Stress

Stress

Control Is the Cure

You can't get enough rest, and you can't get enough done. And your stomach is always wrapped up in a knot.

"Stress will do that to you," says Leah J. Dickstein, M.D., professor in the Department of Psychiatry and Behavioral Sciences at the University of Louisville School of Medicine in Kentucky and former president of the American Medical Women's Association. "It can really wear you out. And the real problem is that you could be paving the way for other troubles later on."

The American Institute of Stress in Yonkers, New York, estimates that 90 percent of all visits to doctors are for stress-related disorders. In women, stress has been linked to fatigue, hair loss, bad complexion, insomnia, disruption of the menstrual cycle, low libido and lack of orgasm, among others. There's even evidence that it can increase your risk of more serious problems such as high blood pressure and heart disease.

"Stress speeds up your entire system and produces conditions in younger people that are more commonly associated with growing old," says Allen J. Elkin, Ph.D., director of the Stress Management and Counseling Center in New York City. "Virtually no part of your body can escape the ravages of stress."

There are lots of ways we can reduce the stress in our lives. But before we can beat it, experts say we have to understand what stress is--and how it works.

You Can't Always Run

Despite its bad reputation, stress is one of our bodies' best defense systems. When we sense danger--such as a car coming at us--our bodies release adrenaline and other chemicals that make us more alert, raise our blood pressure and increase our strength, speed and reaction time.

That's great if we're responding to a threat that requires physical action. Unfortunately, Dr. Dickstein says, our bodies don't recognize the difference between physical threats and mental ones. When we get nervous about meeting a deadline, for instance, we may produce the same stress chemicals as when we see that oncoming car. And if we don't burn off these chemicals through physical exertion, they can linger in the bloodstream and start causing problems.

Studies show that stress can reduce the power of our immune systems. A study in Britain exposed 266 people, most of them in their thirties, to a common cold virus and then tracked who became sick. The study showed that 28.6 percent of those with few signs of stress caught the cold. But the figure jumped to 42.4 percent for those who were under high stress.

The reason? Stress may inhibit the disease-fighting cells in our bloodstreams. "Everybody gets sick from time to time," Dr. Dickstein says. "But if you're under a lot of stress, a virus may get to you that you would have been able to fight off otherwise."

Other studies show that women who have trouble coping with stress may be at risk of building up dangerous abdominal fat. A study at Yale University in New Haven, Connecticut, of 42 obese women found that those with abdominal fat--so-called apple-shaped women--secreted more stress hormones than those with pear-shaped bodies, who carry extra weight on their hips. And doctors know that apple-shaped people are more at risk of heart disease.

Until menopause, women have extra protection against heart problems. That's because of estrogen, which blocks the buildup of plaque in our arteries. But once we stop producing estrogen, our risk of heart attack rises to that of men. And that's when stress can really cause trouble. "Stress increases heart rate and blood pressure, therefore changing the inner lining of our blood vessels, making our blood more likely to clot," says Robert DiBianco, M.D., director of cardiology research at the Washington Adventist Hospital in Takoma Park, Maryland. "Stress may change the way cholesterol is handled by our blood vessels and, in doing so, may increase plaque formation."

Though we usually get a two- or three-decade reprieve from heart disease, younger women are already facing other troubles with stress. A study of 5,872 pregnant women in Denmark showed that women who are under moderate to high stress in the last trimester are 1.2 to 1.75 times more likely to give birth prematurely. Noise also stresses us out more than men. Studies show that women are irritated by sounds at half the volume that troubles men and can hear higher-frequency sounds better, according to Caroline Dow, Ph.D., assistant professor of communication at the University of Evansville in Evansville, Indiana.

A study that Dr. Dow helped conduct shows what noise can do. One hundred female college students were given a standardized test on a computer. Half had terminals that emitted high-pitched sounds, while the other half didn't. The women with noisy computers scored 8.5 percent lower on the test. They worked faster and were more prone to mistakes--an indication, Dr. Dow says, that they were operating under stress.

Even society itself can stress us out. Now that women are building careers like men do, we face working-world stress like never before. In fact, our jobs cause the majority of our stress, Dr. Dickstein says. But it doesn't stop there. Women with careers must still cook, clean, look after children and be loving spouses. And that kind of double-barreled stress can be hard on your system. A Swedish study of men and women automobile plant managers between the ages of 30 and 50 showed that the blood pressure and levels of stress hormones went up for everyone during the workday. But when men went home, their blood pressure and stress readings dropped dramatically, while the women, with more left to do in the day, stayed higher.

"That study encapsulates everything," says women's health researcher Margaret A. Chesney, Ph.D., professor at the University of California, San Francisco, School of Medicine. "It's psychological proof that women are going home to second jobs. Men know that there's a distinction--that they're off duty at home. Women are not off duty. They're under more duress."

Pull the Plug on Pressure

The key to beating stress? Creating a sense of control. We have to understand that some stress is inevitable. In fact, a little stress helps us accomplish tasks and meet goals, Dr. Dickstein says. But too much from the wrong sources--such as arguments with spouses or unrealistic expectations at work or at home--can make us feel helpless and unable to cope. And that's when stress does most of its dirty work.

Here are some tips to help you put stress in check.

Work it out. Nothing eases stress more than exercise, according to David S. Holmes, Ph.D., professor of psychology at the University of Kansas in Lawrence. "Regular aerobic workouts reduce stress more effectively than meditation, psychiatric intervention, biofeedback and conventional stress management," he says.

Exercise helps burn off all the stress-related chemicals in your system. During a workout, your body will also release mind-relaxing endorphins, Dr. Holmes says. And exercise strengthens your heart, too, further protecting you against the ravages of stress.

Research by Robert Thayer, Ph.D., professor of psychology at California State University, Long Beach, showed that 30 minutes of intense aerobic exercise immediately reduces body tension--and it does so even more effectively than moderate exercise such as walking.

Don't be listless. So many projects, so little time. To beat stress, you have to learn to prioritize, according to Lee Reinert, Ph.D., director and lecturer for the Brandywine Biobehavioral Center, a counseling center in Downingtown, Pennsylvania. At the start of each day, pick the single most important task to complete, then finish it. If you're a person who makes to-do lists, never write one with more than five items. That way, you're more likely to get all the things done, and you'll feel a greater sense of accomplishment and control, Dr. Reinert says. Then you can go ahead and make a second five-item list. While you're at it, make a list of things that you can delegate to co-workers and family members. "Remember: You don't have to do everything by yourself," Dr. Reinert says. "You can find help and support from people around you."

Just say no. Sometimes you have to learn to draw the line. "Stressed-out people often can't assert themselves," says Joan Lerner, Ph.D., a counseling psychologist at the University of Pennsylvania Counseling Service in Philadelphia. "And so they swallow things. Instead of saying 'I don't want to do this' or 'I need some help,' they do it all themselves. Then they have even more to do."

Give your boss a choice. "Say 'I'd really like to take this on, but I can't do that without giving up something else,' " says Merrill Douglass, D.B.A., president of the Time Management Center in Marietta, Georgia, a company that trains individuals and corporations in the efficient use of time and energy, and co-author of Manage Your Time, Manage Your Work, Manage Yourself. " 'Which of these things would you like me to do?' " Most bosses can take the hint, Dr. Douglass says. The same strategy works at home, with your spouse, children, relatives and friends. If you have trouble saying no, start small. Tell your hubby to make his own sandwich. Or tell your daughter to find another ride home from volleyball practice.

Pad your schedule. "Realize that nearly everything will take longer than you anticipate," says Richard Swenson, M.D., author of Margin: How to Create the Emotional, Physical, Financial and Time Reserves You Need. By allotting yourself enough time to accomplish a task, you cut back on anxiety. In general, if meeting deadlines is a problem, always give yourself 20 percent more time than you think you need to do the task.

Trade in the Jag for a Hyundai. Living beyond your means can actually make you sick. A researcher at the University of Alabama in Tuscaloosa studied British census data on 8,000 households and found that families that tried to maintain lifestyles they couldn't afford were likely to have health problems.

Sit up straight. A good upright posture improves breathing and increases blood flow to the brain. We often slouch when stressed, which restricts breathing and blood flow and can magnify feelings of helplessness.

Get a grip. Keep a hand exerciser or a tennis ball in your desk at work and give it a few squeezes during tense times. "When stress shoots adrenaline into the bloodstream, that calls for muscle action," says Roger Cady, M.D., medical director of the Shealy Institute for Comprehensive Health Care in Springfield, Missouri. "Squeezing something provides a release that satisfies our bodies' fight-or-flee response."

Pop a bubble. A study found that students were able to reduce their feelings of tension by popping two sheets of those plastic air capsules used in packaging. "Now we know why people hoard those things," says Kathleen Dillon, Ph.D., psychologist and professor at Western New England College in Springfield, Massachusetts, and the author of the study.

Practice your snorkeling. Want to really relax your muscles? Soak in a hot tub. To get the most relaxation from a hot bath, soak for 15 minutes in water that's just a few degrees warmer than your body temperature, or about 100° to 101°F. But be careful: Longer soaks in warmer water can actually lower your blood pressure too much.

Tune out--have a potato. If you want to unwind at the end of the day, eat a meal high in carbohydrates, says Judith Wurtman, Ph.D., a research scientist at the Massachusetts Institute of Technology in Cambridge and author of Managing Your Mind and Mood with Food. Carbohydrates trigger release of the brain neurotransmitter serotonin, which soothes you. Good sources of carbohydrates include rice, pasta, potatoes, breads, air-popped popcorn and low-cal cookies. Dr. Wurtman says just 11/2 ounces of carbohydrates, the amount in a baked potato or a cup of spaghetti or white rice, is enough to relieve the anxiety of a stressful day.

Try some fiber. "Stress often goes right to the gut," says George Blackburn, M.D., Ph.D., associate professor of surgery at Harvard Medical School and chief of the Nutrition/Metabolism Laboratory at New England Deaconess Hospital, both in Boston. That means cramps and constipation. To avoid these problems, Dr. Blackburn suggests eating more fiber to keep your digestive system moving. You should build up gradually to at least 25 grams of fiber per day. That means eating more fruits, vegetables and grains. Try eating whole fruits instead of just juice at breakfast time, and try whole-grain cereals and fiber-fortified muffins.

Have a laugh. Humor is a proven stress reducer. Experts say a good laugh relaxes tense muscles, speeds more oxygen into your system and lowers your blood pressure. So tune into your favorite sitcom on television. Read a funny book. Call a friend and chuckle for a few minutes. It even helps to force a laugh once in a while. You'll find your stress melting away almost instantly.

Hold your breath. This technique should help you relax in 30 seconds. Take a deep breath and keep it in. Holding palm to palm, press your fingers together. Wait 5 seconds, then slowly exhale through your lips while letting your hands relax. Do this five or six times until you unwind.

Take a ten-minute holiday. Meditation is a great stress reliever, but sometimes it's hard to find the time or place for it. Dr. Reinert suggests taking a mini-vacation right at your desk or kitchen table instead. Just close your eyes, breathe deeply (from your stomach) and picture yourself lying on a beach in Mexico. Feel the warmth of the sun. Hear the waves. Smell the salt air. "Just put a little distance between yourself and your stress," Dr. Reinert says. "A few minutes a day can be a great help."

Keep it down. If you work, live or play in a high-noise area, consider wearing earplugs. Make sure the ones you buy reduce sound by at least 20 decibels, says Ernest Peterson, Ph.D., associate professor of otolaryngology at the University of Miami School of Medicine.

You can also use sounds to your advantage. Try listening to gentle music, with flutes or other soft-sounding instruments, says Emmett Miller, M.D., a nationally known stress expert and medical director of the Cancer Support and Education Center in Menlo Park, California. He also suggests taking walks in quiet places and listening to leaves rustle or streams babble. Recordings of ocean waves or gentle rainstorms also help, he says.