The Third Pillar of Functional Medicine: Stress Management
- Donna Strickland
- Jul 30
- 7 min read
We are over halfway done with our four-part series on the pillars of functional medicine! As always, our goal is to implement small, feasible habits to avoid becoming overwhelmed and ensure that we can rely on these practices for years to come. Using these four pillars — nutrition, sleep, stress management, and movement — as a foundation, we can take small steps towards a healthier future. Today we will focus on our third pillar — stress management — and how vitally important it is in achieving optimal health.
The world we live in is fast, that is something we can all agree on. We often oversleep, jumping out of bed at the last minute to get to work or school, leaving no time for breakfast or a slow morning routine. The to-do lists are endless and tend to keep us awake at night anxious and restless. Relationships, work, school, packed schedules, kids’ commitments — these things will cause unwanted stress if we aren’t careful. In addition to our own personal lives, we now live in an age where everything happening in the world is at our fingertips. With just a few clicks, we have access to the news, crime stories, natural disasters, heartache, anger, societal unrest, tragedy, on and on until we just can’t handle it anymore. Our nervous systems were never meant to carry all these stressors. Our minds were not designed to comprehend so much all at once. Our bodies begin to break under the weight of all we are trying to carry, resulting in symptoms such as anxiety, immune system dysfunction, gut dysbiosis, exhaustion, hormonal imbalances, fatigue, or brain fog. Chronic stress is one of the biggest silent killers in our society today, but it doesn’t merely affect our mental state — every inch of our physical body is negatively impacted as well.
The nervous system possesses two important branches between which we alternate, known as the parasympathetic and sympathetic systems. Both systems are vitally important when discussing chronic stress. The sympathetic branch is home to our ‘fight or flight’ response. Upon detecting a threat, this branch prompts the brain, initiating a spike in adrenaline hormones. One of these hormones is cortisol and is crucial in assessing our level of chronic stress. Cortisol is not the villain, rather it is vital for survival, blood sugar regulation, and immune system function. However, when we live under constant stress, the body becomes stuck in sympathetic overdrive, leading to chronically high cortisol. This increases risk factors for a number of negative consequences and chronic diseases, most notably heart disease, insulin resistance, impaired brain function, and atrophy of certain areas within the brain. Acute cortisol elevation creates a temporarily elevated heart rate, but when it becomes chronic it is associated with heart disease. Stress must also be regulated to ensure proper hormone production, one of these being insulin. Cortisol triggers the release of glucose (sugar) back into the bloodstream in preparation for ‘fight or flight’. Repeated instances of this lead to chronically elevated blood sugar levels, and thereby insulin resistance and type 2 diabetes. The hippocampus is the brain’s memory center and is responsible for regulating emotional responses. This is a critical region of the brain that is significantly impacted by long-term stress. Persistent stress subjects the hippocampus to prolonged exposure of a family of hormones called glucocorticoids, one of which is cortisol. Chronic glucocorticoid exposure impairs function within the hippocampus, eventually leading to the loss of hippocampal neurons. The loss of these neurons shrinks the hippocampus over time, causing memory loss and impaired brain function. The brain and nervous system work together to create the downstream effects that we see in other areas of the body — prioritize this and the body will benefit!
Due to the gut-brain connection, elevated levels of cortisol within the brain affect nearly every cell and organ in the human body — especially those that make up the digestive system. When the body is stuck in survival mode, all regular processes are shut down to preserve energy. Starting in the stomach, chronic stress affects its ability to function properly and break down food for digestion. Moving on, our food enters the GI tract, where the brain has intentionally altered gut function as a survival mechanism. This changes the gut microbiome and weakens the gut lining, allowing pieces of undigested food to leak out into our bloodstream. Known as leaky gut, this promotes gut dysbiosis and malabsorption of essential nutrients. Our microbiome influences the brain’s biochemistry, neural development, emotional behavior, and stress response. Since the gut is unable to digest and absorb nutrients effectively under stress, the body’s detox pathways also become sluggish and inefficient. The liver, the lymphatic system, and even pooping are all negatively impacted by inadequate gut function. A weak gut also leads to a weak immune system, as approximately 70-80% of the body’s immune system resides in the gut. Yet again, we see how crucial the gut-brain connection is in achieving optimal health — read more about this here. This is why stress management is so vital — a healthy brain creates a healthy body, and vice versa.
When living in a state of chronically elevated cortisol, we are impacted even down to our cells. It is commonly known that anxiety causes poor appetite and therefore inadequate nutrition, but this doesn’t just affect our gut or energy levels. Proper nutrition protects our cells from oxidative stress and mitigates inflammation in the body. Without this barrier of self-defense, our cells — particularly the mitochondria — struggle immensely. Our cells are the body’s cleanup crew and if they cannot function properly due to high levels of stress, the rest of the body suffers. Stress throughout the body also draws energy away from our cells to instead manage inflamed areas elsewhere. Our cells are the foundation of our health — they are building blocks upon which every function in our body rests. If they are not functioning properly then neither will we!
From internal stressors to the environmental barrage that we experience every day, it is apparent that living in a state of sympathetic overload is not cohesive with achieving optimal health. Thankfully, there are simple tools that we can utilize and habits we can set in place to be set free from a life stuck in survival mode.
Turn off the news, TV, social media, etc. Log off for the weekend or practice the Sabbath, go outside instead or spend time away from technology. The world will end up the same whether you are watching or not — let it rest!
Do your best to not bring your job into the home. Establish clear boundaries that allow your mind and body to rest apart from the daily tasks of a 9-5.
Avoid foods that spike cortisol such as those high in refined sugar, refined carbs, caffeine, alcohol, and ultra-processed foods. Kick the alcohol and caffeine altogether, especially energy drinks — yes, even the ‘healthy’ ones! Anything containing more caffeine than a basic cup of coffee (70-80mg) is a heart attack waiting to happen. Consumption of high amounts of caffeine is linked to high resting heart rate over time, and we know this to be a risk factor for heart disease later in life. Alcohol and caffeine also cause undue stress on the liver, further impairing detox processes within the body.
Emphasize a nutrient-dense diet of foods that relieve stress and facilitate gut health. Utilize probiotic-containing foods such as yogurt, kefir, sauerkraut, kimchi, raw milk, and certain cheeses. Regularly include Omega-3s, complex carbs, healthy fats, and grass-fed protein (especially from red meat) into your diet. Phytochemicals, a compound found in plants, is known to facilitate cellular repair, enhance neuroprotection, cultivate a diverse gut microbiome, and support the growth of beneficial gut bacteria. These are found in bright, colorful foods such as berries, cherries, citrus fruits, red onions, salmon, garlic, red meat, avocados, and sweet potatoes.
When building a meal, always pair carbs with protein and fat to support your blood sugar.
Eat a nourishing breakfast within 1 hour of waking. This is your foundation for energy throughout the rest of the day, start strong with plenty of protein and healthy fats!
Prioritize regular exercise, but never on an empty stomach. Ladies, aim for lower intensity options such as low-impact strength training, mobility movements, or simple stretches, rather than something like HIIT — your hormones will love you for this!
Take barefoot walks in the grass.
Stay hydrated with filtered water and get plenty of electrolytes — tap water is dead water! Check the "SWAPS" highlight on Instagram for our electrolyte recommendations.
Establish a calming bedtime routine, stick to it, and aim for 9-10 hours of sleep per night. For more information on the importance of adequate sleep and how to achieve it, check out our past blog here.
Build a strong, Godly community around yourself. Prioritize relationships that challenge you and promote growth in your relationship with Christ, with people who will pray fervently for you and point you to Jesus at every step. Find a biblical church and commit to being involved there.
Fight for something bigger than yourself. Serve others — find a need in your community and see to it being met. Focusing on those around us forces us to get out of our own heads for a bit and see the world a little more clearly.
Stress management is not about complete elimination of stress but rather managing its intensity and effects. Curate a healthy resilience and response to stress by giving your body what it needs to do this effectively. Most importantly, do your part and give the rest to God. He absolutely designed our bodies to heal, but he also created us in need of a Savior. No amount of grass-fed beef or raw milk will accomplish what only He can do. He not only heals our physical bodies but promises us an eternity with Him if we will simply hand our lives over to Him. As believers, we are commanded to both honor our bodies by caring well for them and surrendering all to Christ in the areas that we can’t carry on our own. We can’t handle the stress of the world and everything in it, but He can — what a blessing!
Or do you not know that your body is a temple of the Holy Spirit within you, whom you have from God? You are not your own, for you were bought with a price. So glorify God in your body. 1 Corinthians 6:19-20
Research:
Regularly watching the news & increased stress levels:
Signs & symptoms of chronic stress:
Parasympathetic & sympathetic nervous systems:
Elevated cortisol & insulin resistance:
Elevated cortisol & atrophy of the hippocampus:
The gut-brain connection, digestion, and chronic stress:
Impact of chronic stress on cellular health:
Simple ways to reduce stress:
Foods that relieve stress & facilitate gut health: