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STRESS BUSTERS

by Mark Houston, M.D. with Barry Fox, Ph.D. and Nadine Taylor, M.S., R.D.

De-Stress Your Life
Stress does more than ruin your mood. Mental stress makes your nervous system leap into action, with potentially harmful results. You’ve experienced this many times: Just think of how your body would react if you were suddenly asked to stand up and deliver an impromptu speech to a large group. There’s a good chance your heart would start to pound and you’d begin to perspire. Perhaps your breathing would become shallow and rapid, and your face might get hot while your hands grow icy. If someone were to take your blood pressure right then and there, it would undoubtedly be higher than it normally is. That’s because the sympathetic nervous system’s normal response to stress includes increases in heart rate, vascular resistance, the thickness of the blood, and the stickiness of the blood platelets—all of which jack up the blood pressure.
When you’re stressed, your body prepares itself to handle a physical emergency, even if the stress is 100 percent mental. Your bloodstream is flooded with supercharged stress hormones like adrenaline, norepinephrine, and cortisol, giving you the strength and energy to physically fight off an enemy or run for your life—or both. All of this is very helpful when a mugger is chasing you down an alley, or if you need to lift a two-ton car all by yourself in order to free a loved one trapped beneath it. In cases like these, the stress response is a lifesaver.

But what if there’s no physical outlet for your stress response. Suppose you’re furious with your boss but have to hold your tongue. Or maybe your stress response is triggered over and over as you battle difficult customers, traffic, family problems, and so on. In either case, the results can be extremely hard on your body and your health. Just imagine the superstressed person facing the equivalent of emergency after emergency, day after day, heart pumping like crazy, blood vessels constricting, blood platelets ready to clump together, and blood pressure skyrocketing. Something similar happens in the case of the hot reactor. These people have exaggerated sympathetic responses to everyday stresses, even small ones. They might not actually have more stress in their lives than anyone else, but for them, getting cut off in traffic has the same internal effect as meeting a grizzly bear in the woods. Since every little stressor sends their bodies into overdrive, it’s not surprising that hot reactors often develop atherosclerosis and chronic hypertension.

Any way you cut it, excessive amounts of stress are bad for your body—and the effects on your blood vessels are particularly devastating. Repeated stimuli from the sympathetic nervous system injures the all-important endothelium, the inner lining of the arteries. This, in turn, makes the blood vessels tighten up and become more prone to developing atherosclerosis. Unfortunately, atherosclerotic blood vessels become even more constricted in response to sympathetic stimuli. So the more you’re stressed, the more your blood vessels clamp down and the more your blood pressure rises. After a while, your blood vessels no longer know how to relax, and your hypertension may become chronic.

It doesn’t require a terrible mental stress to make your arteries tighten up. Routine activities, such as hearing a loud noise, accidentally breaking a glass, or having a chat with your boss can raise your systolic blood pressure 5 to 10 mm Hg, or more.
Even brief periods of mental stress can cause temporary endothelial dysfunction in healthy people for as long as four hours after the event.

However, it’s chronic stress that really takes a toll on the body and contributes heavily to hypertension. The stress of working long hours, for example, can significantly increase your risk of hypertension, heart attacks, and diabetes mellitus. If you’ve got a job that’s demanding but allows you very little control (think of Lucy and Ethel in the chocolate factory), there’s a good chance that both your blood pressure and blood fats will rise. To make matters worse, people who have too much stress in their lives often compensate by developing unhealthy habits like smoking, drinking, or overeating, all of which can contribute to hypertension.

Isn’t Physical Stress Also Dangerous?
Studies have shown that mental stress can be much more damaging to the body than the routine physical stresses we encounter while going about our normal daily activities or exercising properly. One such study looked at 196 patients, ages forty to seventy-five, who had stable coronary artery disease. The researchers tested the volunteers’ physiological reactions to mental stress (via public speaking and a color-word test) as opposed to physical stress (via a stationary bike). When the patients were told to pretend they had been caught shoplifting and had to prepare and deliver a three-minute defense in front of a group, their vascular resistance increased markedly. But when they rode stationary bikes with the workload increased at regular intervals, their vascular resistance decreased. This is most likely because the mental stress triggered the release of epinephrine (adrenaline), which causes vasoconstriction. But the stationary bike challenge didn’t alter epinephrine levels, so the blood vessels were able to relax and deliver a greater supply of blood to the working muscles, as they should.

How Do You Know If You’re Stressed?
We’re all hit with a certain amount of stress in our lives. Some of us can handle it fairly well, even large amounts. But at some point you’ll find yourself on overload, stretched to the breaking point, up to your eyebrows, and just plain stressed out. For the sake of your physical, mental, and emotional health, it’s best to recognize the symptoms of impending stress overload before you actually get to the end of your rope. Then you can scale back your responsibilities and activities and take things a little easier. If you should find yourself exhibiting one or more of these symptoms, you probably need to find more effective ways to manage and release your stress:

• alcohol abuse
• anxiety
• apathy
• back aches
• chronic anger
• clenching of the jaw
• crying excessively
• depression
• drug abuse or dependency
• edginess
• fatigue
• headaches
• heart palpitations
• insomnia
• light-headedness
• loneliness
• overeating
• racing heart
• stomach aches
• sweaty palms
• tightness in the shoulders or neck
• teeth grinding

Anxiety, Depression, And Loneliness
Mental stress often manifests as anxiety or depression, or sometimes both—and each increases the risk of developing hypertension. One study gathered data from nearly 3,000 people, ages twenty-five to sixty, who participated in the National Health and Nutrition Examination Survey (NHANES), a long-range study that has been following some 14,000 Americans since 1975. All of the volunteers for the anxiety/depression study had normal blood pressure in the beginning. They had their blood pressures taken and they filled out a questionnaire that evaluated symptoms of anxiety and depression. Ten years later, the subjects had their blood pressure readings taken again. Those who had scored high in either anxiety or depression on the initial questionnaire had two to three times the risk of developing hypertension during the next ten years. In whites, the risk doubled only after the age of forty-five, but in African-Americans, the risk tripled and was seen in all age groups.

Stress in the form of loneliness can also push up blood pressure. One study of older people, ages sixty-five to seventyeight, found that those who were lonely had blood pressures an average of 16 points higher than those who were not lonely.

The Good News
It’s impossible to avoid all of the stressors of life, but you can do something to lessen their effects on your physical, mental, and emotional health. One antidote to the stress response is the relaxation response, which takes you to a deep state of restfulness while you remain awake. Dr. Herbert Benson, founder of the Mind/Body Medical Institute at Harvard Medical School, developed the relaxation response as a way to reverse stress-induced damage to the body. The response taps into an area of your brain that releases and diminishes your physical responses to stress. When practiced regularly, the relaxation response can effectively slow your metabolism, decrease your heart rate and muscular tension, and lower your blood pressure. By experiencing deep relaxation for just twenty minutes a day, you can do a lot to relieve your stress and bring your blood pressure down to a more healthful level.

The relaxation response, also called progressive relaxation, is easy to do, takes no equipment, and feels great. Just find a quiet, comfortable place where you can be alone for twenty minutes and follow these steps:

• Sit in a comfortable chair or lie on a mat on the floor and close your eyes.
• If you’re lying down, let your arms lie at your sides. If you’re sitting, let your hands lie relaxed in your lap.
• Take a deep breath: Slowly inhale for 4 counts, hold for 4 counts, and exhale for 4 counts. Repeat, if desired, then resume breathing normally.
• Focus on your feet: Relax them completely, letting all the tension go, until they feel so heavy and relaxed that you can hardly imagine moving them.
• Then focus on your ankles and repeat the process.
• Gradually work your way up through your body, relaxing all of your muscles, one by one, including those in your face and head.
• Take the entire 20 minutes to complete the process.
• When you’re finished, gradually begin to wake up again by wiggling your fingers and toes, and gently shaking out your arms and legs. You may also want to do some easy stretching.
• Take your time getting up, especially if you’ve been lying down. Slowly and gently ease yourself back into the real world.

A Better Approach To Smoothing Down Stress?
Although progressive relaxation is an excellent tool for physically relaxing the body and lowering the blood pressure, a mental form of relaxation called Transcendental Meditation (or TM) may be even better. The Indian yogi Maharishi Mahesh first introduced TM to the Western world back in the 1960s. Now in use by over four million people worldwide, its effectiveness as a stress reliever is beginning to be accepted by even the most traditional medical establishments.

In 1995, researchers pitted TM (the mental approach to relaxation) against progressive relaxation (the physical approach) to see which was most effective at lowering blood pressure. One hundred twenty-seven mildly hypertensive African-Americans between the ages of fifty-five and eighty-five took part in the study. Progressive relaxation worked well: It lowered systolic blood pressure an average of 4.7 mm Hg and diastolic 3.3 mm Hg. But TM proved to be the big winner, lowering systolic blood pressure by 10.7 mm Hg and diastolic by 4.7 mm Hg. As an antihypertensive technique, TM proved to be about twice as effective as progressive muscle relaxation. TM is also associated with a lessening of atherosclerosis, lowered cholesterol, and a decrease in rates of hospitalization.6 (For unknown reasons, other forms of meditation haven’t produced such beneficial results.) More and more, doctors are beginning to realize the value of Transcendental Meditation as a method for preventing and treating coronary heart disease.

TM is easy to learn, but it takes practice to be able to do it right. The more you do it, however, the easier it will become. But first you’ll need to decide on a word or short phrase (such as “love” or “universe” or “we are one”) that you’ll feel comfortable repeating to yourself silently, over and over again. If you take private instruction in TM, you’ll be given a word (a mantra) to repeat. Either way, the silent repetition of a word or phrase will induce deep relaxation. Once you’ve got your word or phrase, follow these steps:

• Find a place where you can sit quietly in a comfortable position and close your eyes.
• Inhale and exhale slowly but naturally as you silently repeat your word or phrase. Concentrate solely on your word or phrase as you try to keep your mind completely blank.
• As thoughts and feelings come into your mind, simply let them go and return your concentration to your word or phrase. Stay relaxed; don’t get anxious about these stray thoughts. Just acknowledge that they are there and dismiss them.
• Continue your repetition for 10 to 20 minutes, then slowly open your eyes.
• Gently and gradually ease yourself back into the conscious world before standing up and going on your way.
• Repeat twice a day.

Other Stress Busters
Of course, TM and progressive relaxation aren’t the only ways to relieve and manage the stress in your life. Exercise is a key element in stress relief. Deep breathing, yoga, t’ai chi, qigong, self-hypnosis, aromatherapy, warm baths, prayer, relaxation tapes, and soothing music are all effective ways of bringing your blood pressure, heart rate, muscle tension, and breathing down to lower, more healthful levels. As with any health practice, the one that works the best is the one you’ll do regularly. And the one you’ll do regularly is undoubtedly the one you like the best. So take your pick! Or mix and match. Just do some form of stress-relieving activity at least twenty minutes every day.

Stress is here to stay. Difficult customers, demanding bosses, terrible traffic, government scandals, and all the rest aren’t going away. But what can change is your reaction to the inevitable annoyances and disasters of life. You can learn to turn off your overreaction to stress, and blunt its ability to send your blood pressure soaring.

Excerpted from WHAT YOUR DOCTOR MAY NOT TELL YOU ABOUT HYPERTENSION: The Revolutionary Nutrition and Lifestyle Program to Help Fight High Blood Pressure by Mark Houston, M.D. with Barry Fox, Ph.D. and Nadine Taylor, M.S., R.D. Copyright © 2003 by Mark Houston, M.D. with Barry Fox, Ph.D. and Nadine Taylor, M.S., R.D. Excerpted by arrangement with Warner Books, Inc., New York, NY. All rights reserved. $14.95. Available in local bookstores or click here.