Nervous Depletion. Fatigue. Exhaustion. Burnout.

We have all experienced the signs of accumulated stress at one point or another. Since stress has such broad implication on health, I like to be quite specific about supporting it.

Physiologically, accumulated stress impacts our systems in three stages, or levels of severity.

• Alarm Stage: At first, the body responds to elevated stress by trying to speed up and meet additional demands by secreting excess catecholamines. Increased secretions of catecholamines (adrenaline) maintain a level of sympathetic activation for as long as possible. This phase might include anxiety, irritability, mood issues, interpersonal and decision-making impacts, but physical stamina is not as deeply affected.

• Resistance Stage: Over time, the body begins to adapt to higher daily stress demands. The stress hormone cortisol, which controls energy levels throughout the day as well as the sleep-wake cycle, begins to be affected. This stage of our stress response might include interruptions in sleep and changes in daily energy levels. It may be accompanied by a sense of numbness or decreased mental or emotional capacity as the body is less physically resourced to respond.

• Exhaustion Stage: While our nervous systems are well-equipped to recover from short bursts of stress, prolonged high stress can compound and more deeply impact the stress-response system (also referred to as the neuroendocrine immune system or hypothalamci pituitary axis). When this happens, deeper health issues may appear, such as: reduced immunity, hormonal issues, changes in metabolism (weight loss or weight gain), skin or hair issues, and/or accumulated body pain such as muscle tension and headaches.

Ideally, the warning signs in the earlier stages of stress nudge us towards seeking rest and recovery, but occasionally, that’s out of reach for longer than we can healthfully withstand.

Getting to the roots of our stress can be big work. Thankfully, there are botanical medicines called adaptogenic herbs specifically suited for re-balancing the stress response system. I often find myself introducing patients to adaptogens during visits and find them to be a healpful resource.

What are adaptogenic herbs?

Certain plants and herbs are considered “adaptogenic” because of their capacity to increase adaptability, survival, physical stamina, and resilience in stress and aging.

Although modern research is beginning to understand more about how adaptogens work, adaptogenic herbs have been used traditionally for millennia.

How do they work?

Adaptogens impact cellular signaling in our stress hormone, immune, and neurological system. We’ve been trained to accept the ways that pharmaceutical medications affect our physiology, but adaptogens operate via a slightly different paradigm that does not quite match a drug framework (‘ligand-receptor model’).

Trying to understand herbal medicine asks us to shift the way we relate to our bodies and how they can heal. For now, here are three traits of adaptogenic herbs. They are:

• Non-toxic: adaptogenic herbs are considered generally safe for most people when taken at normal doses; they more often have side benefits than negative side effects

• Pleiotrophic: capable of having a multitude of therapeutic effects at once

• Harmonizing: adaptogens have an equilibrating effect on the stress response system, capable of tonifying weakness and calming agitation

Over 70 plants are considered adaptogenic; however, each plant has a slightly different way of supporting the mind-body. Some are more energizing and others are more soothing or leveling. Certain adaptogenic herbs can be considered better for physical fatigue while others are better for mental/emotional depletion.

I’ll share a little bit about some of the adaptogens that appear frequently in my practice so that you can familiarize yourself with these kinds of herbs and perhaps consider this form of support for yourself one day.

Adaptogenic Herbs:

• Siberian Ginseng (Eleutherococcus senticosus): Considered a tonic for the exhaustion phase of prolonged stress, eleuthrococcus enhances physical stamina (especially in adverse conditions), and boosts baseline energy levels. It is thought to strengthen the threshold at which the body experiences distress, improving resiliency over time. This herb boosts immune function and may be helpful for those seeking to recover from states of suppressed white blood cell counts (e.g. chemotherapy or prolonged illness). It can also support the immune system in ways that reduce allergic reactivity.

• Holy Basil (Ocimum sanctum): Ocimum sanctum (Holy Basil or tulsi) is in the mint (Lamiaceae) family. From India, this plant has been used traditionally as a tea in the treatment of diabetes, stress, ulcers and inflammation. Constituents in Ocimum have anti-stress effects in that they help to normalize hyperglycemia (high blood sugar) and excess serum cortisol from chronic stress. Ocimum has anti-inflammatory properties.

• Rhodiola (Rhodiola rosea): Rhodiola, commonly called Arctic Rose, grows out of rock crevices in Northern Europe and Siberia. Think of this herb as a hardy adaptogen especially for the mood. Thought to elevate serotonin levels, rhodiola can address symptoms of oscillating mood, anxiety, depression, insomnia, and OCD. It should not be combined with SSRI or MAOIs. Studies show that rhodiola helps stabilize mental-emotional capacity and reduces perceived distress in stressful situations.

• Bacopa monnieri (Water hyssop): Bacopa is adaptogenic for the cognitive effects that come from overwork, over-stimulation and excessive attentional demands. It is considered neuroprotective for the resistance phase of stress and supports mental focus. It is considered a bit more sedating allowing those with anxiety to experience energy with calm. Preliminary studies have shown this herb to be a helpful herbal addition to the management of ADHD.

• Ashwagandha (Withania somnifera): The species name somnifera means ‘sleep-inducing’ in Latin. As an adaptogen, consider ashwaganda as half-relaxing and half-energizing. Well-suited for those whose stress causes insomnia and who may need more help winding down, this adaptogen protects your energy by letting you rest when you need to. Ashwagandha has positive effects on the endocrine, nervous, immune and cardiovascular systems. Long used specifically for thyroid conditions, the appropriate use of withania for autoimmunity has recently come into theoretical doubt because it may be too stimulating for the immune system. Also ashwagandha is classified as a nightshade (a member of the solanaceae plant family), and although it has fewer irritating constituents than other more potent nightshades some nightshades are known to instigate inflammation in some people.

How to work with Adaptogens

In my experience, working with adaptogenic herbs occurs best under the following circumstances:

• Selection: I recommend selecting your adaptogenic support with the help of an experienced practitioner who knows herbs, can take into consideration your specific health profile (including any other supplements or medications you are taking), and your nervous system tendencies.

• Respect constitution: Some herbal medicines are derived from the root part of the plant, others from the leaves, and should be prepared differently. Some people’s bodies respond differently to different delivery formats. Choosing the appropriate format (e.g subtle water-based extracts, stronger decoctions, or encapsulated powders), may affect the desired response.

• Quality: Seek verifiable sources that can vouch for eco-sustainability, potency, and purity of the contents.

• Consistency: Regular use over time is most likely to help nurture rebalancing effects (e.g consistently for 6-8 weeks prior to re-evaluating).

Of course, adaptogens aren’t meant to cure everything, but they can play an important role in regaining equilibrium after high stress periods.

I like to encourage people to develop a relationship with the characteristics and qualities of the herbs that they are taking. Remember that we have co-evolved with our plant allies over millenia . . . so maybe connecting to the long history of adaptogen-human survival will help you overcome some forms of daily stressors.

REFERENCES

❍ Agrawal P, Rai V, Singh RB. Randomized placebo-controlled, single blind trial of holy basil leaves in patients with noninsulin-dependent diabetes mellitus. Int J Clin Pharmacol Ther 1996; 34(9):406–9.

❍ Panossian AG. Adaptogens: A historical overview and perspective. Natural Pharmacy 2003;7(4):1,19-20.

❍ Vinod A, Sathianarayanan S, Babu AE, Sadanandan P, Venu AK, Venkidasamy B. Bacopa monnieri for Disorders Affecting Brain: Current Perspectives. Currently Top Med Chem 2022;22(23):1909-1929. doi: 10.2174/1568026622666220119111538.

❍ Jamshidi N, Cohen MM. The Clinical Efficacy and Safety of Tulsi in Humans: A Systematic Review of the Literature. Evid Based Complement Alternat Med. 2017;2017:9217567. doi: 10.1155/2017/9217567.

❍ Ishaque S, Shamseer L, Bukutu C, Vohra S. Rhodiola rosea for physical and mental fatigue: a systematic review.Complement Altern Med. 2012 May 29;12:70. doi: 10.1186/1472-6882-12-70.

❍ Todorova V, Ivanov K, Delattre C, Nalbantova V, Karcheva-Bahchevanska D, Ivanova S. Plant Adaptogens-History and Future Perspectives. Nutrients. 2021 Aug 20;13(8):2861. doi: 10.3390/nu13082861.