12 Months of Resolutions: All in Your Head: Stress can have an effect on your physical health

By David Steinkraus

Thursday, April 6, 2006 2:09 AM CDT

There's more to it than your rapid heartbeat or knotted stomach. You think stress is a passing thing, but it really isn't. Researchers are finding that stress is intimately linked to your physical health.

"We've known for a long time the fight-or-flight phenomenon where essentially the body's sort of shifting from its equilibrium state to a more emergency state," said Dr. Carlyle Chan, a professor of psychiatry at the Medical College of Wisconsin in Wauwatosa. Breathing and heart rate increase. Extra glucose flows into to the blood to provide more energy to muscles in case the person has to run. The body releases endorphins to reduce pain. Skin blood vessels contract a bit so that a cut won't bleed as much. And part of all this, Chan said, comes from the release of the hormone norepinephrine into the bloodstream.

"The phenomenon that we're just beginning to understand a little bit more is what happens if you keep doing that over time rather than just for the immediate situation? And so that's where some of the concerns and dangers are because high blood pressure and cardiovascular disease and diabetes and anxiety and depression are all sort of some of those consequences of stress."

There are also ulcers, colitis, and chronic bowel issues, said Mary Dutkiewicz, a nurse-practitioner in the Cardiovascular Institute at St. Mary's Hospital in Racine. Often the heart and gastro-intestinal system are most affected by stress, she said. The science is still a bit soft, she said, but there is a view emerging which labels stress as a heart disease risk factor that is just as significant as blood pressure, smoking, and cholesterol.

"We've become so medical and so scientific that we have lost control of how strong our mind and our will can be," she said.

We're learning there's much more of a mind-body connection than we thought, Chan said. It's not that we've forgotten the folk wisdom which has told us that, he said, but that we are only now just developing the tools which provide the evidence that science needs. We're also learning more about how this happens as we learn more about hormones.

In the journals Consider these medical insights.

A 2001 study in the Archives of Dermatology found that exposing a group of young people to stress - in this case final examinations - reduced the ability of their skin to recover from damage, in other words reduced its ability to act as a barrier to disease.

A study in the Journal of the American Medical Association last year found that giving heart disease patients a program of exercise and stress management was better than usual medical care alone when researchers measured indictors of heart disease risk.

A January study in Clinical Cancer Research found that when cells were exposed to levels of norepinephrine like those appearing during stress, the invasiveness of ovarian cancer cells increased by 89 to 198 percent. This study was done on cells in a culture dish.

A study from Vancouver researchers, reported last week in the Proceedings of the National Academy of Sciences, says that in children under stress cells become less receptive to glucocorticoids, some of the body's natural anti-inflammation chemicals, leaving them more vulnerable to asthma.

The nature of stress Exercise is one of the keys to stress reduction.

"If we go back to our hunter-gatherer state," Chan said, "the hunters would sort of , as they're searching for their prey, would get a little bit excited as they close in on their prey. The epinephrine would be flowing through there. They throw a spear and wound an animal. Then there's a chase and there's a physical activity involved.

"But the modern day thing, you're going to give a talk, you're going to a big sales meeting. That same sort of excitement and preparation sort of gets in place, and what do you do? Well, you have lunch afterwards."

At St. Mary's, there's relaxing music playing in the reception area to lower people's heart rates, Dutkiewicz said. She also refers people to relaxation CDs or even computer programs that provide feedback on heart rate and help people learn to control their stress levels.

Changing your response is another way to reduce stress, said Terrie Garcia, a nurse and community educator for Aurora Health Care's south region, "because it's often not the stressor but how you respond to the stressor that determines your reaction."

The same is true for people afflicted with a disease, Dutkiewicz said. "People who dwell on their disease become the disease because they're depressed, because they've succumbed to the disease. They've lost their identity. � They actually become more ill."

Brain limits Another key to cutting stress lies in a modern myth about how brains work, especially young people's brains.

"One of the things that I think we're understanding about the human brain," Chan said, "is that it doesn't multitask very well. There's sort of an illusion. You can do an automatic task and then do something else, but to do a couple of complicated tasks, really how your brain functions is that it sequences the thing. It goes to one thing and then It'll go to the other."

Many stress-reduction techniques use that idea, he said. If you use guided imagery to think about pleasant things, then you're not thinking about something disturbing.

And once you start feeling anxious or scared, your body releases hormones which start a cascade of the fight-or-flight reactions through the body, he said.

"As I was looking around through the literature, I was struck with one of the tips for stress reduction is to find some activity that defies acceleration, meaning find some things that slow you down, that help you sort of focus on the present time and you're not hurrying and doing things."

"Oftentimes," Dutkiewicz said, "I believe that mankind forgets that peace is really the norm, and we always feel that we have to live in turmoil."

"We're always in a hurry, and we always feel that's the sign of the times, and it's not."

"There is a lot of information out there how important it is to give of yourself, not only in a marriage but even outside of a marriage, and to not expect necessarily love back always, to be really unselfish, and how important it is to be truly kind to people, to be a kind person. And those individuals do so much better in general throughout their whole lives."

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