Stress

Increasingly, doctors are recognizing that too much stress, or an inability to cope with it, is a serious health threat. Although many people think of stress as a modern phenomenon, humans have never lived in a stress-free environment. Indeed, many experts contend that our prehistoric ancestors, in their quest for food, shelter, and safety, faced stressors much worse than those of the 20th century. Still, the way in which our bodies respond to stress is a holdover from our earliest forebears.

When confronted with any stress, the body automatically goes into high gear, preparing either to defend itself or escape, the so-called fight or flight response. Here's what happens:

• Acting on the brains command, the adrenal glands immediately pump out adrenaline, Cortisol, and other hormones that travel through the body and prepare various organs to go into action to either flee or fight.
• Digestion slows to divert blood from the intestines to the muscles and brain. This sudden diversion and halt of digestion produce the stomach knotting or fluttering sensations, and perhaps nausea, associated with fear.
• Breathing speeds up to draw more oxygen into the body.
• The heart beats faster and blood pressure rises to ensure that muscles and the brain get enough blood.
• The liver pours extra sugar (glucose) into the bloodstream, and the pancreas supplies the insulin needed to metabolize it quickly.
• Sweating increases to cool the body, allowing it to burn extra energy.
• Muscles tense, getting ready to move.
• Chemicals that increase formation of blood clots are released in case the ensuing danger results in a wound.

If faced with a real emergency, the body remains in a state of preparedness until the danger is past or the person becomes exhausted. But the body responds in a similar fashion to such minor stresses as running late for an appointment or standing in a long line. We are so accustomed to facing scores, even hundreds, of such stressors each day that we barely notice our physical reactions. The effects add up, however. Frequent rises in blood pressure can eventually take a toll on the heart and blood vessels. Repeated shunting of blood from the intestines can promote digestive problems. Formation of a clot can precipitate a heart attack or stroke. Tensed muscles can trigger headaches, back pain, and other discomforts.

Not all stress is detrimental. Without some, life would be impossibly boring. In fact, many people seem to thrive on stress; they need a deadline or confrontation to get going. Others, however, fall apart when faced with even minor stress. Experts say that it's not necessarily the degree of stress that is harmful, but rather the way in which the individual copes with it.

Diagnostic Studies and Procedures

Before concluding that symptoms are stress-induced, a doctor must investigate and rule out organic causes. A person experiencing chest pains could be having a heart attack, suffering a bout of indigestion, or overreacting to stress. In this situation, an ECG and other heart studies are needed to eliminate the possibility of a heart attack. Only after a careful physical examination and appropriate tests fail to find a physical cause can a doctor safely conclude that stress is the problem.

Medical Treatments

Stress can generally be controlled with a combination of alternative therapies and self-care (see below). But in some instances, short-term medication may be needed to get through a particularly trying period, especially if tension is contributing to a serious medical condition, such as angina or an intestinal disorder.

If stress is interfering with sleep and thereby contributing to a worsening cycle of stress and insomnia, a doctor may prescribe a sedative for a few weeks. Severe anxiety or panic attacks may be treated with a benzodiazepine tranquilizer, such as diazepam. Because illness contributes to stress, treating an underlying medical condition may also help.

Alternative Therapies

Aromatherapy. Relaxing in a bath scented with chamomile, sandalwood, lavender, geranium, cypress, juniper, rose, or clary sage can be helpful in alleviating stress. Alternatively, a few drops of one of these oils can be placed on a handkerchief and its scent inhaled when stress is felt.

Biofeedback Training. This technique can help lessen the body's response to stress by fostering relaxation and also by allowing the patient to control, at least for short periods, blood pressure, heart rate, breathing, and other body functions that are normally automatic.

Massage. Few activities are more relaxing than a massage, especially one that uses the aromatic oils listed above. When a full body massage is impractical, shoes and socks can be removed and the feet massaged.

Meditation. Deep breathing, progressive relaxation, visualization, and other techniques are the key to finding effective ways of coping with stress.

Music Therapy. Playing some of your favorite music can help relieve stress. It doesn't have to be slow or boring to be relaxing; listening to music you enjoy is more important than its tempo.

Yoga and T'ai Chi These movement therapies foster relaxation and enhance well-being -- important factors in effective stress management.

Self-Treatment

Stress is especially detrimental when you feel that you have no control over the situation. When faced with a seemingly impossible task, try breaking it into manageable segments and then tackle them one at a time.

Learn to set priorities. If you have so much to do that you don't know where to start, list the various tasks. Assign each a number signifying its priority; for example, 1 might designate what needs to be accomplished today, 2 what can wait until tomorrow, and 3 what can be postponed until later. Then look at today's list, arrange the tasks in order of importance, and tackle them one at a time. As you finish each task, cross it off your list, reflect on what has been accomplished, take a 10-minute break, and then continue. If you don't get through the entire list by quitting time, shift what's left to tomorrow, and try to make that day's list more realistic.

No matter how rushed you feel, leave some time each day for pleasurable activities -- reading a good book, visiting a friend, or simply enjoying a sunset or pleasant scenery. Regular exercise is also a good means of combating stress. DO NOT turn to alcohol or recreational drugs as a means of relaxation; such escapes only create new problems, leading to further stress.

Finally, learn to share your stress and ask for help. Confiding in a relative or good friend can help put a problem into proper perspective. If you feel you cannot turn to a friend or family member, consider participating in group therapy or a self-help group of others who are experiencing similar problems. Just knowing that you are not alone can help alleviate stress.

Other Causes of Stress

Pheochromocytoma, an adrenal tumor that produces adrenaline and other hormones, can cause body responses that mimic those related to stress, as can other hormonal disorders. Many women going through menopause or those experiencing premenstrual syndrome develop unexplained periods of anxiety. Grief, illness, and traumatic experiences can also bring about significant stress.