Stressed out?\u00a0 How can one deal with stress without getting stressed!?<\/p>\n
What is stress and what’s the best way to deal with it?\u00a0 Stress comes from multiple sources-work, family, expectations, health, finances, but the most important source of stress is YOU.<\/p>\n
Stress has been studied a lot in the medical literature.\u00a0 How do medical researchers measure stress? How do they quantify it? Do they run a battery of test? No, they just ask.\u00a0 Patients are asked how much stress they are under.\u00a0 No blood pressure or heart rate measurements. No galvanic skin response measurements. No EEG brain recordings or MRI scans.\u00a0 Just a simple question.<\/p>\n
The fact is, everyone is under stress.\u00a0 The most common conditions leading to stress in a large survey done by the Robert Wood Johnson Foundation<\/a> were poor health, disability, chronic illness, low income, experiencing dangerous situations at home or at work, single parenting, or being the parent of a teen.\u00a0 Many of us can relate to at least one, or more, of these factors.<\/p>\n This leads us to the first and most important finding in the stress research literature:<\/p>\n In an interesting study, patients were placed into groups that had \u2018almost no stress\u2019, \u2018mild stress\u2019, \u2018moderate stress\u2019, and \u2018a lot of stress\u2019. They also asked them if they felt that their stress impacted their health.\u00a0 Out of all 8 groups the only group that had more clinical events was the group that had a lot of stress AND felt that it was impacting their health.\u00a0 If you had a lot of stress, but felt it was not effecting your health, it didn\u2019t!<\/p>\n In another study<\/a> researchers simply asked patients AFTER a heart attack if they had low stress, moderate, or high stress.\u00a0 The group that said they had low stress had less clinical events after their heart attack compared to the group that had moderate to high stress after their heart attack!<\/p>\n Stress is real, but the more important aspect of stress is how we choose to respond to it.\u00a0 Attitude itself is highly associated with death rate.\u00a0 In a large review article multiple studies were listed that showed between a 10% to a high of 73% reduction in cardiovascular complications with an optimistic outlook.\u00a0 Conversely, pessimism was associated with a 32-42% increase in events.<\/p>\n Two large philosophical groups also espouse this view.\u00a0 One is the Stoics and the other are the Christians.<\/p>\n Seneca, one of the most famous Stoics said, \u201cHe who suffers before it is necessary suffers MORE than is necessary.\u201d\u00a0 The idea is that worry about a future problem only increases stress.<\/p>\n The most famous Christian verse in this regard is Matthew 6:25-27, 34 which states that worry and being stressed are a waste of time.<\/p>\n \u201cTherefore I tell you, do not be anxious about your life, what you will eat or what you will drink, nor about your body, what you will put on. Is not life more than food, and the body more than clothing?\u00a0 Look at the birds of the air: they neither sow nor reap nor gather into barns, and yet your heavenly Father feeds them. Are you not of more value than they? And which of you by being anxious can add a single hour to his span of life? Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.<\/u> <\/em><\/p>\n Mark Twain has an excellent quote that puts this all into perspective.\u00a0 He said, \u201cI am an old man and I have known a great many troubles, but most of them never happened<\/u><\/em>.\u201d<\/p>\n Perspective is also incredibly important to how your form your outlook which leads to your attitude. Here are some examples.<\/p>\n During a discussion about making movies Denzil Washington got irritated when other actors were talking about how difficult it was to make a movie.\u00a0 He then went on this mini rant:<\/p>\n \u201cPeople say, \u2018Oh the difficulty of making a movie.\u2019 I say, \u2018Send your son to Iraq. That\u2019s difficult.’ It\u2019s just a movie.\u00a0It\u2019s like, relax. I don\u2019t play that precious nonsense. Get outta here. Your son got shot in the face? That\u2019s difficult. Making a movie is a luxury. It\u2019s a gift. It\u2019s an opportunity and most importantly it\u2019s a gift. Obviously everybody here is talented enough to do that. But don\u2019t get it twisted.\u201d<\/u> <\/em><\/strong><\/p>\n This also occurs in sports, but a great example of the opposite mindset was demonstrated by Steph Curry several years ago.\u00a0 He was asked how he felt to be the 4th<\/sup> highest paid player, not in the league, but on his own team after winning league MVP.\u00a0 Here is what he said,<\/p>\n “One thing my pops always told me is you never count another man’s money. It’s what you’ve got and how you take care of it. And if I’m complaining about $44 million over four years, then I’ve got other issues in my life.”<\/p>\n So attitude, mindset, outlook, perspective, and mood can impact overall health, but how does this happen?<\/p>\n Can stress be transformed into biochemical and physiologic mechanisms that result in cardiovascular disease?\u00a0 In an excellent study researchers put this idea to the test. They thought that increased stress would activate the amygdala (one of the emotional centers of the brain), thus releasing stress hormones, which in turn would activate the bone marrow to release pro-inflammatory monocytes and cytokines which would then lead to atherosclerotic inflammation of the arteries which then could cause stroke, heart attack, and death.\u00a0 They checked their hypothesis by looking at radioactive imaging of the brain, bone marrow, and aorta with positron emission tomography (PET) scanning.\u00a0 What they found was that as a patients perceived stress score increased the degree of amygdala activation, bone marrow activation, and aortic inflammation<\/a> all increased proportionally.\u00a0 Also CRP (c reactive protein) levels (a blood test that is associated with global inflammation) was also increased with increased stress scores.\u00a0 Finally, and most importantly, patients with high amygdalar activity had more clinical events!<\/p>\n Another physical manifestation of stress is that it actually ages your cells. Telomeres are the end caps of your chromosomes and the longer they are the \u2018younger\u2019 your cell is.\u00a0 People with increased stress have measurably shorter telomeres consistent with their cells being older than they should be!\u00a0 If your cells are old, then you are too.<\/p>\n What can cause stress?\u00a0 It\u2019s hard to measure, but there are 2 things that are associated with stress and stress relief that are easily measurable and correlate with clinical outcome. These 2 factors are work hours and sleep duration.\u00a0 Interestingly these both also have a u shaped relationship.<\/p>\n Regarding work if you work less than 25 hours a week the event rate starts to climb.\u00a0 If you work more than 55 hours a week the event rate also climbs. The sweet spot is in between. This probably relates to being underemployed and financially stressed at the low end, and being overworked and stressed out at the high end.<\/p>\n But wouldn\u2019t people be less stressed and happier if they didn\u2019t work at all?\u00a0 What if they were rich and didn\u2019t need to work?\u00a0 Well psychologist Mihaly Csikszentmihalyi looked at that in his well-known book Flow<\/em>.\u00a0 Flow is that state when you are in the \u2018zone\u2019 and time doesn\u2019t matter, you are totally focused on what you are doing, and where and when most people feel the most enjoyment.\u00a0 Interesting flow occurred most often at work, 54% of the time.\u00a0 Flow only occurred 18% of the time at leisure. In fact one of the least flow inducing activities was power boating which is typically in the domain of rich people.\u00a0 Apathy occurred only 16% at work, while 52% at leisure.\u00a0 This makes sense.\u00a0 How often have you been bored during vacation and looking to \u2018fill in\u2019 the time?\u00a0 In contrast work often requires focus, but also provided purpose which leads to enjoyment.\u00a0 Also most people are actually good at their jobs which also helps fulfillment and enjoyment.<\/p>\n Sleep is similar. The sweet spot is from 6-9 hours with less or more associated with increased death.\u00a0 Too little sleep is probably related to increased stress and worry and also poor sleep quality.\u00a0 Also, too little and too much sleep are both factors in major depression.\u00a0 The great thing is that adjusting your sleep time actually reduces your risk so this is something that should be worked on.<\/p>\n Environment can also impact stress levels and even mental illness.\u00a0 Studies have shown that just living in an area that has greenspaces is associated with less stress and decreased incidence of multiple different mental health disorders.\u00a0 The interesting factor is that it is unclear if those people even utilized those greenspaces, but that just by living near them it positively impacted their mental health.<\/p>\n But what if you took the next step and went outside and used those greenspaces?\u00a0 \u2018Forest bathing\u2019, what used to be called taking a hike, has now been studied scientifically<\/a> and been associated with quantitative results such as lower blood pressure and reducing cortisol levels (a stress hormone), and also improving mood, decreasing depression, decreasing stress, improving immune function, and enhancing brain function.<\/p>\n Emotion is also not just a powerful outlet for stress, but can impact your internal physiology as well.<\/p>\n Angry outbursts are closely linked to increased rates of heart attack, stroke, abnormal heart rhythm, and aneurysm rupture. What is the time frame between the angry outburst and the event?\u00a0 How long does that risk last?\u00a0 For 2 hours. This has also been seen after earthquakes where there is an increased heart attack risk shortly after he event.\u00a0 Short term stress or anger can lead to physiological changes, but how?<\/p>\nPerception is everything.<\/h2>\n