It's widely known that acute stress can damage the heart. For example, the risk for sudden cardiac death is, on average, twice as high on Mondays as on other days of the week, presumably because of the stress many people feel about going back to work after the weekend. People also experience more heart attacks in the morning because of increased levels of cortisol and other stress hormones.
Important recent research: In a study of almost 1,000 adult men, those who had three or more major stressful life events in a single year, such as the death of a spouse, had a 50% higher risk of dying over a 30-year period.
But even low-level, ongoing stress, such as that from a demanding job, marriage or other family conflicts, financial worries or chronic health problems, can increase inflammation in the arteries. This damages the inner lining of the blood vessels, promotes the accumulation of cholesterol and increases risk for clots, the cause of most heart attacks.
Among the recently discovered physical effects of stress...
Increased blood sugar. The body releases blood sugar (glucose) during physical and emotional stress. It's a survival mechanism that, in the past, gave people a jolt of energy when they faced a life-threatening emergency.
However, the same response is dangerous when stress occurs daily. It subjects the body to constantly elevated glucose, which damages blood vessels and increases the risk for insulin resistance (a condition that precedes diabetes) as well as heart disease.
What helps: Get regular exercise, which decreases levels of stress hormones.
More pain. Studies have shown that people who are stressed tend to be more sensitive to pain, regardless of its cause. In fact, imaging studies show what's known as stress-induced hyperalgesia, an increase in activity in areas of the brain associated with pain. Similarly, patients with depression seem to experience more pain-and pain that's more intense than those who are mentally healthy.
What helps: To help curb physical pain, find a distraction. One study found that post surgical patients who had rooms with views of trees needed less pain medication than those who had no views. On a practical level, you can listen to music. Read a lighthearted book. Paint. Knit. These steps will also help relieve any stress that may be exacerbating your pain.
Also helpful: If you have a lot of pain that isn't well-controlled with medication, ask your doctor if you might be suffering from anxiety or depression. If so, you may benefit from taking an antidepressant, such as duloxetine (Cymbalta) or venlafaxine (Effexor), which can help reduce pain along with depression.
Impaired memory. After just a few weeks of stress, nerves in the part of the brain associated with memory shrink and lose connections with other nerve cells, according to laboratory studies.
Result: You might find that you're forgetting names or where you put things. These lapses are often due to distraction-people who are stressed and always busy find it difficult to store new information in the brain. This type of memory loss is rarely a sign of dementia unless it's getting progressively worse.
What helps: Use memory tools to make your life easier. When you meet someone, say that person's name out loud to embed it in your memory. Put your keys in the same place every day.
Also: Make a conscious effort to pay attention. It's the only way to ensure that new information is stored. Sometimes the guidance of a counselor is necessary to help you learn how to manage stress. Self-help materials, such as tapes and books, may also be good tools.
Weight gain. The fast-paced American lifestyle may be part of the reason why two-thirds of adults in this country are overweight or obese. People who are stressed tend to eat more-and the "comfort" foods they choose often promote weight gain. Some people eat less during stressful times, but they're in the minority.
What helps: If you tend to snack or eat larger servings when you're anxious, stressed or depressed, talk to a therapist. People who binge on "stress calories" usually have done so for decades-it's difficult to stop without professional help.
Also helpful: Pay attention when you find yourself reaching for a high-calorie snack even though you're not really hungry.
Healthy zero-calorie snack: Ice chips.
Low-calorie options: Grapes, carrots and celery sticks. Once you start noticing the pattern, you can make a conscious effort to replace eating with nonfood activities-working on a hobby, taking a quick walk, etc.
There are a number of ways to determine whether you are chronically stressed-you may feel short-tempered, anxious most of the time, have heart palpitations or suffer from insomnia.
However, I've found that many of my patients don't even realize how much stress they have in their lives until a friend, family member, coworker or doctor points it out to them. Once they understand the degree to which stress is affecting their health, they can explore ways to unwind and relax.
In general, it helps to...
Get organized. Much of the stress that we experience comes from feeling overwhelmed. You can overcome this by organizing your life.
Examples: Use a day calendar to keep your activities and responsibilities on-track, and put reminder notes on the refrigerator.
Ask for help. You don't have to become overwhelmed. If you're struggling at work, ask a mentor for advice. Tell your partner/ spouse that you need help with the shopping or housework.
Taking charge of your life is among the best ways to reduce stress-and asking for help is one of the smartest ways to do this.
Write about your worries. The anxieties and stresses floating around in our heads often dissipate, or at least seem more manageable, once we write them down.
Sleep for eight hours. No one who is sleep-deprived can cope with stress effectively.