Stress Management

I believe that stress is one of our most serious health problems because it affects every aspect of how the body works. Any illness is made worse by stress. If you have a tendency to headaches, stress will increase their frequency. If you have a predisposition for cardiovascular disease, stress will increase your risk. Even if you're in excellent health, uncontrolled stress will keep you from achieving the sense of calm that can make life far more meaningful and enjoyable.

People talk about stress constantly today, often referring to someone as "stressed-out." But few people really understand the gravity of a highly stressed body.

The body is constantly trying to maintain internal stability and will do what it can to return to stability if that state is altered. This is called homeostasis. If it's a very hot day, your body will cool itself by perspiring. To repair a cut, the body creates a scab, which helps heal the wound and protects the skin from further damage. Homeostatic activities include everything from the replacement of the lining of the digestive tract to the regulation of a woman's menstrual cycle. You depend on homeostasis for your health, and if one of your stabilizing systems breaks down, the result will be disease and perhaps death.

Your body responds to stress with a complex series of biochemical changes that attempt to bring the body back into its prestressed state. This seems like a simple concept, but its ramifications in respect to maintaining health are awesome; indeed, many scientists consider stress theory to be one of the greatest contributions to the understanding of disease made in this century.

In simplest terms stress refers to the everyday wear and tear on the body caused by any physical or emotional demand, from a broken leg to an invading virus to a sexual encounter to a screaming baby. The stress can be physical or emotional. When the body is stressed it reacts with a series of biochemical changes, the most significant being the secretion by the adrenal glands of various hormones, including epinephrine and norepinephrine, which energize the body. This mobilization of energy is commonly known as the "fight-or-flight" response because the body is preparing to react in a decisive, physical fashion to the stress.

When epinephrine and norepinephrine are released, they immediately heighten the nervous system's sensitivity, quicken the heartbeat, and sharpen the reflexes. The muscles tense, the pupils dilate, and the blood vessels of the skin contract so as to retain body heat and force more blood into the major organs. The liver releases stored glucose, for energy to fight the stress. The digestive tract ceases its normal activity, also to conserve energy. The ability of the blood to coagulate is increased so that in case of a severe wound, blood loss will be prevented. These physical responses are obviously appropriate to someone facing a severe physical trauma, but for someone stuck in a traffic jam or opening a credit card bill, the response is really a primitive reaction to a modern world.

When you experience a stress that's immediate and limited, like a skid on an icy road, your body will quickly recover from its stress response once the event is over. But when the stress is constant anxiety over job performance or an unhappy marriage, then your body has no opportunity to restore its re/serves. It goes into what Hans Selye, the father of stress theory, calls the "stage of resistance," or adaptation, where the body tries to adjust to the constant stress. This is useful initially for coping with long-term stress like a severe illness or severe hardships. But for the kind of constant stress most of us endure daily, it's overkill. Eventually, in the face of unremitting stress, the body will enter the "exhaustion stage." It can now no longer function properly. At this stage you begin to exhibit minor symptoms of disease. If you have a tendency to develop headaches, you'll have them constantly. If you suffer from digestive problems, they'll worsen. You may begin to develop allergies or constant colds. The weak links in your individual biochemical makeup will begin to break down.

The effects of stress are far more real and visible than most people realize. Animal research has shown in a dramatic way what stress can do. For example, mice flown from Boston to Seattle took three days to recover from dangerous levels of adrenaline, cortisol, and other body chemicals. The stress of the flight had aroused the fight-or-flight response in the mice, yet there was no way for them to discharge the resulting chemicals.

The increased blood pressure caused by constant stress is one of its most dangerous side effects. High blood pressure is one of the major contributing factors to atherosclerosis. If you don't control the stress in your life, you dramatically increase your chances of having a heart attack or a stroke. It has been estimated that deaths traced to high blood pressure account for more than half of the deaths in this country every year. Moreover, varying degrees of hypertension, or high blood pressure, are present in 15 to 33 percent of the adult population. Stress is as important, if not more so, as smoking, high blood pressure, and raised cholesterol levels in determining your chances of heart disease. You cannot eliminate all the stress in your life. Many people live for years thinking that once they get that new job or once they have their house paid off or once the kids leave home, they'll be free of stress. I have yet to find anyone, in all my years of medical practice, who has finally achieved a stress-free life. In any case, a totally stress-free life is not really a desirable goal.

The challenge is to deal sensibly with stress and to take specific action to defuse it. When I searched for a method of relaxation for myself and for my patients that would be simple to learn, relatively fast, and easy to do anywhere, I eventually selected Dr. Herbert Benson's relaxation response as satisfying every criterion. Dr. Benson is a cardiologist associated with Harvard Medical School, and chief of the Section on Behavioral Medicine at New England Deaconess Hospital. Among the first to do extensive research on meditation, he reported on the connection between meditation and reduced blood pressure and the decreased use of drugs for the treatment of high blood pressure. After researching the literature on meditative practices in yoga, Sufism, Zen, Judaism, and Christianity, Dr. Benson distilled the technique, common to all those practices, that produced a quiet mind and a peaceful heart. He called the technique the "relaxation response." It's really a form of demystified meditation.

The relaxation response (RR) is the physiological opposite of, the fight-or-flight response. It decreases the activity of your sympathetic nervous system as it decreases your metabolism, heart rate, and rate of breathing; decreases the blood flow to your muscles; increases the alpha brain waves that are associated with feelings of relaxation and wellbeing; and decreases your blood lactate levels, which are associated with muscular fatigue. Benson notes that these changes are distinctly different from the physiological changes you experience when you sit quietly or sleep.

Some of my patients initially scoffed at the relaxation response. How could something so simple make a difference in the way you feel? Believe me, it does. Here's what you need to invoke the relaxation response:
- A QUIET ENVIRONMENT. This can be anywhere--home or office. Many of my patients sit at their desk and invoke the RR. One man told me that his gym has a "nap room" where people can rest and he uses that. Just be sure to choose a place with no loud noises or distractions.
- A MENTAL DEVICE. This is equivalent to using a mantra while meditating. It's a single-syllable sound or word that you repeat silently or in a quiet tone. It helps you to remove yourself from logical thought and distractions. Dr. Benson suggests using the word one. A patient told me she uses the word snow in the summer and sun in the winter.
- A PASSIVE ATTITUDE. This sounds simple and it should be, but people sometimes make too much of it, defeating the purpose. A passive attitude means not focusing on how well you're doing in the exercise or whether you're getting the correct response. When either of these thoughts occurs to you, let it go and focus instead on repeating your chosen word.
- A COMFORTABLE POSITION. You want to reduce any awareness of your muscles as much as possible. A comfortable chair that supports your head is good. It's even better if you can lie down.

Here's how you invoke the relaxation:
1. Sit in a comfortable position in a quiet environment.
2. Close your eyes.
3. Relax your muscles beginning with your feet, then your calves, thighs, lower torso, chest, shoulders, arms, neck, and head. Pay special attention to the muscles in your neck and face, which get very tense.
4. Breathe through your nose, paying attention to your breathing. As you exhale, say aloud or just think about your chosen word.
5. Do this for at least ten minutes--twenty, if you're able. You can open your eyes to check the time, but Dr. Benson cautions against using an alarm.

I suggest that you practice the relaxation response at least once, better twice, a day. You may come to feel, as many of my patients do, that it's the most important part of your day. Patients who practice the RR regularly are always enthusiastic about its calming and invigorating effects.

I find it is most effective when done in the middle of the day, and again in the evening. Many of my patients do it just before or after lunch at their desks or at home or just after work. It should become part of your daily routine and it will help you cope with daily stresses in your life on both a physiological and psychological level. You'll be amazed to find that such a simple exercise that takes so little time can have such an important effect on your body and mind.

For the nutritional supplements useful in combating stress, use the basic antioxidant vitamin/mineral supplements as described throughout this website.

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