Stress and Relaxation

• The 21^st Century

• The Definition of Stress

• The Cortisol Effect

• Time Off, What's That?

Stress and relaxation are often mentioned in the same breath.

"I'm stressed!" Your friend, spouse, partner, or doctor answers, "Then you need to relax more."

But how do you do that? It sounds so easy, doesn't it? The truth is, however, that we need to learn to relax because it is not something that we do naturally.

Learning to relax after having been raised in a Western culture such as the United States is a very, very difficult task. Most people do not have a consistent form of relaxation that works. Most of us don't even know what it feels like to be relaxed and completely at peace.

Even worse, even when we think we're relaxed, our physiologic markers like heart rate, breath rate, and blood pressure indicate that we're poised for action. When we are in a constant state of readiness, our bodies fatigue and fail us, leading to greater incidence of stress-related illnesses.

The 21^st Century

The World Health Organization (WHO) recently called stress the "health epidemic of the 21^st century." More than 70 percent of all illnesses can be attributed to stress as a causative factor. This results in billions of dollars spend on medical care to treat illnesses caused by stress, to say nothing of the billions of man-hours lost for people unable to report to work for headaches, backaches, upper respiratory illnesses, and GI upset like irritable bowel and heartburn. Add to that the ever increasing profile of diabetes, heart disease, and cancer that can also be linked to stress and we have a boiling cauldron of disease caused by one single word: stress.

It is almost impossible to believe that a single factor can contribute to so many illnesses. If that is the case, what would/could happen if we could somehow manage the stressors in our lives? Obviously, "Learn to relax," is the answer. However, we must first understand what stress is, how it affects us, how it helps us, and when it begins to hurt us.

The purpose of going in to all these relaxation techniques is to raise your awareness to the things that hurt, you so that you can then begin to help and heal yourself.

We will begin by defining stress and how it appears in our lives in the 21^st century.

The Definition of Stress

Stress can be defined as a number of things. One of the most common that is used in medical school is to have you imagine what life would be like if you were a caveman. Imagine what life might be like when you are having a breakfast of berries and leaves with your family. Suddenly a saber-toothed tiger appears and your physiology changes dramatically. Your breathing changes, your heart rate increases, your hormones begin to surge, specifically epinephrine; it is the typical fight-or-flight response. Not so bad, right? True, not all stress is bad. An acute stress response can actually save your life, moving out of the way of an oncoming car, the acute stress response gives your body the necessary ability to move quickly.

There is nothing wrong with the fight-or-flight response. Without it, the human race might not be around today. The problem with the fight-or-flight response, is that in the 21^st century, there are no saber-toothed tigers. And yet, our bodies respond in a similar fashion any time we feel that we are confronted with a stressful situation.

What makes it so difficult is that for some people, even the doorbell ringing or the sound of a telephone triggers the fight-or-flight response. And if something that minor triggers it, how long is it before the response dissipates? You're beginning to see, aren't you? The very response that was designed to protect us is the very same response that is now killing us slowly, because chronic stress causes chronic illness.

Ever since the 1950s, Dr. Hans Selye, a stress expert, defined stress as something that happens to us, and that stressors are a stimulus or event that produce our stress response. In doing so, he popularized the term "stress" as something that happens to us. He defined stress as, "the nonspecific response of the organism to any pressure or demand."

Let's say, for example, that you were a zebra. You're grazing on the plains, and when the tiger comes after your group, your heart rate increases, you breathing changes, you're charged with adrenaline, and you run like crazy to get away from the tiger. Once the tiger's gone, what happens? If you're a zebra, you'll settle down, your heart rate slows, your breathing returns to normal, the adrenaline is absorbed, and you resume grazing. This is considered to be an acute stress response. Once the danger is over, stress levels and all physiologic markers return to normal.

As a human being, we are aware of danger and we can often predict it. This means that we're often on a higher level of alert than a zebra would be. Spring forward to the 21^st century and the number of stressors we experience have increased exponentially. This means that we're facing a chronic condition of an increased stress response and as a result, our bodies are paying a price for that.

During the time that Mozart lived, life was so quiet at night that a night watchman could announce to most of the town that all was well. We live in a much noisier world today, especially if we live in a larger city. That elevated noise level is considered a stressor.

Those cell phones we carry cause stress. When we are awake, we are always at attention; we are stressed more often than not because we respond to all manner of alerts. We wake to an alarm. The coffee pot and microwave signal our attention. The car tells us if a door is ajar or if we've forgotten to put on our seatbelt. A 15-minute drive to work can have as many as a thousand stressors from our driveway until we turn off the ignition at work. Perhaps you take public transportation to and from school or work. You must arrive on time, fight for your seat or position, and pay attention to when you need to get off, otherwise you'll be additionally stressed trying to make up for lost time.

Here is your Assignment for this article:

Starting with the instant you become aware in the morning, keep track of all things that signal your attention. That includes all bells, whistles, rings, beeps of phones, kitchen appliances, motor vehicles, traffic signals, cash registers, the beep at the self-checkout line at the grocery store, etc.

Here is a sample chart for you to use to keep track. Make it easy on yourself and just make columns in a common spiral bound notebook to help you keep track of the stressors you face in your daily life. You will likely be surprised at the number of things you feel compelled to attend to.

Time is exactly what that means, if your alarm goes off at 5:30 in the morning, mark 5:30 am. Incident is Morning Alarm. Level of Alertness is on a scale 1 to 10, 1 being something that is relatively easy to ignore, and 10 is something that you respond to immediately. Length of time is how many seconds or minutes are required to respond to the incident.

Say, for example, your alarm goes off at 5:30 am and you hit snooze. Your level of alertness would be about a 2 or 3. Length of time would be 2 to 3 seconds. Each time your alarm goes off and you hit the snooze button, however, counts as another incident. If you hit snooze four times, you have four incidents even before you've gotten out of bed.

If you have an argument with your boss at work and it lasts for 15 minutes, then make sure you mark that on your chart. We'll talk more about noticing how long it actually takes you to calm down later. For now, you are just to become aware of incidents, how often they occur, and how long they last for one 24-hour period.

This is simply an example, but as you can see, in the first hour alone there are seven alerts that require a response of some kind.

TIME	INCIDENT	LEVEL OF ALERTNESS	LENGTH OF TIME
5:30 am	alarm (snoozed)	2	2 seconds
5:35 am	alarm (snoozed)	3	2 seconds
5:40 am	alarm	3	5 seconds
6:05 am	coffee pot	2	2 seconds
6:20 am	argument with son	5-6	7 minutes
6:30 am	rush hour	5	15 minutes

How many alerts do you experience on an ordinary day? You may be surprised to discover that you respond to hundreds of alerts in a single day and you usually feel that you must respond.

Keep this list handy to record your normal experiences and habits. As we continue, you will learn about yourself, and how certain habits might not be serving you very well.

The Cortisol Effect

In his 1984 study on stress and its effect on adrenal glands, Dr. Hans Selye determined that chronic and protracted stress can result in adrenal gland exhaustion. Adrenal gland exhaustion comes on in stages.

The first stage is when we are beginning to face stressful situations on a regular basis. Our adrenal glands begin to function too much, pushing too many stress hormones into our system. These include adrenaline, noradrenaline and the steroid hormone known as cortisol.

When excess cortisol is constantly circulating in our system, we are at risk for a number of chronic diseases. The most well-known consequence of increased cortisol levels is increased appetite and food cravings that lead to increased body fat, particularly in the stomach area. This type of body fat is considered deadly because it is a precursor to conditions such as diabetes and heart disease, a condition now coined as diabesity.

Diabesity is obesity with anticipated onset of Type II diabetes, and if this condition is not managed, will lead to increased fat deposits in the arteries, elevated blood pressure, kidney disease, ocular pressure problems, and ultimately to stroke and heart attack.

Cortisol is not toxic at normal levels.

With increased chronic stress, however, cortisol levels are not normal. Those with elevated levels of cortisol are facing a lifetime of health complications that reduce quality of life. Elevated levels of cortisol have been connected not only to weight gain, Type II diabetes, and heart disease, but also to the following conditions:

• Decreased muscle mass

• Decreased bone density

• Increased anxiety

• Increased depression symptoms, including mood swings, anger, and irritability

• Reduced libido resulting from lowered testosterone and estrogen levels

• Compromised immune response

• Memory difficulties

• Worsening PMS symptoms

• Magnification of menopausal symptoms such as hot flashes and night sweats

• Increased blood cholesterol and triglyceride levels

• Elevated blood pressure leading to heart disease

• Increased appetite and enhanced abdominal fat storage leading to obesity

Time Off, What's That?

While it may seem that you might not have too much stress in your life, it will be a good idea to pay attention to the kind of stress you experience, the frequency of it, the duration of it, and how much it affects you.

Taking time off from work is important. Unfortunately, more and more Americans are not using their vacation time, they are working longer hours, and expressing less and less satisfaction in their jobs.

Americans have become a nation of workaholics. According to a recent study, the following statistics give evidence that stress is becoming a way of life:

• One in three American adults does not take vacation days

• 50 percent of workaholics are divorced

• 27 percent of workers have not taken a personal or sick day in the past year

• 10 million Americans put in more than 60 hours a week at their job

• Workaholics are 67 percent more likely to suffer from heart disease than people who average 7 to 8 hours per work day.

• Both men and women are at risk of becoming workaholics; more than 50 percent of males and females work more than 40 hours a week.