Although stress seems to be on everyone’s mind, it is a surprisingly difficult term to define. The ancient Greek stoic Epictetus stated: “People are disturbed not by a thing, but by their perception of a thing”. Overall I think this statement is true, but it doesn’t really address the true threat that any given stress generates. For example, if a tiger suddenly jumped out of the weeds and attacked you, I suspect that you would have a major acute stress reaction. If you happen to survive the attack, I suspect that every time you walk by the site of the attack, you will have some type of stress reaction even though there is no tiger. That suggests that perception does play a key role in stress.

The Many Flavors and Colors of Stress
I think it’s also important to differentiate acute versus subacute (episodic) or chronic stress. Again the line between these two categories is somewhat blurry. I define acute stress is any event that generates a stress reaction mainly generated through the automatic subconscious mind rather than the conscious mind. When that Tiger pounces, your body will react almost before you actually see the Tiger. Your subconscious mind acting through the hypothalamic pituitary endocrine axis will automatically react to the attack in a manner that will most likely lead to your survival. You can imagine what would happen if your conscious mind got involved—you would end up being Tiger lunch!

Things get complicated because your subconscious mind can be programed to perceive something as stressful and dangerous when in fact it is benign. You brain and body quickly go through the typical “fight or flight” reaction when you aren’t evenly consciously aware of the threat. For strange noises in the night—is it a dangerous beast lurking ahead or merely the wind blowing the grass? Your bodies’ reaction likely will be the same for either scenario and it will occur quickly without any input from your conscious mind. In summary, acute stress, whether benign or dangerous, is an automatic response orchestrated by the lower subconscious parts of your brain.

Chronic Stress Destroys Your Health Slowly over Time
Subacute and chronic stress are by definition stressful events that act over a longer period of time, at least long enough for your conscious brain to get involved. Subacute stress is likely a single stressful event that lasts hours, days or weeks. Chronic stress is a persistent stress that can act over months or years. Subacute or chronic stress can generate the same physiological reaction as acute stress, but there often isn’t a clean cut off. Once your conscious brain gets involved with your subconscious brain, you suddenly don’t know whether you are on foot or horse back. It really gets confusing because sometimes your subconscious and conscious brain don’t agree on whether a stressor is present and the degree of danger associated with the stressor. To add to the confusion positive events like winning a race, getting married or completing a complex project can also be stressful but up to a point these situations can have a positive influence on performance. Once a line is crossed, this positive stress can rapidly turn into negative stress.

To Optimally Manage Stress, Optimize Your Brain Function
The question arises, what can you do to mitigate negative stress and benefit from positive stress? The answer is straightforward—make sure that your brain and hypothalamic pituitary endocrine axis are functioning optimally. This includes your subconscious brain and lower more primitive parts of the brain and the higher brain centers responsible for conscious thought. Once the brain perceives stress, it reacts through the hypothalamic pituitary endocrine axis, especially the adrenal glands.

As a practicing Family Physician with over 40 years of experience, over the years I have seen thousands of patients who appear to have significant brain dysfunction to the point where they can’t react appropriately to any stress. In my opinion virtually all of these folks have a form of food-induced brain dysfunction caused by the long-term consumption of highly processed food. This type of food contains the toxic triad of excessive fructose mainly from added sugars, excessive highly refined carbohydrates mainly from grains and excessive omega 6 fatty acids relative to omega 3 fatty acids. Over time this type of food affects the brain in a predictable way that fits a disease process. We now call this disease Carbohydrate Associated Reversible Brain syndrome or CARB syndrome. There is no blood test for this disease because it is essentially a clinical diagnosis based on the presence of the 22 symptoms of CARB syndrome. The lead symptom is strong cravings for sweet and starchy food. If you have such cravings your brain is likely not in optimal shape to deal with any type of acute, subacute or chronic stress. In other words your reflexive “fight or flight” might transition to “disagree or crawl”. Thus your ability to survive any type of dangerous acute stress will be compromised if you have CARB syndrome.

Those with CARB syndrome faced with acute trauma don’t have optimal brain function to properly respond. The same is true for any type of subacute or chronic stress. Because our conscious brain is involved in subacute and chronic stress, this is where the many “stress management” techniques come into play. These include meditating, deep breathing, walking in nature, yoga, soaking in a bubble bath, dancing, cognitive therapy, getting a message, self-hyponosis, listening to music, tapping (emotional freedom technique), earthing, visiting with friends, watching a comedy, singing in the rain, switching to decaf coffee and so on. I believe that many of these techniques can be helpful, but they work much better if your brain is in tip top shape with no CARB syndrome. If you do seem to have CARB syndrome there are some simple and safe things you can do to turn the ship around:

Brain Enhancer Number 1:  Diet.
As they say, this is a “no brainer”. If you consistently consume a diet of highly processed food as most folks do in modern societies, at some point you will end up frying your brain. You won’t be able to handle any type of acute or chronic stress.

What exactly is the ideal diet? This is a somewhat complex question because each person has a unique genetic makeup that influences the type of food they should try to eat. To keep things simple, I need to generalize a bit. I think science supports the idea that everyone should consume a whole foods diet that consists of real food, not processed fake food. Highly processed food contains the deadly triad of excessive sugars, excessive high glycemic carbohydrates especially from grains and excessive omega 6 fatty acids relative to omega 3 fatty acids. In my opinion healthy fats should always be included in such a diet. I strongly recommend that you read Dr. Mercola’s new book “Fat for Fuel”.

Mediterranean, Paleo and ketogenic diets tend to be my favorites but even a whole foods vegan diet is better than the Standard American Diet (SAD). Reducing calories might be helpful as long as you reduce the right calories.  Intermittent fasting has recently caught a lot of attention and I think this approach can be incorporated into any healthy whole foods diet. Because people with CARB syndrome tend to crave sweet and starchy food leading them to consume the very food that is frying their brain, an effort must be made to suppress these cravings with supplements like L-glutamine and CARB-22. Low dose medications can also be useful in reducing these cravings. I discuss this approach in other blog posts.

For more information on eating a healthy diet I recommend visiting Dr. Mercola’s site. It is loaded with solid information about both diet and exercise. I also recommend reading Robb Wolf’s new book “Wired to Eat”. I also recommend visiting Loren Cordain’s and Jimmy Moore’s web sites. They have a lot of great information on the healthiest way to eat. All four of these nutrition leaders have written great books about how to eat a healthy diet. You won’t get this information from your local dietician (it’s a long story) so when it comes to eating a healthy diet, you really need to become self-educated

Brain Enhancer Number Two: Exercise.
Exercise has been touted to be the fountain of youth and the key to optimal health and longevity. I’m not sure if this is the case, but I do know one thing—exercise is very, very good for your brain. There are almost endless studies documenting how any type of exercise enhances brain function. Anaerobic exercise, aerobic exercise, strength training—do them all if you can. It comes down to getting up off your butt and doing something, anything to get you moving and into shape. It seems that every conceivable form of exercise is good for your brain so go for it! I am currently out of work because of a back injury and I became quite de-conditioned. I recently signed up for a local exercise center where I work one on one with a professional trainer.

One of the key ways that exercise enhances brain function is by stimulating the production of brain-derived neurotrophic factor (BDNF). This remarkable growth protein enhances and stimulates synapses, improving communication between neurons. It is also critical for memory and it promotes neurogenesis. It also appears to lower the risk of many common brain diseases and I suspect that it also reduces the risk of CARB syndrome.

Brain Enhancer Number Three:  Lower Your Homocysteine.
This one is a bit boring but please don’t tune out—this information could literally save your life and your brain! Most people and physicians don’t have a clue when it comes to homocysteine. This amino acid has a very complex biological profile, but all you need to remember is that a high homocysteine is very bad for your circulation and your brain. High homocysteine is also a marker for inadequate folic acid in the brain. You need folic acid in your brain to make the key monoamine neurotransmitters serotonin, dopamine and norepinephrine. In today’s world, virtually no one is low on folic acid because it is added to all processed foods to prevent neural tube defects in developing babies. Folate is the natural form of the vitamin found in food whereas folic acid is the unnatural chemical that is converted to tetrahydrofolate (THF) in the liver. Folate from food is converted to THF in the small intestine. To get into the brain THF must be converted to L-methylfolate and for various reasons some folks don’t make enough L-methylfolate for optimal brain function.

The best marker for low brain folate is an elevated homocysteine. For optimal brain function your homocysteine should be below 7. The easy work around if your homocysteine is too high is to take L-methylfolate as a supplement. It’s interesting to note that L-methylfolate is the only vitamin to be approved by the FDA to treat a disease. It’s called Deplin and it is approved for depression. Once it was approved there was an effort by the drug company that sells Deplin to limit the OTC availability of L-methylfolate, so it’s a bit hard to find. I buy mine from Life Extension (lef.org) as Optimized Folate. I recommend taking a minimum of 5 mcg daily and the dose can be adjusted as needed.

To knock down your homocysteine you will also likely need two or three other B vitamins. You should take around 5,000 mcg of vitamin B12. I prefer the form that dissolves under your tongue. You should also take vitamin B6 100 mg daily. I personally prefer the more bioavailable form called pyridoxal 5’-phosphate 100 mg daily. It is also available at Life Extension although you can also buy it from various venders on the Internet.

I would wait 2-3 months and then recheck your homocysteine level. This is a test that is readily available through your PCP. If the level is still above 7, I would add trimethylglycine (TMG) 500-1,000 mg daily. This dose can be increased as needed to get the level below 7. I know a lot about this topic because high homocysteine runs in my family. At one point mine was above 18 and now it averages 5-6. Who knows, in a few decades I might be the smartest 100 year old on the block!

Brain Enhancer Number 4:  Optimize Your Fatty Acids.
Fatty acids are fats that are critical to our health. There are two essential fatty acids that we need for optimal health:  omega 6 fatty acids like alpha lipoic acid and omega 3 fatty acids like EPA and DHA. Humans evolved with about equal amounts of these fatty acids in their diet, but our diet of highly processed food has loaded us up on mostly omega 6 fatty acids and minimal omega 3 fatty acids. The chemistry is a bit complicated, but let me summarize things and state that omega 3 fatty acids tend to be anti-inflammatory and omega 6 fatty acids tend to be pro-inflammatory. We need both in balance and one of the best ways of measuring this is to do an AA/EPA ratio. For optimal health, this ratio should be between 1 and 3. This simple blood test is available from OmegaQuant.

Most Americans (including myself) can only attain a healthy ratio by supplementing with a high-quality omega 3 supplement. I prefer Omega Rx2 sold by Barry Sears of Zone diet fame. It’s important to remember that you need to take enough omega 3 to make a difference. Most people and many medical studies use low placebo doses that won’t have much clinical benefit. I managed to reduce my ratio to 1.9 by taking about 8 capsules of Omega Rx daily. I endorse eating some fatty fish but I wouldn’t try to get to an ideal ratio just by eating fish because of the issue of mercury poisoning. Small fish are the best because they are less likely to be contaminated by dioxins and mercury.

Brain Enhancer Number 5:  Precursor Supplements
For various reasons people with CARB syndrome have low levels of monoamine neurotransmitters like dopamine, norepinephrine and serotonin. These low levels actually generate the symptoms of CARB syndrome. Psychiatric drugs do not raise neurotransmitter levels and over time they can lead to further depletion. Whether or not you are taking brain drugs, you should take a neurotransmitter precursor supplement like CARB-22.

If you take advantage of the above 5 “brain enhancers”, you will be in good shape to handle just about any type of stress. For subacute and  chronic stress it’s also important that you become familiar with some of the stress management techniques listed above. Once again Dr. Mercola’s site has a lot of detailed information about many of these techniques. I recommend that you sign up for his two daily articles to get the most up to date information on a long list of medical topics.