Bruce Alan Kehr, M.D. is the Founder and President of Potomac Psychiatry, ranked “Best Psychiatry Care Provider in Maryland” in 2020 by Global Health & Pharma. He has been named a Washingtonian Magazine “Top Doctor” for each of the past eight years. Dr. Kehr is a best-selling author whose works have been read by over 800,000 people in 206 countries. In 2020, Dr. Bruce Kehr’s blog was ranked #2 in the nation among mental health-related blogs. Dr. Kehr’s book, Becoming Whole: A Healing Companion to Ease Emotional Pain and Find Self-Love, is an Amazon Best Seller in the self-help categories: Happiness, Counseling, Healing, and Self-Esteem.
Stop Stressing So… Your Genes Will Help You!
DNA+Environment+Triggers+Chance = “Good Stress” or “Bad Stress”
Win Your DNA-Mediated “War on Stress” through Modifying the Expression of FKBP5, CRHR1, and BDNF Genes
-Bruce Alan Kehr, M.D.
My dear Reader, have you ever felt out of control of your own life? Let me tell you a story about a woman named Lisa to see if you can relate. Lisa is a successful young businesswoman normally able to juggle a full schedule of work, volunteer gigs, and a healthy lifestyle to boot. She can go months maintaining this schedule smoothly. And then, every season it seems, something happens. She misses a workout…. then a whole week of workouts. Her deadlines start to slip away. Trying to make up for them, she finds herself eating junk food and drinking way too much caffeine. Sleep becomes a luxury. It all seems so out of character. This isn’t who I thought I was, she tells herself—but then doubt slips in…or is this actually EXACTLY who I am, and the other “me” is just an act? She spirals in to an existential crisis, worrying she may never regain the structured life she had. Lisa believes all of this to be an internal, self-imposed problem—and that’s where she’s wrong. It’s a simple mistake we all make—to blame ourselves when we feel in over our heads. Unfortunately, that is the exact opposite of what’s really happening. What Lisa—and all of us—are really going through when we feel overwhelmed is excessive stress, pure and simple. And when we receive too many stressful inputs from the outside world particularly when they become chronic, our bodies and our minds react accordingly. The danger is when we don’t recognize this “bad stress” for what it is (so-called “good stress” can motivate and mobilize us, and promote personal growth), and when we don’t recognize the warning signs of dealing with too much of it. When we blame ourselves instead, we never address the problem… and our whole being suffers.
Today, we’re talking about a domain that is a near-perfect example of how interconnected our minds and bodies are—and how susceptible they are to outside factors. We’re talking about stress and emotional well-being… and how your genes may predispose you to react in more extreme ways toward those outside factors than you may otherwise if you had a different personal genome. Each and every one of us suffers stress at some point or another. Think of this blog as a starting point to help you take control of your stress once and for all… and to help you quit blaming yourself!
Stress and Emotional Wellbeing: When the External Impacts the Internal
When I type in the words “How does stress” into Google, it autofills as “how does stress affect the body”. I count this as a good thing, as we are all coming to understand that stress is a very real and potentially dangerous cause of a number of symptoms, both mental and physical. The Mayo Clinic outlines those symptoms as ranging from headaches, muscle tension or pain, chest pain, fatigue, change in sex drive, upset stomach, sleep problems, anxiety, lack of motivation, irritability, and sadness. Given this robust list of negative outcomes which impact our whole body, perhaps it’s not surprising that we have a hard time connecting all of these things to a single cause—but that’s exactly what chronic stress does. We may find it easier to think of the root cause as our “self” simply “falling apart”… but if we don’t pin these effects on stress, we often just worsen the symptoms. How? Because instead of focusing on identifying the things that stress us out, we focus on the individual outcomes: we try to sleep more, only to fail because… we’re stressed. We try to eat healthy and when we fail we feel that failure harder than usual and we set ourselves up to do it again. We stop having sex with our partners and blame them, rather than the external stressors. We try to cure our fatigue by drinking more caffeine or eating more sugar… and then crash.
Understanding that all of these body and mind impacts have a specific cause—chronic stress—gives us the power to address that root cause head-on. But genetic testing takes that power one-step further and can give us more specific tools and resources to help ensure we don’t become a victim of out-of-control stress.
Stress and Genetic Testing: FKBP5, CRHR1, and BDNF
There are a number of fascinating gene variants that can dictate not only the magnitude and duration of our stress response, but also our emotional responses to other stimuli—from things as diverse as social environments to cannabis use. We’ll undoubtedly return to these unique genes in the weeks to come, but for now I want to talk about three genes that have an unusually significant impact on our stress response.
A little bit of an introduction is warranted to the first two genes—FKBP5 and CRHR1—which relate to one another in ways that are still not fully understood. Both of these genes have influence over the functioning of the Hypothalamic Pituitary Adrenal Axis, or the HPA, which is in charge of regulating our response to stress. Activation of the HPA triggers the release of cortisol and epinephrine/norepinephrine from the adrenal cortex, which then activates the fight or flight response in certain organs. With that in mind….
FKBP5: The HPA activation process—which in turn activates the release of cortisol into our bloodstream—is partially regulated by receptors known as “Glucocorticoid Receptors” or GR. This gene regulates GR function, and variants of the gene thus understandably have an impact on the stress-activation process itself. The T allele of the FKBP5 variant, for instance, confers a dysregulated cortisol response to stress, fails to “turn off” the stress response, decreases the ability to “come down” after a stress response, and has been shown to possibly increase the risk of depression following trauma. Bottom line? If you know you have a risk variant on this gene, and thereby know you may have an atypical and heightened response to stress, you might consider lifestyle changes that will decrease your chances of dealing with too much stress in the first place—meditation is just one example. Vitamin D has also been shown to aid in terminating the stress response. N-acetylcysteine (NAC) has also been shown to modulate the effects of stress-related addictions, compulsions and mood disorders.
CRHR1: This gene encodes for the corticotropin releasing hormone receptor, which is essential for the activation of the HPA process. As a pair, it seems that CRHR1 helps to establish the HPA response to a stressful episode, while FKBP5 helps to eventually terminate it. So, just as certain risk variants on FKBP5 may impact our stress reaction, CRHR1 is no different in this respect: the G allele in particular is associated with significantly increased cortisol in response to stress, as well as poor working memory and increased rates of depression. The A allele confers resilience to stress. If your genetic test shows you have the risk allele, again: do what you can to take extra precautions against chronic stress—and if you find yourself in a chronically stressful situation (for example a boss or loved one who repeatedly emotionally abuses you), understanding what you and your body are working with can help you feel more in control about what you need to do to not feed the stress further. In these situations, as my author-friend Mary Loverde puts it, “Winners Quit.” Meditation and Ashwaganda may also help as you ponder how to extricate yourself.
BDNF: Remember this one? We first spoke of this gene in Session 5 of DNA: I Am Who I Am… Or Am I?, where we referred to it as the “rainforest gene”. Why? Because BDNF plays a major role in neurogenesis and synaptic plasticity—the process that allows our neurons to grow, adapt, connect to one another, and thrive. One variation of this gene known as the Val66Met polymorphism is associated with reduced BDNF, which means reduced neuroplasticity… which has a surprising negative impact on our resilience to stress. The good news is, studies have shown that regular exercise improves BDNF levels and our resilience to stressors, and even just a single session of exercise can benefit cognition by increasing BDNF.
Stop Those Stress Genes from Taking Over Your Life!
Blaming ourselves for feeling out of control is never a good strategy. Chronic stress has a huge impact on our bodies and our mental health, and sometimes our genes can accentuate our response to that stress through no fault of our own. The more we know about our personal genetic code, the more we can to do tweak it. Learn about your genes and take thoughtful control over those “stress modifiers” today!
Read my Amazon Best Seller Book, ratings on Amazon and Goodreads, Becoming Whole: A Healing Companion to Ease Emotional Pain and Find Self-Love, if you would like to feel better through genetic testing, and improve your love relationships.
Proceeds from your purchase of my book will be used to directly help victims of child abuse.
(*Dr. Kehr holds no ownership interest in Genomind and receives no consulting fees)