Stress and Health:
Don't Worry Yourself to Death!

Let's start our discussion of stress and health with a few very penetrating quotes.

"Your body is an amazing creation, capable of performing great wonders, but you can destroy that miraculous machine's potential with an overdose of STRESS".  Harry J. Johnson American, Medical Doctor 

“Every stress leaves an indelible scar, and the organism pays for its survival after a stressful situation by becoming a little older.” Dr. Hans Selye (Canadian Endocrinologist)

“If you ask what is the single most important key to longevity, I would have to say it is avoiding worry, stress and tension. And if you didn't ask me, I'd still have to say it.”  George F. Burns quotes (American comedian 1896-1996)
 
"Worry and stress affects the circulation, the heart, the glands, the whole nervous system, and profoundly affects heart action."  Charles Mayo

And my favorite, although cleaned up a bit..."Stress: The confusion created when one's mind overrides the body's basic desire to choke the living daylights out of some jerk who desperately deserves it”, source unknown.

As we can see from these few quotes, there is no shortage of opinions about stress and health.  From the three medical doctors quoted the common thread is that stress is harmful, it degrades our health, damages our hearts, and shortens life.  

George Burns smoked cigars, avoided stress and lived to be a hundred.  From that I would conclude that it's Okay to smoke cigars if you do it calmly.

So why is there a banner for coconut oil shown below?  Glad you asked.  Among its many health benefits, coconut oil is good for the brain and has shown positive results for Alzheimer's patients.  Can it be that easy?  Probably not but it can't hurt.

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The Holmes and Rahe Studies

There is no doubt that stress and health are linked. In 1967, two psychiatrists, Thomas Holmes and Richard Rahe, conducted a
study of 5000 patient's medical records to determine the extent that stress and health problems are a cause and effect.  There was a positive correlation. 

The study resulted in the Holmes and Rahe stress scale that listed 43 life events and their corresponding "life change units (LCU)".  Death of a spouse was at the top of the list and had an LCU of 100.  A total of 300+ LCUs in ones life indicates the a high risk of illness. 

In 1970, Dr. Rahe conducted a follow-up study of 2500 sailors using the LCU scale and found a positive correlation between their stressful life events and subsequent medical issues.

The top ten life event and LCU values
from the scale are:

Life Event Life Change Units
Death of a spouse
100
Divorce
73
Marital separation
65
Imprisonment
63
Death of a close family member
63
Personal injury or illness
53
Marriage
50
Dismissal from work
47
Marital reconciliation
45
Retirement
45

The following paragraphs will examine how stress does its dirty work and how we can make a few changes in our lifestyle to deal to deal with stress.  The people that prescribe and sell prescription drugs will tell us that drugs are the answer.  I hope to show you a better way.


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Stress and Health:
The Physiology of Stress

Let's look at exactly how stress harms our bodies but first let’s be clear about what we mean by "stress".  Hans Selye was one of the founding fathers of stress research. His view was that “stress is not necessarily something bad – it all depends on how you take it.

The Stress of Life

The stress of exhilarating, creative successful work is beneficial, while that of failure, humiliation or infection is detrimental.” Selye believed that the biochemical effects of stress would be experienced irrespective of whether the situation was positive or negative.

Selye's landmark book is available at Amazon and can be accessed via the link or book cover above.  The "Stress of Life" book is for lay readers.

Since then, a great deal more research has been conducted, and ideas have moved on. Stress is now viewed as a "bad thing", with a range of harmful biochemical and long-term effects. These effects have rarely been observed in positive situations.

the face of fear

The most commonly accepted definition of stress (attributed to Richard S Lazarus, a psychologist and pioneer in emotion and stress) is that stress is a condition or feeling experienced when a person perceives that “demands exceed the personal and social resources the individual is able to mobilize.”

In short, it's what we feel when we think we've lost control of events.

Photo attribution: Stress Miedo (fear) by Arturo J. Paniagua

Describing stress as acute or chronic is a matter of duration.

Acute health effects are characterized by sudden and severe exposure. Normally, a single incident is involved.  Acute health effects are often reversible such as in carbon monoxide or cyanide poisoning. Acute stress is usually sudden but temporary with the body returning to a state of balance (homeostasis) when the crisis passes.

Chronic health effects are characterized by prolonged or repeated exposures over many days, months or years.  Symptoms may not be immediately apparent. Chronic health effects are often irreversible. Examples: lead or mercury poisoning, cancer. 

paperwork stress

Chronic stress, unlike health stresses, is not viewed as irreversible but does require special interventions to modify the behavior or perceptions underlying the ongoing stress response.

Photo: Paperwork: the Epitome of Stress!

The link below will take you to a Great Courses 24-lecture presentation on Stress and Your Body presented by Dr. Robert Sapolsky, professor of biology, neurology and neurosurgery at Stanford University.  To say the least, Dr. Sapolsky is a character and his lecture style will keep you riveted to the course.  It is by far one of the best offerings from The Great Courses.

Click on the Great Courses button below and it will take you to the landing page where you can enter Stress and Your Body in the search box and examine this offering.  


Stress and Health:  The Effects of Stress,
The Nun Study

Research has shown that lifestyle factors have a great effect on how humans handle and react to stress.  It was noticed that groups of Catholic nuns living in some convents were living in excess of one hundred years with no signs of cognitive disorders, no Alzheimer’s or dementia.  They were learning new skills and even new languages in their 90's.

A 20 year study was done on the physiology of their longevity and many of them agreed to donate their brains to science upon their death.

no stress and health prevails

The ones that did show signs of Alzheimer’s disease also showed signs of having experienced small strokes.  This was another confirmation that the risk factors for Alzheimer’s and cardiovascular

A significant finding in the nun study was found in their writing samples. The ones exhibiting Alzheimer’s, showed a decline in writing skills and ideas up to 50 years before their diagnosis.  The nuns showing more complex writing skills with more emotional content and fresh ideas were less likely to be diagnosed with Alzheimer’s.

no stress in a nun's life

The conclusions of the nun study suggest that significant cognitive decline is not a normal part of aging.  The nuns studied lived a life conducive to being mentally healthy; they lived quiet, low stress lives with others whom they shared similar viewpoints, they were well read, exercised regularly and ate good nutrition.


The Physiology of Stress and Health:
The Effects of Stress

The Players

The stress response in humans has been well mapped and it goes directly to specific regions of the brain; four to be exact.  Brain chemistry is at the heart of stress and health interactions. 

The four lobes of the brain in the photo are the frontal (red), parietal (purple), occipital (blue) and temporal (green)

sress and health of the brain

The Amygdala, in the temporal lobe, is part of the brain circuit that equips us to respond quickly to a threatening situation: the well known "fight or flight" response.

The Hippocampus, also in the temporal lobe, is an area of the temporal lobe involved in learning and memory.  It is an evolutionary old part of the cortex.

The pre-frontal cortex area appears to be critical in "unlearning" a behavior and even very small lesions (damage) in this area can prevent the unlearning or reversal of a learned response.  In this case to key to fixing stress and health restoration may not work.

The reticular formation, in the brain stem, is a collection of neuron groups in the core of the brain that controls many vital functions including selective attention.

Neuroscience recognizes that the way in which we interpret and experience the world emotionally has a deep effect on both our physical and mental health.  The traffic jam isn't the problem; with stress and health, it's all in how we respond to it.

Emotions guide us to make good or bad decisions so how do we harness that to our benefit?

A threatening situation activates the sympathetic nervous system, that part of the nervous system, under the control of the hypothalamus, which prepares us for fight or flight.  The hypothalamus is a part of the brain involved in maintaining homeostasis or balance or "normality"

When we are confronted by a saber tooth tiger who thinks we would make a great appetizer, the hypothalamussaber tooth stress maker

causes the release of a hormone, adrenocorticotropic (ACTH), from the pituitary gland.  The pituitary is an endocrine gland about the size of a pea, located at the bottom of the hypothalamus at the base of the brain.

Its hormones serve to regulate other endocrine glands and have a role in regulating homeostasis (the "health" in the stress and health relationship).
 
Adrenal glands located above the kidney respond to ACTH by releasing catecholamines (neurotransmitter chemicals) and cortisol into the blood stream. 

Cortisol is a corticosteroid hormone, often referred to as the
"stress hormone" as it is involved in response to stress. It increases blood pressure and blood sugar, and reduces immune responses.
   
Peripheral Nervous System (PNS) catecholamines are dopamine and epinephrine and in the short term are useful responses. They enable a quick response, alertness and stimulate muscle. 

When the saber tooth tiger is gone and the crisis is over; another part of the PNS under the control of the hypothalamus brings about a state of rest and relaxation.  The PNS are parts of the nervous system that lie outside the brain and spinal cord.

The Sympathetic Nervous System is "fight or flight"; the PNS is "back to normal".

Chronic stress...
Our Perception is the Problem.

Regarding stess and health, chronic (long term) activation of the stress systems damage the immune and cardiovascular systems and cause the death of neurons in the brain.

Stress and Health - The Immune System

Let's examine the immune system first.  Chronically high cortisol levels cause a decrease in the body's natural immune response. The whole immune system is designed to fight foreign invaders so if we are facing a saber tooth tiger, the immune system doesn't need to worry about fighting a virus right at that moment.  "Stress and health" suddenly becomes a matter of "stress and survival".

Cortisol causes a decrease in the body's desire to have the immune system work properly since we have to survive the tiger first and all the body's resources need to be focused on that end.  Cortisol also causes a chronic decrease in our DNA repair mechanism. 

Little pieces of DNA is constantly getting damaged so when we are facing the tiger,

stress and health of DNA

the DNA repair mechanism is shut down as well; another aspect of "stress and health" taking backseat to "health and survival".

Photo:  DNA representation superimposed on endoplasmic reticulum; from National Science Foundation

In addition there is an increase in the autoimmune mechanism.  This is where some part of the immune system goes awry and attacks its own body thus autoimmune diseases are very sensitive to chronic stress and health greatly suffers.

In summary, cortisol decreases the immune response, increases the autoimmune response and decreases the DNA repair mechanism.

The consequences are more colds, infections, cancer (no DNA repair), more autoimmune diseases such as multiple sclerosis (MS) in which the immune system attacks the neuron's dendrites and myelin sheaths (insulation).  Lupus and arthritis flare ups may start occurring among other things.

Stress and Health -
The Cardiovascular System

The cardiovascular System is damaged by chronic stress in two ways: non-ischemic and ischemic.

Non-ischemic refers to direct damage to heart muscle itself. The release of high levels of catacholamine, translates to high levels of epinephrine from the adrenal glands.

This was first noticed by NASA in heart attacks and the sudden death of astronauts from constant chronic stress.  Besides the long term stress of a launch and space voyage, after every launch most astronauts would lose their job, causing more stress. 

Abnormally high levels of cortisol and catacholamine were found to be the culprits and the mechanism has since been validated by inducing heart attacks in lab rats.

Ischemic damage is the result of a blocked blood supply to a structure.  Blocked vessels to the heart cause heart attacks.  Cortisol and epinephrine are responsible for scarring in blood vessel walls causing plaque buildup and eventual clotting.  The same risk factors occur in Alzheimer’s disease.

To summarize, the stress system was designed to start and stop. Under acute conditions, there is no problem and we return to homeostasis.

If a return doesn't come, as in chronic stress, we get all the health issues described above.

Again, the message is simple; chronic stress is a killer to the body.

What about the brain?

Chronically high levels of cortisol cause neuron death in the brain's hippocampus.  It was found that the hippocampus is especially sensitive to cortisol in that it has a very high number of cortisol receptors and binds cortisol.  Why is there no problem on acute level?  We don't know yet.

When receptors are chronically bound, it sets up a cascade of events causing neuron death.  Mitosis does not replace cells killed under these circumstances.  The process Kills so many hippocampus neurons that the atrophy from it can be seen on MRI scans.

Photo below:  MRI scans with hippocampus indicated

Photo credit: Michael Firbank

stress and health of hippocampus

Adults abused as children show excessive hippocampus atrophy. Long term depression and prolonged grief all cause chronic stress activation as does post traumatic stress syndrome (PTSS).

Not all PTSS or depressives show hippocampus atrophy, why?  Again, science hasn't cracked this one yet either.

Long term emotional distress shows decreases in cognitive ability, especially memory; all because the hippocampus likes binding to cortisol.

Reduce Stress...Health Improves!

The problem is how do chronically stressed out or depressed people go about climbing out of the abyss of despair.  Remember, we are talking about chronic, long term ongoing emotional trauma; stress and health are inseparable.  It's easy to say, "get happy" or "get over it" but gratuitous comments like these don't help anyone. 

If you want a quick fix or something to handle the symptoms of stress go to your doctor and chances are you will walk out with any one of fifteen or so popular drugs for depression, anxiety and stress. 

It depends on what the pharmaceutical detail people are pushing on the doctors that week.  Detail people are the field salesmen and women that call on doctors and give them all those free samples.

For a real stress reliever, try getting your hands dirty doing some backyard gardening.  Plant some flowers, grow some herbs, watch the vegetables grow that you planted.  Go to Burpee, look at their stress medicine and give it a try.

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Happiness is a Pill...Not!

The book Anatomy of an Epidemic asks why the number of mentally disabled ill people has tripled in the U.S. over the last 20 years.  Why are so many of our children kept doped up on psychotrophic drugs?  It appears that the profession of psychiatry has discovered a gold mine in prescribing a drug for every imaginable human condition.  These are dangerous drugs and should be handled with care and prescribed sparingly at best.

You probably know some of these drugs as Prozac, Valium, Ritalin, Adderal, Xanax or Zoloft; there are many more not so familiar names.  Being pharmaceutical drugs, they all have at least two things in common; they all have side effects and do not cure anything...they treat symptoms. Generally, taking drugs for depression, panic attacks and stress, is a lifetime journey. 

Just to look at one or two, let’s take Ritalin and Zoloft.

Ritalin:  Brave New World!

Ritalin from Novartis is commonly prescribed for young people who have trouble paying attention and are hyperactive. It sounds like a normal teenager to me but the doctors call it ADHD for Attention Deficit, Hyperactive Disorder and the drug companies were quick to roll out a whole menu of drugs to pacify these kids.  You won't believe the list of serious and Common adverse reactions attributed to Ritalin.  Here we go:

Serious Reactions

Dependency, abuse psychosis, mania, aggressive behavior, Tourette's syndrome (rare), arrhythmia, MI (myocardial infarction), stroke, sudden death, seizures, growth suppression (long-term use), hypersensitivity, exfoliative dermatitis, erythema multiforme, thrombocytopenic purpura, leukopenia, neuroleptic malignant syndrome (rare), cerebral arteritis (rare) and hepatic coma.

Common Reactions

Nervousness, insomnia, anorexia, abdominal pain, tachycardia, nausea, motor tics, headache, palpitations, dizziness, fever, rash, urticaria, depression (transient), drowsiness, dyskinesia, angina, blood pressure changes, visual disturbances and elevated liver transaminases.

Zoloft

Now let's do the same exercise for Zoloft from the folks at Pfizer.  This drug is widely prescribed for depression, panic attacks, post traumatic stress disorders, obsessive-compulsive disorders and several "off-label" uses. 

Here we go with the side effects listed for Zoloft:

Allergic reactions

Skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Zoloft can actually worsen emotional disturbances in the form of mood or behavior changes, anxiety, panic attacks, trouble sleeping, or feelings of impulsiveness, irritability, agitation, hostility, aggressiveness, restlessness, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

More serious side effects include:

Seizure (convulsions); tremors, shivering, muscle stiffness or twitching; problems with balance or coordination; agitation, confusion, sweating, or fast heartbeat.

Less serious side effects include:

Drowsiness, dizzinee:ss, weakness, nausea, diarrhea, dry mouth, or
changes in appetite or weight; or decreased sex drive, impotence, or difficulty having an orgasm (ooh, that's a bad one).

Do you <em>really</em> want you or your children taking drugs for stress?

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There has to be a better way!

Getting back to the root cause of stress, how we perceive events is what is critical to reduction of stress and health optimization; not the event itself.

Coping skills can be taught and how we interpret events can be changed.  How does the brain affect these changes?

The brain is anything but a static, fixed organ.  Yes, much of the brain structure is hard-wired, a necessity to insure that the various structures are correctly connected to each other.  On the other hand, a major system of the brain is soft-wired. 

So called soft-wiring is what allows the brain to enact change based on our experiences in the world.  Our Behavior and response to the world is <em>learned</em> and this has huge implications for stress and health by changing the way we react to potentially stressful situations. 

This ability of the brain to change or modify its synapses in response to experience is a characteristic known as plasticity. 

synapse representation

A synapse is the junction between neurons, specialized cells of the nervous system, by which communication takes place throughout our nervous system and brain.  Continued negative emotions as well as positive emotions will modify synapses accordingly.

Photo: neuron communication Inset: Synapse

Moving to higher order brain structures, research has proven that four areas of the brain play a critical role relative to stress and health in learning fear as well as "unlearning" fear.  One of those four regions is called the amygdala, an almond shaped collection of neuron cell bodies that is involved in the processing of emotions, particularly fear.

In lab animals, removal of the amygdala results in the loss of a learned fear response and they no longer show a fearful response to a threatening stimulus.  It doesn't matter if the fear was a learned fear or intrinsic to the animal.

This is the basis for the belief that chronic stress can be treated by psychotherapy and training to alter the way we interpret or handle stressful conditions.  It has tremendous implications for stress and health.

Try These - you Don't Have to Pay a Doctor!

In addition to neurological retraining of the brain there are societal and interactive approaches pertinent to stress and health that must not be overlooked.

For starters, here's a book by Dr. Robert Sapolsky that has been widely acclaimed.  Yes, you met Dr. Sapolsky near the top of this page when we introduced him as the lecturer in the Great Course, Stress and Your Body.  Click on the book cover to learn Why Zebras Don't Get Ulcers.

Great stress reducers are laughter, meditation, friendships and support groups, exercise and nutrition.

We will briefly touch on how these are beneficial to stress and health management without going into a great amount of detail on each one.

Laughter is great medicine. So much research has been done on its effects on stress and health that it will be covered in a separate page of this site.  But until then, know that laughter has been proven to:

    • lower blood pressure
    • decrease the stress hormones discussed earlier
    • rotects the cardiovascular system
    • improves brain function

Exercise has many of the same benefits on stress and health as laughter and will likewise be covered in a separate page of the site.

The obvious beneficial effects of exercise are on the cardiovascular system and musculoskeletal system.  In addition exercise has been shown to be very effective in combating depression and raising self-esteem.

Meditation provides several benefits for handling stress and health as well.  It helps maintain the health of brain cells and preserve memory related functions which imply that it acts on the limbic system.  The limbic system is an interconnected group of neuron cells that are involved in learning, memory and emotion. 

According to Dr. Mehmet Oz, in one of his appearances on the Oprah show, a good long "Ommmm" during meditation releases nitric oxide, a potent lung and blood vessel dilator. Clicking on the book cover will take you to his and Dr. Michael Roizen's book, You, Breathing Easy.

What about Dietary Supplements?

Nutrition and supplementation can be critical elements of any effort to overcome chronic stress, depression and related conditions.  Recall that the stress hormones are produced by the adrenal and pituitary glands, both part of the endocrine system. 

Supplements that are focused on supporting the endocrine system should contain wild yam extract, L-glutamic acid, Glycine, L-Lysine, L-Arganine and Beta-Sitosterol plus a blend of the essential sugars required for intercellular communication.

Any nutrients that will aid the cardiovascular circulation plus reduce inflammation in the blood will go a long way in managing stress and health responses.  These would include Folate, vitamins B6 and B12, Coenzyme Q10, Alpha Lipoic acid, L-Carnitine, reservatrol and a high quality omega-3 essential fatty acid.


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