A Note from Miguel: Here goes nothing... Talking about stress today

I'm packing up my car with my bike, wetsuit, and all my gear and heading to Lake Placid for the weekend.

I'm going for a 4-day training camp in prep for Ironman Lake Placid next month.

This is my first camp experience ever. I've never been to camp before, unless you count boot camp - this might feel similar.

To say that I feel like I don't belong is an understatement.

When I signed up for this race, I had no idea what it all actually entailed. Add in a few of life's curve balls and it's taken up a lot of my mental space. The wins, the sacrifice, the athlete's guilt for sitting at my computer for hours on end instead of training, and everything in between. Doing it while trying to run a practice in the first year was not the smartest decision.

Recently, I had someone explain to me that she feels like she's been in "high stress" mode for some time, and I think a lot of us can relate, so let's talk about how that affects us.

When we think about stress, we usually think of it as a feeling. It could be a tightness in the chest, racing thoughts at 2am, the guilt of sitting on your computer or your phone when you "should" be doing something else.

Stress is more than just a feeling or a sensation.

When your body perceives a threat - they always use the bear in the woods example, but it can be as simple as a notification on your phone, or an overflowing laundry basket - it activates the HPA axis (hypothalamic-pituitary-adrenal axis). This stressful event triggers a cascade via that axis which ultimately sends a signal to the adrenal glands above the kidneys to release cortisol, our stress hormone.

This isn't a bad thing. We need this response to survive. When stress becomes chronic over long periods of time, that's when I start paying attention and asking patients (any myself) about a few things.

Sleep disruption - If cortisol stays elevated in the evening, it interferes with your ability to fall and stay asleep. Poor sleep amplifies the stress response, which makes sleep worse, which raises cortisol even more. It's a viscous cycle.

Inflammation - Chronic stress drives systemic inflammation, and inflammation is a primary driver for heart disease, metabolic problems, and even depression. If we check a CRP and it's elevated, stress is something that should be taken into consideration, amongst a list of other things.

Mental Health - The same brain regions that regulate mood are directly affected by sustained cortisol exposure.

The good news is that it's not permanent. The body can recover, but it needs the conditions for that to happen.

Before researching for a supplement or purchasing a product you found, look at what's already in your control.

How are you sleeping? Are you moving your body consistently? Have you actually acknowledged that you've been running in high-stress mode? What have you tried to change?

If you're not making progress, it might not be a bad idea to check your labs, but they don't always tell the full story either.

Sometimes we can even reframe our stress into a blessing.

This weekend will be the first time I'll be testing the bike course (it's hilly), getting in the full distance swim (I'm not an open water swimmer), and closing out the weekend with a 22-mile run (if my legs still cooperate).

I'm stressed, but I'm blessed to be able to make an attempt at this race. It's too late to back out now, so here goes nothing.

Be well,

Miguel

Disclaimer: Information provided is for educational purposes only and is not medical advice. Always consult a healthcare professional for specific medical decisions.