Stress: a circumstance, external to a person, which makes unusual and extraordinary demands on him/her, or threatens him/her in someway”
— Richard Lazarus
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Slipping gradually into a state of overwhelm is becoming all too common today. As we try to navigate each of the tasks we must perform to get through each day, each week, each month, it is easy to forget to breathe, forget to stop just for a moment and recalibrate.

 Increasingly, the boundary between our work life, social life, and personal life is becoming blurred and those shifting boundaries gradually become part of our normal rhythm. For a while, we can carve out time so that sleep is sacrificed, good nutrition is less of a priority, and we postpone social events with friends. But suddenly, once we have cut out all that sustains us, we find ourselves in a state of depletion and overwhelm.

 This scenario is not uncommon. I am often surprised at how much load a person can actually carry before they reach a state of overwhelm. We are robust and resilient beings but there is always a limit to our load carrying capacity. The point at which we reach our capacity varies for everyone, nonetheless, once capacity is reached, the physical, emotional and mental experience is very similar.

So What Happens When we Reach Overwhelm/Depletion/Burnout ?

Much of what we know today about the effect of stress on the body was discovered at McGill University in Montreal by Austrian- born endocrinologist Hans Selye. He has been called the ‘father’ of the field of stress research.

 He found that all stress in any form, whether it be physical, psychological or emotional, follows a predictable biological response pattern in order to help the body to regain balance.

He termed this response the General Adaptation Syndrome (GAS) and it is divided into three phases. Although not everyone agrees with every aspect of this stress paradigm, it gives us a usable model to explain the body’s response to stress.

1. Alarm Phase

This is a primal response that is coordinated by nervous system messengers that connect the primal brain with the rest of our body. This is often felt physically as a jolt and sets off a cascade of events as a distress signal is sent out and coordinated by the nervous system. It results in an increase in hormones called cortisol, noradrenaline and adrenaline, which are released by our adrenal glands, which two little organs that sit like little hats on top of the kidneys.

Release of these hormones leads to:

  • An increase in your heart rate and breathing rate

  • Loss of appetite as blood is diverted from digestion to your muscles

  • Goosebumps  (this is because blood flow to your skin is reduced so you don’t bleed so much if injured by the stressor like a foe or a wild animal), 

  • Increased alertness

  • Increased focus and mental clarity

  • Increased blood glucose levels to provide energy to your muscles

  • Dilated pupils so you can see the enemy better

 You are now ready for action and able to respond effectively and efficiently to the stressor.

2. Resistance Phase

The resistance phase is where the body builds resistance to the stimulus and attempts to counteract all those physical effects resulting from the stressor and bring the body back into equilibrium. It dampens the adrenaline and cortisol, reduces blood glucose and generally dials everything back to neutral.

However, if the stressor remains, then the body will continue to secrete the hormones cortisol and adrenaline and the body remains on high alert as other body systems struggle to regain control and find equilibrium.

3. Exhaustion Phase

If stress is prolonged or chronic, then the body moves into the exhaustion phase. It is continually trying to reconcile, trying to recover from the prolonged initial alarm phase, but failing to do so. The body eventually fails to cope with and quench the continual stimulus. In other words there comes a point, whether related to intensity or time, when the body’s ability for adaptation to stress becomes exhausted.  

What are the impacts of chronic stress?

 A little stress can be useful – it can motivate and inspire us to perform optimally. It is a primal response to a physical, mental or emotional challenge, and is unavoidable throughout our life. Our response is self serving when it occurs in short bursts. It can get students though exams, it motivates us to meet deadlines, it can save our lives if we are in danger or injured, and it carries us through short, difficult challenges and illnesses.

But chronic stress such as money or job concerns, caring for the well-being of a loved one, shift work, these can all take a toll. Overall, chronic stress has wide social and personal implications. It has real physical, mental and emotional consequences and can eventually lead to ill health. People are more likely to get sick when they are under chronic stress. 

Some of the known and studied effects of prolonged stress:

  • Compromises immunity

  • Reduces quality and duration of sleep

  • Changes eating patterns, dampens established hunger cues and alters appetite leading to weight loss, or weight gain.

  • Reduces cognitive ability to process and follow logical thought patterns

  • Impacts Heart health, increases blood pressure

  • Digestive  - bloating, gas, abdominal pain,  the microbiome is negatively impacted (which impacts immunity and mood)

  • Skin break outs

  • Hormonal disruption

  • Emotional changes such as social withdrawal or angry outbursts

  • Depression

  • Anxiety

Finding the Balance

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Some of the foundational principles that create vitality within the body, assisting it in resisting the negative effects of stress:

  • Sleep - 7-8 hours is optimal for longevity and performance

  • Baths using your favourite relaxing essential oils

  • Nature/forest bathing – one study found that even just 15 minutes a week can be beneficial.

  • Nature is a great healer, take a walk in her energy and let her hold you for a while

  • Walking barefoot in nature when the opportunity presents

  • Social connection in the company of friends/family

  • A cup of calming tea

  • Exercise when you can

  • Singing – even in the shower has been shown to reduce cortisol levels and possibly boost immunity

  • Limiting exposure to adverse news events

  • Introduce times of disconnect. For example avoiding checking phone messages/work emails/social messages for the first hour of the morning and last hour of the night so that you are not entering the day or leaving it in a reactive mode.

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If our nutritional state is not optimal then we run the risk of failing to provide the basic fuel for adaptation. All aspects of our make up, our biochemistry, requires micronutrients and macronutrients for optimal performance.

  • Low glycemic load diet (protein and fat significantly reduce cortisol levels compared to refined carbohydrates).

  • Magnesium – leafy greens, wholegrains, beans, nuts

  • B vitamins – leafy greens, wholegrains, salmon, liver and organ meats

  • Vitamin C – citrus fruit, bell peppers, tomatoes, rosehips, berries, parsley

  • Omega 3 – salmon, sardines, mackerel, tuna, flaxseeds, walnuts, borage seed oil

  • Culinary herbs and spices that reduce the inflammatory response often accompanying stress. For example - rosemary, sage, turmeric, black pepper, ginger.

  • Maca root powder - Peruvian, belongs to the same family as cauliflower and broccoli - increasing evidence supports its use for improving energy and stamina

  • Green tea - contains L-theanine, phytonutrients and less caffeine - relaxing and and may improve mood

  • Mushrooms - especially reishi and shiitake but any mushrooms added to your diet regularly


Caring for Ourselves with Herbal Medicine

There are a number of herbs that we can choose from to provide support and enhance healthy function of specific body systems, help with relaxation and to aid sleep. Herbalists will formulate an individual herbal blend for patients that considers all aspects of their health.

 I would like to concentrate however in a very specific category of herbs called adaptogens. Plants with adaptogenic properties have a long history of use in traditional systems of medicine for addressing chronic stress. In India and China they are known as ‘royalty’ in the hierarchy of herbs. Their role is to help the body respond to stress and restore balance and a sense of well-being.


 The adaptogens that have been heavily researched originate mainly from the Traditional Chinese Medicine and East Indian (Ayurvedic) traditions. This relates back to a time when Soviet research was heavily funded to study plants that could improve the stamina and output of athletes, cosmonauts and the military. The Russians thus became pioneers in the field of adaptogen research. Although less well studied until recently, Western Herbal Tradition also includes herbs that have traditional use as what we call nervine tonics or trophorestoratives for the nervous system for example vervain, rosemary and green oats. Milky green oat tops combined with nettle leaf are a favourite blend of mine for new mums. In my experience this safe blend provides a tonic effect, improving energy and creating balance as she recovers from giving birth, meets the demands of nursing and adjusts to new responsibilities and long night shifts.

The term ‘adaptogen’ was originally proposed in 1962 a Soviet scientist called by Lazarev. He defined adaptogens as ‘those plants that improve nonspecific resistance to all kinds of stressors by helping an organism adapt or adjust to changes in the environment’. The definition of an adaptogen has evolved over the last 60 years or so.

 A group of scientists in the 1990’s further defined adaptogens as: ‘natural bioregulators that increase the ability to adapt to environmental factors, and avoid the damage caused by those factors.’

In fact, the advantages of adaptogens include their ability to minimize the bodily response to stress, reducing the negative reactions during the alarm phase and eliminating, or at least decreasing, the onset of the exhaustion phase that is part of the General Apaptation Syndrome (GAS).

Health is the ability to adapt to one’s environment
— George Canguilhem

The American Food and Drug Administration (FDA) defined an adaptogen as ‘a new kind of metabolic regulator that has been proven to help in environmental adaptation and to prevent external harms’.

 In other words, adaptogens can protect the body against the physical and mental effects of stress. Over the years I have effectively included adaptogenic herbs in formulas for various circumstances, such as for shift workers, night workers, following bereavement, life transitions, job changes, weddings, new mothers. These are times when the body is vulnerable to burnout, vulnerable to picking up infections. They are times of predictable stress.

 We will soon move into the 3rd decade of the 21st century and it would appear that adaptogens could be a great ally for us at this time. Change is occurring at a much faster rate than ever before, work is more precarious and unpredictable and families and communities perhaps less cohesive.

One caveat though is that adaptogens are never a substitute for responding to stress and overwhelm with sustainable changes that increase and support vitality. They can, however, carry you through a difficult period, while you reassess priorities and unhelpful stressors.

 Herbalists often combine adaptogens with other herbs and there is some evidence that the synergism potentiates the formula. In my practice I like to combine adaptogens with other herbs such as licorice, astragalus, turmeric, holy basil, milky green oats, gotu kola, sage, rosemary, hawthorn, rose hips, elderberry and warming spices such as ginger, cinnamon, turmeric.

 Adaptogens are considered to promote physical and mental health, improve the body’s defense mechanisms and enhance longevity.
— I. Brehman

Adaptogens can:

  • Increase resistance to colds and flu

  • Improve recovery from fatigue

  • Improved blood glucose balance

  • Normalize blood pressure

  • Improve hormonal balance (thyroid, cortisol, insulin, melatonin)

  • Promote relaxation

  • Provide protection from environmental toxins

  • Improve blood cholesterol

  • Improve fertility

  • Enhance healing

  • Improve sleep

  • Support longevity

Below is a list of commonly prescribed adaptogens… 


Eleutherococcus senticosus – stimulating, immune modulating

  • increases mental focus and performance,

  • improves physical stamina,

  • improves immunity,

  • dampens the alarm reaction thus delaying the exhaustion phase

  • helps re-establish circadian rhythms  -commonly known as our ‘body’clock’, a 24 hour biological clock that determines sleep/wake patterns, the ebb and flow of our hormones, and key to balanced health  

The most widely studied of the adaptogens and one of my favourites. It is very safe and can be used over longer periods. I choose this herb specifically for patients who are convalescing, work shifts and nights, who are caring for loved ones and whose stressors are fixed, as it can be tolerated over the longer term and has an excellent safety profile.

Dose: 2-3g of the dried herb daily or 1-4ml (of a 1:2 tincture) in water twice daily or as directed by your herbalist

Caution: I avoid this in those with high blood pressure as a precaution.  In insomnia, it may be too stimulating and another adaptogen may be a better choice or taking it before noon. 


Withania somnifera  - gently calming, nourishing, warming, immune modulating

Ashwaganda has been used in India for over 4000 years and is considered safe. It has rejuvinating properties, and is useful for the elderly showing protection against cognitive decline. I generally use it for people who have trouble sleeping and whose minds are active, for nervousness and anxiety, for arthritis and other inflammatory conditions, and for muscle tension.

Dose 3-6g of dried herb/day or 3-7ml (of a 1:2 tincture) twice daily

Caution: Use with caution if you are sensitive to plants in the nightshade family.


Schisandra chinensis: promotes energy and alleviates stress induced fatigue, depressed mood and protects the liver. I use this herb where brain fog is a significant symptom, where a patient requires physical stamina such as during physical endurance training.

Dose 2-4ml of a 1:2 tincture twice daily


Rhodiola rosea - energizing, stimulating, anti-inflammatory, immune enhancing

Used in stress induced mild depression, improved cognitive performance in burnout and fatigue, reduces chronic inflammation, enhances immunity, improves blood supply to the muscles.

Rhodiola grows in northern latitudes, including the northern coast of Scotland. It is reputed to have been picked by the Vikings to provide sustenance on long journeys. It is foraged in the wild and added as an ingredient to one of Scotland’s best selling Craft gins. Although it is not related to the rose family in any way, its root has a rose-like fragrance.

I do not personally prescribe this plant very often as it can be too stimulating, although I have colleagues who use it successfully. I would be cautious about taking it in depleted states. I am including it here as I see it  often in over the counter generic herbal formulas.  Start low and go slow with this plant.

Cautions: not to be taken in cases of bipolar disorder.


Astragalus membranaceus - immune enhancing tonic

This is a sweet root that I love and will often include in a formula where a patient is run down, fatigued and catching colds or has a chronic sinus infection not responding to conventional antibiotics. I like to combine it with warming stimulants such as ginger and cinnamon.  It is a herb I use more in the winter months and is first on my list for teachers, nurses and children who are constantly in contact with, and fighting off, colds.

Dose: 3-4 mls of a 1:2 tincture twice daily or about 20g of the root can be added to soups. 

Adaptogens are stress response modifiers that nonspecifically increase an organism’s resistance to various stressors, thereby promoting adaptation and survival.  
— A. Panossian


Liao, L., He, Y., Li, L., Meng, H., Dong, Y., Yi, F., & Xiao, P. (2018). A preliminary review of studies on adaptogens: comparison of their bioactivity in TCM with that of ginseng-like herbs used worldwide. Chinese Medicine13(1). doi: 10.1186/s13020-018-0214-9


Panossian, A. (2017). Understanding adaptogenic activity: specificity of the pharmacological action of adaptogens and other phytochemicals. Annals Of The New York Academy Of Sciences1401(1), 49-64. doi: 10.1111/nyas.13399


Yance, D. (2013). Adaptogens in Medical Herbalism. Rochester, Vermont: Healing Arts Press.

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Jill Burns