Nearly half of all Australian adults will face mental health challenges during their lives - 1 in 5 will experience this each year.1 Sadly, these statistics have become all too familiar, and many of us have grown desensitised to the magnitude of the ongoing mental wellbeing crisis.
In a world where exhaustion, a culture of busyness, and pushing through have become the norm, addressing these challenges remain as crucial as ever.
As practitioners, what is our role, and how can we best support our patients?
This article introduces the Mental Wellbeing Spiral (MWS) alongside the foundational principles of the General Adaptation Syndrome (GAS). We will explore their practical applications in holistic medicine and their critical role in promoting resilience and sustainable healthcare practices. By integrating these concepts into clinical approaches, practitioners can navigate the complexities of stress with both precision and empathy, ultimately enhacing patient outcomes and practitioner well-being.
REVISITING THE GENERAL ADAPTATION SYNDROME
Recognising its profound impact on health outcomes, Hans Selye's GAS stands as a timeless framework offering valuable insights into stress management. Originally conceptualised in the mid-20th century, GAS delineates stress response patterns into three distinct stages: alarm, resistance, and exhaustion.2 (See Figure 5.) This model not only details the physiological underpinnings of stress but also provides a structured approach for practitioners to orientate effective intervention.
HYPOTHALAMIC-PITUITARY-ADRENAL AXIS AND GAS
The role of the hypothalamic-pituitary-adrenal (HPA) axis in mediating the stress response is central to understanding the physiological mechanisms of GAS. Notably, the first two phases - alarm and resistance - occur during exposure to acute stress and are part of everyday life. In contrast, the assault of chronic, ongoing stress can push an individual into the third stage - challenging coping mechanisms both physically and emotionally, leading to exhaustion.2
The Importance of Perception of Stress
Stress perception significantly influences the degree to which an individual suffers from stress. Recent studies have shown that viewing stress as harmful amplifies its negative effects, whereas perceiving stress as a manageable challenge can mitigate its impact on health.11
For healthcare practitioners, understanding this dynamic is central in stress management strategies. While it's important to acknowledge the real and tangible impacts of stress on the individual, educating patients to reframe their stress perception can enhance resilience and reduce stress-related health issues.
By promoting a mindset that views stress as an opportunity for growth - while supporting with adaptogenic herbs and supplements - practitioners can use these strategies to help patients harness stress for improved mental and physical well- being.12
The synergy between the MWS and GAS equips healthcare practitioners with a powerful toolkit to navigate the dynamic, multifaceted terrain of mental wellbeing, stress, and burnout. By integrating these frameworks, practitioners can forge more resilient pathways for their patients, bringing together psychological insights with physiological responses to stress.
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References
1. Commonwealth of Australia, Department of Health, National Mental Health and Suicide Prevention Plan. Available from: https://www.health.gov.au/resources/publications/the-australian-governme... prevention-plan
2. Mental Wellbeing - The essential guide to herbs and nutritional supplements, Braun L. 2021, Blackmores Institute, a division of Blackmores Limited
3. Silverman, M. N., & Sternberg, E. M. (2012). Glucocorticoid regulation of inflammation and its functional correlates: From HPA axis to glucocorticoid receptor dysfunction. Annals of the New York Academy of Sciences, 1261(1), 55-63. doi:10.1111 /j.1749-6632.2012.06633
4. Herman, J. P., McKlveen, J. M., Solomon, M. B., Carvalho-Netto, E., & Myers, B. (2012). Neural regulation of the stress response: Glucocorticoid feedback mechanisms. Brazilian Journal of Medical and Biological Research 45(4):292-8. doi:10.1590/ S0100-879X2012007500041
5. Selye H. The Stress of Life. New York: Mcgraw-Hill; 1956.
6. Joëls, M., & Baram, T. Z. (2009). The neuro-symphony of stress. Nature Reviews Neuroscience, 10(6), 459-466. doi:10.1038/ nrn2632
7. Herman, J. P., & Tasker, J. G. (2016). Paraventricular hypothalamic mechanisms of chronic stress adaptation. Frontiers in Endocrinology, 7, 137. doi:10.3389/fendo.2016.00137
8. Peters A, McEwen BS, Friston K. (2017). Uncertainty and stress: Why it causes diseases and how it is mastered by the brain. Progress in Neurobiology. Available from: https://www.sciencedirect.com/science/article/pii/S0301008217300369
9. Johnson, S. B., Riley, A. W., Granger, D. A., & Riis, J. (2013). The science of early life toxic stress for pediatric practice and advocacy. Pediatrics, 131(2), 319-327. doi:10.1542/peds.2012-0469
10. Sapolsky, R. M. (2015). Stress and the brain: Individual variability and the inverted-U. Nature Neuroscience, 18(10), 1344-1350. doi:10.1038/nn.4129
11. Crum, A. J., Akinola, M., Martin, A., & Fath, S. (2017). The role of stress mindset in shaping cognitive, emotional, and physiological responses to challenging and threatening stress. Anxiety, Stress, & Coping, 33(3), 302-320. https://doi.org/10.1080/10615806.2016.1275585
12. Jamieson, J. P., Crum, A. J., Goyer, J. P., Marotta, M. E., & Akinola, M. (2018). Optimizing stress responses with reappraisal and mindset interventions: An integrated model. Stress and Health, 37(3), 452-464. https://doi.org/10.1080/10615806.2018.14 42615