It’s common to ignore stress since it is such a subjective measure compared to other familiar risk markers like blood pressure and cholesterol. Many of you reading this blog may already have a regular stress-reducing practice like meditation in place, but today’s post is for those of us who might keep pushing stress reduction aside. Most of us know what acute or severe stress feels like, like during an emergency or emotional crisis. However, many of us are living in a constant state of low-grade simmering stress that has become an unrecognized state of normalcy. Let me warn you that there is absolutely nothing normal about this. I’m overwhelmed now in my clinic and during wellness programs by how much disease (heart disease, cancer, autoimmune conditions, etc.) is triggered by stress. Read this post for more on how isolated stress without other risks is triggering disease in so many of my patients. Stress reduction is no longer “alternative medicine.” It is central and core to everything related to your physical and emotional health. I’ve also included a video of how to use some of these stress monitoring tools at the end of this post.
Resting Heart Rate and Stress
So one way for us to detect that low-grade simmering stress is to become familiar with our heart rate (aka “pulse”). Many of us know our heart rate during exercise, but may not be aware of it during periods of rest. Your first step is to keep track of your resting pulse at various times of the day. Know what your calm and relaxed pulse rate is first as your baseline. For me this is when I first awake or after a session of meditation. It usually is between 52-56 to be exact! Our sympathetic nervous system (SNS) is a complex mechanism that allows our body to fight or flee from stress…aka “fight or flight response.” One of the effects of the SNS is to raise our heart rate. This effect is counterbalanced by our relaxation response, mediated by the parasympathetic nervous system (PNS). Essentially our goal is to activate our PNS as often as we can through stress reduction measures so our SNS isn’t constantly in overdrive. An elevated resting pulse can be an indicator of a constantly revved up SNS. Now keep in mind that there are various other factors that can raise your resting pulse, such as that morning coffee, changes in hormonal patterns, reactions to foods, etc. If you are on medications like beta blockers for blood pressure or a heart condition, it may lower your pulse. Think of your resting pulse as a blunt tool for assessing stress levels. You can check your pulse throughout the day the good ol’ fashion way by placing your fingertips on your wrist or on your neck. A high tech alternative to this is downloading a smartphone app (most are free) and using your camera lens to measure your fingertip pulse. I just posted a video demo on this at the end. There are also plenty of wrist wearable activity trackers and the Apple watch that can help you track your resting heart rate. Also keep in mind that one of the wonderful benefits of regular exercise is that it lowers your resting pulse over time, which is an indicator of improved fitness and lower heart disease risk.
Heart Rate Variability (HRV)
I mentioned that your resting pulse is a “blunt” tool for you to help quantify stress to some degree. Heart rate variability (HRV) is a measurement that can provide some additional accuracy. Let me explain. If your resting pulse is 60 beats per minute (bpm), what this means is that your heart beats 60 times in one minute. Contrary to common belief, your heart beat intervals are not completely equal. I’m using “boom” below to signify a single heart beat and the periods in between are the intervals:
High Heart Rate Variability (HRV): boom..boom……..boom….boom……………boom….boom (notice varying intervals between beats or increased variability)
Low Heart Rate Variability (HRV): boom…boom…boom…boom….boom (notice fairly consistent intervals between beats or lower variability)
Which of the above cases do you think is a sign of optimal health? Your instinct might tell you that the 2nd case is a healthier scenario since a healthy heart is a steady heart that beats with little variation, right? Wrong! Having more variability, or high HRV, is an indicator that your parasympathetic system (aka relaxation response) is nice and active. When we are chronically stressed, our sympathetic system takes over and we lose that precious HRV. I give the analogy of music. If I pushed a piano key at a constant interval, that would be monotonous. Now add some variation to those notes and you’ve got beautiful music. Variety or in this case “variability” is the spice of life. You get the picture! Now take a look at the tracings below produced by a company called Heartmath, who have done pioneering work in this field. The vertical, Y-axis is heart rate and the tracings indicate the variability in the heart rate. Notice how even a subtle negative emotion like frustration registers low HRV illustrated by short squiggly lines in the top tracing, whereas a positive emotion like appreciation registers excellent HRV with large sine-wave type fluctuations in heart rate.
In reality, these variations in heart rate are imperceptible to us. You won’t be able to pick up on them by checking your pulse. This is where your phone can come to the rescue again. I demo an app and the heartmath device in my video below. I’m sure the suspense is killing you, right?
Raising Stress Awareness
I’m not going to focus on stress reduction in this post. I provide lots of techniques in my book and have written on it already in prior posts. Using heart rate and HRV as a tool to increase stress awareness serves as a quantifiable trigger to remind you to implement some simple stress reducing techniques. Don’t over-obsess with the heart rate numbers. Your heart rate will go through normal variations throughout the day. When I do a pulse check or HRV check and find my numbers out of range, I turn away from my screen and look out the window while doing some deep breathing or I take a short walk outdoors. These mini-breaks to intermittently reboot our parasympathetic system are essential for mitigating the long-term effects of chronic stress.
I look at stress reduction the same as physical activity. You can’t just do a 60 minute workout in the morning and expect to sit all day without suffering health consequences. Read about the effects of prolonged sitting and inactivity here. In the same way, a 20 minute meditation session or yoga class in the morning is a great start, but we still need to intermittently relieve and release stress throughout our hectic daily lives. We also need to observe and reframe negative emotions like anger and frustration which as I illustrated above have adverse effects on HRV and your overall health. I recently had some serious issues with my blog crashing and I felt at that moment that it was the end of the world….really? While I was dealing with my blog crash, there were others being handed the diagnosis of a life-threatening disease, the loss of a loved one or some other human tragedy happening every second. I needed to take a deep breath and “reframe” and deal with it in a calm, rational manner in the comfort of my own temperature-controlled office and with my own healthy body…those daily things we all take for granted. Remember, if you constantly react to common daily situations with a catastrophic or near-catastrophic emotional response, your body and mind will suffer.
By the way, as a follow-up to this post and all the questions I received, I did part 2 where I talk about the connection between heart rate and heart disease (“When is a High Heart Rate Healthy vs Unhealthy”) which you can find here.
My Stress Video: The “Raw” Video Series:
I’ve been meaning to post useful Youtube videos for over a year. I decided to put aside my perfectionist tendencies and just film these “raw,” meaning unprocessed and largely unedited. Please excuse the lack of polish in these videos…I’m on a tight budget and my camera crew consists of my 11 year-old twin boys who I pulled aside between homework and basketball practice. Speaking of which, please be sure you teach your kids about stress reduction techniques. Shally, my pediatrician wife, has seen the mental and physical effects of hard-driving parents constantly pushing their kids. Yes, my kids are also overscheduled to some degree, but we absolutely make sure they have plenty of free time to play and be kids. We also emphasize relaxed sit-down meals without devices and try to do a short bedtime meditation session whenever we can. If you haven’t already, sign up for my newsletter and you’ll get a free copy of the children’s chapter of my book which faces our high stress parenting habits head on with some practical solutions. Enjoy the video and please “like” it if you do so I feel confident producing more “raw” videos in the future!