Stressed to kill – report by Deborah Hodgson. (The Bulletin)
New research reveals that stress can be good for you - the real danger is too much. Ways are being devised to avoid the worst symptoms. Deborah Hodgson reports.
Imagine you’re a zebra, running from a lion. Just a split second ago, your sensitive nose picked up the predator’s scent. Before your brain has time to fully process the memory of fear associated with the smell, you’ve begun to sprint. Emergency messages are sent out, telling your lungs to send more oxygen to your heart. Hormones – adrenaline and cortisol – shut off everything other than immediately necessary bodily functions. Digestion and white blood cell production cease to work, vessels contract to avoid bleeding in case of a wound, and the heart rate increases dramatically to race blood to the large muscles of the charging legs.
In many ways, this is the same experience we have every time we face something as prosaic as an unrealistic sales quota or an altercation with the boss, according to Robert Sapolsky, biologist and author of Why Zebras Don’t Get Ulcers. We react to psychological stressors the way animals do – and our ancestors did – to predators and natural disasters. But although our bodies are great at dealing with these temporary, dramatic stressors, cumulative psychological stress plays havoc with our system – we often don’t know how to turn the stress response “off”. We get digestive upsets like diarrhoea, irritable bowel syndrome and constipation. Our depleted white blood cells and immune system can’t keep up with infections invading our body. And hunger-inducing cortisol makes us desire comfort food that lingers on our waistline and makes it harder to deal with stress long-term.
Unlike the zebra, we tend to remember stressful events long after they’re over, and we don’t run great distances to burn off the excess energy that stress makes us want to consume. It’s partly because our bodies haven’t evolved along with the change in our contemporary environments that, in the past 10 years, cases of depression have tripled and anxiety attacks doubled in most developed societies. “There’s no label for it yet,” says Sapolsky, “and for many people there is nothing demonstrably out of whack, but diseases related to stress are becoming the epidemic of westernised living.”
The downsides of stress are well documented. The estimated annual cost of workplace “psychological injury” to the Australian workers’ compensation system is about $35m, and stress accounts for 18% of the country’s compensation expenditure. A Northwestern Life Insurance Company study conducted in 1992 discovered that seven out of 10 workers in the US believe that job stress causes them to have frequent health problems. Stress is blamed for a variety of ills by clinicians who previously pooh-poohed the psychosomatic link, not just to ulcers, but to obesity, cardiovascular disease, stroke and diabetes. And yet, as psychologists and scientists start to understand stress more intricately, they’re finding that it’s an inevitable and even necessary part of life. Even high levels can be helpful, as long as they’re intermittent, temporary and predictable, and tempered with life satisfaction and a general sense of control.
Stress is a bit like the opposite sex – we say we can’t live with it, but we can’t live without it, either. It’s the stress function that helps us adjust to daylight after hours of sleeping, to open our eyes in bed, sit up and reach for the coffee pot, then stand up in the shower to get going in the morning. From then on, our day is a constant interplay of sympathetic and parasympathetic nervous systems in what experts call an allostatic (or adaptation) response to the changes of day and night, summer and winter. Stress helps zebras escape lions; it also helps us gather energy for a presentation to an indifferent or hostile group, and perform, hopefully, at our best.
Without it, we even get sick. While high levels of the stress hormone cortisol can lead to melancholic depression, diabetes, anorexia and heart disease, too-low levels of cortisol have been linked to atypical depression, allergies, fibromyalgia and chronic fatigue syndrome. “Living a stress-free life is not a reasonable goal,” says psychiatrist Ned Hallowell of the Boston , Mass. , Hallowell Center which specialises in cognitive and emotional health. “The goal is to deal with it actively and effectively.”
Humans can be successful and healthy when high amounts of stress are predictable or controllable. The second Whitehall Study published last year, tracking the health of 10,000 British public servants, found that lower-ranking bureaucrats had more heart disease and mental illness than their managers, even though they had fewer responsibilities and less to do. Conventional wisdom may have it that a stressful job is one with great responsibility and importance, but not according to this study. “It shows that stress is not about increased work, but about a person’s control over his or her work and life,” says one of the fathers of stress research, Professor Bruce McEwen, of New York ’s Rockefeller University , and author of The End of Stress as We Know It.
It’s also about our personality. For decades, psychologists have talked about two broadly different types when it comes to stress: A and B. Any minor event that disrupts their normal routine or gets in the way of their plans can upset a Type A person, while a Type B is much better able to take life in their stride. Not surprisingly, Type A people are much more prone to stress than Type B. Another way to think of it is in terms of “stress thresholds”. Someone with a low stress threshold can become highly stressed by simple events, such as being late for a meeting or forgetting their keys. It would take something much more threatening, such as death or disease, to initiate the stress response in someone with a high stress threshold.
But it’s not the whole story. A CEO of a large company may be considered a Type A personality because he or she is so driven and ambitious. But they also obviously handle what most of us consider huge amounts of stress extremely well, or else they wouldn’t be a successful CEO. The CEO may work 10 hours a day, seven days a week, and still be perfectly happy. However, should the same person then take a family holiday, they could find it extremely stressful. “It’s important to remember that ‘thriving on stress’ really doesn’t exist,” says Hallowell. “Rather it’s perceptions of stress that matter.”
Some people weather devastating experiences – captivity, torture, illness or loss – with uncanny serenity. By studying them, researchers have found they share distinctive habits of mind. They tend to focus on immediate issues (a dying child’s comfort) rather than global ones (the prospect of death). And they find ways to rationalise problems – many interpreting their ordeal as a special assignment from their god. Stress-resistant people also tend to share what experts call an optimistic explanatory style. An optimist would assume his troubles are temporary (“I’m tired today”) rather than permanent (“I’m washed up”) and specific (“I have a bad habit”) rather than universal (“I’m a bad person”), says University of Pennsylvania psychologist Martin Seligman. In addition, he would credit himself when things go right, while externalising his failures (“That was a tough audience”, not “I gave a wretched speech”).
New research shows that the brain remodels itself, in a process called “neurogenesis”, well into adulthood, offering hope if you want to change your outlook. “Once you start monitoring your explanatory style, you can catch yourself leaping to awful conclusions – and instead consider the alternatives,” says Seligman. We often simply think ourselves into a stressed state. In a University of California (San Francisco) study of caregivers of chronically ill children published last year, researchers noted that carers who perceived their situation as stressful incurred more biological markings of ageing, a sign of stress in the body, than those who didn’t think of themselves as stressed.
With stress being so subjective, it’s hard for doctors to know when to step in. Even measuring levels of cortisol isn’t conclusive – we all have slightly different levels to begin with. But Professor Kazuhito Rokutan and his team at the Department of Stress Science at Japan ’s Tokushima University are developing a diagnostic gene chip, set to be on the market in two years. Rokutan tested the white blood cells of students who were taking graduate school exams, and measured the activity in about 70 different genes he’s isolated as being active in the stress response. The results showed clearly which students had got over the stress of the exams, and which others were still suffering hours or days later. Surprisingly, students who said they were very stressed during the test sometimes didn’t show a strong stress response in the lab later. “That’s why it’s much more objective than any stress diagnosis ever done before,” says Rokutan. In the future, he expects doctors to use his simple diagnostic tool in routine check-ups.
Once abnormal stress is diagnosed, there’s still no pill to make it go away. But there’s a lot you can do to modulate the mind’s response to stress. Studies suggest that meditation, massage and other relaxation exercises can stem the flow of stress hormones, lowering both heart rate and blood pressure. Richard Davidson, a professor of psychology and psychiatry at the University of Wisconsin at Madison , has conducted experiments for the past 20 years on meditating Buddhist monks, fixing electrodes to their heads as they sit on his lab floor watching visual stimuli, including disturbing images of war, flash on a screen. Examined later, the monks’ left prefrontal cortices – the area associated with positive emotion – turned out to be far more active than in the brains of people who didn’t meditate. Meditation doesn’t lobotomise people; it simply allows them to detach from their emotional reactions so they can respond appropriately, says Davidson. And exercise can be a powerful medicine. American researchers have found that after a half-hour on a treadmill, young men score 25% lower on anxiety tests and exhibit favourable changes in brain activity (less action in the stress-sensitive amygdala and more action in the more self-possessed left prefrontal cortex).
Almost anything, whether it’s yoga, bio-feedback or music therapy, can give relief from stress. The key, experts agree, is that you combat feelings of helplessness. “Anything that fosters a sense of control – for example, putting a traumatic memory into words, calming a racing heart through breathing exercises, even planning your own imminent funeral – lets you stop feeling like a victim,” says Hallowell. “When that happens, your body stops treating itself like one.”
Employers also need to stop treating employees like victims. In 2001-02, stress accounted for more than half of all long-term non-injury compensation claims in Australia . The perceived higher costs of stress have ushered in a sea-change among Australian employers, previously apathetic about employee health, says Ken Buckley, managing director of Health Works Corporate in Sydney . “The more enlightened employers are asking what can we do to change corporate culture to preserve human capital.” Employees who took in-house wellness programs set up by Health Works have reported lower levels of stress, higher job satisfaction, more productivity and improved health overall.
Of course, being told by one’s employer to relax more while upping one’s sales figures is enough to stress anyone. In the well-known satirical comic Dilbert, the title character is told by his boss he’s working too hard and to go home early, but to be sure to finish that report by the next day. Dilbert asks bemusedly: “But how can I relax and do urgent work at the same time?” His boss replies coolly: “Work smarter, not harder.” Dilbert: “Aieeee!” Mercifully, the angel of cynicism appears just then. “Slap something together in the morning; he won’t look at it anyway,” it counsels. Dilbert’s newly learnt lesson, muttered as he leaves his cubicle and heads home: “Freedom’s just another word for not caring about the quality of your work.” Funny because it’s true? Stress may make a cynic out of you yet. l
With additional reporting by Joan Raymond. This story originally appeared in Newsweek Japan.
The Bulletin
http://bulletin.ninemsn.com.au/bulletin/site/articleIDs/FEEB72A3AB7B0F3BCA256FAB00082563
