E-BRIEFING: All About Stress
The threat of war, terrorism alerts, a volatile economy, an unstable workplace -- is it any wonder that Americans are feeling the stress?
This weeks University of Cincinnati e-briefing examines the facets of stress, including where to turn for relief. Other questions: Why is it that some people never seem to get rattled while others are often on edge? And how does our stress affect our children?
Table of contents:
1. Stress defined
· Stress is a reaction to real or expected trauma
· Cortisol: The stress hormone
2. Stress takes a toll
· Stress may link to depression
· Memory and mood
· A dangerous trigger
3. Suffer the children
· Anxiety disorders and children: A growing problem
· Genetics and early experiences are key
· Parental influence
· Parents model the stress children learn
4. Stress relief
· Popular prescriptions
· One remedy: Elect to exercise
· Working out and working off stress
· Yoga: An ancient remedy
1. Stress defined
A. Stress is a reaction to real or expected trauma
"Stress is the reaction of the body to a perceived or present threat," says James Herman, professor of psychiatry, University of Cincinnati Medical Center. Herman studies the neurobiology of stress as it pertains to stress circuits in the brain. He says the stress response can be generated in two different ways -- the brain can either react to physical threats, such as illness or trauma, or generate a response in anticipation of possible trauma.
B. Cortisol: The stress hormone
James Herman, UC professor of psychiatry, explains that when the body encounters stress, it generates chemicals such as cortisol that are meant to protect us from a threat. "Let's say I'm out in the wild and encounter a predator. I need to make sure I have the energy to keep up my pace, so cortisol causes the liver to mobilize the energy to meet this challenge. At the same time, I don't need to expend energy on growing bone or making sex hormones, so cortisol can shut these processes down. While this cortisol response is adaptive in the short run, long-term elevations can overwhelm the body's restorative capacity, resulting in major health problems under chronic stress conditions."
2. Stress takes a toll
A. Stress may link to depression
Stress can take a physical toll on the body and has been linked to stomach disorders, stroke, dementia, increased risk of heart disease and depression. Dr. Erik Nelson, M.D., is a University of Cincinnati assistant professor of psychiatry and is assistant director of UC's psychopharmacology research program. Nelson specializes in treating depression and other mood disorders. "Depression is the medical syndrome that in some ways looks like a severe stress reaction, and it could be triggered by stress in some people."
B. Memory and mood
Prolonged exposure to the bodys natural stress hormone, cortisol, has a negative impact on the brain, causing shrinkage of areas involving memory and mood. James Herman, UC professor of psychiatry, says this is of particular relevance to disease states associated with elevated cortisol, most notably major depressive illness, which affects some 20-25 percent of the population. Herman adds that research also suggests high cortisol levels associated with stress-related diseases such as depression can put women at higher risk for developing other health problems, such as osteoporosis.
C. A dangerous trigger
Lawrence Anthony, director of the University of Cincinnati Addiction Studies program, says stress is another dangerous trigger for people suffering and recovering from addictions. "Stress is one of those variables added onto preexisting conditions that affects a person psychologically and physiologically, and can lead to self-defeating behaviors in an attempt to cope with the stress," he says. "For example, let's say someone is stressed from a difficult work environment -- so he or she may attempt to relieve the stress through alcohol or drug abuse, gambling, sexual activity or even compulsive shopping." But what turns out as a form of relaxation ends up aggravating the stress even more because the behaviors create additional problems.
3. Suffer the children
A. Anxiety disorders and children: A growing problem
Health professionals are seeing a "sizable percentage" of anxiety disorders in children, according to Keith King, University of Cincinnati assistant professor of health promotion. King says comparing today's children with those of decades ago shows major changes in the American family structure. "The structure changed from a two parent home with an intact family structure to working parents, single parents and blended families -- all increased stresses that children never had to face before."
B. Genetics and early experiences are key
One of the key areas in stress research is why some people are more susceptible to stress than others. "If you look at the experiences of soldiers at war, they are all under stress. But only a small proportion of them are coming back home with a mood disorder or Post Traumatic Stress Disorder," says James Herman, UC professor of psychiatry. Evidence from research on animals points to genetics and early childhood factors -- so by extension, a child brought up in a non-nourishing family environment may be more at risk for developing stress-related disorders."
C. Parental influence
Thomas Power, chair of the Department of Human Development at Washington State University, explains there are three different areas where parents can have an impact on how a child copes with stress. First, they do so by influencing their child's exposure to certain events.
"Coping with stress takes practice, so it's good for parents to expose their children to solving problems that are age appropriate. Children won't learn those skills if parents are constantly sheltering them. On the other hand, there can also be too much exposure to stress -- especially if children are expected to deal with issues that they are not developmentally ready for. Secondly, parents influence children by influencing their appraisal of stressful situations. So, let's say a child brought home a B on his report card. One set of parents might be ecstatic, while others might consider that B a failure. Parents serve as filters of their child's reality. If the child does badly in school and the parent sees that as a crisis, the child is likely to do worse than if a parent sees it as a challenge. Finally, parents influence their children's coping strategies by providing models of coping and problem solving."
D. Parents model the stress children learn
Anxiety disorders like depression are inherited to some degree, explains Dr. Erik Nelson, MD, University of Cincinnati assistant professor of psychiatry. "We inherit some aspects of our parents' behavior through our genes as well as through learned behaviors, so people may learn certain behaviors from a parent who is behaving in an anxious way." Nelson adds that people who suffer severe stress during childhood are more apt to develop depression and certain anxiety disorders, including Post Traumatic Stress Disorder (PTSD), even in adulthood.
4. Stress relief
A. Popular prescriptions
Dr. Erik Nelson, MD, University of Cincinnati assistant professor of psychiatry, says use of antidepressants is at an all-time high. That may be due to higher levels of depression and anxiety. But, it could also be that doctors are becoming better at recognizing the symptoms of depression: insomnia or excessive sleeping, irritability, lack of appetite or overeating, difficulty concentrating or depressed mood. He says the antidepressants work by regulating neurotransmitters, or chemical messengers, in the brain that affect emotion and stress levels. The most popular class of antidepressants is called Serotonin Reuptake Inhibitors, or SRIs, and include brands such as Paxil, Prozac and Zoloft. Nelson says that while these drugs may cause side effects such as stomach upset, headache or sexual dysfunction, the majority of patients not only tolerate the drugs well, but also can take them over a longer time period than the earlier drugs.
B. One remedy: Elect to exercise
In addition to drug therapies, researchers are examining how exercise and diet can hold unhealthy stress at bay. "Exercise is a stressor, but it is a controllable stressor," explains James Herman, UC professor of psychiatry. "In animal research, animals that choose to exercise are better able to control stress than animals forced to exercise. The work in this research area is currently preliminary, but it's a promising new avenue."
C. Working out and working off stress
Regular exercise can lower high blood pressure commonly associated with stress as well as bring a physical and mental break from the stress. Kinder Violet, assistant director of University of Cincinnati Recreational Sports, says the best benefits will result from a 20-to-30 minute period of exercise three times a week.
D. Yoga: An ancient remedy
More people are learning to curb stress through a practice more than 5,000 years old. Certified Yoga instructor Julie Lusk is author of the books, Desktop Yoga and 30 Scripts for Relaxation Imagery and Inner Healing, volumes 1 and 2. She says the breathing techniques and physical stretches in Yoga ease stress because they quell the "fight or flight" response and instead, generate the relaxation response. "Yoga teaches people how to recognize stress in the body -- emotionally, physically and mentally."