Think about the last time you ran late, and traffic wasn’t cooperating. It could be for work, an appointment, or picking up your kids. You look at the clock on the car dashboard, knowing you’re not going to make it on time. Your heart beats faster. You start moving again but get caught at the next light. You look at the clock. Your chest is rising and falling more quickly now. Check again. A bead of sweat falls down your face. This sensation is stress. And stress is more than just an emotion. 

Stress’s domino effect on your body is a remarkable evolutionary tool and valuable in short bursts. For example, if you come across an angry bear in your bedroom, you may choose to run. And run fast. During this fight-or-flight response, one’s heart rate increases, lungs expand, eyes dilate, and digestion gets switched off. You didn’t know you could move like that! You aren’t thinking about it now, though, you’re running for your life*. The problem is that your body cannot distinguish between running from a bear and running late in traffic. The response is the same; if left unchecked, it can cause considerable damage. 

*Do NOT run from bears—they will chase you, catch you, and probably eat you. Instead, fight your instincts and remain calm, make yourself big, and back away slowly. If you find yourself in this situation, it’s an excellent opportunity to practice your breathwork. See below for more details. 

When you are stressed, the adrenal glands release the hormones cortisol, epinephrine, and norepinephrine. These hormones enter circulation and find their way to the heart, where they increase blood pressure and heart rate. Chronic exposure to these hormones on the blood vessel walls contributes to atherosclerosis, increasing the risk of heart attack and stroke. 

When stress hits the brain, the fight-or-flight response begins. This response is your sympathetic nervous system. The gut stops digesting food. Instead, it diverts circulation to the brain and extremitiesgood for quick thinking and fighting but not so good for digestion. The rhythmic muscle contractions in the intestines are disrupted, leading to irritable bowel syndrome and increased sensitivity to gastric acid, leading to GERD. In addition, the gut microbiome, which contributes to the regulation of the immune system, becomes imbalanced. 

Our appetite is affected as well. Initially, epinephrine will reduce the desire to eat and prioritize survival, but if cortisol remains elevated our hunger increases. Excess calorie intake while in a stressed condition may contribute to the accumulation of fat, or adipose tissue, around the organs. This fatty tissue is an organ that releases inflammatory immune molecules and cytokines, increasing the risk of chronic diseases, including diabetes and heart disease.

Meanwhile, back in the brain: chronic stress is changing brain function. An area in the brain called the hippocampus helps with learning, memory, and stress response. Degeneration occurs here under chronic stress, making it more challenging to deal with acute stressors and increasing the risk for depression and Alzheimer’s disease. In addition, the amygdala, our fear center, becomes overstimulated and may increase in size—more fear and less ability to cope: not a good situation. 

When our body is constantly in fight-or-flight, a lot can go wrong. Balance through the parasympathetic, or rest and digest mode, is paramount. As practitioners, the problem is that we rarely have a chance to talk about stress as a significant contributor to chronic disease. At Integrative Family Medicine of Asheville, practitioners can explore topics like this in more detail. Our team can provide tools and support, including an integrative health coach, to move you toward your health goals. 

Here are some practical tips to stimulate the parasympathetic nervous system so you can rest and digest in peace:

It seems simple enough, but we often need a reminder. You may notice when you are overwhelmed that you are not taking deep breaths. I know it happens to me. Take a few deep breaths every hour, at least. More often if you can. 

Inhale through your nose and feel your abdomen rise. Hold this breath for several seconds. Breathe out through your mouth slowly. Repeat as many times as you need. 

Intentional Movement
We all know that exercise has benefits, including stress reduction. However, it is often difficult to find the time. For this reason, I encourage doing an activity that you enjoy. If you stress about going to the gym, then that is counter-productive. Exercising in groups helps build community and accountability. Join an exercise class or a recreational team if you play sports. Taking walks in nature reduces stress and gets your body moving. Yoga is a great way to combine breath, exercise, and meditation.

The data supporting meditation is striking, but many of us need help getting started. How do we know we’re doing it right? Here’s the thing: you can’t mess it up. It could be as simple as getting lost in music, art, or even during exercise. Nowadays, there are smartphone apps that can help guide you through a meditation sessionthis has been super helpful for me. 

Emphasizing stress’s impact on our overall health, longevity, and risk for chronic disease is crucial. We can use the above tools to reduce the long-term effects of stress on our physiology. Educating ourselves is a significant piece of the puzzle to optimize our health and live our best lives.

If you feel stress negatively impacts your health and want to talk with an integrative medicine practitioner, reach out! At Integrative Family Medicine of Asheville, our practitioners and integrative health coach are happy to take a deep dive into stress management with you. And remember: It’s ok to run late, just don’t run from a bear. 

This blog post was written by Thomas Everts, PA, who is part of the medical provider team at Integrative Family Medicine of Asheville.


  1. Chu B, Marwaha K, Sanvictores T, Ayers D. Physiology, Stress Reaction. 2022 Sep 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 31082164.
  2. Yaribeygi H, Panahi Y, Sahraei H, Johnston TP, Sahebkar A. The impact of stress on body function: A review. EXCLI J. 2017 Jul 21;16:1057-1072. doi: 10.17179/excli2017-480. PMID: 28900385; PMCID: PMC5579396.
  3. Tsigos C, Kyrou I, Kassi E, et al. Stress: Endocrine Physiology and Pathophysiology. [Updated 2020 Oct 17]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA):, Inc.; 2000-. Available from: