Stress – The double-edged sword

Stress involves two-way communication between the nervous system, directed by the brain and the cardiovascular, immune, and other systems. The central nervous system (CNS) controls the “fight or flight” response. It all starts in the brain with the hypothalamus, which triggers the adrenal glands to release the stress hormones adrenaline and cortisol. They speed up the heartbeat and send blood rushing to where it is needed the most – muscles, heart, and other vital organs. These stress hormones help to cope with the situation. Once the crisis has passed, the hypothalamus tells all systems to go back to normal. However, if the stressor continues and becomes an ongoing or repetitive strain, it can put anyone’s health at serious risk.

However, the personal emotional situation is the deciding factor. It is easier to handle demanding situations better in a good mood. But this also goes the other way. With a negative, pessimistic approach, that situation might be too much to handle. Then one thing leads to another, and even the slightest disruptions cause tension and nervousness. The frequency and consistency of stress are also significant factors.

What helps against stress?

It is impossible to avoid stressful times altogether because it is part of life. But there are simple measures that can help to cope with pressure, strain, or possibly nervousness. The ideal solution is to stop the stressors or the factors that cause these feelings. When dealing with stress, this is often easier said than done. There are healthy ways to handle the stress that help to recover.

The World Health Organization classified stress as the health epidemic of the 21st century.² However, there are currently no suitable, evidence-based guidelines for managing problems and disorders related to stress, and there remains a strong medical need for such treatments. In contrast, international guidelines address sleep disorders, and there are several recommended treatments.

Cognitive Behavioral Therapy (CBT)

Treating stress symptoms such as nervousness, restlessness, anxiety, and insomnia remains challenging due to their complexity and various origins. European and US guidelines recommend Cognitive Behavioral Therapy (CBT) as a first-line treatment for insomnia and some anxiety disorders. CBT is a form of psychological treatment demonstrated to be effective. The therapy can include sleep hygiene, relaxation training, stimulus control therapy, sleep restriction therapy, and cognitive therapy. CBT is based on the concept that it’s not simply the life events that cause stress but also the thoughts concerning these events. It rests on the premise that thoughts, feelings, and actions are interconnected.

Pharmacological approach

There are relatively few recommended short-term pharmacological treatments for stress, nervous restlessness and resulting insomnia. An increasing number of people seek help from pharmacological stress-relieving medications. However, such medications can be problematic due to unwanted side effects, especially for long-term applications. These drugs are effective but associated with unwanted daytime sedation (the so-called “hangover effect”), cognitive impairment, and the development of tolerance, leading to reduced effectiveness. Some of them can also lead to addiction. Benefits may not outweigh disadvantages. A multidisciplinary approach is necessary for treating chronic stress and related sleep disorders because drug therapies are often unsatisfactory and are associated with adverse effects.

Natural medicine approach

Natural medications are widely used as mild and safe alternatives to conventional medicines. Several single herbal preparations have been evaluated for nervous restlessness, resulting insomnia and related conditions, such as anxiety. Clinical studies have shown that natural medicine effectively treats stress-related disorders without serious adverse effects, such as addiction, daytime fatigue, or concentration deficits. Natural medicines for nervous restlessness and sleep disorders include single herbal preparations; those currently approved in Europe are valerian, hops, Melissa leaf, passionflower, oats, lavender oil, and St. John’s Wort. Valerian is the herbal product most commonly used to treat nervous restlessness and sleep disorders in both the US and Europe. There is some evidence to suggest that valerian might improve sleep quality. However, valerian showed a gradual onset of action – in some studies, the beneficial effects of valerian were not seen until after 2-4 weeks – residual daytime sedation has been observed at a high dose, and long-term safety data is lacking.³ Studies show that other natural medications are more effective in treating nervousness, restlessness, and resulting insomnia than valerian. Other natural ingredients such as purple passionflower, common oats, coffee plant, and valerianate of zinc are traditionally well-known to affect stress and sleep disturbances.