Stress is all but universal — not many people can say that they don’t have any stress. Usually it’s a matter of degree: How much stress are you experiencing right now?

Maybe you’re only somewhat stressed, so you’d shrug and say ‘Just the usual’. Maybe there’s performance stress involved in getting an important project delivered on time. Or maybe feeling stress tells us that something needs to change. These kinds of stress aren’t necessarily bad. We can feel energized and excited about possibilities, even create new possibilities in our work and personal lives. Short-term loss of sleep and lack of attention to diet or exercise usually don’t leave a lasting mark. Some forms of pressure can help bring out the best in us, and managing these kinds of stress can be relatively straightforward.

Or circumstances could combine to create significant ongoing stress, at work or in private life — even both at the same time. There is such a thing as toxic stress: the kind that just wears you down and eats you alive, rather than alerting you to a problem or bringing out the best in you. This form of stress can not only erode your sense of well-being and purpose, it can ultimately cause serious harm to your bodily health.

What does stress do to our bodies?

The physiology of stress in Western biomedicine is complex. Most people may experience stress; few can describe precisely what it’s doing to their bodies in biomedical terms, although you’re probably thinking ‘Don’t I recall something about cortisol being the stress hormone’? Similarly, most people have encountered the concept of the fight-or-flight response; it’s not always possible to fight stressors, or run away from them, but we still experience the surge of adrenaline that’s supposed to help the body respond to sudden physical threat, and the diversion of circulation from digestive, reproductive, and other routine maintenance to muscles. We may all be a little fuzzy on the biomechanics, but people dealing with IBS are well aware that stress can trigger or worsen their symptoms, and those experiencing fertility issues know that stress and anxiety can impair reproduction.

We might not be able to fill in all the blanks, but it’s easy to recognize the effects of stress as we experience them: Sleep, appetite, energy levels, circulation, digestion, reproduction, and mood are all vulnerable to ups and downs when we’re stressed. If stress is bad enough, and goes on long enough, we can gain or lose weight, become angry or depressed, develop insomnia, irregular menses or other fertility issues, take up smoking or drinking, and feel exhausted — all of which can compound the original stressor(s). If you’ve been severely stressed for a while, you might be wondering whether you have adrenal fatigue, or are developing an ulcer.

According to Traditional Chinese Medicine (TCM), stress affects your Liver. This Liver is, and is not, the same as your Western biomedical liver. It’s the same organ in your body, but what it is, and what it does, are seen in such different terms by Traditional Chinese Medicine that we can’t always draw one-to-one correspondences between the two sets of concepts.

Traditional Chinese Medicine’s ideas about the Liver are good at explaining what stress does to our bodies in terms that relate to our experience, and TCM therapies, such as acupuncture and herbal formulas, are excellent at relieving stress, and helping the body resist its effects.

The Liver does many things, but one of its major functions is to regulate all the energy traffic in your body. Yes, just like an air-traffic controller, being your Liver is a high-stress job. What happens when you get stressed, then? The short answer is, you get an energy traffic jam in your Liver. This in turn readily explains many of the common immediate and long-term effects of stress.

Why do we feel tired when we’re stressed, but refreshed by moderate exercise (like taking a brief walk)? Why does stress make us hungrier, or lose our appetite, or grind or clench our teeth? Why does stress make it harder to get a good night’s sleep? How does stress derail normal reproductive functions? And what about cleanses?

You’re tired because your energy isn’t available — it’s stuck in traffic and can’t get to work. But a quick stroll later, your mind is working again, you don’t feel so tired, and your hands and feet have warmed up. This is because moderate exercise is enough to break up the energy traffic jam, so now the energy is circulating to warm your hands and feet, refresh your mind, and support your activities.

Appetite and digestion are often affected by stress. This is because the Liver shares the thoracic cavity with the Spleen and Stomach. So when the trapped energy builds up in the Liver, it wants to vent — and the Spleen and Stomach are close neighbours and easy targets. When the trapped energy attacks, the digestive process can be slowed or interrupted (accompanied by bloating or constipation, or loss of appetite), or it can cause irritation that moves everything through too quickly (bloating, frequent bowel movements or even loose stools or diarrhea). Some people experience reflux, nausea, or even vomiting with stress, because the Liver’s attack has made the Stomach energy reverse its usual downward course. If the Liver is aggressive and persistent in its attacks, ulcers can form. With ongoing stress, the digestive functions weaken, resulting in lower energy levels, ‘brain fog’, impaired focus or memory, and/or weight loss or gain.

Sometimes the trapped Liver energy vents into a meridian, or energy channel. When this happens, the rogue energy travels up the channel into the jaw, and expresses in grinding or clenching motions. These repeated movements can make neck and jaw muscles ache, cause wear on the temporo-mandibular joint (TMJ), damage teeth, and cause headaches.

What about sleep? The Liver also shares the thoracic cavity with the Heart, which is located higher than the Liver inside the chest. When trapped energy persists long enough to build up heat, the heat rises and agitates the Heart. This is most likely to be noticed in the small hours, when we wake up between 1 and 3 a.m., and have trouble falling back asleep because our thoughts are racing.

Besides anxiety and restlessness, the heat buildup due to stuck energy can cause us to feel frustration, irritability, or anger. Feelings like frustration or anger can be a source of stress (nursing a grudge will definitely cause stuck energy), but they can also be caused by stuck energy. If your moods vary with your cycle, your TCM provider will want to work on regulating your Liver.

Irregular menses are definitively caused by stuck energy, according to TCM. This is because, when energy gets stuck, blood can’t circulate freely. Briefly put, stress affects reproduction because reproductive organs need a sufficient and consistent supply of energy and blood to maintain normal function. Continual interruption of the smooth flow of energy and blood makes it difficult for the body to carry out the complex routines involved in monthly cycles, from triggering timely ovulation to building up, and then shedding, a healthy uterine lining.

So what does TCM think about liver cleanses?

It’s a huge topic, but a few brief points can be offered here. The Western view assigns the liver responsibility for detoxifying the body. TCM doesn’t. This is one area where there isn’t a point-to-point correspondence between TCM and biomedicine. So  ‘toxins’ aren’t the first thing that comes to mind when TCM practitioners think about the Liver.

Taking something gentle, like milk thistle or chamomile, will probably not do you any harm. But much of what people attribute to toxins is actually due to the hypofunction of other organ systems, so it may not do much good either. Gentle therapies won’t transform you overnight, or correct more severe imbalances. And please don’t use anything drastic — dumping stored toxins into your system all at once sounds like a bad idea because it is a bad idea. If you’re going to diagnose and treat yourself, a good rule is: First, do no harm.

So what does Traditional Chinese Medicine think we should do about stress?

For milder forms of stress, nothing beats moderate exercise. A heavy workout schedule will likely overtax your physical resources if you are under prolonged or severe stress, so don’t overdo it. Simple dietary modifications can also make a big difference. For example, rich, greasy or oily foods are hard for your body to break down, so they can easily jam your energy traffic. Sometimes snacking on ice cream, chocolate, potato chips, or pizza may be just what you need to stay sane, but maybe not when you have a difficult meeting scheduled for the next day and need to keep your temper.

Irregular eating weakens digestion, and weak digestions have trouble making enough blood and energy to support routine maintenance. So try to prioritize regular meals if you’re under stress. And rule number one of regular eating habits is, Always eat breakfast! If you’re not hungry in the mornings, try ‘priming’ your digestive system with a small snack first. A few mouthfuls of soup can give a weakened digestive system the energy it needs to get down to business after fasting all night.

As for drinking, spirits can overheat the Liver, as can excessive drinking; but moderate drinking (one drink a day) can relax the Liver and smooth energy flow. And for those times you can’t fit in a quick walk, squeezing a wedge of lemon into a glass of water will help your Liver traffic keep moving.

When it comes to coping with stress, every little bit helps. For more severe forms of stress, however, moderate exercise, eating breakfast, and drinking lemon water can only do so much. Fortunately, acupuncture, herbal therapies, or both together, are all excellent at breaking up the trapped energy caused by stress, clearing out the heat buildup caused by trapped energy, and restoring normal blood circulation to organs slowly starving from the effects of chronic fight-or-flight activation. For some people, the original stress is over, but their nervous systems have forgotten how to switch out of high gear. Acupuncture can help your body remember what ‘normal’ looks like. If the stress is severe and ongoing, it will come back after treatment — but regular acupuncture can help your body withstand the worst of its long-term effects.