from, 6 Lessons for Handling Stress by TIME
Take a deep breath. Now exhale slowly. You're probably not aware of
it, but your heart has just slowed down a bit. Not to worry; it will
speed up again when you inhale. This regular-irregular beat is a sign
of a healthy interaction between heart and head. Each time you exhale,
your brain sends a signal down the vagus nerve to slow the cardiac
muscle. With each inhale, the signal gets weaker and your heart revs
up. Inhale, beat faster. Exhale, beat slower. It's an ancient rhythm
that helps your heart last a lifetime. And it leads to lesson No. 1 in
how to manage stress and avoid burnout.
NO. 1
REMEMBER TO BREATHE
EVOLUTION
HAS BEQUEATHED TO OUR BRAINS A variety of mechanisms for handling the
ups and downs of life--from built-in chemical circuit breakers that
shut off the stress hormones to entire networks of nerves whose only
job is to calm you down. The problem, in the context of our always
wired, always on-call world, is that they all require that you take
regular breaks from your normal routine--and not just an occasional
weekend trip. You can try to ignore the biological need to periodically
disengage, but there's growing evidence that it will eventually catch
up with you. Insurance claims for stress, depression and job burnout
are now the U.S.'s fastest-growing disability category.
Making
matters worse, Americans tend to cope with stress in all the wrong
ways. A November survey by the advocacy group Mental Health America
found that we frequently deal with chronic stress by watching
television, skipping exercise and forgoing healthy foods. The problem
with these coping mechanisms is that they keep you from doing things
that help buffer your stress load--like exercising or relaxing with
friends or family--or add greater stress to your body. Indeed, using
many of our most cherished time-saving gadgets can backfire. Cell
phones and mobile e-mail devices--to give just two examples--make it
harder to get away from the office to decompress. Working from home
may, in some cases, exacerbate the situation because it isolates
employees while simultaneously blurring the line between work and
leisure.
We also have a lot of misconceptions about who gets
stressed out and why. Twenty years ago, psychologists almost
exclusively blamed job stress on high workloads or lack of control on
the job. More recent studies, says Christina Maslach, a pioneer in
burnout research at the University of California, Berkeley, show that
unfairness and a mismatch in values between employees and their
companies play an increasing role in triggering stress. "Probably one
of the strongest predictors is when there's a vacuum of
information--silence about why decisions were made the way they were,"
Maslach says. "Another is having to operate in conflict with your
values. Do you need to shade the truth to get authorization from the
insurance company? Are you selling things that you know people don't
really need?"
NO. 2
STRESS ALTERS YOUR BLOOD CHEMISTRY
FOR
YEARS PSYCHOLOGISTS HAVE concentrated on the behavioral symptoms of
burnout: lost energy, lost enthusiasm and lost confidence. Now, thanks
to new brain scans and more sophisticated blood tests, scientists can
directly measure some of the effects of stress on mind and body--often
with surprising results.
You are probably
familiar with the signs of an adrenaline surge (racing pulse, hairs on
the neck standing on end), which evolved to help us fight or flee
predators and other immediate dangers. And you may have heard of
cortisol, another stress hormone, which is produced more slowly than
adrenaline and lingers in the bloodstream longer. But did you know that
too little cortisol in your bloodstream can be just as bad as too much?
Or that tucking into comfort foods, while soothing in the short term,
can sabotage your long-term stress response by increasing the number of
inflammatory proteins in your body?
What's emerging is a complex
picture of the body's response to stress that involves several
interrelated pathways. Scientists know the most about cortisol because
until now that has been the easiest part to measure. "But when one
thing changes, all the others change to some degree," says Bruce
McEwen, a neuroendocrinologist at Rockefeller University who has spent
decades studying the biology of stress, primarily in animals. So just
because you see an imbalance in one area doesn't mean you understand
why it is happening. "We're learning that post-traumatic stress
disorder (PTSD), burnout, chronic fatigue syndrome and fibromyalgia are
all related in some ways," McEwen says. The next step is to figure out
if there are any genetic predispositions that tip the response to
stress toward one set of symptoms or another.
NO. 3
YOU CAN'T AVOID STRESS
EVEN
GETTING OUT OF BED CAN BE TOUGH ON THE BODY. SEVERAL hours before you
wake each morning, a tiny region at the base of your cerebrum called
the hypothalamus sends a signal that ultimately alerts your adrenal
glands, which sit on top of your kidneys, to start pumping out
cortisol, which acts as a wake-up signal. Cortisol levels continue to
rise after you become conscious in what is sometimes referred to as the
"Oh, s___! It's another day" response. This may help explain why so
many heart attacks and strokes occur between 6 a.m. and 8 a.m.
Because
cortisol is a long-acting hormone, you can dally under the covers a bit
without losing any steam. But your brain is already taking steps to
protect you from the shock of starting a new day. Rising cortisol
levels signal the hypothalamus to stop sounding the alarm. Other parts
of the brain chime in, and eventually the adrenal glands ratchet down
their cortisol production. In other words, the brain's stress response
contains its own off switch.
Most people's cortisol, as measured
by a saliva test, peaks a few hours after waking. Levels then gradually
decline during the course of the day--with a few blips scattered here
and there. That pattern typically changes, however, in people who are
severely depressed. Their cortisol level still rises early in the
morning, but it stays high all day long. It's almost as if their
hypothalamus has forgotten how to turn off the stress response.
(Intriguingly, people who are sleep deprived also exhibit a high, flat
cortisol level.)
Researchers figured something
similar had to be happening in burnout victims. But rather than finding
a prominent cortisol peak, investigators discovered a shallow bump in
the morning followed by a low, flattened level throughout the day.
Intriguingly, such blunted cortisol responses are also common among
Holocaust survivors, rape victims and soldiers suffering from PTSD. The
difference seems to be that people with PTSD are much more sensitive to
cortisol at even these low levels than those with burnout. "We used to
blame everything on high cortisol," says Rachel Yehuda, a neurochemist
and PTSD expert at the Mount Sinai School of Medicine in New York City.
"Now we can blame things on low cortisol as well."
NO. 4
STRESS CAN AGE YOU BEFORE YOUR TIME
SCIENTISTS
HAVE LONG SUSPECTED THAT unremitting stress does damage to the immune
system, but they weren't sure how. Then two years ago, researchers at
the University of California, San Francisco, looked at white blood
cells from a group of mothers whose children suffered from chronic
disorders like autism or cerebral palsy. The investigators found clear
signs of accelerated aging in those study subjects who had cared the
longest for children with disabilities or who reported the least
control over their lives.
The changes took place in microscopic
structures called telomeres, which are often compared to the plastic
wrappers on the ends of shoelaces and which keep chromosomes from
shredding. As a general rule, the youngest cells boast the longest
telomeres. But telomeres in the more stressed-out moms were
significantly shorter than those of their counterparts, making them,
from a genetic point of view, anywhere from nine to 17 years older than
their chronological age.
NO. 5
STRESS IS NOT AN EQUAL-OPPORTUNITY EMPLOYER
IN
1995, IN A NOW CLASSIC EXPERIMENT, SCIENTISTS AT THE University of
Trier in Germany subjected 20 male volunteers to a situation guaranteed
to raise their stress levels: participating in a mock job interview and
solving arithmetic problems in front of strangers who corrected them if
they made mistakes. As expected, each subject's cortisol level rose at
first. But by the second day of the trial, most of the men's cortisol
levels did not jump significantly. Experience had taught them that the
situation wasn't that bad. Seven of the men, however, exhibited
cortisol spikes every bit as high on the fourth day as the first. Only
by the fifth day did their stress reaction begin to disappear.
More
recently, researchers have found that subjects with low self-esteem are
more vulnerable to stress. Jens Pruessner at McGill University in
Montreal believes that the hippocampus, a finger-size structure located
deep in the brain, is at least partially responsible. It turns out that
the hippocampus, which helps you form new memories and retrieve old
ones, is particularly sensitive to the amount of cortisol flooding your
cerebrum. So when cortisol levels begin to rise, the hippocampus sends
a set of signals that help shut down the cortisol cascade.
Using
several different types of brain scans, Pruessner has shown that people
who test below average on self-esteem also tend to have
smaller-than-average hippocampi. The differences become clear only when
you compare groups of people, Pruessner notes, so you can't look at any
single person's brain scan and determine whether he or she has low
self-esteem. But when you look at overall results, they suggest that a
smaller hippocampus simply has more trouble persuading the rest of the
brain to turn off the stress response.
Still unclear is how the
body goes from having repeated activation of the stress response to
showing the typically blunted cortisol levels of someone suffering from
burnout. "We are still studying this," says Samuel Melamed of Tel Aviv
University in Israel. "But if there is no relief and the cortisol stays
up for long periods of time, the body stops responding and readjusts
the level."
NO. 6
THERE'S MORE THAN ONE WAY TO RELIEVE STRESS
THIS
IS PROBABLY THE TOUGHEST LESSON TO INTERNALIZE BECAUSE when stress
overwhelms the system, your choices often seem more limited than they
are. Behavioral scientists have a name for this psychological reaction.
They call it learned helplessness, and they have studied the phenomenon
closely in laboratory rodents, whose nervous system bears striking
similarities to that of humans.
Here's how the experiment works:
if you provide mice with an escape route, they typically learn very
quickly how to avoid a mild electrical shock that occurs a few seconds
after they hear a tone. But if the escape route is blocked whenever the
tone is sounded, and new shocks occur, the mice will eventually stop
trying to run away. Later, even after the escape route is cleared, the
animals simply freeze at the sound of the tone--despite the fact that
they once knew how to avoid the associated shock.
Obviously,
humans have more intellectual resources at their disposal than mice do,
but the underlying principle remains. When too many of the rules
change, when what used to work doesn't anymore, your ability to reason
takes a hit. Just being aware of your nervous system's built-in bias
toward learned helplessness in the face of unrelieved stress can help
you identify and develop healthy habits that will buffer at least some
of the load (see box).
But the one thing you should not do is
ignore the risks. Animal research has shown that there is a relatively
small window for reversing the physiological effects of chronic stress.
Studies of people are starting to produce similar results. Once a
person's cortisol level gets completely blunted, it seems to stay that
way for years. You owe it to yourself and your loved ones not to let
that happen.
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