Condensed and Reprinted with permission from Chicago magazine by WFMT, Inc.
Living With Stress
by Dennis L. Breo A prescription for a healthier and more productive life
Rule No1. is, Don’t sweat the small stuff.
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Rule No.2 is, It’s all small stuff.
-Robert S. Elliot, M.D.
For far too many of us, alas, it’s all serious stuff. Our competitive American culture reminds us every day that we must drive harder, run faster, strive higher. The result is often stress - a mismatch between our expectations and what our environment can deliver. To begin to find our own personal solution to life’s stresses, medical experts say that we must first develop self-awareness. In time, and with discipline, this can effect remedies.
Dr. Robert S. Eliot-a native of Oak Park who founded the department of preventive and stress medicine at the University of Nebraska Medical Center and later a similar one in Phoenix, where he works today, is living proof. On a beautiful spring day 13 years ago, this world-renowned cardiologist, then 44, suffered a heart attack-as he stood on a podium lecturing on how to prevent heart attacks.
He made a full recovery. "If you have a heart attack," he jokes today, "mine is the kind to have-mild and in a hospital." Today he is in the forefront of a growing movement to teach people that they can be productive without being self-destructive.
Dr. Eliot was his own first stress patient, and his prognosis was bleak until he dramatically changed his lifestyles. He rediscovered two strangers-his body and his family. He began a program of recreation and relaxation, and he became not "Robert the Robot," as he put it, but a human being who learned to enjoy his family and his work as more than props to his own ego. The past 13 years, he says, have been the best of his life, and as a consultant to Fortune 500 firms, foreign governments, and Pentagon officials, he is leading the movement to help people make stress work for them, not against them.
This movement has reached Chicago, among many other places. The management of stress is being taken out of psychology, where it has been mired, and put into mainstream medicine, where many fell it belongs.
Stress In Action:
How your body responds
The signs of stress are familiar and troubling: anger, anxiety, and sleeplessness. Along with these come headaches, muscle tensions, maybe a backache. But far more serious are the reactions you can’t feel. Your body responds to danger, both real and perceived, in ways that have evolved over millions of years-and often they are totally inappropriate to today’s problems. We have been three millions of years-and often they are totally inappropriate to today’s problems. We have been three millions years in the forest, 3,00 years on the farm, but only 150 years in the factory. The life we live today, the life of modern technology, has existed for only about 40 years.
Depending on the danger, the body responds in one of two major ways. The first is the acute alarm reaction, sometimes known as the fight-or-flight response. If you feel immediately threatened, your body responds in one of two major ways, your body produces chemicals for extra strength and energy. Adrenalin races through your body, commanding a series of changes: The heart beats faster and stronger and blood pressure rises abruptly; automatically, blood is shunted away from the stomach and skin, where it is; high-energy fats are rushed into the blood stream; chemicals are released to make blood clot more quickly in case of injury. The pupils of the eyes dilate the facial muscles tense, blood vessels in the skin open up and the face flushes, breathing quickens, blood sugar increases. You’re ready for action. Such a response often was needed by primitive man-as when he faced a saber-tooth tiger. We sometimes need it too: The fireman charging down the pole, the mother rushing to pull her toddler from oncoming traffic, soldiers in combat-all require an acute alarm reaction. But more often than not, the fight-or-flight response, which can occur anywhere from 2 to 40 times a day, is physiologically inappropriate to such modern-day stresses, as losing a promotion, losing a lover, or losing anything else important to one’s ego.
The long-term vigilance reaction is the body’s conservation-withdrawal system. It prepares the body for long-term survival in the face of scarce nutritional resources. It is the body getting ready for cold and storms and days without food, water, and salt; it conserves vital resources when there is no control over a hostile environment. When the body is in a state of vigilance, the chemical cortisol moves slowly through it commanding a series of changes: Blood pressure rises slowly; body tissues retain vital chemicals such as sodium; high-energy fats are released into the blood; production of sex hormones is repressed (when you’re in danger, you’re not thinking of sex). The cortisol increases flow of gastric acid to aid digestion. Vigilance sustained too long, however, will weaken the body’s immune system against disease.
Vigilance can occur on a limited basis if you need to stay up all night to pass your final exams or if you are trying to write a novel while holding down a full-time job. If you are an accountant working night and day during tax season, you will use the vigilance reaction. But the vigilance can also be a way of life. The chronically vigilant person may be the air-traffic controller at O’Hare who has too many planes in the air. Or a mother who always agonizes over her teenage daughter’s whereabouts and sits up into the wee hours and sits up into the wee hours waiting for the phone to ring with bad news. Or anyone who feels that he or she is in a losing situation, with no personally acceptable options to change things. Or anyone who asks himself that dirgeful question; "Is that all there is?"
Relaxing your body:
Joseph Barr, co-director of the Center of Medical Psychology in Des Plaines, says that many people "have developed bad psychophysiological habits and go around in a constant state of high arousal.
"These people have learned to live with high levels of anxiety, including occasional panic attacks, and they think that this condition of psychophysiological arousal is normal. Many present symptoms of colitis, headaches, or high blood pressure. We try to quiet them down."
Barr often uses biofeedback, a system that makes people are of how their bodies are reacting to stress. For example, hand temperature is a symptom of cardiovascular arousal. By teaching a patient to be aware when his hands are becoming cold and to be able to relax and warm them up, Barr is providing a valuable antistress technique. He also teaches patients to observe their breathing patterns. While shallow breathing from the chest results in a rapid 18 breaths a minute-a sign of stress and, occasional, hyperventilation-the deeper breathing form the diaphragm requires only 12 breathes a minute and brings a sense of relaxation and well-being. Barr’s sophisticated lab can also measure the electrical activity of muscles and demonstrate to a hot reactor that when he is in the combat reaction his muscles are giving off three to five microvolts, compared with a normal two.
Frank Collins, Jr., a Ph.D., and director of the Biofeedback and Stress Management Program at Rush-Presbyterian-St. Luke’s Medical Center, uses a similar technique. Electrical activity from a muscle in a patient’s forehead is converted into an audio tone, and the patient is taught how to recognize when the tone is getting higher-a sign of arousal and stress-and to consciously lower it.
By making the covert overt, biofeedback enables patients to regulate their bodily reactions to stress and therefore gain a sense of reassurance.
"Some of my patients are astonished to see how their bodies are overreacting to stress," says Collins. "Some patients who are really up tight and into rigid self-control are frightened of deep relaxation," says Barr. "But only at first. Once they learn how to regulate their responses, they think it’s great."
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