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The American Institute of Stress is proud to announce that our Combat Stress editor, AIS Fellow Alison Lighthall, was awarded The National Education Association’s Art of Teaching Prize for 2012 defined as: “A $2,500 award for an article that illuminates one educator’s approach to the complex and tangible dynamic that inspires a love of learning or an article that offers practical approaches to improved teaching and learning at the college level” for her article “Ten Things You Should Know About Today’s Student Veteran” published in the 2012 edition of Thought and Action.
This article explores the epidemic of suicides in the military and the correlation to dramatic increases in psychiatric drug prescriptions to treat the emotional scars of battle.
ScienceDaily (Nov. 5, 2012) — Recent combat veterans who are diagnosed with post traumatic stress disorder have significantly smaller volume in an area of the brain critical for regulating fear and anxiety responses, according to research led by scientists at Duke University and the Durham VA Medical Center.
ScienceDaily (Nov. 2, 2012) — Contrary to popular perception, stressors don’t cause health problems — it’s people’s reactions to the stressors that determine whether they will suffer health consequences, according to researchers at Penn State.
German researchers report that heart attack patients who have high levels of anxiety are at greater risk for subsequent coronary events including heart attacks and death than more relaxed controls. Physical examinations and psychosocial assessments were conducted on 76 patients one week and 31 months after a myocardial infarction. During this period, 24 patients required some type of revascular procedure or suffered a cardiovascular death. A review of the records revealed that this group had significantly higher anxiety levels than similar patients who did not experience these complications. In addition, coronary events occurred much earlier in the convalescent period compared to their more relaxed counterparts. A low state of anxiety was much more common in those who had no coronary symptoms (77% vs. 54%).
Several studies have shown that hostility, depression and lack of social support are risk factors for poor prognosis following a heart attack but few studies have examined the role of anxiety. Some have previously suggested anxiety might even have a favorable influence by encouraging the adoption of a more healthy lifestyle. This study found that “Anxious patients tended to continue smoking, whereas less anxious patients were more likely to give up smoking during the follow-up period.” In addition to high anxiety levels, being older, female, living without a partner and having diabetes at the onset of the study also contributed to increased risk of a subsequent complication.
Reference: Benninghovena D, Kadkub A, et al. Influence of Anxiety on the Course of Heart Disease after Acute Myocardial Infarction – Risk Factor or Protective Function? Psychotherapy and Psychosomatics 2006; 75: 56-61.
Several studies have confirmed the cardioprotective benefits of stress reduction in patients at increased risk of coronary events. The Congressional Prevention Coalition on Stress Prevention reported that cardiac patients who learn to manage stress reduce their risk of having another heart attack or heart problem by 74%, suggesting that stress management is even more effective than exercise in preventing heart disease. In one study, researchers took 107 patients with coronary heart disease and put them on either a four-month stress reduction program, a four-month exercise regimen or allowed them to receive usual heart care from their personal physicians. Over the next five years, only three of the 33 people given stress management suffered cardiac events, defined as a heart attack or heart surgery such as a bypass or angioplasty. Seven of 34 people in the exercise group suffered such events, as did 12 of the 40 patients receiving typical care. Those in the stress management program were 74 percent less likely to have additional heart problems than those who received only routine medical care. Stress management training consisted of 16 small-group weekly sessions that provided participants with ways to control negative emotions and thoughts and other stress reduction techniques. Patients who received stress management training had lower hospitalization and physician’s bills with average costs $5,998 compared to $10,338 for those who received usual care. These findings are of particular interest since none of the patients entered the study “complaining of stress”, suggesting that any patient with heart disease can benefit from stress reduction. Ironically, only about 10 to 20 percent of heart patients even wind up in rehabilitation programs since, although it has proven to be cost effective, insurance is often an issue. And doctors say it is surprisingly hard to convince patients that they’ve got a stress problem, even after a heart attack.
References: Hagelin J. “Stress Prevention: Its Impact on Health and Medical Savings”, The Congressional Prevention Coalition on Stress Prevention. June 24, 1998. Blumenthal JA, Babyak M, Wei J et al. Usefulness of psychosocial treatment of mental stress-induced myocardial ischemia in men. American Journal of Cardiology January 15, 2002;89:164-168
Studies have shown that many depressed patients have high levels of the stress hormone cortisol, but it is not clear whether this is cause or effect. It’s much like which came first, the chicken or the egg? Depression is obviously stressful but there is also evidence that stress can cause depression, especially depression that is associated with anxiety. Harvard neuroscientists have recently confirmed this latter link in mice by giving them corticosterone, which is the equivalent of cortisol in rodents. Corticosterone was administered in drinking water to avoid the stress of injections in chronic doses over 17-18 days as well acutely within a period of 24 hours. Compared with mice given the stress hormone for a day, those who received it for more than two weeks took significantly longer to emerge from a small dark compartment into a brightly lit open field. This is a common behavioral test for anxiety in animals. Chronic, but not acute administration of the stress hormone not only made the mice more fearful and less willing to explore any new environment but also dulled reactions to a startling stimulus, another indication that their nervous systems were overwhelmed. This is consistent with studies in humans showing that chronic stress, such as caring for a spouse with dementia, as opposed to acute stress, often leads to clinical depression. Further support comes from the observation that more than half of patients with Cushing’s disease, which is characterized by high cortisol levels, suffer from depression and anxiety. Patients who receive chronic corticosteroid therapy for rheumatoid arthritis and other inflammatory disorders also have a high incidence of similar mood disorders. In addition, chronic elevation of corticosterone or cortisol levels are associated with increased activity in anxiety-related brain regions such as the amygdala in both rodents and humans. Preliminary animal studies suggest that drugs that can block the deleterious effects of these stress hormones may help prevent the development of anxiety and depression in certain patients.
Reference: Ardayflo P, Kin K-S. Anxiogenic-like effect of chronic corticosterone in the light-dark emergence task in mice. Behavioral Neuroscience 2006; 120 (2) 46-51. Stress And Health Newsletter #7 2005, #4 2004, #11 2003, #4 1994
Losing your job is always stressful but it can also have significant adverse health effects. This is especially true if you are nearing retirement according to Yale researcher William Gallo and coworkers. They followed 4,301 employees who were 51-61 years old when the National Institute on Aging Health and Retirement Survey began in 1992. Over the next ten years, almost 600 had been laid off and it was found that those over 50 had twice the risk for stroke and heart attack compared to controls that were still working. In addition to the stress of significant reduction in income there was often a loss of longstanding social support networks and people over 50 also had more difficulty in finding another job than much younger workers. The authors had previously reported an increase in depression and alcohol abuse in older workers who had lost their jobs.
References: Occupational and Environmental Medicine, posted online (June 21, 2006)
The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 61:S221-S228 (2006)
Sick Building Syndrome refers to various symptoms including cough, wheezing, shortness of breath, dry or itchy eyes, runny nose, sore throat, skin rashes and unusual fatigue thought to be due to deficiencies in the design of a building design. These complaints have been associated with poor air quality, increased mold, temperature, humidity and other problems in the physical environment. The disorder costs businesses millions of dollars/year from absenteeism for sickness as well as lost productivity.
However, British researchers recently reported that many of these complaints are more likely due to job stress than environmental irritants. They asked 4,000 civil servants working in 44 London buildings about physical and emotional environmental conditions at work, as well as the presence and severity of any respiratory, skin or other symptoms that might be related. Around 14% of men and 19% of women reported five or more complaints commonly seen with the syndrome. Outside observers evaluated temperature, humidity, light, air quality and other possible physical contributors that might be relevant. Although they found higher levels of symptoms in buildings with temperatures outside the recommended range, poor humidity, airborne bacteria and dust, lower levels were reported in buildings with poorer air circulation, as well as unacceptable levels of carbon dioxide, noise, fungus and volatile organic compounds.
The most significant factors associated with increased symptoms were high job demands, lack of support and increased workplace conflicts. The researchers did not deny that poor building design could affect workers’ health but rather that job stress could exacerbate such problems. They also concluded that, “There is increasing evidence that the psychosocial work environment is related to health and that the physical responses to work stress may resemble symptoms that have been attributed to the physical work environment.”
Marmot AF, et al. Occupational and Environmental Medicine, March 2006; 63: 283-289.
Japanese researchers have developed a rapid and relatively inexpensive way to determine stress levels by what the media have referred to as a “spit test”. This label is not as derogatory as it might seem because this method has a more scientific basis than stress dots, stress meters and other devices described in a Newsletter devoted to this subject. These merely detect alterations in blood flow or sweat gland activity due to stimulation of the sympathetic nervous system and the secretion of adrenalin and similar catecholamine hormones.
Measuring blood levels of these and other stress-related hormones is much more accurate but not practical or convenient because blood tests are expensive and can be difficult to obtain.
Determining salivary concentrations of some of these hormones seems to be a very satisfactory alternative that has been used by researchers for over two decades since there is a close correlation with blood test results. This non-invasive approach also avoids the stress often associated with obtaining blood that can affect the results. Cortisol and DHEA
(dehydroepiandrosterone), are the steroid hormones that are most affected by stress and measuring their concentrations in saliva has become a particularly popular way to determine stress levels.
| Kits such as the one on the left are readily available that instruct consumers how to collect saliva and mail it to a laboratory for testing. The cost is under $60.00 and an analysis of the results is returned in less than a week. DHEA levels start to steadily decline after age 25 so the results have to be corrected for age. Some laboratories also measure salivary concentrations of male and female hormones as an indicator of biological aging since these can drop up to 80-90% from youthful peaks. However, these salivary measurements do not correlate as well with their blood levels compared to cortisol and DHEA. |
Cortisol is increased and DHEA is greatly reduced during stress and seem to balance one another since they have opposite effects on protein, carbohydrate and fat metabolism, immune system function and blood pressure. The secretion of these steroid hormones is regulated by the hypothalamic-pituitary-adrenal axis rather than stimulation of the sympathetic nervous system and the secretion of catecholamine hormones that produce “fight or flight” responses. Catecholamines are protein hormones that are very difficult to measure accurately in saliva in contrast to steroids like cortisol and DHEA. This obstacle has been overcome by determining the concentration of a chemical called alpha-amylase that is produced in response to sympathetic stimulation of the salivary glands. These results correlate with blood catecholamine levels and can be used as a surrogate since the degree to which they rise during stress corresponds very well with the increase in blood levels of catecholamines but not cortisol. This makes it feasible to assess both aspects of hormonal responses to stress by measuring cortisol, DHEA and alpha-amylase concentrations from the same saliva specimen. Some companies like Salimetrics provide assay kits for salivary alpha-amylase (as well as the steroid hormones noted above) that specifically state that they are intended only for research studies and should not be used for diagnostic purposes.
Collection is complicated and requires abstaining from cigarettes, coffee and other beverages containing caffeine, duration of time from your last meal must be noted, calibrated pipettes are needed and all specimens must be kept frozen prior to submission. In addition, these test kits are fairly expensive and are not likely to appeal to most consumers.
Japanese researchers have recently developed a method to measure salivary alpha-amylase that is much more convenient and much less costly. The Corcoro Meter is a hand held device weighing about a quarter of a pound that comes in four colors, sells for around $165 and comes with 20 strips. Packs of 20 strips are under $20 so that each additional test costs less than a dollar. As illustrated below, the strip is m oistened with some saliva and inserted into the device, which displays the results in less than a minute as one of four levels of stress. While not as accurate as blood tests, this approach seems much superior to stress dots, GSR devices and similar products that claim to measure sympathetic nervous system responses to stress.
 | Nipro, a Japanese medical supply company offers the Cocoro Meter to measure stress based on salivary alpha-amylase levels. You simply moisten a special strip with some saliva and put it into the machine. Results are displayed as numbers accompanied by stick figure icons portraying four different levels of stress. The happy and smiling young lady above registered a relaxed reading of 20. An obviously very harried and tense executive had a score of 80, or four times higher. |
Ref: http://www.japantoday.comMarch
Several studies show that stress can cause or aggravate hives, itching, rashes, acne, psoriasis, atopic dermatitis and other skin disorders. There is also anecdotal evidence suggesting that stress may contribute to hair loss and premature graying. Many authorities believe that such problems result from glucocorticoid hormones like cortisone that are produced in increased amounts during psychological stress. Support for this comes from a recent report showing that inhibiting glucocorticoids can reverse these undesirable effects.
The skin is the body’s largest organ and protects us from harmful microorganisms, ultraviolet light and toxic chemicals. One of its most important functions is to prevent us from drying out, since the body is about 65% water. Without the skin’s permeability barrier, we could not function properly or survive in very dry and hot environments. This protective mechanism is located in the stratum corneum, the outermost layer of the skin composed of dead cells surrounded by lipid membranes that control permeability. The stratum corneum continuously sloughs off and must be regenerated from cells in lower layers that are constantly proliferating to provide cells that later die and form a new outer layer. Studies show that emotional stress disturbs this orderly sequence of events by decreasing cell proliferation and disrupting this delicate balance.
Researchers recently confirmed that blocking glucocorticoids or preventing them from acting on the body could prevent this harmful effects of stress in mice. Stress was created by placing the animals in a much smaller cage and subjecting them to constant light and noise from a radio playing at high volume for 48 hrs. Prior to this, one group was treated with RU 486, a substance that blocks glucocorticoid effects, a second group received antalarmin, which blocks glucoccorticoid production and neither of these was given to a third group. A fourth control group of littermates remained in their usual cages and were not exposed to the stressful light and noise stimuli. Sophisticated studies revealed that the stressed mice that had received either RU486 or antalarmin had significantly better skin structure and function compared to the untreated group, particularly with respect to preserving healthy permeability and barrier protection. The researchers are now studying whether stress reduces the skin’s production of antimicrobial peptides that provide protection from infection. Stress has been shown to reduce immune system resistance to other infections but there may also be a direct local effect.
Whether this study has clinical implications remains to be seen since it was done in a strain of hairless mice and needs to be repeated in humans. In addition, glucocorticoids are essential hormones and blocking their production or actions could produce serious side effects that would outweigh any benefits.
Reference: Eung-Ho Choi, Marianne Demerjian, Debra Crumrine et al. Glucocorticoid blockade reverses psychological stress-induced abnormalities in epidermal structure and function
Am J Physiol Regulatory Integrative Comp Physiol, Dec 2006; 291: R1657 – R1662.
While chronic job stress as assessed by high demands and little control has been clearly linked to increased risk for coronary heart disease, sustained hypertension has been hard to prove because of conflicting results. There is little doubt that various stressors can cause transient spikes in blood pressure that are often alarming. However, no permanent elevations have been proven according to an analysis of almost 50 studies making this claim published in Current Hypertension Reviews. Some had serious flaws such as basing the conclusions only on diastolic pressure. Others looked at several variables measuring stress and emphasized only one or two with a weak link to hypertension while ignoring all the negative ones. Although the study’s author admitted that job stress could cause hypertension in certain predisposed individuals, it’s overall role is likely small. He explained that 40 percent of hypertension is due to genetics, another 40 percent to overweight, poor diet, salt intake and lack of exercise, leaving about 20 percent available for smoking, alcohol, stress and other causes. He also believes that “If somebody has hypertension and they don’t like their job, medically there’s no reason to tell them to quit their job because it adversely affects their blood pressure.”
Support comes from a study published in the American Journal of Public Health that followed 6700 white-collar workers for 7.5 years. Those who reported high job demands, and low levels of social support at work tended to have higher blood pressure than other employees. However these were modest increases of comparable magnitude to those seen with aging and sedentary behavior. The relationship was stronger in men compared to women and men with high job strain were also at greater risk of blood pressure increases over time than those reporting less stress. Men were also much more likely to show further elevations over the course of the study compared to low stress controls. It was suggested that job stress might raise blood pressure by chronic stimulation of the sympathetic nervous system. Stressed out workers may also have little time or energy for exercise, eat poorly or have higher smoking rates but the results persisted when these factors were taken into consideration. Although the study failed to prove that chronic job stress could cause hypertension, it did demonstrate the important influence of social support on blood pressure.
References: Mann SJ. Job Stress and Blood Pressure: A Critical Appraisal of Reported Studies. Current Hypertension Reviews; 2:127-138, May 2006
Guimont C, Brisson C. Effects of Job Strain on Blood Pressure: A Prospective Study of Male and Female White-Collar Workers. American Journal of Public Health; 8:1436-1443, August 2006.
When chronic fatigue syndrome (CFS) was first described over two decades ago many did not consider it to be a legitimate disorder because there were no definitive diagnostic tests and the cause was unknown. It is now recognized as a physical disease by the Centers for Disease Prevention and Control and other respected groups here and abroad based on specific diagnostic criteria. Over 1 million Americans are estimated to have CFS with women being affected four times more frequently than men. Although most common in the 25 to 45 age group, it can occur in children and the elderly and in people of all racial, ethnic and economic backgrounds. CFS is thought to be due to some combination of genetic influences, viral or other infection, over reactive immune system, endocrine dysfunction and/or a psychiatric or emotional predisposition. A recent report suggests that chronic fatigue syndrome results from an inherited inability to cope with stress resulting from injury, illness, divorce, or your job. Researchers studied some 227 CFS patients over a two-day period during which they performed psychiatric evaluations, assessed physical limitations, tested blood and urine for chemical and biological abnormalities and also recorded their medications and other treatments. The data included 500 clinical measures and 20,000 measures of gene expression that were then given to four teams of investigators, including medical experts, molecular biologists, mathematicians and engineers.
Prior research had shown that CFS sufferers had various disturbances in the hypothalamic-pituitary-adrenal axis that mediates responses to stress. This was confirmed by the observation that these patients were twice as likely to have a high allostatic load index compared to healthy controls. Allostatic load index is a measure of hormonal responses to stress, blood pressure and other signs of wear and tear on the body. It was also found that certain genetic sequence variations in five stress-moderating genes showed up consistently in chronic fatigue patients. At least five subtypes of chronic fatigue syndrome were identified that were classified according to criteria based on genetics and the manner in which symptoms appeared. The Centers For Disease Control described the results as “groundbreaking” and the head of their CFS Research Laboratory explained, “Because we have this information, we’re going to be able to predict who is more susceptible to certain types of stressful events”.
Reference: Goertzel BN et al. Allostatic load is associated with symptoms in chronic fatigue syndrome patients. Pharmacogenomics, Apr 2006; 7:485-494.
Numerous studies have shown that stress can contribute to heart attacks and sudden death through various mechanisms. Most reports have focused on depression as a possible cause of heart attacks and especially increased mortality following a heart attack. Investigations into the role of anxiety have been limited and usually measured anxiety only once. In that regard, it is also important to recognize that many patients who appear in Emergency Rooms because of chest distress, shortness of breath, nausea, rapid or irregular pulse are found to be suffering from an acute anxiety attack and have no evidence of cardiac damage. A recent study now confirms that chronic anxiety increases risk of fatal and nonfatal heart attacks in those with a history of heart disease. Harvard researchers followed 516 such patients for over three years. Their average age was 68, 82 percent were male and all participants completed a standard anxiety questionnaire on entry and every year thereafter. Over the course of the study period there were 44 nonfatal heart attacks and 19 deaths. A high cumulative anxiety score was associated with an elevated risk of both heart attack and death from any cause. The importance of this is underscored because the initial anxiety score had no predictive value. It’s what happens subsequently that is important. An increase in anxiety over time raised the risk of heart attack or death by 10 percent. Patients whose anxiety intensified over time were in greatest danger of a recurrent problem whereas those whose anxiety level was in the highest third at baseline but in the lowest third when cumulative average anxiety levels were tallied, were among the least likely to have a heart attack or to die.
Subjects with average cumulative anxiety scores in the highest 25 percent were nearly twice as likely to die of a heart attack or death from any cause compared with those with scores in the lowest 25 percent. Even after researchers factored in the effects of other known risk factors like high blood pressure and diabetes, each unit increase in the overall anxiety score increased the odds of nonfatal heart attack or death by 6 percent.
As one of the authors commented in an interview, “Spending extra time with patients and families gives the cardiologist an opportunity to talk about heart disease, adjust medications, encourage exercise, and come up with effective strategies to improve cardiac risk factors, such as smoking, high cholesterol and high blood pressure. Equally important, it helps to establish a caring relationship that allays the fears that could shorten a patient’s life. I tell patients that well-managed coronary disease is consistent with a long happy life. If you give people this type of reassurance, it turns a frightening disease into something they can grow old with….cardiologists have traditionally focused their therapeutic efforts on factors known to influence long-term outcome in coronary disease, such as making sure to aggressively lower LDL cholesterol. The results of this study demonstrate that we may need to consider more thoroughly evaluating patients with mood disorders such as anxiety, as treatment may very well reduce the risk of heart disease.”
Woldercherkos A et al. Anxiety Worsens Prognosis in Patients With Coronary Artery Disease. Journal of the American College of Cardiology, May 22, 2007; 49:2021-2027.
It has been well established that stress destroys cells in the hippocampus, a brain site responsible for memory storage and retrieval. This happens to most of us as we get older, especially memory for recent events such as forgetting familiar names, what we went shopping for, and where we left our keys or glasses. A recent study that followed over 1200 senior citizens without such problems for 12 years, found that those who began to exhibit mild cognitive impairment due to stress or depression were much more likely to develop Alzheimer’s Disease.1 Of equal concern is strong evidence that memory loss is starting to surface in individuals in their forties due to increased stress.2
Fortunately, you can reduce these damaging effects of stress and improve focus, concentration and productivity due to recent advances in neurofeedback. The Peak Achievement Trainer, which provides very understandable real time feedback on brain wave activity in the form of a video display, teaches you how to strengthen the mind to improve alertness and concentration.3 It has been used by coaches and elite athletes to improve performance and leading golf instructors like David Leadbetter have demonstrated how it can perfect your mental game to lower scores.4 The Peak Achievement trainer has numerous other applications, needs no messy electrode paste and is easy to use.3
Other devices that provide immediate heart rate variability feedback can also quickly teach you how to lower stress levels, improve performance and even reduce insomnia.5 Diminished heart rate variability is seen in a variety of stress related disorders and is a powerful predictor of sudden death. Learning how to increase heart rate variability has numerous cardiovascular and other physical as well as mental health benefits.
References
1. Wilson, RS, Schneider, JA et al. Chronic distress and incidence of mild cognitive impairment.
Neurology 2007; 68:2085-2092.
2. Boehringer Ingleheim Pharmaceuticals, Inc. 1996 Survey Call (203) 798-4700 for a copy.
3. www.peakachievement.com
4. Quencer RM, Winters RK, Leadbetter D. Unlocking the Mental Aspects of the Golf Swing. American
Journal of Neuroradiology 2003; 24:1033-1034.
5. www.stresseraser.com, www.emwave.com
Some technological advances designed to make life easier turn out to be two- edged swords that boomerang and increase stress levels. Cell phones can be life saving, but as noted in a previous Stress Scoop, they can also be intrusive annoyances and sometimes addictive. One survey reported that 40 percent of 18-25 year old students said they couldn’t cope without their cell phones and nine out of ten admitted they took them everywhere. When asked to stop using cell phones for three days, students reported less stress and had lower blood pressures and heart rates. There is also disturbing evidence that excessive long term use is associated with an increase in tumors on the side of the brain cell phones are usually applied.
Computers are also becoming a growing addiction. A recent study found that 65 percent of consumers spend more time with a computer than with their significant other. Around 85 percent said they were more dependent on their home computer compared to three years ago, although this was sometimes a stressful relationship. Breakdowns had occurred an average of eight times over the last three years and respondents described their most recent experience as causing significant anger or depression. When confronted with a dead computer, 19 percent admitted to wanting to hurl it out the nearest window, 9 percent felt stranded and alone, 11 percent resorted to loud language not used in public and 3 percent vented their wrath on inanimate objects. An average of 12 hours a month were wasted on home computer problems, or about half a weekend.
Another boon that often turns out to be a bane is e-mail, which can become more of a burden than a benefit. Spam and other unwanted communications clog up mailboxes, some contain viruses that can contaminate or inactivate your computer, while others surreptitiously gather information that enables identity theft. E-mails have also become “the interpersonal coward’s device of choice” to avoid personal contact when dealing with troublesome issues.
The above and other forms of technostress are largely due to the current epidemic of what has been termed “affluenza”. This refers to an obsessive and envious desire to “keep up with the Joneses” as soon as new devices and software or upgrades to old ones become available. In many instances, although what they have serves its purpose admirably, some people feel compelled to get the latest devices, even though they can’t really afford them, don’t need all their bells and whistles, and are often replaced by a newer version in a year or less due to planned obsolescence. Oliver James was curious as to why so many people feel that too much is never enough, want what they haven’t got, or to be someone they’re not, even when they are rich. After nine months of traveling the globe and conducting interviews, he concluded that affluenza was prevalent and spreading all over the world. This was evident in very different cultures and levels of wealth and had caused huge increases in stress, depression and anxiety among millions in different countries. In his recent book, Affluenza, he suggests that the best solution is learning how to reconnect with what really matters and to value what you already have. This will help you reduce stress so that you can not only be successful, but also stay sane in this rapidly changing world.
References:
“Cyber Stress” study conducted between December 2006 and January 2007 (see www.supportsoft.com)
Christian Science Monitor, Oct. 18, 2007
Oliver James, Affluenza – How to be successful and stay sane. 2007; Vermillion Press[/toggle]
[toggle title=”Are There Blood or Other Tests For Diseases Due to Mental Stress?”]
Acute stress is associated with a transient increase in hormones like cortisol and adrenaline and persistent low-grade stress can affect immune system components that influence susceptibility to infections. But are there any tests that can determine the presence of chronic or intermittent stress related diseases like depression, anxiety or panic attacks? If not, how can these be diagnosed with any accuracy? Most people, including physicians, may be surprised to learn that there are no objective blood, imaging, or other tests that can provide an objective diagnosis for any mental or emotional disorder, including, phobias, manic-depressive psychosis, schizophrenias and depression. Medications commonly used to treat depression that boost serotonin are based on the premise that low levels of this neurotransmitter are the cause of this common and sometimes disabling disease. However, this has never been proven, has recently been discredited, and clinical trials show these drugs to be little better than placebos. The diagnosis of mental disease is based on arbitrary criteria established by psychiatrists, many of who have been shown to have strong financial ties to pharmaceutical companies that make drugs for different disorders. Any benefits may be far outweighed by their adverse long-term side effects. This is especially true for small children with exaggerated normal and temporary behaviors designed to attract attention, and who are increasingly being treated for attention deficit and hyperactivity disorder or bipolar disease for years or a lifetime. However, blood tests for panic disorder and other mental health disorder may soon be available according to a recent report.
Panic disorder, which affects about three percent of the population, is manifested by symptoms such as palpitations, shortness of breath, sweating, a feeling of loss of control or dying, that occur at least once a month. Since these are very similar to an impending heart attack, patients often wind up in Emergency Rooms, which is one of the reasons a blood test for panic disorder would be particularly useful. University of Iowa researchers now believe this is possible based on based on genetic information contained in white blood cells that is not found in people without panic disorder. A commercial blood test is now being developed, and according to the senior author, “Panic disorder will no longer be a purely descriptive diagnosis, but, as with cystic fibrosis, Down syndrome and other conditions, a diagnosis based on genetic information. In addition, the finding could help us better understand the pathways that initiate, promote and maintain panic disorder.”
Reference: Philbert R. et al. Medical Genetics. 144B: 674 – 682, 6 March 2007
There is abundant anecdotal evidence linking stress with both the development of cancer and accelerating its course. This has also been confirmed in numerous animal studies for different types of cancer. In some instances, the mechanisms mediating these effects have been identified. Chronic stress reduces immune system resistance to viral linked malignancies and stress related hormones may also promote the proliferation of cancer cells. Support for the latter comes from a recent study showing that epinephrine and norepinephrine stimulate the growth of ovarian cancer.
This is of particular interest since ovarian cancer may be associated with job stress, particularly in women that have never been pregnant. As previously noted, single working women can be 20 to 26 times more likely to develop this deadly disease compared to non working mothers. Researchers started the study because they noted that ovarian cancer patients who reported high levels of stress also had an increase in beta-adrenergic receptors for these hormones that stimulate blood vessel growth in tumors. In addition, patients who reported more social support and less stress had lower levels of this factor. It was discovered that these hormones were produce three specific compounds that break down tissue around ovarian cancer cells and allow them to rapidly spread throughout the body. More importantly, all these tumor promoting activities were blocked by administering a common drug that has long been used to treat patients with hypertension and heart disease.
Two of these chemicals, MMP-2 and MMP-9 break down the scaffolding surrounding cancer cells that allow them to move into the blood stream. The third, VEGF (vascular endothelial growth factor, promotes the growth of new blood vessels to facilitate this and to supply nutrients needed for rapidly growing cancer cells. When mice with ovarian cancer were stressed by confining them in a small space, these stress hormones were increased over 3.5 times more than in non-stressed controls. Tumor growth was also confined in the no-stress mice, but had spread to the liver or spleen in half of the stressed group. Subsequent studies revealed that giving propanalol (Inderal), a beta blocker, completely erased these stimulating effects on tumor growth. Propanalol and other beta blockers reduce anxiety stress in humans and are used to treat hypertension, coronary disease and other stress related disorders.
Reference: Premal H, Thaker PH, Han LY et al. Chronic stress promotes tumor growth and angiogenesis in a mouse model of ovarian carcinoma. Nature Medicine 2006; 12:939-944.
The ongoing London Whitehall II study of British civil servants recently released its latest report confirming the relationship between job stress and heart disease. It also contained information on the mechanisms involved that showed reduced heart rate variability (HRV) may be much more important than hormonal influences and other risk factors like obesity, cholesterol and smoking. Low HRV has long been known to be a powerful predictor of sudden death and heart attacks. The good news is that diminished HRV is something you can learn to correct in order to reduce risk of these and other stress related disorders.
The Whitehall I study that began in 1967 was designed to determine psychosocial factors that affected health by examining the prevalence of cardiovascular and lung disease in over 17,000 male civil servants aged 20 to 64. It found that mortality rates from heart disease were significantly higher in lower grade employees. This group also tended to be more obese, smoke more, exercise less and have higher blood pressures. However, even when correcting for these factors, deaths from heart disease was twice as high compared to upper echelon employees. In other words, people in high stress jobs didn’t have more heart attacks as was commonly believed. Nor did a high fat diet, cholesterol, smoking, obesity or hypertension explain this marked difference between messengers and mandarins. Smoking explained the difference in lung cancer but not heart disease.
Whitehall II, which began in 1985, consists of over 10,000 civil servants aged 35 to 55, one third of whom are now women. It has focused on the relationships between work, stress and health in an effort to determine why and how socioeconomic status contributes heart attacks. The current report, found that both men and women workers under 50 who described their work as stressful were nearly 70% more likely to develop heart disease than others with little or no job stress. What was surprising, was that this increase in heart disease was not related to grade of employment. Although morning cortisol levels tended to be higher in stressed workers, increased heart attacks and deaths were best expLained by low heart rate variability. In addition, these biochemical and autonomic nervous system changes were independent of unhealthy lifestyles and metabolic syndrome, which were seen in less than a third of the heart disease group. It was suggested that the relative lack of work stress effects on older workers might be due to the fact that many were approaching retirement and therefore less likely to suffer its damaging effects. Although job stress has been linked to problem drinking, no such relationship was found. Nevertheless, it was associated with unhealthy behaviors such as eating less fruit and vegetables and less exercise as has been shown in previous studies. The most important finding was that job stress seemed reduce “vagal tone”, which regulates heart rate variability.
Keeping fit by exercise and proper nutrition undoubtedly reduces risk for heart disease. However, learning how to cope with stress and reduce its dangerous effects on heart rate variability may be even more important, and exiting new technologies can facilitate this. This was underscored by an Italian study showing that low heart rate variability due to predominant sympathetic activity leads to sustained hypertension and high cholesterol in young individuals as well as possible increased risk of subsequent heart disease. The recent availability of inexpensive hand held devices that provide immediate HRV feedback not only enable users to detect dangerous levels but also learn how to correct them.
References
Chandola T, Britton A, Brunner E, et al. Work stress and coronary heart disease: what are the mechanisms? Eur Heart Journal. 2008; 0:ehm584v1-9. Published on line January 21
A recent report from the Bioinitiative Working Group of respected authorities who reviewed over 2,000 publications in peer reviewed journals leaves little doubt that low-level radiation from cell phones can cause brain tumors and other adverse health effects. Cordless phones have also been shown to be associated with an increase in brain tumors. Laws preventing driving while using a cell phone applied to the head that have led to wired earpieces and Bluetooth wireless devices are hardly the solution since their electromagnetic fields also have cumulative bioeffects. Blackberries and PDA’s pose similar health hazards as do radiofrequency chips being implanted into people and animals for identification and determining their location. Microwaves, electromagnetic fields generated by electrical appliances and power lines, radiofrequency and microwave radiation from cell towers, WiFi and WiMax wireless communication networks contribute further to the damaging effects of electromagnetic pollution of the environment.
This problem is likely to become more serious as cell phone sales are exploding, especially in younger age groups where children and teenagers can become addicted to them and other text messaging devices. Much of this information has been suppressed by powerful vested interests that continue to deny that weak and especially extremely- low frequency fields have no biological activity because they have no thermal effects. What is worse is that although we do not know the lowest EMF level that is safe, authorities here want to relax the current standards for radiofrequency exposure from cell phones. For further information about EMF effects on stress proteins and immune system function and the urgent need to protect the public from these and other dangerous consequences of electromagnetic pollution see www.bioinitiave.org and www.microwavenews.com.
Job stress is far and away the leading source of stress for American adults and has progressively increased in the past few decades. Because of the resultant adverse health and fiscal effects, government guidelines have repeatedly emphasized the need for companies to offer stress management training programs to their employees. However, the message does not seem to be getting through. According to a recent survey, job stress, and especially working long hours is the most frequent reason workers cited for why they would leave their job. But although nearly half of employers acknowledge that workplace stress is hurting their bottom line, only one in 20 is doing anything about it. About 30 percent believe that technostress from use of cell phones and personal digital assistants is also having a negative effect on productivity but only 6percent are confronting this issue. Watson Wyatt, a global consulting firm with 7,000 associates in 332 countries, conducted the survey. According to their director of health and productivity, “Many companies don’t appear to appreciate how stress is affecting their business. Too much stress from heavy demands, poorly defined priorities and little on-the-job flexibility can add to health issues. By leaving stress unaddressed, employers invite an increase in unscheduled time off, absence rates and health care costs — all of which hurt a company’s bottom line.”
Although 40 percent of workers list job stress as one of the top three reasons they would leave, companies seem to be oblivious. They believe the main reasons employees quite are insufficient pay, lack of career development and poor supervisor relationships. Stress is not even included in their top five list. “Pay alone is not enough to retain and engage today’s workers.” according to Watson Wyatt’s global director of strategic rewards. “To remain competitive, companies need to understand fully what causes employees to join or leave and what causes them to be productive if they stay. A total rewards approach that includes both monetary and nonmonetary rewards is more meaningful for employees and more effective for employers.”
Reference: Watson Wyatt 2007/2008 Global Strategic Rewards® report.
Numerous surveys show that job stress is far and away the leading source of stress for American adults. The same holds true in other developed countries, where its repercussions also affect other demographic groups. A recent Australian study found that job stress and money concerns were the leading causes of stress for 75 % of the entire population. Job stress complaints are likely to increase in the U.S. due to increased layoffs from downsizing and mergers that threaten retirement savings. Layoffs are also associated with increased health problems, especially in workers over the age of fifty. Yale researchers followed 4,301 employees who were 51-61 years old when the National Institute on Aging Health and Retirement Survey began in 1992. Over the next ten years, almost 600 had been laid off and it was found that those over 50 had double the risk for stroke and heart attack compared to controls that were still working. These differences between employed and laid off workers persisted even after factors like smoking and other health influences were taken into account. In addition to loss of income, layoffs can disrupt longstanding social networks and support that provide strong stress reduction benefits. People over the age of 50 are also likely to have more trouble finding another job than younger workers. These researchers previously reported that older workers who had lost their jobs were much more apt to suffer from depression and alcohol abuse.
Some useful tips to avoid the stress of involuntary job loss include: Don’t Panic! Avoid getting caught up in doom-and-gloom hype that often causes severe anxiety and bad decisions. Try not to overreact or to become overly passive but remain calm and stay focused. Take time out to evaluate your financial situation and make a list of specific ways your family can reduce expenses. Create a plan that everyone agrees with and commit to it. Having dinner at home with your family may not only save you money, but also help bring you closer together. Try taking a walk, especially with one or more family members. Walking is an inexpensive way to get exercise that provides not only proven physical rewards but also many mental benefits, including reducing stress, anxiety and depression. Consider learning a new skill that could lead to a better job by taking a course through some inexpensive community resource.
Recognize how you deal with financial and other layoff stresses. Some people tend to cope by turning to unhealthy activities like smoking, drinking, gambling or emotional eating. This doesn’t solve anything and frequently causes conflict and arguments with loved ones. It is important to be alert to these self-destructive behaviors and not to be ashamed to seek help from a qualified health professional to prevent the problem from worsening. If you are having difficulty paying bills, reach out for assistance and suggestions from your bank, utilities and credit card companies. Professional financial planners may also be of assistance but beware of advertisements that promise to restore your credit rating and reduce your payments by “consolidating” your credit card and other debts. The closest Chinese word to signify stress is translated as CRISIS and consists of two characters. The upper one connotes DANGER with the lower representing OPPORTUNITY. Staying calm and focused makes it easier to explore other options that could turn the challenges of losing your job into an opportunity that provides change and growth.
References:
Gallo WT, Bradley EH, Alba TA, et al. Involuntary job loss as a risk factor for subsequent myocardial infarction and stroke: findings from the Health and Retirement Survey. Am J Ind Med. 2004 May;45(5):408-16.
Gallo WT, Bradley EH, Siegel M, et al. The impact of involuntary job loss on subsequent alcohol consumption by older workers. J Gerontol B Psychol Sci Soc Sci. 2001 Jan;56(1):S3-9.
Most surveys and authorities usually list stress as the leading cause of insomnia and other sleep disorders. As emphasized in our Newsletters, lack of sleep, causes more stress, which often leads to a self-perpetuating cycle that becomes progressively dangerous. Further support for this comes from a recent poll showing that one third of Americans now complain of not being able to get enough sleep because of financial worries. Sleep problems have increased 15% over the past eight years, sleeping less than six hours a night jumped from 13% to 20%, and sleeping eight hours or more has fallen from 38% to 28%. Although almost half of respondents agreed that sleep was as important as diet and exercise to overall health and a feeling of well being, less than one in three with sleep problems ever discuss them with their doctors, who also often fail to inquire about this.
The National Sleep Foundation’s 2009 Sleep in America™ poll also found that sleep deficiency had adverse effects on health, quality of life and safety. Sleep problems are associated with and often contribute to other chronic disorders, especially those that can be stress related, like hypertension, diabetes and arthritis. Many complained that they nod off during the day or are so sleepy that their work suffers. Over half said they had driven while drowsy at least once in the past 12 months, and nearly one-third admitted that they had nodded off or fallen asleep at the wheel. According to The National Institutes of Health, some 70 million Americans suffer from significant sleep deficiency. Even minimal loss of sleep that does not cause symptoms can add up over time, and like constantly withdrawing a few dollars from your bank, account, does not hit home until you are suddenly overdrawn. Women are more likely to be affected than men, and sleeplessness tends to increase with age.
A few helpful tips include avoiding coffee, colas, tea and anything containing caffeine for at least six hours before retiring, and avoid exercising for three hours or more. Try to develop a standard relaxing bedtime routine and to go to sleep at the same time each day. Bedrooms should be dark, cool and quiet, with comfortable coverings and pillows, and used only for sleep and sex. Remove work related materials, computers and televisions in order to strengthen the association between bed and sleep. Additional suggestions can be found in the References below.
References:
2009 Sleep in America™ poll www.sleep foundation.org
American Institute of Stress Health And Stress Newsletter #8, 2008
American Institute of Stress Health And Stress Newsletter #2, 1996
American Institute of Stress Health And Stress Newsletter #8, 1996
