November 12, 2016

Stress and the Human Body: Part II

Mary MahoneyBY Mary Mahoney

J. Robinson Group Blog

In this two-part series on stress, we look at some new, eye-opening discoveries about that very basic phenomenon. What does stress do to us and what do we do about it?

hand clenching stress ball

In Part I, we looked at some surprising results from new research. The bottom line is, anxiety and tension are worse for our health than we thought, but the medical community has yet to take stress seriously, as a dangerous condition.

When the hormones adrenaline and cortisol flood the body, they create problematic side effects. Despite the documented physiological manifestations of chronic or acute stress, however, there is little systematic available to prevent or treat stress.

The second part of this series on stress will look at whom is most affected and why, and offer some tips on stress management.

In the latest version of its annual “Stress in America” report, which reflects data from 2014, The American Psychological Association shows that money worries are a key cause of stress. “The United States is the world’s richest country, yet our economic inequality is among the highest in the world,” it says. “The Great Recession may have officially ended, but most American households face stagnant wages and increasing debt — many Americans are actually considered to be poorer than they were a decade ago.”

An APA report from 2011 shows that people older than 67 report the lowest levels of stress. They also cope with it differently. Seniors read more and pray more. Millennials and Gen Xers are more likely to smoke, go online or listen to music instead.

Stress as we know it today didn’t even exist until relatively recently. In the late 1800s, Harvard Medical School alumnus Walter Cannon observed stress responses, leading to his being credited for the expression “flight or fight.”

An interesting piece on NPR revisited research done in the 1930s  by endocrinologist Hans Selye, who wrote many books on the subject. Selye observed that regardless of the type of stressor, his experiments revealed the same type of physical damage and disease.

Stress affects different people in different ways, and while some stress is okay and even motivating and energizing for some, too much or chronic stress can have lethal consequences.

A Wall Street Journal article from 2013 reported that more women than men are under stress and they suffer more symptoms such as headaches and upset stomach. Working women reported strain from bias and a lack of career opportunity. Working moms added factors such as having to do the lion’s share of the housework and child care. Indeed, it’s usually the moms who get calls for emergencies, to cook dinner and to coordinate all the kids’ activities, meaning working moms are “on” 24/7.

A University of Pittsburgh Schools of the Health Sciences  report published in August 2016 sheds new light on how stress, depression and other mental states can alter organ function, and show that there is an anatomic basis for psychosomatic illness. The research also provides a concrete neural substrate that may help explain why meditation and certain exercises such as yoga and Pilates can be so helpful in modulating the body’s responses to physical, mental and emotional stress.

In issues spanning skin problems, a heart attack, hives and insomnia, we may not know that stress is the cause.  But research is finally catching up to – and reflecting – that possibility.

So why isn’t a stress assessment part of our annual physical? Why is stress management not prescribed as part of our daily routine, like using fluoride toothpaste or taking blood pressure meds?

Indeed, there is no better time than now to take stress seriously. An October study published by the APA reports that even the 2016 presidential election is causing significant stress for more than half of Americans.

But how do we relax? Worrying about how to get rid of stress can be, well, stressful. Meditation is not for everyone. Rewiring your brain sounds daunting.

However, we found some ideas, both traditional and of the envelope-pushing variety, that we wanted to share. For example, the AARP outlines case studies of real people in real situations and what they did to combat stress. Gardening, meditation or exercise seem to work, backed by “proof it works” studies that shows these approaches helped.

Likewise, the American Heart Association suggests strategies like self-talk, with specific examples of how to turn anxiety-inducing negative, hopeless thoughts into positive mantras, and replacing “I can’t do this” with “I will do the best I can.” There is also a list of quick, emergency stress-stoppers like hugging a loved one or going for a brisk walk.

An artcle published in Harvard Health Pubications talks about the benefits of mindful meditation, which doesn’t only – or necessarily – involve sitting cross-legged for hours. Rather, meditation is a way to reposition your thinking.

The goals include harnessing positive thoughts, making problems appear more manageable and finding a little core of peace to better handle all that life throws at us. Stress reduction must become a daily habit.

Along similar lines, the Anxiety and Depression Society of America has published an interesting article on exercise and stress, with data to back up its opinion. There are practical tips, too, such as safely exercising in cold weather so exercise becomes part of a regular, year-round routine. Other tips include becoming active in your community, perhaps through volunteering or by injecting humor into your day, as well as setting small, tangible daily goals.

An ABC news report discussed the importance of time management – planning ahead and being more organized to avoid that overwhelmed, panicky feeling.

There are not many conclusive studies on stress and nutrition (other than ones linking stress to over- or under-eating.) But there are many claims that green tea, which is rich in the L-theanine compound, has a calming effect.

Ironically, an article in July 2016 in the Boston Globe titled Doctors Need Help with Stress, Burnout describes just how physicians themselves have high levels of stress, starting during their years in medical school and residency.

The news-medical.net site reported in September 2016 of a long-term study to be undertaken by  NYIT College of Osteopathic Medicine called “Fit Physicians,” with the goal of promoting wellness activities to medical students.

Hopefully, some of the advice doctors will be getting will carry over to their patients as well.

November 1, 2016

Stress and the Human Body: Part I

Mary MahoneyBY Mary Mahoney

J. Robinson Group Blog

In this two-part series on stress, we will look at some new, eye-opening discoveries about that very basic phenomenon. What does stress do to us and what do we do about it?

woman with hands on forehead

Is there anyone who hasn’t felt stressed out at some point in life?

What about stress we suffer every day?

All of us know stress can be bad, but new studies show it is even worse than we thought, and strategies from the medical community to keep it at bay are lagging.

What exactly is stress? The National Institute of Mental Health defines it as “the brain’s response to any demand.” It is a normal reaction – your brain and body instantaneously teaming up to confront the world.

The physiology of stress entails a purposefully orchestrated strategy. Within seconds, your brain orders your body to release the hormones adrenaline and norepinephrine. Minutes later, cortisol is released.

Breathing becomes faster, to draw more oxygen into your lungs, and the heart rate increases to pump more blood and raise blood pressure. The goal of these changes is to carry more oxygen to the brain and heart so as to give you strength.

An energy boost also is produced from the extra glucose made in the liver (the cortisol hormone is in charge of that.) Cortisol also helps with tissue repair. Your muscles are called to action, “tensing up to protect internal organs.”

Cortisol alters immune system responses and suppresses the digestive system, the reproductive system and growth processes. This complex natural alarm system also communicates with regions of your brain that control mood, motivation and fear.

Known as the fight or flight response, these changes add up to a mammal’s age-old survival tactic. But modern-day stressors are more of the chronic, less singular variety. We are not designed to be in fight-or-flight mode every day, year after year.

Unfortunately, the body can also overreact to stressors that are not life-threatening, such as traffic jams, work pressure, and family difficulties.

So how much stress can your body safely handle? How much stress is too much? The problem is there is no personalized “stress-o-meter” to tell you.

Most people can handle occasional periods of stress. But daily, grinding stress or a very traumatic episode can have dangerous and previously unknown effects on your body.

According to an article in the Huffington Post, “When you stew on a problem, the body continuously releases cortisol, and chronic elevated levels can lead to serious issues. Too much cortisol can suppress the immune system, increase blood pressure and sugar, decrease libido, produce acne, contribute to obesity and more.”

Stress symptoms include headaches, poor sleep, alcohol abuse, depression and overeating. But new connections have been discovered: Medical News Today reported that “stress may also reduce blood flow to the heart, particularly for women.” Researchers found that stressed women with coronary heart disease had three times greater reduction in blood flow than stressed men.

Stress has been associated with increased risk of diabetes. A 2015 study in JAMA Psychiatry found that women with symptoms of post-traumatic stress disorder (a psychological state very distressing events trigger) were more likely to develop the condition than those without PTSD.

Because cortisol can increase the amount of glucose in the blood, stress also may be linked to higher risk of diabetes.

Another study published in 2010 by Finnish researchers found that women who had either high blood pressure or higher cortisol levels were more than three times as likely to develop Alzheimer’s disease.

And some links we suspected, like the effect of stress on conception, may be more dramatic than previously known. A University of Louisville study published in Science Daily showed “women who generally reported feeling more stressed than other women were about 45 percent less likely to conceive.”

Even more surprising to researchers is that the negative effects of stress can be so powerful as to cancel out the positive effects of other aspects of habits. A September 2016 article in The New York Times, Stress May Counteract Effects of a Healthful Diet, summarizes a study published in Molecular Psychiatry, saying: “Among women who had low levels of stress, markers of inflammation tended to be higher after eating the meal containing high levels of saturated fat than after the low saturated fat meal. But for women who had high levels of stress, those differences disappeared; they had high levels of inflammation even after the meal that was low in saturated fats.”

The surprise here is that stress made the healthier-fat meal look like the saturated-fat meal, said lead author Janice K. Kiecolt-Glaser, a professor of psychiatry at Ohio State University. “Stress is doing things with the metabolism that we really didn’t know about before.”

Findings the University of Pittsburgh Schools of Health Sciences published in August 2016 show the workings of the brain-body connection in a stressful situation and the brain’s response to relaxation techniques.

“Our results turned out to be much more complex and interesting than we imagined before we began this study,” said senior author Peter L. Strick, PhD, Thomas Detre chair of the department of Neurobiology and scientific director of the University of Pittsburgh Brain Institute.

These findings, which shed new light on how stress, depression and other mental states can alter organ function, also show there is an anatomical basis for psychosomatic illness.

The research also provides a concrete neural substrate that may help explain why meditation and certain exercises such as yoga and Pilates can be so helpful in modulating the body’s responses to physical, mental and emotional stress.

The two most recent reports from the American Psychological Association paint a picture of a stress epidemic.

This all begs the questions: What on earth is going on? Why isn’t stress management part of our daily routine, like brushing our teeth? Why isn’t some kind of stress analysis part of our annual physicals, like checking our cholesterol? Why isn’t stress regularly monitored by our doctors, like blood pressure?

This also raises the question of whether doctors should prescribe medication for stress, just as they prescribe pharmaceuticals to control asthma and heart conditions.

In Part II, we will look at various options to mitigate stress and why there is no one-solution-fits-all to stress relief.

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