Cleaveland: Stress can tear down your body

Cleaveland: Stress can tear down your body

January 1st, 2009 in Health

Dr. Clif Cleaveland, Commentary

The sustained, severe downturn in our nation's economy will adversely affect the health of millions of Americans. Those with jobs will work harder, often for less pay and under more difficult circumstances. Those who lose jobs will stay in a constant scramble for employment under threats of mortgage foreclosure. Health care will become unaffordable for many people. Without counter measures, the resulting stress will take a steady toll.

A complex, automatic pattern of responses allows us to respond continuously to challenges, whether physical or emotional. Researcher Hans Selye called this the "general adaptation syndrome" and described three stages:

n Alarm reactions allow us to swerve to avoid a collision or to put on a burst of physical exertion. This is also called our fight-or-flight reaction. It is of brief duration and depends upon the immediate release of such hormones as adrenaline and noradrenaline. Our pulse, respiratory rate and blood pressure immediately rise so that we can meet the brief challenge.

n If the stressful situation persists for hours to days or weeks, our bodies enter a resistance and adaptation mode. Our nervous system and glandular system manage responses that include higher levels of blood sugar and blood fats, increased cortisone release and improved concentration, motivation and wakefulness.

n Stress that lasts for weeks or longer may result in chronic fatigue, disordered sleep and depression and/or anxiety. These are also the hallmarks of the post-traumatic stress disorder. Physical consequences may include high blood pressure, diabetes, worsening coronary disease and reduced immunity to infectious and malignant diseases.

We grew up with advice to eat properly, exercise regularly and get ample sleep. But what if work schedules prevent these commonsense measures?

In the 1970s, Harvard-based cardiologist Herbert Benson published the Relaxation Response (updated 2000 paperback edition by HarperCollins Publishers), which described an inexpensive, nondrug strategy for preventing or reversing the effects of emotional stress. Dr. Benson used sustained high blood pressure as a marker in testing a daily, four-step routine that would last 10 to 20 minutes:

* Find a quiet place.

* Assume a comfortable posture.

* Repeat a comforting word, phrase or prayer.

* Assume a detached, serene attitude.

Carefully documented, clinical studies showed that blood pressures decreased significantly during these intervals. Over time, sustained pressure reductions were achieved. Medication could be given in reduced doses or dropped altogether. Convinced by Dr. Benson's articles and lectures, I advised patients to follow his guidelines.

Though not hypertensive, I worked out my own routine in which I closed my office door each day after lunch, cut off the light, stretched out on the floor and for 15 minutes contemplated a happy memory. The benefits for me were a reduction in tension-vascular headaches and refreshed thinking for the afternoon's work.

Elements of the relaxation response, as Dr. Benson describes, are found in yoga and in many religious and cultural traditions around the world. His studies provide reproducible measures of the benefits. Essentially, each technique, however it is labeled, seeks to create a peaceful island in the midst of a busy day. During this break, our reflex responses to stress are quieted.

With practice, a detached attitude can be achieved even in a noisy environment. Relaxation can be attained during noncompetitive exercise such as swimming or walking. Listening to or performing music can yield similar benefits, as can painting, knitting, gardening, woodworking or any activity that isolates us from the psychological pressures of the day. We may choose a variety. The keys are a daily routine and detachment from stressful thoughts.

If despite our best efforts, we find that our days are marked by fatigue, insomnia, nervousness and depression, we should seek medical consultation to exclude a variety of illnesses. If stress is determined to be the cause of our symptoms, we should advocate a role for nondrug therapy in our recovery.

Tough times call for planned periods of relaxation.

Contact Clif Cleaveland at