Stress and Health

Behavioral Health Update
BHSI Newsletter Vol. 1, No. 3

Stress, Health, and Stress Reduction Training
Drevis Hager, Ed.D., L.P.
The American Academy of Family Physicians estimates that 60% of the health problems brought to physicians are related to stress in one way or another. In some instances an illness is the direct result of the body’s sustained stress response, while in other instances the stress response exacerbates or extends pre-existing illness. The list of stress-related maladies includes (but is not limited to) psychological disorders, insomnia, tics, headaches, diabetic instability, sexual dysfunction, impaired immunity, hypertension and other cardiovascular diseases, gastrointestinal distress, elevated cholesterol, and impaired wound healing. The physiology of the stress-health nexus is complex, but several potent processes have been identified. For example, when an individual is subjected to stress, catecholamine levels spike, and glucocorticoid levels gradually elevate as part of the process of gluconeogenesis -- the creation of new glucose necessary for extended fight-or-flight response. If the stressors are sustained, the persistently high glucocorticoid levels impair the operations of the thymus, lymph nodes, and spleen, thus interfering with the production of T cells, helper T cells, B cells, natural killer cells, large granular lymphocytes, and gamma interferon.

The Influence of Coping Skills

Technically speaking, environmental events aren’t the most potent “stressors;” thoughts are. On the individual level, there is a tremendous range of reactivity to environmental events, and this is determined principally by each person’s unique cognitive processing style. Stress-hardy individuals view stressors as challenges, are optimistic problem-solvers, and maintain proper perspective on the relative importance of each stressor. Those who meditate regularly and who maintain healthy lifestyles also demonstrate greater coping abilities. It is no surprise that these individuals demonstrate fewer health complications. In contrast, stress-impaired individuals view stressors as direct threats, ruminate pessimistically, over react, and easily loose proper perspective on stressor severity. They have significantly higher catecholamine and glucocorticoid levels (even at rest) and, consequently, far greater health complications.

Stress Reduction Tips for Patients

Healthcare professionals have the opportunity to reduce the incidence of stress-related illnesses. When it comes to this intersection of stress and health, an ounce of prevention is truly worth a pound of cure. Here are some measures that can be taken:?1. Teach patients the cognitive habits that are used by stress-hardy individuals. Emphasize optimistic problem solving, viewing the stressor as a challenge, and maintaining proper perspective on the relative importance of the stressor.2. Address various lifestyle considerations such as adequate exercise, diet, social supports, rest, recreation, sleep, minimizing or eliminating use of alcohol, other substances, and realistic scheduling.3. Encourage patients to learn a relaxation/meditation technique, and practice it daily. The body of research on meditation and health is impressive, with hundreds of studies demonstrating a vast array of benefits such as fewer infections, faster surgical wound healing, lowered cholesterol, reduced arterial occlusion, and less anxious reactivity.4. Recommend a self-help book such as Joan Borysenko’s Minding the Body, Mending the Mind or Herbert Benson’s The Relaxation Response.5. For the patient who is in need of more extensive stress reduction training, encourage mental health treatment such as individual psychotherapy or participation in a stress reduction group.