Information on Stress

Posted on Nov 16, 2011 05:41am

The Biology of Stress, the Financial Meltdown and What to Do About It.
Esther M. Sternberg M.D., National Institute of Mental health, National Institutes of Health, Bethesda, MD.

Why do you feel a thrill when riding a roller coaster but get that sick feeling in the pit of your stomach when watching the stock market and your 401k numbers take the same careening ride? What is it about these two experiences, which c­an make you feel stressed or stimulated?

Open up any newspaper, watch the television news reports, or surf the web in the last couple of weeks and you will see the faces of stock traders with the same expressions of alarm, whether they are based in the Americas, Asia, Europe, indeed, all over the world. Their brows are furrowed, they look anxious, you know they are sweating, that their hearts are pounding and that they have the urge to run to the bathroom. What you are watching is their biological stress response, writ large across their faces. You know how they feel because you feel it yourself and have felt it many times, every time you are stressed.

Or try what I did the other day. I visited my financial advisor to review my accounts. (Don't try this alone at home unless you have a strong stomach!). While we were talking, she flipped her computer screen round to face me and said:

"Watch the numbers on the screen – they're the financial markets. When they're red, they are in negative territory, when they're green, they are positive."

As we watched, in a matter of minutes, the screen turned from green to red and back again, like a Christmas tree. As they changed color I could feel my heart start to pound, and my anxiety increase. These were not some theoretical numbers, or a computer game. This was my money, my savings, my retirement taking a dive, and it scared me.

A recent study released by the American Psychological Association reported that 8 out of 10 Americans surveyed have felt stressed over finances in the weeks since the stock market took its first precipitous plunge. The reason these events are making us all feel this way is that they are a perfect storm – the coming together of some of the most powerful triggers of the brain's stress response: rapid change, uncertainty and uncontrollability. Any one of these alone would be a strong trigger of the stress response, but together they are a potent mix, in the face of which very few of us can remain calm.

All animals, whether a fruit fly, a fish, a mouse, a rat, a dog, a cat, or a human, have a stress response, and for good reason. Without it we could not survive. It is our brain's stress response that gets us out of danger, within a few thousandths of a second after experiencing a stressful event. It is our stress response that makes us focus attention on the threat at hand, and gives us the energy to fight or flee. If a field mouse were to arrive in a new field, saunter about and promptly fall asleep it would be eaten by the next cat that came along. It has to remain vigilant, a little on edge and ready to run if it is to survive. That strength, energy, get-up-and-go, comes from its stress response working for it. It works the same for all of us.

This is because a tiny part of the brain, no bigger than the tip of your finger, called the hypothalamus, which controls the stress response, starts pumping out its hormone, CRH. This starts a cascade of other hormones that makes your adrenal glands pump out cortisol. At the same time, the adrenal glands pump out adrenalin and adrenalin-like nerves release adrenalin-like nerve chemicals. Together all these hormones and nerve chemicals create the brain and body's stress response, which get you out of danger. But they also make you feel all those things you feel when you are stressed: anxious, sweaty, make your heart beat faster – in short they make you feel stressed.

What is the difference between an event that makes you feel stressed and one that stimulates you? Back to the roller coaster – in a roller coaster, you are in control even though you are experiencing rapid change. You know this is just a ride and that in the end you will arrive safely back on the ground. The same is true for thriller movies, video games, in fact any of those things we do to feel a buzz by triggering our stress response. But with the stock market, most of us have very little control. We don't know where the bottom is, nor when we will reach it. All sorts of other uncertainties come into our heads when we see the numbers tanking. Will I have enough money to live comfortably, keep my house, put my kids through college, pay the medical bills? When all this is over, will I still have a job? Uncertainty is a powerful trigger of the stress response. So what can we do about it?

Understanding how the stress response works can help you figure out what to do. The first thing to know is that there are many parts to stress. There is the bad thing that happens – in this case the financial markets falling, and the uncertainty and threat of all the bad things that might follow. There is the brain and body's physiological stress response: all those stress hormones and nerve chemicals that are released into your bloodstream, which make you feel stressed. Then there is something very important that happens between the bad thing and your stress response, and that is perception. In other words, in order for the stress response to kick in, you need to recognize the event as bad. If you have paid off your mortgage, sent your children through school and have all your savings in gold bullion under your mattress, chances are this economic crisis is not going to affect you the way it is affecting the rest of us.

But for the rest of us, it turns out there are many things we can do to handle that stress response and help keep it in line. The first thing to remember is that most of the time we can't do anything about bad things that happen. So forget about even trying. What we can do something about is that piece in the middle: like the meat in a sandwich, it is the perception piece that we can change.

One big difference between feeling stressed or stimulated is how much control we have over a situation compared to the demands that are placed on us. If we are in a low control, high demand situation, we feel stressed. If we are in a high control, high demand situation, we feel stimulated. This is like being a passenger in an airplane flying loops – you feel stressed and the pilot feels stimulated because only one of you is in control: the pilot.

The trick is to try to fool your brain into thinking you are in some degree of control. You will never be completely in control, so this has to be done in tiny baby steps. Whatever you can do to get yourself into a position of more control will help to lower your stress response bit by bit, and in fact will eventually help you to get into control. This can involve something as simple as making a list of all the things you need to do in every aspect of your life: family, home, finances, school, retirement, etc.. Prioritize the items on the list and attend to them in order of urgency. Each time you complete a task, cross it off the list. That alone will make you feel better.

Another way to gain a sense of control is to turn your own area of expertise to solving part of the problem. You may say, 'But I don't have any expertise to help solve the financial meltdown.' That may be true, but examine every aspect of your life, and think about how you can help – help a neighbor, help out at school, volunteer in your community or religious organization. All this will give you a sense of purpose, a sense of control, helps lower your stress response, and it helps others in the bargain. In fact, altruistic activities have been shown to have many health benefits and have been associated with living longer, healthier lives.

It is also important to remember that you can't do it all on your own. Social support is a very strong buffer to the stress response. If you feel overwhelmed, seek out the help of friends and family, and experts and professionals in whatever area of your life is most in need, whether it be financial advice, assistance from healthcare professionals, or support services to help you take care of family. Just getting together with loved ones to enjoy what you do have, will take the edge off the anxiety and stress that you feel.

Sometimes too much stress can trigger depression or anxiety in vulnerable individuals. How do you know when stress has crossed the line to clinical depression or anxiety? If you are having trouble sleeping or are waking up in the middle of the night, have lost your appetite, are unable to concentrate, have lost interest in the things that usually delight you, are irritable and angry all the time, can no longer function at your usual peak, feel listless and sad all the time, or are having thoughts of ending your life, it's time to seek the help of a mental health professional. This is nothing to be ashamed of. What has happened is that your brain's stress response has gotten stuck in the on position. When that happens you need the assistance of an expert to help get it unstuck. This may involve psychotherapy, behavioral therapy or other psychological training, or it may require medications that are designed to target the parts of the brain where nerve chemicals are out of balance. The important thing to remember if you find yourself in this situation is that you can't do it on your own – it's your biology, so you should not feel bad if you can't fix it by yourself. Most people would not think of trying to repair their car engine if they were hurtling down the highway at maximum speed and the engine burnt out. You call an expert mechanic to get your car back in shape. It is the same with your brain on stress – you need that mental health expert to help get you back to your previous self.

What about other things that you can do to buffer against stress? Exercise has been shown to be very effective in strengthening brain connections and nerve chemicals that enhance positive emotions. It doesn't have to be strenuous exercise – even 30 minutes of walking a day will work, and you can even split it up into 10 or 15 minute segments. Meditation and prayer are great antidotes to stress. Practices that combine gentle exercise and meditation, like Tai Chi and yoga are also effective. Activities that absorb you, like singing, listening to music, or the creative arts can also make a dent in stress. The important thing to remember is that no one way works for all people and no one way works for any one person at all times in our lives. There are some days when exercise may help and others when quiet meditation does the trick.

The important thing is to pace yourself and find times to go off-line, literally and figuratively. Take a holiday. Even if you can only take a short break, take it. A short break is better than no break. If watching the news on television at night is making you anxious and interfering with your sleep, switch it off and read a good book. Or do your deep breathing exercises or meditation before bed.

Why do activities like meditation and prayer work? Just as the brain has a stress response, it also has a 'belief' or 'relaxation response'. Meditation and prayer trigger brain pathways and release nerve chemicals that both counter the stress response and also have positive effects in enhancing mood and reducing pain. One feature common to these activities is deep slow breathing. This kind of breathing activates brain outflow pathways that downshift the brain from a stress mode into a relaxation mode and literally put the break on stress.

Why work so hard to reduce your stress response? Some people, especially caregivers of young children or Alzheimer's patients may feel guilty taking time off to care for themselves. The reason it is important to take time for yourself is that stress really does make you sick, and if you get sick, you will not be able to take care of your loved ones. Chronic stress, and the stress hormones that are released during stress, dampen the immune response and blunt the ability of immune cells to do their job in fighting infection and healing wounds. If you are chronically stressed, you will be more prone to more frequent and more severe viral infections. If you get a flu shot, your body will not mount an effective antibody response, so you will be less protected from the flu. Wounds take longer to heal in chronically stressed individuals. The stress hormone cortisol also kills nerve cells, especially nerve cells in the brain's memory centers, so chronic stress can impair memory and concentration. Stress also speeds aging, particularly aging of chromosomes. As we age, the ends of chromosomes naturally become frayed, like the ends of old shoelaces. Stress speeds that process and can shorten the length of chromosomes, so that they may look up to 10 years older than they really are. The good news is that a combination of stress management techniques and healthy lifestyle changes, including daily walking, meditation and healthy diet have been shown to boost the enzyme that repairs those frayed ends, and can slow or even reverse the process.

So, although you may not be able to do anything about all the frightening and uncontrollable events that are happening in the world today, there is a lot that you can do to buffer your stress response, and to keep you and your loved ones healthy. In so doing you will feel less stressed, help others and do your bit to help your community, the country and the world.

Suggested additional reading:

Brain-Immune Connection
Sternberg, E.M. The Balance Within: The Science Connecting Health and Emotions (2000) Hard cover W.H. Freeman, New York; (2001) Paperback Holt, Times Imprint.

Sternberg, E.M. and P.W. Gold (2002) "The Mind-Body Interaction in Disease." Scientific American Special Edition: The Hidden Mind. 12 (1): 82-29.

Stress and Illness
Cohen, S., D. Janicki-Deverts, et al. (2007). "Psychological stress and disease." JAMA 298(14): 1685-7.

Glaser, R. and J. K. Kiecolt-Glaser (2005). "Stress-induced immune dysfunction: implications for health." Nat Rev Immunol 5(3): 243-51.

McEwen, B. with E.N. Lasley. (2002) The End of Stress as We Know It. New York. Joseph Henry Press.

Sapolsky, R.M. (2004) Why Zebras Don't Get Ulcers. 3rd Edition. New York, NY. Henry Holt & Co.

Neurobiology of Meditation
Barinaga, M. (2003). "Buddhism and neuroscience. Studying the well-trained mind." Science 302(5642): 44-6.

Davidson, R. J., J. Kabat-Zinn, et al. (2003). "Alterations in brain and immune function produced by mindfulness meditation." Psychosom Med 65(4): 564-70.

Lutz, A., J. Brefczynski-Lewis, et al. (2008). "Regulation of the neural circuitry of emotion by compassion meditation: effects of meditative expertise."
PLoS ONE 3(3): e1897.

Neurobiology of Prayer
Beauregard, M. and V. Paquette (2006). "Neural correlates of a mystical experience in Carmelite nuns." Neurosci Lett 405(3): 186-90.

Newberg, A., M. Pourdehnad, et al. (2003). "Cerebral blood flow during meditative prayer: preliminary findings and methodological issues." Percept Mot Skills 97(2):625-30.

Exercise: Effects on neuroplasticity, mood, immune system and health
Duman, R. S. (2005). "Neurotrophic factors and regulation of mood: role of exercise, diet and metabolism." Neurobiol Aging 26 Suppl 1: 88-93.

Yeung, R. R. (1996). "The acute effects of exercise on mood state." J Psychosom Res 40(2): 123-41.

Physiology of Tai Chi and Yoga
West, J., C. Otte, et al. (2004). "Effects of Hatha yoga and African dance on perceived stress, affect, and salivary cortisol." Ann Behav Med 28(2): 114-8.

Yeh, G. Y., J. E. Mietus, et al. (2007). "Enhancement of sleep stability with Tai Chi exercise in chronic heart failure: Preliminary findings using an ECG-based spectrogram method." Sleep Med.