I Didn't Realize I was Chronically Stressed
Stress rarely shows up as stress. Here's how to recognize it and take care of it.
I’ve had a few major periods in my life when my body was overwhelmed by stress but I didn’t know I was stressed.
As a physician I was taught to ask my patients, “Are you stressed?” If the answer was no, I would take it at face value.
We feel the consequences of stress often before we recognize stress as an emotion in our body.
My Chaotic Gut
In my second year of medical school I was bloated, had acid reflux, bouts of diarrhea and constipation. I assumed it was what I ate.
But stress changes the way the intestines move and how enzymes are released to digest food.
The same food I ate 2 years later weren’t causing any problems.
Appetite Skyrocketed
Stress puts the body in the fight and flight mode. We want to constantly get simple carbs in us to quench anxiety.
I developed a binge eating problems sometime around the first year of medical school but it didn’t really bloom until my third year.
If I ate enough, I would eventually settle down. The food would overfill my stomach, signal my parasympathetic system, and my stress hormones would crash.
My Mood Crashed
Most of the time my mood was fine. But it took very little to overwhelm me or make me irritated.
I experienced this again a few years later when I was dealing with a medical board investigation. On the surface I was still cooking, exercising, and socializing. But my internal processing of signals was overamped.
These days, when I feel irritable I know I have to check in to see what my stress level is. The stress bypasses our ability to calmly assess a situation. Our presentness gets hijacked and we lose our ability to process.
Energy & Stamina Were Rock Bottom
A few months ago I was onboarding new team members in my practice and the first thing I noticed was that my stamina in the gym was lower. I hadn’t changed anything else.
My amygdala was likely firing constantly with no way for me to override it. This crashed my nervous system, unable to make my muscles fire the way I wanted.
Cognition Couldn’t Keep up
The ability to focus, process information, and form new memories is highly dependent on our stress levels.
There are lots of studies, such as the 2009 Lupien et al, that track how adults with higher cortisol levels often have lower cognitive function.
Currently, in my practice, stress management is our top priority for any health coaching client experiencing cognitive difficulties.
Worse Aches & Pains
Our body has a natural way of suppressing excess pain signals. But chronic stress lowers the brain’s ability to mute pain. This was demonstrated in Pola et al, 2024.
I felt this in my lower back in 2016. I was slowly transitioning out of the insurance-based world and launching my own medical practice came with stress. No matter what I did, I felt pain in my back.
I was fortunate to work with a great personal trainer who showed me that I had excess tension in the paralumbar muscles. Once I got a handle on my stress, the pain disappeared.
Immune System Couldn’t Recover
Between 2010-2012 I was always sick. I was a full-time physician at Kaiser Permanente in the family medicine department, I picked up shifts in the urgent care and in pediatrics, and I had way too many hobbies outside of medicine.
High catecholamines suppress immune cells such as NK cells and increase inflammatory molecules like IL6. This combination crashes the immune system, which is needed not just for fighting off infections but fighting off cancer cells.
Segerstrom et al reviewed 300 articles to show that while fight-or-flight stress can improve the immune system temporarily, chronic stress caused global suppression of it.
Blood Pressure Was Super High
We have a lot more data on stress and blood pressure. And my system certainly wasn’t naive to it.
In 2016, during my career transition, my blood pressure was routinely in the 170s/100s range. It wouldn’t have made sense to take a blood pressure medication because I would have just masked the problems.
I still tried a blood pressure medication but it crashed really bad. Fortunately, as soon as I made the career move my BP was down to 90/60s, like usual. This was the biggest ah-ha moment for me.
10 Things I’ve Since Learned About Stress
1. Breathing is one of the most effective ways to lower stress.
You can try the box breathing method below. My personal favorite is the 4-7-8 breath.
2. Natural sunlight protects against stress.
While many fear skin cancer, we forget all the benefits from the sun. It’s not just about vitamin D but also mood.
3. “Release” stress by going for a walk or doing a hard workout.
I do my health coaching meetings when I go for a walk. It’s better than sitting behind a computer screen.
4. Don’t ignore the constant, low-level stress.
If there’s something bothering you, talk about it, journal about it, or at least do some mindfulness to avoid obsessing over it.
5. More sleep time is needed because stress dampens sleep.
When stressed, the same 8 hours in bed will be more like 6. So add a little more bedtime if possible.
6. Stretching your muscles lowers your stress hormones.
Eda et al measured salivary stress hormones and showed that stretching decreased cortisol and increased testosterone.
7. Caffeine is the enemy of stress (and sleep.)
During high-stress days, it’s best to cut back on caffeine. It’ll take longer to get cleared from the bosy, negatively affecting sleep.
8. Socializing can be frustrating when stressed, but it’s therapeutic.
When I’m stressed I don’t want to socialize. But if I can do it in a supportive space, it’s healing.
9. High-intensity exercise during stress is as bad as caffeine.
I’ve learned from my patients that intensity has to go down when stress levels are high.
10. Stress is physiological, not cognitive. You can’t think your way out of it.
Overanalysis, repetitive thinking, and having internal dialogues often are more harmful than helpful.
Taking New Health Coaching Clients!
If you’ve been looking for a partner to help you solve a health mystery, this is your chance. Below are 3 ways to work with me to help you feel better:
One-Time Deep Dive (60 minutes)
This is a focused session to review your symptoms, labs, and lifestyle. In this physician-led health coaching hour you can pick my brain. I’ll share my experience and the latest research relevant to you.Monthly Coaching
Ongoing support with one live session per month plus direct messaging.
This is best for making steady progress with accountability.Weekly Coaching
This is much more hands-on, with weekly live 1-hour sessions and close guidance.
Ideal if you want faster and more structured change.
Find out more at https://drashori.com/health-coaching/
Disclaimer:
Dr. Mohammad Ashori is a U.S.-trained family medicine physician turned health coach. The content shared here is for education and general guidance only. It is not personal medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Humans are complicated and context matters. Always talk with your own healthcare team before making medical decisions, changing medications, or ignoring symptoms. This information is to help you add more depth to those conversations.
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