The Toll of Stress

How big a contributor to illness is stress? Herbert Benson, MD, originally trained as a cardiologist and now the director of the Mind/Body Medical Institute at Harvard Medical School and author of the best-selling book The Relaxation Response, estimates that 60-90 percent of all doctors' visits are linked to stress-related symptoms or medical conditions. Among physical symptoms he lists headaches, stomach problems and backaches. Emotional problems include nervousness, edginess and anger. Relationship problems such as nagging, resentment and lowered sex drive he says can also point to stress.

Among more serious stress-linked conditions are the following:

• Heart disease. Benson says that even though stress isn't usually counted among such classic heart attack risk factors as smoking, diabetes and high cholesterol levels, it ought to be. And heart disease isn't just a man's disease: Almost 250,000 women per year die of heart attacks-five to six times as many as from breast cancer. While you're unlikely to drop dead of heart disease in your 30s, doctors now know that the fatty plaques in your arteries that can lead to heart attacks in later life can start building up as early as your teens.
• Memory loss. Stanford University's Robert Sapolsky, a professor of Biological Sciences and Neuroscience and author of Why Zebras Don't Get Ulcers: An Update Guide to Stress, stress-Related Disorders, and Coping, says there's "zero evidence that stress can increase the likelihood of Alzheimer's disease (AD)," though it may accelerate the decline. "Stress, on its own," he says, "can cause some mild versions of the memory problems seen in AD -- problems with declarative working memory, issues with concentration, issues with what is called "executive" function -- how you strategize about using your knowledge."
• Infections. Ever notice that you seem to get sick right after you finish a big project at work? This may more than your imagination. Scientists have repeatedly linked the suppression of the immune system that accompanies chronic stress with things like how likely you are to develop a cold if exposed to a cold virus and how severe the symptoms will be. In fact, Sapolsky had this happen to him recently, in what he calls an "amazing demonstration of psychoneuroimmunology," the emerging field linking our mental states to our nervous system and immune function. After "going on zero sleep for weeks," working on two major grant proposals, he came "dramatically down with the flu within 6 hours of mailing them off." High levels of stress are known to reactivate cold sores and genital herpes, both caused by related viruses, and to make your immune system less likely to respond to vaccines.
• Autoimmune Diseases. These diseases occur when the body's immune system mistakenly attacks parts of your own body. For unknown reasons, they tend to hit women far more often then men. Many people with autoimmune disorders like rheumatoid arthritis, multiple sclerosis and lupus first developed symptoms or had marked exacerbations of their condition during or immediately after a period of intense stress. While these reports are considered anecdotal, Benson says there is "no question" that stress contributes to autoimmune conditions, possibly by increasing inflammation in the body.
• Asthma. While stress itself doesn't cause asthma, high stress levels are felt to worsen symptoms and even increase the likelihood of a fatal attack. And the incidence of both asthma and fatal asthmatic attacks has been rising in recent years.
• Skin Problems. Perhaps the best demonstration of the role stress plays in skin disorders came from a study of people with moderate to severe psoriasis conducted by psychologist Jon Kabat-Zinn, Ph.D., director of the University of Massachusetts Stress Reduction Clinic. Psoriasis sufferers who listened to a guided meditation tape while they received the standard treatment of ultraviolet light therapy were almost four times more likely to have complete clearing of their skin. Some dermatologists also believe greater stress levels among women in their 30s and 40s may be contributing to a growing incidence of adult acne.
• Infertility. When it comes to infertility we tend to look for mechanical reasons such as blockages in the fallopian tubes. At Harvard's Mind/Body Medical Institute, however, half of couples--many of whom had already run the gamut of high-tech infertility solutions without success--have gotten pregnant within the first six months of beginning a program that combines group therapy with relaxation techniques. One reason for these dramatic results according to Benson is that stress can suppress ovulation.

One final way that stress contributes to poor health is by leading to bad habits. Benson cites the connection of stress to smoking as well as drug and alcohol abuse. A recent study from the Journal of Occupational Health Psychology found that workers who were worried about getting laid off were less motivated to take safety precautions--increasing their odds of getting injured on the job. When we're frazzled, we're probably also more likely to blow off a trip to the gym, veg out in front of the TV or give in to that beckoning pint of Ben and Jerry's. And, of course, any extra pounds that result probably won't do much for your stress levels either.

If you suspect stress may be getting the better of you, you may not want to wait for your doctor's suggestion before taking action. Part of the problem is that these days docs themselves are so stressed-out that many aren't taking the time to find out if stress in your life could be contributing to your problems or to learn about stress-reduction techniques might help you -- and them.. Luckily, you can start using many effective stress-reduction techniques on your own without a lot of training. You might end up even being able to give your doctor a little advice.

Next: Rx for Stress