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The Perception of Stress

the perception of stress

Many people in North America identify as being busy. As a naturopath, I often feel torn about what to recommend as the best treatment plan for a patient who is already busy. On the one hand, I want to suggest adding meditation for their stress, more home-cooked meals for their digestion, or more physical activity for their high blood pressure. On the other hand, doing more of these things sounds unachievable considering their packed schedule. In many of those cases, I’ve wondered if the best thing for their health is to help them to ‘stop the busy’ rather than add anything new to their plate.. Who’s to say that hitting the couch and running through 10 seasons of Friends wouldn’t improve someone’s blood pressure or digestion? (although I haven’t prescribed it yet, I’ve personally tried it, and it’s amazing).

I think we can all agree that, striking a balance between ‘busyness’ and ‘down time’ is important for stress management. But our perception of what is stressful is very individual. For example, many find public speaking stressful. Others don’t perceive it the same way. For them, the stress response may not be activated. I’m a person who needs a reasonable amount of down time in order to feel balanced. What’s reasonable to me? Well, I start most days reading a book with my cat for an hour. I don’t work weekends. And my brain shuts down if I have too many evening activities planned. I work hard at achieving a work-life balance that’s right for me. I know some people would find my work schedule and marathon training too busy. I know others who would be chomping at the bit.

Take Ben and Candace Wagner, for example. They are busy by most people’s standards. Candace is in my running group and trains about 10-12 hours per week. She also manages her own business – SupperWorks Waterloo. Husband Ben is the Director of Engineering at Christie Digital’s Medical Division, travels for work on a regular basis, and is an ironman triathlete, training 8-16 hours per week. They have three children (ages 13, 11, and 9) who each swim competitively and have music lessons. These activities total 8-14 hours each outside of school per week. Hannah, the oldest, has her sights set on the Olympics. Um … how do they do it? Candace says “it’s like a game of Tetris or an intimate dance routine to make everything work”. Ben and Candace share a google doc for groceries and a google calendar for their schedule. Candace has some flexibility in her schedule because she runs her own business, and brings healthy meals home from Supperworks, which saves time. They share driving with another “swim family” nearby and hire someone to do the laundry and clean the bathrooms. They are both active in childcare and each have designated tasks to make sure the household runs smoothly and that everyone gets to where they need to be. Says Ben, “I think it is good for the kids to see us making everything work for our family and we have them help out as much as possible so they understand the work that goes in.”

They do manage to have down time, though they admit it’s quite scheduled. They make sure they talk about their day over family dinners or driving to and from swimming. They read the kids stories before bed, play board games, take the dog for walks, go for bike rides. They try to travel as a family for major competitions and turn it into a family vacation. By spending time on their own fitness goals, both Ben and Candace are modelling the importance of physical activity and of their own self-care for their kids, a valuable gift. They are also improving their general state of physical health which may help prevent their busy lifestyle from eliciting a harmful stress response. So from their own perspective, are they managing their own stress adequately? Do they have work-life balance? They both say, yes. (Really? I wonder …) Just to be sure, I hunted around for an objective way of measuring their stress.

The Perceived Stress Scale

The Perceived Stress Scale (PSS) was designed in the 1980s. It measures a person’s subjective interpretation of a stressor, rather than the frequency of specific life events (divorce, moving, etc.). Studies show that people who score high on the PSS are more likely to have high cortisol, depression, common colds, slower wound healing, and cellular damage associated with accelerated aging. Research also shows that people who participate in vigorous physical activity report lower perceived stress on the PSS. Neither Ben nor Candace scored high on the PSS. Interesting! Being busy doesn’t necessarily trigger the stress response. Perception and level of physical activity may be making a big difference for Candace and Ben. They have reached a balance that works for them but might not for someone else.

So what did I learn about perception of stress for my patients? Variability in reaction to stress means I should never make assumptions about stress and busyness without checking in with perception first. I might start using the Perceived Stress Scale to help decide how fast or slow someone’s treatment plan should be implemented. If any of you are inspired to run marathons or Ironman triathlons, but are intimidated by Tetris-style scheduling, check out Leo Babauta’s approach for getting things done. On his blog Zen Habits and in his book The Power of Less, Babauta helps you meet your goals by limiting yourself to the essential and eliminating the unnecessary. A big thanks to the Wagners for answering loads of questions!

Michael Torreiter

Michael Torreiter

Dr. Michael Torreiter is a Naturopathic Doctor at CARESPACE. He obtained his Doctor of Naturopathic Medicine designation at the Canadian College of Naturopathic Medicine in Toronto in 2005, worked at Healing Path for 13 years, and moved to CARESPACE in 2019. About half of Dr. Michael’s practice is focused on Precision Nutrition — a comprehensive weight management and lifestyle program that helps people lose weight, gain weight or just improve their diet. In addition, he treats a variety of conditions including digestive concerns, stress and anxiety, hormonal imbalance and men’s health. As well as being certified in Precision Nutrition, Dr. Michael has completed a Mind/Body Medicine Certification from Harvard Medical School and a certificate in Applied Mindfulness Meditation at the University of Toronto. He offers nutrition talks at the Running Room on a regular basis.