A renowned integrative physician identifies a modern syndrome through which patients experience clusters of serious physical ailments that rise from a continuous flow of stress hormones, outlining a four-week program to heal and rebalance the body that addresses such areas as diet, exercise and sleep.
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Roberta Lee, M.D., is vice chair of the Department of Integrative Medicine, director of Continuing Medical Education, and co-director of the Fellowship in Integrative Medicine at Beth Israel's Continuum Center for Health and Healing at Beth Israel Medical Center in New York City. Dr. Lee attended George Washington University Medical School and is one of the four graduates in the first class from the Program of Integrative Medicine at the University of Arizona conducted by Andrew Weil, M.D.
Part 1 SuperStress and You
CHAPTER ONE
SuperStress in Your Body and on Your Mind
Stress is a word we toss around every day, but what does it really mean? There are probably as many definitions as there are people you ask for them. Stress is both a physiological and a psychological response to events that upset our balance. Stress is what happens when the demands and daily challenges of the outside world are greater than our ability to cope with them. But stress is related to internal factors as well-factors that include how healthy we are, our emotional well-being, what we eat, and how much sleep we get. It's also strongly dependent on how we interpret what comes our way-that is, how we perceive what's happening to us.
Each person interprets a prospectively dangerous situation differently. Let's say, for example, that six-foot-two-inch Anthony runs out of gas in the middle of a dark street in a not-so-safe neighborhood. While walking to the nearest filling station, he notices a group of four burly guys heading in his direction. He barely pays attention to them and continues on his way, never changing his pace. If his sister has the same experience with her car, when she sees the men coming her way she might a) cross the street, b) duck into the nearest open store, or c) pull out the pepper spray that she has in her handbag "just in case." For Anthony, this nonevent creates nothing more than a blip on the stress radar screen. But his sister, who perceives that she might be in danger, has a much more pronounced stress response. The stress response is about protecting ourselves and it's about having control over a situation. How much stress we feel as a result of our perception of things determines how much control we think we have.
Anything that triggers stress is known as a stressor. Anything that forces us to adjust to the degree that it strains our coping skills is a stressor. Stressors can range from small aggravations to fear of something or someone that might pose a threat to your well-being. Large stressors include major life events, such as a divorce, a child leaving home, an unexpected pregnancy, a move to a new town, a career change, graduating from college, or a diagnosis of cancer. But while major life changes are stressful, it's the stressors that come at us-and consequently at our nervous systems-all day long that affect us the most. These include:
• Environmental stressors, such as noise pollution (from blaring radios, barking dogs, or police sirens) or living in a crime-ridden neighborhood where you never feel safe.
• Work stressors, such as job dissatisfaction, overwork, disagreements with your boss, low pay, or nasty office politics.
• Relationship stressors-defined as a fight with a friend; problems with partners, children, or other family members; or loss of a spouse.
• Social stressors that occur when you're trying to keep up with the Joneses or trying to be the Joneses.
• Spiritual angst, which can come from loss of a purpose in your life. Loss of community. Loss of control. Loss of meaning.
Fear as a Stressor
Fear is one of the great stressors of all time. Fear heralds many dangers and yet it can save us by keeping us in fight-or-flight mode. Our ancestors-long ago-had no choice but to be faster, stronger, and more cunning than the predators that waited for them to make a mistake. The fact is, a guy going out alone on the savanna in search of food knew well that when he came face-to-face with a beast, he was either going to get lunch or be lunch. In those days, if you didn't have enough you were going to die of starvation or hypothermia. If you were successful, you might be alone. The last one standing. And then what?
Today, our fears are more socially related and can almost always be broken into different categories: fear of failure, fear of not having enough, fear of not being enough, fear of losing what you've got, fear of success. Do I have enough to keep up with the neighbors? Am I pretty enough for the guy I have a crush on? It seems almost banal to label some of these trivial things "fears," but the threats are very real to the person who experiences them. The problem is that the brain doesn't understand enough to think: Are you kidding me? You call this a threat or a danger? The brain interprets fear as Oh, my God, we're under siege! It immediately signals a meant-to-be-protective cascade of hormones: epinephrine, or epinephrine and cortisol. So whether you fall off a cliff or dream you're falling off a cliff, your neurological response will be precisely the same.
Stressors are cumulative, so the more life changes or daily hassles you're dealing with at any one time, the more intense the symptoms of stress. With our twenty-first-century lifestyle, the hassle factor of everyday life has grown exponentially. Bear in mind that a series of small hassles can eventually combine to become several dangerous ones.
Chronic Stress and the Load You Carry
Our bodies are hardwired to respond to stress the same way our ancestors did, and under acute conditions that response did (and still does) protect us. It helped our ancestors out of dangerous situations when the best course of action was to literally get out of harm's way. Acute stress can have positive benefits. It has been shown to improve certain body systems, such as the immune system. The skin is more able to fight infection and our five senses and short-term memory are often enhanced during acute stress situations. However, in today's world, most of the stress we feel is in response to chronic rather than acute threats. Unfortunately, the brain, for all its majesty, can't distinguish acute from chronic. In that respect, it's a lot like Chicken Little, assuming the worst-case scenario every time it senses a threat. And when the stress doesn't go away-when your project deadline is two weeks away and that seems like less than half the time you need to complete it-then the hormones dispatched by the brain in an effort to mount a defense just keep coming. Dr. Bruce McEwen of Rockefeller University, an expert on the physiological effects of chronic stress, describes this crossover from acute to chronic stress as a journey from allostasis to allostatic load.
Allostasis is the body's way of keeping all systems in balance, particularly as we move from one situation to another. For example, climbing stairs sets our heart working harder for the extra effort our legs need, but at the top of the stairs, the pumping slows down again. The same adjustments work when you leave your walk in the snow and head inside for a chat by the fire; your body temperature automatically adjusts itself. Last example: Imagine you are crossing the street. You see an out-of-control car coming at you; your brain senses the danger and thinks, Get out of the way! In a split second, your body produces stress hormones that fuel your sprint to the other side of the street and safety. Ten minutes later, the incident is all but forgotten and you're happily trying on shoes in Target. Your stress hormones, no longer needed, have stopped surging and all systems are back to normal. This is allostasis in its finest hour.
It's one thing to dash across a street to avoid an oncoming car, but when there are too many such threats in a relatively short period of time or when any one stressor goes on too long-as when a person stays in a bad marriage-then we begin carrying what is known as an allostatic load. If allostasis is the body's...
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