatigue, nervousness, irritability, anxiety, an inability to concentrate, etc. The product is a chewable delivery method and it is made with “…ingredients such as Calcarea carbonica to address anxiety and sleeplessness, Passiflora incarnata to address restless sleep and stress, and Valeriana officinalis to address nervousness and digestive symptoms due to stress,” said Arik Johnson, vice president of sales at Genexa, a manufacturer based in California.
Though she first focuses on dealing with stress, Dr. Mellin does recommend fish oil and a therapeutic multivitamin, helpful for neuroplasticity and changing brain circuits.
All of Elixinol’s products contain CBD, including its Stress Less Capsules, which also contain ashwagandha to help regulate cortisol levels in the body; Omega Turmeric Capsules made with algae-derived omega-3; Good Night Capsules, which pair CBD with melatonin; and Body Comfort Capsules, which includes boswellia to aid in reducing stress-provoking inflammation.
State of the Market
It is an unfortunate fact that at least for the time being, primarily due to the global pandemic, many people around the world are experiencing an almost unprecedented degree of stress and are seeking better means of controlling the stress and related physical symptoms. “The stress supplement market is poised to skyrocket in the near future given the state of the world,” said Edwards.
Also, people are looking for ways to optimize their immune systems. “We are also seeing increased demand for CBD, other botanicals and minerals. That demand will continue and probably increase in the fall and winter during the traditional seasons requiring immune support,” said Dr. Shade. And because COVID-19 has been showing to have a more detrimental effect on those with pre-exiting conditions, Dr. Shade added that people are looking to improve their metabolic health, in part through supplementation.
Cole said that while the state of the market is already strong for adults, she anticipates that the market for children’s stress and relaxation supplements will experience a growth. In general, she said that clean label products and those with plant-based ingredients also are trending, as are adaptogens.
“Many people are choosing more natural approaches to deal with stress. We continue to see a sales increase year-over-year of our top-selling homeopathic stress products, a trend that can be seen across the category. Generally, people are looking for cleaner products and more natural ways to handle acute symptoms like stress and anxiety,” said Johnson.
Incorporating Supplements Into Practice
Because of shutdowns affecting many facets of business, including doctors’ offices, practitioners have had to rely more on telemedicine. Practitioners who sell supplements in their offices are having to shift to fulfillment services, such as online dispensaries. Edwards cautioned, however, that some dispensaries keep most of the profit and said that “it is questionable how many patients will follow through with that purchase anyway.”
In order to help with that issue, Rebel Herbs launched a new dropship option for doctors. “The doctor can present the patient with the option to buy the product in the office, they collect the money and the shipping address on the spot and then order from us and we send it straight to the patient—no lag time, no lost revenue to a third party, and no compliance issue on the purchase of the medicine,” he explained.
Johnson said that practitioners should investigate pharmaceutical and nutraceutical companies that offer sampling and in-office merchandising.
“When it comes to any kind of CBD use, practitioners also can take advantage of digital efforts that better support consumer information, too. For example, sites such as realmofcaring.org, leaf411.org, CBDplusme and others allow CBD users to chronicle and track their usage and outcomes, regardless of brands. The aim is better education, and health practitioners of all kinds can incorporate these kinds of digital tools into their practices,” said Davis.
Helping Patients Manage Stress
Edwards suggested that practitioners “…make stress mitigation a package deal.” Specifically, they should talk to patients about getting outside, moving their bodies and recommending daily use of adaptogens.
Dr. Shade suggested that practitioners should encourage their patients to adopt a blend of supplementation and lifestyle changes, such as breathing techniques and meditation. Another trick is to incorporate such digital tools as apps for medication or ambient music with binaural beats to aid in sleep. “If patients are undertaking lifestyle changes along with the supplementation, they can make very deep changes into what are normally very reactive response patterns,” he said.
Johnson said that practitioners can incorporate natural stress relief products into a holistic regimen that also includes exercise, medication, therapy and nutrition.
Cole also believes that a growing number of practitioners are beginning to look at health conditions holistically. “Some health conditions that are a result of chronic stress have traditionally been treated as an isolated condition, and not part of the larger health issue. Practitioners care about the well-being of their patients and are making the connection between stress reduction and long-term health,” she said.
Healthy Take Aways
• Chronic stress can manifest as physical symptoms as well as lead to a multitude of health conditions, such as high blood pressure, gastrointestinal disturbances and sleep difficulties.
• The autonomic nervous system has two sides, the sympathetic and the parasympathetic, which act as sort of a yin and yang.
• Tried-and-true methods of relaxation include yoga, tai chi and meditation.
For More Information:
Childlife Essentials, https://childlifenutrition.com
Quicksilver Scientific, www.quicksilverscientific.com
Rebel Herbs, www.rebelherbs.com