Stress: An insidious, ubiquitous assassin
New research links stress to course of diseases
Delicate balance of body systems may be disrupted

4/09/2004


JANE ALLEN
SPECIAL TO THE STAR

LOS ANGELES—As a high-level executive for a large computer manufacturer, Dan Bishop was a self-described workaholic who thought he was ably juggling daily demands and corporate pressures. Then he woke up one night with tightness in his chest, barely able to breathe. At first he suspected a heart attack. The tightness quickly passed, but he was frightened enough to see his doctor.

The doctor diagnosed an anxiety attack — caused by stress — and told him to "stop being so driven."

"I didn't know what stress was; I didn't think I had stress," said Bishop, now 52, referring to the 1990 diagnosis.

As Bishop found, stress can be insidious.

It can be devastating to the body. And it can kill.

Scientists are only now beginning to understand what happens when stress disrupts the delicate interplay between the brain, the endocrine system — the glands and organs that make and release hormones — and the immune system, stimulating the release of compounds that cause inflammation.

Recent research has identified some of the ways in which stress influences the course of illnesses linked to viruses, aging or the body's misguided attack on its own tissues.

For example, physical or mental stress can take an enormous and sometimes deadly toll on the heart. It increases blood pressure, narrows blood vessels and causes blood to become stickier and more likely to clot, increasing the likelihood of a heart attack or stroke.

In February, a study published in the American Journal Of Psychiatry showed that stress and depression in heart attack patients increase amounts of chemicals that make certain immune cells sticky and help them travel to artery linings, where they produce inflammation and promote coronary artery disease.

A study published last week in the journal Circulation found that mental stress also triggers irregular heartbeats, which can be deadly.

"Numerous studies show that psychological stress can lead to illness, or even death," said Dr. Michael Irwin, director of the Norman Cousins Center for Psychoneuroimmunology at the University of California, Los Angeles' Neuropsychiatric Institute. "How we cope with stress and whether or not we get depressed is crucial for our health.''

The pressures of daily life — jobs, relationships, money, raising children and now, war and terrorism — have become such constant companions that many of us operate with ever-present feelings of pressure, anxiety or burnout.

The stress can become so unflagging that many people have accepted it as a standard part of life. Although we may try to ignore its presence, stress doesn't go away. It just goes to work inside the body.

Prolonged stress contributes to many physical and psychological ills. It overrides natural defences against viruses that cause AIDS, chickenpox and the common cold.

It also encourages the production of inflammatory hormones that drive heart disease, obesity and diabetes; sparks flare-ups of rheumatoid arthritis and digestive disorders; creates depression and ages the brain.

Unchecked stress sends out complex signals that unleash a cascade of activity throughout the body.

When someone is confronted with stress — whether physical or psychological — the brain is the first part of the body to respond, reacting in two distinct ways.

In one of the reactions, a regulatory part of the brain called the hypothalamus sends signals through sympathetic nerves near the spinal cord to the adrenal glands, commanding them to release the stress hormones epinephrine and norepinephrine (also called adrenaline and noradrenaline).

These hormones gird the body for action. They boost heart rate, blood pressure, breathing and blood flow to the muscles and brain, providing an extra surge of energy in times of physical danger. They can also keep athletes, entertainers and others on their toes, keeping them alert and productive when performance counts.

But chronic stress opens the floodgates to epinephrine and norepinephrine, regardless of whether there's a threat, allowing bacteria, viruses or tumours to flourish and making blood more prone to clotting.

The brain's other reaction comes through the pituitary gland, which sends signals through the bloodstream instructing the adrenal glands to release the stress hormone cortisol and other steroids. In the right amounts, cortisol helps the body recharge, enhances disease resistance, fights inflammation and improves memory.

In excess, however, cortisol promotes the accumulation of abdominal fat, suppresses immunity, shrinks brain cells and impairs memory.

Over time, cells become less sensitive to the protective effects of cortisol, and inflammation goes unchecked.

Stress can certainly give you butterflies or a stomach ache, but chronic stress can trigger flare-ups of irritable bowel syndrome, an intestinal condition that includes cramping, gas, diarrhea and constipation.

Women with the condition (who vastly outnumber men) not only have elevated levels of cortisol, but also have exaggerated differences between the higher morning and lower evening levels found in healthy people, Italian researchers reported in 2001.

Although stress is no longer believed to cause ulcers (they're sparked by an infection of the bacterium H. pylori), it can worsen symptoms.

HIV-infected gay men who keep their sexual orientation secret get sicker and have shorter life spans than gay men who are more open about their sexuality, a 1996 study found. Closeted gay men tend to be shyer and their nervous systems overreact to stress; as a result, their bodies pump out more stress hormones, which encourage the virus to multiply.

People who suffer from rheumatoid arthritis, an autoimmune disease of the joints, already have high levels of hormones called inflammatory cytokines, which cause swelling, pain and inflammation. Stress and depression, which can intensify pain and create more physical limitations, further increase those levels, according to a study in the March issue of the Journal Of Rheumatology.

As their understanding of the biochemistry of stress increases, scientists are developing and testing ways to protect the body from its ravages, using yoga and meditation, psychotherapy and medications, and even experimental devices.

Among the simpler interventions that hold the most promise is tai chi, a centuries-old Chinese exercise often described as "meditation through movement."

In a study of adults older than 60, UCLA researchers found last year that one type of tai chi improves immunity to shingles, a painful nerve disease caused by the re-emergence of the chickenpox virus.

Medications may also prove effective at blocking the destructive effects of stress hormones. For example, Cole and his colleagues have just started a study in which they're giving beta blockers, which are typically prescribed for hypertension and heart disease, to HIV patients. The drugs should block the ability of stress hormones to make HIV multiply, the researchers say, thus lowering viral loads.

Other medications, such as antidepressants and anti-anxiety drugs, alter the brain biochemistry that makes some people overreact to stress.

Dr. Kevin Tracey, head of the Center for Patient-Oriented Research at the North Shore-Long Island Jewish Research Institute in Manhasset, N.Y., has been using vagus nerve stimulation to decrease inflammation in disorders aggravated by stress, including rheumatoid arthritis. The vagus nerve controls involuntary functions such as heart rate, respiration, digestion and bladder function. Stimulating the vagus nerve to slow the heart rate, in this case with a pacemaker-like device, is also the basis of biofeedback and meditation.

Researchers at several institutions are experimenting with rapid transcranial magnetic stimulation, which delivers electromagnetic waves through a device placed against the roof of the mouth, to treat anxiety attacks and other manifestations of chronic stress.

But, cautioned Dr. Paul Rosch, president of the American Institute of Stress in Yonkers, N.Y.: "Just as stress is different for each of us, there is no stress-reduction strategy that's a panacea

Birdbomb

Lately I have been under alot of pressure with the stomach spasms causing nausea and at times having to call my doctor to cancel appiontments at the UCDMC on Stockton then calling the other UCDMC to have my primary doctor call because of the pain I get with stomach spasms and the nausea. The only way for me is to go out to Roseville on Tuesdays at my aunts florist. If I'm home I am calling a pastor who has been helping me through the tough times. The other thing that has annoyed me lately is if I want to read I can't because of my eyes hurting.

My stress has gone.

:D Lindsay, I am happy to hear that, continue to do the things that you enjoy, the things that make you happy, give you joy, pleasure, and peace. And always seek out the positive people in your life for your support.

Keep :) smilin' gal. and Rock on. :note: :note: :note:

Stress has always been a big part of my life.
whenI hear people say this way and that way will relieve stree in your life;I feel like saying you
should try livingmy life. for 1 weeks and see how stress free your life is going to be.
So I keep a diary;which probably seems prety dumb to alot of people.
Belinda

Belinda

I agree because I did it for seizures. I am also triing to keep up with doing it for the stomach spasms.

Actually keeping a diary is an excelent way of reducing stress. Putting it on paper can also give you a better prespective of your problems. Kind of like this type of forum. :rolleyes:

I've kept a seizure diary for years and years.
One year I only had 60 seizures that was a low seizure year for me.
Because now I averave between 8-15 a month so it never comes out to 60 a years.
That's whatI was a month an average before I got the VNS.
Belinda

For me when I can stay focused enough to do the diary, I find that it works fairly well to know when and at approx what times I have my seizures.

I also try to go a step further to include what I was doing before the seizure started, if I can remember that far and what could have possibly led up to the seizure, like what type of situation was it.

Ladies, sometimes, those monthly occurances you know what I mean, can be stressful within themselves and lead to seizures that info is important to know and include in the diary.

Sometimes, it can be just one of those things that creep up on ya, and sometimes it can be brought on given whatever situations you were dealing with at the time.

See for me my family and their attitudes for me were stressful, and all, I tried as best I could to deal with them and all, but sometimes my system got overloaded and then I got a headache, and then things got black, then after that next thing I knew I was seizing.

Also, when I was overworked and exhausted sometimes, I would find that the number of seizures would increase. It is just a way of the body and the brain's cry for relaxation and rest sometimes, in my case anyway.

Of course sometimes, seizures are just a natural response to whatever stressors we deal with, the diary is a good way to keep track of such stressors no matter what they are.For me if seizures return, will keep a closer watch on them and what may be bringing them on, therefore I can better work on prevention.

Joneya,
What I found that stressed me out most was my family.
I have seizures sometimes when I'm on my period but not tjhat often.
I have a mother tell me I need get seizure alert dog when she knows I'm really bad allergic to anything that sheds.
I haven't been able to work since about 1995 because of my seizures.
The one thing that stresses me out more anything and my family actually thinks there helping.
Is when they don't tell methings like when people die or when people get sick cancer because they think I might have a seizure.
It makes me so angry.
Belinda

Belinda, need to tell ya that I have been down that road, family stress me out too sometimes, but there are still some people in my family that I can turn too and will not cause any undue heartache and pain.

Search for people like that in your family and reach out to them, let them help you through this your time of need.

And about the dog, I have a seizure response dog. You can still have one, but choose one that does not shed,, Have a vet or someone well versed in dog breeds to help you or if you don't wish to take the chance, then search for other options in order to help yourself.

You need to see yourself as important and important enough to be taken care of, Life is short enough without us trying to take it into our own hands my friend.

I also understand about the withholding on some parts because my family seems to thing that I am not that strong of a person when it comes to certain things. You only have yourself sometimes to lean on, so if nothing else become strong for yourself through this and other adversities and trials, and show your family that you can and will be strong through anything, then they will come around to you.

Perhaps they use seizures as an excuse because they are worried about your mental state as well when it comes to handling or taking things. Give positive thinking a shot, I hope you find no offence in my post I mean no harm just my advice and suggestions.

Joneya,

I know they use my seizures as an excuse to not tell me things.

And a weak little thinle thing I'm not.

If I can hold under stress as I did in 1993 I was and I him in jail.

Someone who couldn't have handled it wouldn't have held out.

I'm not saying I'm better anyone else by no means.

With the dog yes I am afraid I would have a bad time with my asthma.
It's the daster the only kind of dog that doesn't bother me it is one
I can't spell chaihaha.
The older I got the worse my allergies got .
Belinds.

When MY seizures in crease that can be very stressful.
And it has been for me lately since they have been increasing.
Unliking alot of people say they can I'm not able to control my stress completely especially when it comes to my seizures increaring because I have no control over that.
Belinda

The Mayonnaise Jar and 2 Cups of Coffee

When things in your lives seem almost too much to handle, when 24 hours in a day are not enough, remember the mayonnaise jar and the 2 cups of coffee.

A professor stood before his philosophy class and had some items in front of him. When the class began, he wordlessly picked up a very large and empty mayonnaise jar and proceeded to fill it with golf balls. He then asked the students if the jar was full. They agreed that it was.

The professor then picked up a box of pebbles and poured them into the jar. He shook the jar lightly. The pebbles rolled into the open areas between the golf balls. He then asked the students again if the jar was full. They agreed it was.

The professor next picked up a box of sand and poured it into the jar. Of course, the sand filled up everything else. He asked once more if the jar was full. The students responded with an unanimous "yes."

The professor then produced two cups of coffee from under the table and poured the entire contents into the jar effectively filling the empty space between the sand. The students laughed.

"Now," said the professor as the laughter subsided, "I want you to recognize that this jar represents your life. The golf balls are the important things--the love of your life, your children, your extended family, your health, your friends and your personal growth --, and if everything else was lost and only they remained, your life would still be full.

The pebbles are the other things that matter like business and career goals, your favorite passions, your house and your car.

The sand is everything else--the small stuff. "If you put the sand into the jar first," he continued, "there is no room for the pebbles or the golf balls. The same goes for life. If you spend all your time and energy on the small stuff you will never have room for the things that should be important to you.

"Pay attention to the things that are critical to your happiness. Love somebody. Play with your children. Take time to get medical checkups. Take your spouse (or Mother) out to dinner. Laugh out loud. Play another 18. There will always be time to clean the house and fix the disposal. Take care of the golf balls first--the things that really matter. Set your priorities. The rest is just sand."

One of the students raised her hand and inquired what the coffee represented.

The professor smiled. "I'm glad you asked.

It just goes to show you that no matter how full your life may seem, there's always room for a couple of cups of coffee with a friend."