You Can Learn to Deal With the Stress of Modern Life

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GUEST: Eli Bay, The Relaxation Response Institute

MATHESON: We all experience stress in our lives. Of course some people experience more than others. And we all react differently. We all cope differently. The bad news is too much of the wrong kind of stress can make you ill. The good news is there are ways to cope properly.

Eli Bay is the founder and president of The Relaxation Response Institute in Toronto. He is with us this morning.

Good morning.

BAY: Good morning. Hi.

MATHESON: So, can we talk about stress? What is stress? Because there's good stress, bad stress.

BAY: Yeah, I think most people misunderstand what stress is. The best way to understand it: imagine you're driving down the highway and a truck unexpectedly swerves in front of you, cuts you off. And you automatically react. You avoid an accident, you're driving, your heart is pounding --

MATHESON: You yell at the truck driver.

BAY: -- your neck and shoulders are tight and your breathing is shallow. And it's a fight-or-flight reaction. I don't know if you've ever seen a cat with its back arched ready to fight or to run. Well, that same reaction in your body is what stress is.

And what most people don't realize is that a) it's necessary, it's part of what it means to be human. Yeah, we wouldn't have survived if we had to consciously say when a truck swerved in front of us, "Oh, I have to raise my blood pressure, tense my muscles, speed up my heart rate."

MATHESON: And athletes physically stress themselves to make their bodies better-performing machines.

BAY: Absolutely. And we need stress. The issue is, as you said, managing it so that it stays healthy and it doesn't ravage and destroy. Unfortunately, most people haven't learned how to put that balance into their lives.

MATHESON: Now, we're being told every time we turn around that we all have more stress than we used to. Do you think this is true?

BAY: Oh, absolutely. I think the primary cause of stress is the one that very few people are even aware of. And Alvin Toffler identified it thirty years ago --

MATHESON: Mr. Future Shock?

BAY: Yeah, he called it future shock. Well, it's here and it's now. We went through more change during the last decade, I understand, than all the changes that have happened in the entire sweep of human history. And our bodies haven't changed as we were hunter-gatherers and suddenly we're having to deal with [overtalk] --

MATHESON: And change is unsettling for an awful lot of people.

BAY: Well, change equals stress. The human reaction automatically to change is a fight-or-fight reaction. It served our ancestors well when we were hunter-gatherers. Our bodies haven't changed since we were hunter-gatherers.

MATHESON: But now that we just sit there doing this it's not so good for us.

BAY: Exactly. And the automatic reaction to any change, good or bad, is a fight or flight. And people don't realize that. And it just comes with the territory today. I mean change is the only constant. And when people tell me that they don't have any stress all I can say is either they don't understand what stress is or they're dead.

MATHESON: Mm-hm. And we all suffer stress differently -- bad eating, bad sleeping.

BAY: Exactly.

MATHESON: It eats you up physically.

BAY: And again, a certain amount is absolutely necessary for a healthy, balanced life. If it exceeds that our body gives us feedback. Everything from headaches to gastrointestinal problems to low-back pain to anxiety attacks, grinding teeth, allergies --

MATHESON: So what do we do? What do we do?

BAY: Well, there's nowhere to --

MATHESON: A quick checklist?

BAY: There's nowhere to run. We have to --

MATHESON: You can't avoid stress.

BAY: Yeah, stress is now part of the human condition. And one of the few certainties is that it's going to increase. So what do you do? Well, you have to understand that stress is not the event out there. Stress is your reaction to the event out there. Some people may -- the idea of being on camera would just cause them to just go into a tremendous stress state.

MATHESON: Makes me very nervous.

BAY: And other people love it. Same situation, different reactions. And you have to understand that stress is your reaction. You may not control what's coming at you but you can always learn to regulate and control your reactions through simple techniques of breathing, of muscle relaxation or just awareness. People, with a bit of practice, can literally learn to shut down and break out of the stress cycle. Really to recharge their batteries.

MATHESON: A switch, though. I mean you have to learn these.

BAY: You have to learn it. There's a natural ability that's hard-wired into everybody. A cardiologist at Harvard Medical School called it the "relaxation response". Technically, it's the parasympathetic nervous system. Stress is the sympathetic nervous system. They're antagonistic. One's an arousal state. One's a quieting state.

People can be trained -- with a minimal amount of training, with simple techniques -- to trigger the deeper rest state. And that's what deep relaxation is. It's rest. The blood pressure drops, the heart rate drops, muscles relax, brain waves slow down and the body goes into a quiet zero state, if you will.

MATHESON: Thank you very much, sir.

BAY: Oh, thank you.

Stress, the living experiment

GUEST: DR. BRIAN GOLDMAN, Reporter; MICHAEL MEANEY, Neurologist, McGill University, Montreal; BRUCE McEWEN, Neuroscientist, Rockefeller University, New York City; FIRDAUS DHABBAR, Rockefeller University, New York City; DR. PHILLIP MARUCHA, Periodontist, Ohio State University; RONALD GLASER, Immunologist, Ohio State University; JANICE KIECOLT-GLASER, Psychologist, Ohio State University; BRIAN TOMASCA; DR. IRA SCHULMAN, Cardiologist, NYU Downtown Hospital, New York City

STEVEN HUNTER: Hello. I'm Steven Hunter. Cancer patients who work at managing their stress live longer than those who don't. Or, so says a study that was published just this past month. It's part of a huge wave of interest in how the mental burdens of our lives affect our physical health. Well tonight, we're going to revisit our own special full edition on stress and how this past winter has turned Quebec into a living experiment.

DR. BRIAN GOLDMAN (Reporter): The great ice storm of 1998 will be remembered for many things. Unending power outages, acts of heroism and long dark nights. Many Quebecers will remember it as the most stressful time in their lives. What they don't realize is they're becoming a living experiment on the after effects of severe stress.

MICHAEL MEANEY (Neuroscientist, McGill University, Montreal): Stress often works to be a factor that pushes people over the edge.

GOLDMAN: Stress specialist Michael Meaney of McGill University in Montreal is embarking on a long term mission to study the effects of the ice storm on people living in Quebec and their unborn children.

MEANEY: I think that when you start to look in the population it's not going to be perhaps all that hard to find individuals who are so severely affected by this that the long term consequences will be formidable.

GOLDMAN: He takes his inspiration from this man, the last Dr. Hans Selier, the world's first stress guru.

CLIP: Stress is an important word in Dr. Selier's theory.

GOLDMAN: Dr. Selier figured out how the body responds to stress. The key is a hormone called cortisol. What Dr. Selier discovered is that the body makes cortisol as a kind of antibiotic to battle stress. Say your ancestors were threatened by a cheetah. They'd either fight it or run away with the help of two chemicals - adrenaline to boost your heart, and cortisol to turn excess fat around your middle into energizing sugar in your blood stream. We no longer face cheetahs. Today it's emotional stress, yet our bodies respond to it as if we're still being chased by a cheetah.

MEANEY: It's 95 degrees outside and you're stuck in bumper to bumper traffic. You're half an hour late for an absolutely crucial meeting. Why in the world are you mobilizing all kinds of fat reserves to meet the demand of the situation when the only exertion you're going to experience is that of using the left or the right hand to honk the horn. And yet at the same time we are producing exactly the same set of metabolic responses that we would produce under situations where we might be chased down by a cheetah in the Savannah.

GOLDMAN: Are we more stressed than our parents were? It sure seems that way.

MEANEY: What we've done in more modern times is to basically disperse families and so you end up with a situation now where brother lives in Seattle, sister lives in Houston and during a time of crisis ma Bell is the only relied form of communication you have to rely on. You don't have that immediate proximity of these close relatives and friends that would have been there much reliably in the 50s and 60s.

BRUCE McEWEN (Neuroscientist, Rockefeller University, New York City): There are more families in which both husband and wife are having to work for a living.

GOLDMAN: Meet the stressmiester, Bruce McEwen of Rockefeller University in New York City, the true heir apparent to Hans Selier.

McEWEN: I think the pace of life is probably faster for most people and the demands in terms of daily life are harder.

GOLDMAN: It's one thing to feel stressed. But how do you know if your body is overreacting to it. Try checking out the stress hormones in your saliva. It's a lot less painful than a blood test. Get an unexpected bill and you'll probably spit up a wad of cortisol. Pay your bill and the cortisol should disappear.

McEWEN: And the problem comes with chronic stress and situations where the stress hormones are not turned off when they're no longer needed. If they continue to be secreted, or if the individual simply has a lot of episodes of stress then the body is overexposed to those same stress hormones that are so good in the short run.

UNIDENTIFIED MAN (1): Alright Joey, could I get you to disrobe.

GOLDMAN: So what happens to your body when cortisol flows through your veins all the time?

UNIDENTIFIED MAN (2): Face forward.

GOLDMAN: You thought that middle age spread was just due to overeating. It turns out that the real enemy is cortisol brought on by stress.

McEWEN: The abdominal fat seems to be particularly sensitive to stress hormones, especially to cortisol. And so it seems to accumulate more rapidly than fat in other parts of the body.

GOLDMAN: That spare tire is more than just annoying. It can actually lead to diabetes, high blood pressure, high cholesterol, heart attacks, even strokes. Cortisol also causes weak muscles and osteoporosis. It damages the immune system increasing the risk of cancer. It can even damage the brain. All of these damaging affects are known as allostatic load. Is allostatic load the greatest killer known to human beings?

McEWEN: Well in away it probably is. That is, that we have, I think, tended to focus on the disease itself and not realize what factors in a person's life may lead up to that disease.

GOLDMAN: The problem is allostatic load is a silent killer.

McEWEN: It's pretty well known that if you feel stress that doesn't necessarily mean that your stress hormone levels are up and by the same token they may be elevated and you won't know it.

MEANEY: Individual differences in the way we respond to stress are really at the heart of understanding why some people get sick under conditions of stress and other people do not.

GOLDMAN: Ever seen a stressed out rat? Michael Meaney studies them for a living. He's made a fascinating discovery. Like humans, some rats handle stress rather well. The reason why isn't in our genes. It's in the way we're cared for as children.

MEANEY: A great deal, then, of the way in which individuals do respond to stressors is determined by early life events. If you will, the early life is a way that nature has of telling the individual you can anticipate having this much threat in your environment.

GOLDMAN: Rat pups who get lots of nurturing have a lower response to stress and a lower allostatic load. But what about rats who aren't so fortunate?

MEANEY: They produce a greater emotional response, a greater stress hormone response. There's a certain permanence to these effects. We know that all things being equal, the animals that grow up under the more neglectful impoverished conditions are much more reactive to stressors and much more likely to develop stress induced illness.

GOLDMAN: How does early childhood nurturing lower stress? The answer is here, deep inside the brain.

MEANEY: One of the most interesting recent findings is that the responses to stress, including emotional response as well as the stress hormone and cardiovascular response to stress, is all coordinated by the release of one hormone in the brain. This hormone is known is corticotrophin releasing hormone. So that one hormone released is the brain is basically buying you the entire fight or flight package as it were.

GOLDMAN: Michael Meaney is looking at a mysterious part of the brain known as the hippocampus.

MEANEY: The hippocampus is involved in, one of the structures involved in regulating how much of this corticotrophin releasing hormone we produce.

GOLDMAN: What Meaney has found is that bad nurturing literally shrinks the hippocampus. Fewer brain cells, fewer connections. The smaller the hippocampus the more the rat overreacts to stress.

MEANEY: The interesting thing from our standpoint is that the hippocampus is one area of the brain that is greatly influenced by early environmental events.

GOLDMAN: And not just rats. The hippocampus is equally important in human infants. During the dictatorship of Romanian strongman Nicholai Chochesku, thousands of children were warehoused in orphanages. Researchers found that these children are hyper reactive to stress. What they also discovered is that the orphans' hippocampuses are much smaller than normal. Conditions are far different in North America. But researchers wonder whether hyper stressed children may be a problem here as well.

MEANEY: What it's doing is to create more child poverty, more violence and hence more individuals who are hyper sensitive to sensors and thus more stress related illness.

GOLDMAN: What will the burden of that stress related illness be in the next century?

MEANEY: Oh it'll be tremendous in terms of the list of chronic illnesses that are related to stress. We can talk about a greater incidence of heart disease, a greater incidence of diabetes, greater incidence of depression and effective disorders. And we've already seen evidence of that. Over the last 30 to 40 years there's been a tremendous incidence of each and everyone of these diseases.

GOLDMAN: But there may be a solution. In fact there's growing evidence that we can actually reverse the damaging effects of stress. The way to do that is through the mind. Later on we'll show you how. But first, here's stress on the front lines.

UNIDENTIFIED MAN (2): As an air traffic controller I think the things that are unique in my job are the pressure to perform to an exacting standard all the time. And the other part of it is underlying fear that, of losing the picture which is to forget an airplane, to make an error. That's an underlying fear that's always in the back of your mind.

(COMMERCIAL BREAK)

UNIDENTIFIED MAN (3): My job is operating an automatic (inaudible) sucker. To fill up (inaudible) the piston goes into the loader head and it goes down to the first station and there's a rough cut. And then it goes to the end loader, it comes out of the machine and then pack them into the box. Then I do it all over. It gets tiring.

GOLDMAN: Have you ever gotten the flu on your dream vacation? Believe it or not it's pretty common. Now is it just bad timing or are you actually able to stay well through the crisis before your vacation only to get sick while on holiday? Sounds like a simple question. But researchers have been struggling to try to answer it. They're talking about the holy grail of the emerging field of psychoneural immunology, the ability of the mind to control the immune system. Unfortunately no one in Hawaii is working on that. But researchers here at Rockefeller University in New York City have made some fascinating discoveries on how the mind can control the immune system. And the key is through stress. Researcher Firdaus Dhabbar has demonstrated in lab animals that short term stress, the crunch at work before you go on vacation, can actually boost the immune system. Say, for example, you're attacked by the proverbial lion.

FIRDAUS DHABBAR (Rockefeller University, New York City): The immune system is the body's internal army which will keep it intact or help with wound healing or bacterial fighting in case the lion gets to you and injures you. And that's why there's a very good reason why you would want to enhance your immune system under acute stress conditions.

GOLDMAN: But the effect is only temporary. Your immune system crashes once you're on vacation. And if the stress becomes chronic, watch out.

McEWEN: Chronic stress, repeated stress has the exact opposite effect only it takes a number of weeks in an experimental animal like a rat of repeated stress before you dampen down the positive effects of stress and result in a suppression of the immune response.

GOLDMAN: But while some researchers are studying why stress leads to colds, others are working on a much bigger payoff. Quebec may be the new living experiment for stress. But Ohio State University in Columbus where a lesser ice storm is loosening its grip, has made a critical connection between stress and more serious diseases. Immunologist and periodontist Dr. Phillip Marucha is studying the effect of stress on wound healing.

DR. PHILLIP MARUCHA (Pariodontist, Ohio State University): We found early on that wound healing is one of those basic processes that is dramatically impacted by stress.

GOLDHAWK: The study involved taking samples from the gums of dental students at different times. First.

MARUCHA: During their summer vacation when they were at very low stress levels, lower than the general population. And we found that wound healing proceeded very rapidly in the oral cavity. Later on, three days before a series of very hard exams, and healing was delayed 40 percent in those students.

GOLDMAN: For years, research has been piling up showing that chronic stress has even more dramatic effects on the immune system. Immunologist Ronald Glaser and his wife psychologist Janice Kiecolt-Glaser, co-directors of OSU's Behaviourial Research Institute. In more than 100 studies, they've shown that stress delays recovery from surgery, can even lead to cancer. So what's the best way to boost an immune system damaged by stress? The answer may be as simple as human companionship.

RONALD GLASER (Immunologist, Ohio State University): The literature now is getting very strong. And certainly in our own work, this issue of social support appears to be very, very important and it mike work in buffering the impact of stress.

JANICE KIECOLT-GLASER (Psychologist, Ohio State University): We certainly don't have public health campaigns that stress the importance of positive personal relationships. Those are the kinds of things that could really make a difference long term.

McEWEN: A woman with breast cancer who engages in, interacts with friends and family members and especially important, expresses emotions and fears and gets it out, does much better, that is survives longer than a woman who is more isolated and keeps her feelings more pent up.

MEANEY: Now utilizing a behaviourial intervention would be relatively cheap, non-toxic, you don't lose your hair. And even if it doesn't work the patient might feel better. So it's win, win in a sense.

UNIDENTIFIED WOMAN: It's pretty stressful. Turn the TV off. When the three of them start crying at the same time and tugging at my leg and saying mommy this, and mommy I want milk, mommy I want cookies, mommy I want chips. After a while I feel like pulling my hair, you know.

(COMMERCIAL BREAK)

GOLDMAN: The New York Stock Exchange. A churning caldron of stress. Last March, a 48 year old clerk named Patty Greeve collapsed.

BRIAN TOMASCA: It gets a little crowded at times. So we didn't think anything of it.

GOLDMAN: Brian Tomasca, Patty's protege kept working.

TOMASCA: And, you know, we have to go on with your work.

GOLDMAN: So he died of a heart attack didn't he?

TOMASCA: Ah, yes.

AD: Men are disturbed not by things, but by the view which they take of them. Epictetus.

GOLDMAN: Five clerks a year have heart attacks. That's ten times the national average. Exchange officials are so concerned they installed a defibulator right on the trading floor.

DR. IRA SCHULMAN (Cardiologist, NYU Downtown Hospital, New York City): It's, you know, a very psychologically troublesome thing to have one's friend drop dead on the floor of the exchange in the midst of a trading day.

GOLDMAN: Dr. Ira Schulman is director of cardiology at NYU Downtown Hospital in Manhattan, a stone's throw from Wall Street, or a five minute ambulance trip depending on traffic. The centre was funded by a financial community that's literally stressed to death.

SCHULMAN: I've been to the stock exchange. And the floor of the stock exchange, to me, is a much more stressful area than it is taking care of resuscitating patients in our own emergency room.

GOLDMAN: Everyone knows you can't turn back the clock. But researchers at the forefront are starting to wonder if it's possible to reverse that allostatic load and undo a lifetime of stress. Here at McGill University in Montreal, researchers have proved that rats with neglectful parents become over stressed. Now they've taken those hyper rats and given them a second childhood with nurturing parents.

MEANEY: Animals who grow up in their early conditions of impoverishment, having been exposed to these enriching conditions throughout adolescence then become animals whose responses to stress are much more modest and in whom the threat of stress induced illness is greatly reduced.

McEWEN: The body does have a lot of resilience.

GOLDMAN: Bruce McEwen has made an amazing discovery. Stress makes brain cells shrink. But if you stop the stress, reduce the allostatic load, then brain cells grow back to normal.

McEWEN: If you give it a chance and steer it down a different path it can correct itself before irreversible damage occurs.

GOLDMAN: The same thing can happen in humans. Remember the Romanian orphans? Those who were adopted here in Canada and elsewhere have become far less sensitive to stress.

MEANEY: The quality of childcare is what will ultimately determine the capacity of the individual to respond in a modest and efficient way to stress in their life and to ensure, if you will, minimal chance of developing chronic illness.

SEINFELD CLIP: I've got no leg room back here. Because of her I have to sit here like an animal. Serenity now, serenity now.

GOLDMAN: If you're George Costanza it's probably too late for quality child care. But if you're like his parents, it may be worthwhile to work on your marriage.

KIECOLT-GLASER: We've done some nice studies on marital discord and its effects on stress by bringing couples into the hospital for 24 hours, putting a catheter in each person's arm and asking them to talk about an area where they disagree.

SEINFELD CLIP: Serenity now.

KIECOLT-GLASER: The couples who, when they talk about this disagreement, are nastier or more hostile tend to show much sharper increases in stress hormones and greater downturns in immune function 24 hours later.

SEINFELD CLIP: Serenity now.

KIECOLT-GLASER: The most effective stress buster that people probably don't think about is talking about problems with someone who cares about them who'll listen.

GOLDMAN: In Quebec, the power is back on. Life has returned to normal. But the stress isn't gone. Michael Meaney will study its effects well into the next century. The broken trees are a reminder that some things will take much much longer to heal.

MEANEY: The fact that we see these reminders is certainly going to make it very difficult for some people because they are going to relive the emotional experience of the ice storm for a long period of time.

GOLDMAN: For The Health Show, I'm Dr. Brian Goldman.

HUNTER: Well, that's our show for tonight and for this entire season. I'm Steven Hunter. On behalf of all of us here at The Health Show, have a great summer and we'll see you back here in the fall.