Life under pressure

spring13 Stress can't be avoided. But simple, science-backed tricks can make it less damaging to our health

We've all experienced it: Our heart suddenly starts pounding, adrenaline courses through our legs and, unintentionally, we shout a profanity. Our body's automatic response systems are helping us deal with a sudden stressful situation so we have the energy to act quickly, like when another driver cuts us off.

"These systems are beautifully adapted for helping us respond to unexpected emergencies. They are elegant systems that are there for a reason. But being stressed all the time can also be damaging," says J. David Creswell, Ph.D., a Carnegie Mellon University psychology professor. "The current thinking is we're turning on this stress response fairly often. This can result in wear and tear on a body's systems."

So what does stress do to us?

Acute stress narrows our blood vessels and increases blood pressure. It sends more cholesterol into our bloodstream and makes our blood platelets clump together, setting us up for a possible heart attack. Chronic stress worsens autoimmune disorders such as asthma, multiple sclerosis and irritable bowel disease; our wounds take longer to heal and physical pain is more unbearable. There is some evidence it can increase a person's risk of cancer. You may wonder why your memory is failing or why you have more weight in your midsection. You guessed it: Chronic stress may be partly to blame.

With cold and flu season upon us, it's a good time to get a handle on stress, particularly the long-lasting kind—such as being in a bad relationship, caring for someone with Alzheimer's disease or being unemployed or underemployed. These kinds of stress make us more susceptible to infectious disease.

"Under stress, people cope by smoking, drinking [alcohol] more, not sleeping as well and eating a poor diet. Certainly, having those poorer health practices are related to greater health risks, but they don't account for why stressed people get sick," says psychology professor Sheldon Cohen, Ph.D., director of CMU's Laboratory for the Study of Stress, Immunity and Disease.

His groundbreaking research measured volunteers' stress levels and types and then exposed them to cold and flu viruses. His research has also shed light on how long-lasting stress impairs the immune system. "Historically, people argued that stress influences physical disease because of the impact of a continued increase of heart rate, blood pressure and cortisol [a stress hormone]. None of these can explain the effects. It turns out people were thinking of these mechanisms a little too simply," he says.

Instead, Cohen and his research team discovered that people under chronic stress have dysfunctional cortisol systems, producing too much or too little at the wrong times. Immune-system cells that cortisol would normally stick to become resistant, allowing a continued production of proteins that promote damaging inflammation.

How do we shield ourselves from stress? Interestingly, for men, a good stress-buffer is looking at erotic images. During a research study, "We had people looking at Playboy magazine-type images and found consistent results of reduced cortisol stress activity, compared to men who looked at neutral images of couples having a picnic, for instance," Creswell says. Men who viewed the erotic images also performed significantly better on the math portion of a stress-inducing test.

Creswell manages his own stress through yoga and meditation. Such "self-affirming" exercise, his research has shown, is another effective de-stressor. Creswell is currently conducting a research study on mindfulness meditation (being aware of the present moment). "The lab I direct [Health & Human Performance] is really focused on trying to understand what makes people resilient under stress… and how can we help humans become more resilient," he says. If interested in being part of his studies, contact him at creswell@cmu.edu.

Bruce Rabin, M.D., Ph.D., professor of pathology, psychiatry and psychology at University of Pittsburgh School of Medicine, and less formally known as Dr. Stress, believes stress may be more damaging to the cardiovascular system than a high-fat diet and other unhealthy foods. Like Cohen, Rabin has been researching the impact of stress on the immune system for decades. His mission is to give people simple ways to cope with stress in order to live a long life, free from disease.

Everyone responds to stress differently and not everyone will suffer health complications because of stress, Rabin notes. Still, with many Americans experiencing a host of physical and mental ailments and reporting high levels of stress, it's encouraging to know that we can calm the "stress reactive areas" of our brain. Enhanced stress-coping skills, Rabin says, may help prevent diseases such as hypertension, depression, asthma, arthritis, cancer, atherosclerotic heart disease, chronic pain, sleep disturbances, psoriasis, chronic fatigue syndrome, multiple sclerosis, lupus, fibromyalgia, irritable bowel syndrome and inflammatory bowel disease.

"We cannot make the stress in your life go away, but we can change the way your brain responds to stress," says Rabin, medical director of UPMC's Healthy Lifestyle Program.

How do we keep calm and carry on, healthier? Rabin has several tricks up his sleeve, but it's important to note that while these techniques are relatively simple, their effectiveness is backed by research. When you scream at your teenager or the driver in front of you, you're experiencing acute stress.

Here are ways to immediately keep stress hormones at bay:

Take a few big gulps of air. By breathing through your belly rather than your chest, you take in eight times more air (a large mug instead of a tea cup). More oxygen in your blood signals your brain to release lower amounts of stress hormones.

"Take 2-3 breaths upon arising, at lunchtime, dinnertime and before sleep. Use this preventively in addition to situation-at-hand occurrences," Rabin writes in his workbook.

Make yourself laugh. Store away three to five funny memories. Call on one whenever something upsets you.

Sing a special song. Think of a few words to be your go-to chant, such as "All will be well." Put it to a simple tune and say it throughout the day to train your brain to associate it with being happy. When you're upset, this chant will quickly signal your brain to put you in a calmer state.

Rabin sums up the core of his Healthy Lifestyle program in the word RELAX, which stands for Reflection, Expectations, Laughter, Acquaintances and eXercise.

Reflection means to think of activities that make you feel calm and then do them. These can be anything from attending religious services, praying more, listening to pleasing music or reading a book.

Expectations is about taking a more hopeful view of whatever comes your way, even writing about the good things that you are proud of.

To foster laughter, simply spend more time with someone who has a good sense of humor, watch a funny show, or just smile more.

Acquaintances: Spend less time alone and more time with people you enjoy. Consider joining a club or a volunteer group.

Exercise more with a brisk walk each day. Even better, ask a friend to come along.

No one better exemplifies Rabin's approach to a long and healthy life than Pat Waterman. At 82, she and her 84-year-old husband live at Providence Point, a luxury retirement community designed to keep seniors active, social and carefree on a 32-acre campus in Scott. The Watermans regularly take part in social events and enjoy the community's amenities, such as tennis courts, nature walks and classes on relaxation and foods good for the brain. Recently, Mrs. Waterman needed an MRI test and wasn't looking forward to sitting in the imaging machine for 45 minutes. "I'm not claustrophobic," she says, "but the noise element is really annoying… When I got in there, I started to think about what I think about in Fabi's relaxation class [Fabiana Cheistwer is Providence Point's wellness director]. I love blue and thought about a lake I went to for many years. It made the 45 minutes go a lot faster. I can't tell you what a difference it made."

Waterman encourages others to spend a half hour each day (or even five minutes) thinking good thoughts. "When you're finished, it's like you had a nice rest or even a nap," Waterman says. "It's not so much invigorating, you just feel like a weight has been lifted… It's such a phenomenal way to ease stress."

Kelly Casey is a freelance writer who has been writing about health for more than a decade.




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