Stress is a natural and beneficial part of human life. In small doses it helps spur us on, keeps life interesting and gives us energy to focus and perform under pressure. Only when stress is unrelenting does it begin to take a toll. The problem today is that rather than facing short bouts of stress, our stressors tend to be long-lived: tension in a relationship, competing work and childcare responsibilities, and on-the-job demands.
Stress Makes Us Sick
Chronic stress can lead to both short and long-term illness. There is evidence that stress affects the immune response, making people more likely to come down with colds and recurrences of herpes and irritable bowel syndrome. Chronic stress also raises the risk of high blood pressure, heart disease and stroke.
It’s estimated that 75 to 90 percent of all visits to primary care physicians are at least partly stress related. One study found that patients who had six sessions of stress reduction therapy reported lower stress levels, better sleep and had fewer trips to the doctor than a control group not practicing stress reduction.
Crohn’s disease, a painful inflammatory bowel disease, and irritable bowel syndrome together affect about one million Americans. No exact cause is known for either of these disorders, but stress is believed to play a role. One study found that when 42 patients with Crohn’s disease learned stress reduction techniques, most had significantly less pain. Another study of 432 women followed for 15 years found a significant correlation between stress and weight gain. Subjects who reported frequently feeling angry, depressed or stressed out were about twice as likely to have metabolic syndrome with excess fat stored around the waist, high cholesterol and triglycerides and an increased risk of diabetes.
Stressful emotions are associated with increased levels of cortisol, a hormone which elevates the heart rate and, over time, may tend to slow the metabolism. High circulating levels of cortisol and adrenaline increase blood pressure, pulse, and breathing rates. Over time this can take a toll on the heart and cardiovascular system.
Chronic stress suppresses the immune system, making us more prone to colds and other illnesses. Blood glucose levels rise, setting the stage for the development of diabetes. Stress is also believed to play a role in Crohn’s disease, an inflammatory bowel condition. All too many women are familiar with the concept of stress-induced headaches that can range from everyday to migraine. High stress levels can interfere with sleep, and increase rates of depression and anxiety-related disorders.
Managing Stress
You can learn how to better control stress and your reaction to stressful situations. Rather than becoming enmeshed, you need to face stress head on. One strategy uses a “Three P” offense:
Practical–what you can realistically change to decrease the stress in your life?
Psychological–rethinking your reaction to stress
Physical–exercise and relaxation techniques you can incorporate into your daily life.
Practical solutions to a high-stress lifestyle require a realistic plan. Write down the sources of stress in your life, then brainstorm ways to eliminate or modify them. Of course there will be some things you can’t change, but get creative and consider options for the ones you can. If you’re spending most evenings driving your kids to soccer practice, think about car pooling with other parents, limit the number of sports each child can sign up for in a given year, or trade driving time for laundry duties with your kids.
Job-related stress may be relieved if you work on your organization skills. Planning is often a way to make life at work manageable. If you cannot manage to reduce work stress, talking to a supervisor at your workplace may help. Sometimes a transfer can improve job satisfaction. If that’s not an option, begin thinking about the ideal position for you and start working toward it. Knowing that you’re working toward a change will help relieve job stress.
Psychological strategies can be very effective in changing the way we think about and handle stress. Most situations aren’t inherently stressful. They only become stressful because of how we perceive them. Standing in line for 15 minutes to get an ice cream cone might be a pleasurable occasion but 15 minutes in line at the grocery store may be perceived as highly stressful. The difference is your perception. One very effective way to change your stress levels is to change your mind, or at least how your mind deals with potentially stressful events. You can change some stressful events into neutral incidents by focusing on something positive and simply not allowing yourself to get upset.
One effective technique is to distance yourself from the situation in time by projecting the importance of the event at one, two or three years into the future. If you are late for a meeting at work, you’re obviously going to be concerned. But keep the situation in perspective. Ask yourself how important this will seem to you a year from now, two years from now? The truth is you’ll probably have forgotten it by next week, so don’t give it the power to ruin your day.
Sometimes the way you react to a source of stress can cause more problems than the stressor itself. Rather than experiencing an emotional melt-down when things go wrong, tell yourself you can handle the problem and create mental images of yourself as someone who is calm and in control. By developing a more assertive response you move away from the passive objective role (someone that bad things happen to) to a more subjective and positive role (someone who is capable of dealing with difficult situations.)
We can’t eliminate all stress from our lives but we can learn how to handle it better. Biofeedback offers a painless way of measuring stress and our reaction, teaching people how to monitor breathing and heart rhythms so they can achieve a relaxed state.
Biofeedback is a learned technique taught by a medical professional. Electronic impulses gathered from leads attached to the patient are relayed back to the patient, illustrating the body’s response to stressors. Learned relaxation and breathing techniques make it possible to modify the stress response. The biofeedback machine signals when it detects alpha waves from the brain. Alpha waves are associated with a deep state of relaxation.
With practice, the patient learns to modify his or her stress response, gaining control rather than being at the mercy of stressful events. Studies show that subjects are actually able to decrease levels of cortisol, a hormone involved in the stress response, with biofeedback. The effect can last from six to eight hours.
Physical approaches to stress relief include exercise, yoga, meditation, breathing and relaxation techniques. Exercise is a great tension reducer. Try to schedule a 30-minute walk, jog or swim into your day as a means of invigorating both mind and body.
MRI studies have documented how meditation changes brain centers, putting the body into a more relaxed alpha state. Yoga and relaxation techniques are also able to help achieve these relaxed states. Learned breathing techniques that help alleviate stress can be practiced sitting at the computer, in the grocery line or in traffic.
Take a class or visit your local library for information about yoga, meditation or relaxation techniques. Choose one that appeals to you, practice it and you’ll have the power to find your own calm spot in the midst of a stressful world.
Too stressed out to find time to relax? If you need a little help with slowing down, make an appointment for a therapeutic massage and let someone else do the work. A massage helps muscles relax, is an enforced rest and can actually slow the heart rate while it relaxes the body.
Stress Scores
Stress can be triggered by happy as well as unwelcome events in our lives. Richard Rahe, a noted expert in the field of stress, estimated the stress level associated with major life changes, assigning a score to each. Rahe called the rating system “Life Change Units” and the scale goes from 25 for a change in political beliefs, to 105 for the death of a spouse or a child.
A sampling of scores includes:
Child leaving for college 28
Vacation 29
Job promotion 31
New romantic relationship 32
Trouble with co-workers 35
Major dental work 40
Marriage 50
Marital separation 56
Pregnancy 60
Divorce 62
Getting fired 64
Death of parent 66
Eliminating stress from our lives isn’t an option for most, although for some it may be possible to make strategic changes that can decrease the load. The stress we can’t avoid we can learn to control. Most problems result from our physiological reaction to external events. People who develop coping responses become more resilient. Think of it as developing your own Teflon coating. Resilience makes it possible to keep things in perspective and avoid seeing every bump in the road as a catastrophe.
Another way to keep the daily stressors in perspective is to take a look at the big picture–how important will this problem seem when I look back on it two years from now? If the answer is “very,” then you need to develop an action plan that will help you deal with the problem. If the answer is “not very” (which is true for most of our daily stressors), then you need to take care of the problem calmly, practice your relaxation response and do not allow yourself to become stressed by the situation. Stress is a reality of our modern life. If we can’t eliminate it we have to learn to live with it without allowing it to take control of our lives.
Michelle Herbert Thomas, PharmD, CDE
Clinical Director, Richmond Apothecaries, Inc.
Rev. 1/2010 MHT
