This Is Your Body on Stress

A Second Look at Stress

"It's probably just stress." How many times have you heard those words from your doctor -- or uttered them yourself -- as you complained about the latest ache in your shoulder or pain in your stomach? Before you write it off as just stress, think again. Stress isn't something to be ignored. It's a whole-body experience that, if left unchecked and untreated, can make you old before your time. No body part is spared. From your brain and heart to your muscles and immune system, stress can affect every part of you, leaving you vulnerable to pain, illness, and disease. Stress-related complaints account for at least three-quarters of office visits to doctors, and more than 40 percent of all adults suffer health problems as a result of stress. But research shows that stress affects men and women differently -- not just physically, but in the way they cope with it. A poll by the American Academy of Family Physicians, based in Leawood, Kansas, showed that 42 percent of women regularly fail to manage their stress, compared with 31 percent of men.

So why don't we take stress more seriously? Probably because people think of stress as an emotional state. They don't realize that this emotional response triggers a cascade of physical changes. Of course, a little stress isn't always bad. The pressure of a job deadline can inspire a burst of creativity; the adrenaline triggered during an emergency can help us think clearly and act quickly. But the daily, unrelenting stress that many people experience -- bills, work, unruly kids -- can be remarkably hard on the body. When daily life means your internal stress switch gets stuck in the "on" position, stress can start to take an exacting toll on virtually every body part.

It's not just high blood pressure or heart attacks. Stress can give you headaches, back pain, indigestion, depression, diabetes, and sleep problems. Stress can make you fat, cause your hair to fall out, and ruin your sex life. It wears on your heart, your memory, and your immune system, and may even give a boost to those rogue cells that can eventually lead to cancer. "Stress isn't a single experience," says Bruce S. McEwen, professor of neuroendocrinology at Rockefeller University, in New York City, and author of The End of Stress as We Know It. "It can have a cascading effect that affects your whole lifestyle."

It's impossible to predict exactly how stress will take its toll and where you will feel it most. Some people tense up and feel aches in their muscles; others get headaches or tightness in the chest. How your body responds to stress is determined by genetics, your lifestyle, and even your earliest life experiences (childhood trauma and emotional distress can make you more vulnerable to stress as an adult). Whether you have power and control at work, close friendships and a good marriage also play a role.

Visible physical reactions are only the most obvious signs. Inside the body, stress triggers changes that can take years to show up. "Stress definitely takes a quiet toll," says Robert Sapolsky, PhD, a neuroendocrinologist at Stanford University, in California, and one of the nation's leading stress researchers.

The Early-Aging Effect

That toll can make your body age more quickly than it should. Increasingly, medical researchers are viewing our ability to cope with stress as one of the most important factors for predicting how well the heart, brain, and other organs withstand wear and tear.

There's telling evidence of how this process works from the Nun Study, ongoing research from the University of Kentucky, in Lexington, that has followed the lives of 678 nuns from the School Sisters of Notre Dame in seven religious communities across the United States. Since the study started, in 1990, nuns who have demonstrated optimism, a positive attitude, adaptability, and a sense of humor all have aged better than nuns without those personality traits. The women have led remarkably similar lives -- eating the same foods, living in the same places, and interacting with the same people. Researchers say the more positive nuns may have developed more effective coping strategies that stressed their bodies less, allowing them to lead more energetic lives -- and to live more than 10 years longer.

But just because you're feeling stressed out now doesn't mean you're destined for premature aging. Understanding the stress effect gives you more opportunities to manage it before it does any real harm. And because stress affects so much of the body, there's a big payoff once you learn how to deal with it.

The Right Way to Manage Stress

Most of us just treat the symptoms -- taking an aspirin for a headache or a sleep aid for insomnia -- without focusing on the underlying cause. And even when we do try to relieve the source of our stress, it's usually too little too late: taking a weekend off or squeezing in a brief vacation. What you need is a whole-body approach, but it has to be the right approach, one that has an impact on your actual, everyday life.

Think of it this way: One week away won't help your stress the other 51 weeks a year. Stress is in your life every day, doing its damage. Stress management works only if you make it a daily part of your health routine, like brushing your teeth and getting enough sleep. The best starting point is to take care of yourself. Get used to the idea that everyday stress is inevitable and what matters is how you respond to it. Part of that is mental -- you need to be on top of how you respond to the stressors life hits you with. The rest is physical. A healthy body can weather the ravages of stress better than an unhealthy one. Stress-proof your body by eating the right foods, getting enough sleep, and exercising. Some strategies that can help:

• Pay attention to your aches and pains. They're early warning signs. One of the first places stress shows up is in the shoulders and the back of the head. That telltale tightness is your body telling you to take action and find an outlet for your stress before it has time to do even more damage.
• Stay close to friends and family. Stress releases oxytocin, the bonding hormone that's also produced when mothers breastfeed their babies. (Men produce this hormone, too, but while a woman's estrogen enhances the effects of oxytocin, a man's testosterone inhibits it.) Stress causes the release of this "tend and befriend" hormone -- triggering a desire to pull children and friends close. This closeness in turn releases more oxytocin, which actually helps dampen stress hormones. In fact, studies show that breast-cancer patients who join support groups have lower levels of stress hormones. Therefore, when you're stressed out, use women's secret weapon against stress: Call your mom, call a friend, or have some fun with your kids. Stress levels drop when you like the company you're keeping.
• Choose the right exercise. The body's stress response evolved to help us fight off a threat or run away from danger. Under stress your body sends a spurt of glucose to your muscles to give you a burst of speed and strength. There's also a shutdown mechanism: Once you actually escaped from a predator, you would stop running. Your body would interpret that as "the threat is gone" and shut down the stress response.

  
  That's why exercise still helps relieve stress. First exercising -- then stopping -- mimics this energy spurt/shutdown reaction. Your body doesn't know that the stress you're trying to escape is an annoying boss or a family crisis. It just processes the fact that you've responded, then relaxed. It doesn't take much. A quick walk, 10 minutes on the treadmill, or a game of tug with the family beagle usually is enough to release your stress and turn down the stress response.

  
  Make sure you pick an exercise you like. If you loathe slogging away on a treadmill, the activity may actually add to your stress. Something to think about as you devise your mini-escape from the rat race: In actual rodent studies, animals forced to exercise show a surge in stress hormones, while rodents allowed to trot freely on the exercise wheel when they want to have lower levels of stress hormones.

• Try to gain a sense of control over something. Workers who have little control over their day have more workplace stress than managers with power. While you may not be able to change your job, it still helps to find control where you can. Volunteer for projects at work that interest you. Restore order to a messy kitchen drawer.
• Laugh it up. You wouldn't think that time in front of the tube would do much for your health, but studies show that half an hour to an hour of nightly television comedy can be a medical plus.

  
  In an Indiana study, women cancer patients who watched a funny Bill Cosby video had lower stress hormones and higher natural "killer" cell activity (killer cells attack viruses and cancers) than women who watched a tourism video. Laughter pushes cortisol levels down and increases killer cell levels. A California study found similar results comparing those who read with those who watched a funny TV show. Some of the immune-boosting effects of laughter lasted as long as 12 hours after the show had ended.

  
  In another study, diabetic patients who had suffered a heart attack were "prescribed" a nightly 30-minute regimen of TV comedy. After a year they showed drops in blood pressure, used less medication for chest pain, and had 80 percent fewer heart attacks than a control group that didn't regularly watch funny television.

• Cuddle your kids. This will make you feel better, but that's not all. It's stress innoculation. Whether a child grows up in a stable, loving home or a stressful environment has a huge impact on his or her ability to cope with stress as an adult.
• If self-help doesn't help, consult a professional. Though no one can eliminate everything that stresses her, you can try to control the emotional reactions that turn on your stress response. It's not easy, needless to say. Some people benefit from therapy that teaches stress-coping skills. Learning meditation is another way to build calmness into your life. Ask your primary care doctor for advice on finding experts who can help.

Stress Stop: Your Heart

Stress Response #1: Rapid release of glucose and fatty acids into the bloodstream gives you a burst of energy. But if your muscles don't use that glucose to run from danger, chronic stress can leave you with blood sugar levels that are elevated or fluctuating out of control.

• Blood sugar swings can leave you tired and worsen diabetes, if you have it.
• High bloodstream levels of glucose and fatty acids also increase the risk of cardiovascular disease.
• Stress prompts the body to release cortisol, which makes the arteries more vulnerable to the buildup of cholesterol. This may explain why some studies have found a link between stress and high cholesterol.
• There's growing evidence that stress increases the risk of developing metabolic syndrome, a cluster of conditions that include collecting fat around the waistline, high blood sugar, high blood pressure, and high triglyceride levels. Possible result: cardiovascular disease.

Stress Response #2: An increase in heart rate, blood pressure, and breathing delivers more oxygen faster throughout your body. These physiological changes help your body react with strength and stamina during an emergency.

• Chronic stress can mean lasting high blood pressure and a lot more wear and tear on the heart. One study showed that male government workers in London with stressful jobs for more than 14 years were almost twice as likely to have high blood pressure, high cholesterol, and insulin intolerance compared with workers who weren't exposed to stress. The most stressed-out workers? Those with demanding jobs who had very little control over how they spent their day.
• Even short-term, intense stress poses a risk. One Swedish study showed that people under intense but short-term deadline pressure are at six times higher risk of heart attack in the following 24 hours.

Stress Stop: Your Immune System

Stress Response: Stress hormones help shut down body functions that aren't needed in an emergency, including your immune system. An alternative theory proposes that your immune system first goes into overdrive, then shuts down. Either way, you're at risk. As Robert Sapolsky, PhD, of Stanford University, notes, the body essentially turns off its long-term building "projects" so it can put all its energy and resources into dealing with the immediate crisis.

• Ideally, these functions are shut down just long enough for you to get out of immediate danger. When the stress hormones keep coming, your immune response and other functions suffer.
• When researchers injected a cold virus into 394 volunteers, those who reported having very little stress in their lives had such supercharged immune systems that they were half as likely to get sick as volunteers who described having high stress levels.

Stress Stop: Your Waistline

Stress Response: There's growing evidence that chronic stress can make you thick around the middle -- both heavier in general and more likely to accumulate dangerous abdominal fat. The stress hormone cortisol causes fat to be stored around the abdomen. Stress hormones also play a role in certain medical conditions that cause weight gain, such as night-eating syndrome (binge eating in the middle of the night). However, short-term overeating may result in a temporary lowering of stress hormones.

The stress response of accumulating fat at the abdomen, rather than at the hips, is linked to heart disease. One study comparing women who stored fat at the waist to pear-shaped women who stored fat at the hips found that women with abdominal fat consistently secreted more cortisol in response to stressful lab tasks than women with hip fat.

The above study also suggests that women who tend to accumulate abdominal fat should make an extra effort to manage stress since their body shape shows that their physical response to it is stronger.

Stress-induced weight gain takes a significant long-term toll on the body and adds to your overall stress load. Animal research suggests that stress may trigger the brain's reward center, causing us to seek out better-tasting "comfort foods" -- and that the weight we gain eating them may cause stress hormones to drop. This information comes from a series of studies in which stressed-out rats posted higher levels of corticosterone (the rat equivalent of cortisol), ate more and got fatter around the belly. But then something surprising happened. Once the rats started getting fat, their stress hormone levels dropped. The results suggest that overeating may be a coping mechanism to help lower the body's stress level, notes Mary Dallman, PhD, professor of physiology at the University of California, San Francisco, and lead author of the studies. The problem is that even though the eating makes you feel better and appears to solve the cortisol problem, being overweight is itself a form of stress on the body.

Originally published in Ladies' Home Journal, May 2006.