Stopping Stress at Its Origins

Abstract

W e know that the vasomotor system, which regulates the capillary circulation, is much influenced by the mind. -Charles Darwin, Expression of the Emotions in Man and AnimalsThe practice of medicine today is in need of transformation. The majority of diseases plaguing modern society are initiated by unhealthy lifestyle choices or events, often taking many years to develop and mature to a stage where symptoms and signs become manifest. It is only at this typically advanced stage that the healthcare system initially becomes engaged. Although many diagnoses share a common lifestyle-related etiology, we treat the silos of diagnoses with a growing list of pharmacotherapies, each targeting a single disease process, or invasively with repeated and often palliative procedures such as stents or bypass surgeries. Verbal recommendations are generally provided to our patients to curb poor lifestyle habits, but minimal investment is put forward by the healthcare industry to create an environment where successful lifestyle change can be effected. Of the many lifestyle events that impact our patients, none is more ubiquitous than stress and stress-related conditions.The global impact of stress-related conditions is expected to rise over this decade such that by 2020, depression and anxiety disorders, including stress-related health conditions, will be second only to ischemic heart disease in prevalence. 1 Although stress can occur at home or after trauma, the most ubiquitous and studied form of stress is work related. In this context, stress has been defined as an emotional experience associated with nervousness, tension, and strain. 2,3 In the workplace, stress and performance describe a U-shaped relationship such that low-to-moderate levels of stress generate a positive performance, whereas a negative performance is created at moderate-to-high levels of stress. 2,4 As a result, several studies, including many funded by the National Institute of Occupational Safety and Health, have documented the negative health and financial consequences of job stress. In addition to its impact on health, job-related stress has been shown to increase the cost of doing business by as much as $150 billion per year because of higher levels of absenteeism, worker's compensation claims, accidents, customer service problems, resistance to change, litigation, and loss of intellectual capital. 2 The health consequences of job stress impact most organ systems, including musculoskeletal disorders, psychological disease (ie, depression, burnout, and suicide), workplace injury, gastrointestinal disorders including ulcers, headaches, obesity, and sleep disturbances. By far and away, however, the most common and studied linkage related to stress and health is that from cardiovascular disease, which alone accounts for an estimated $117 billion per year in lost productivity and treatment because of job-related stress. 2 The INTERHEART Study evaluated cardiovascular risk factors in 29 972 people from 52 countries to investigate risk of first myocardial infarc...

Complementary medicine for the management of chronic stress: superiority of active versus passive techniques

“…Thus, studies on the effects of stress and of its treatment must explicitly consider simultaneously these two different aspects [16,17,25,27].…”

“…Accordingly, we employed an indirect assessment of autonomic cardiovascular regulation [39], considering both an hemodynamic component, as indicated by arterial pressure changes (under the simplified assumption that lower pressure suggests less vascular sympathetic drive [40]), and sympathovagal cardiac regulation, as inferred from spectral analysis of RR variability [33,34]. This proved valuable in previous studies and capable of unmasking beneficial effects of integrated stress management approaches in workers subjected to long-term stress [13,16]. Notably, in our previous studies on stress management, we addressed simultaneously the psychological and the functional components by a personalized combination of cognitive restructuring, moderate exercise and breathing techniques that induced a small reduction in arterial pressure and an improved autonomic cardiac profile, suggestive of reduced sympathetic and increased vagal drive.…”

“…Thus, it might seem reasonable to include stress reduction [2,16,17] in integrated preventive strategies.…”

“…Stress assessment is based on self-reports, to evaluate patients' view point, and on heart rate variability, to simultaneously assess autonomic cardiovascular regulation [8,9]. Stress management is based on a multidimensional approach [13]: body-mind interventions such as mental restructuring (focusing on patients view point) and relaxation techniques [19] (focusing on autonomic arousal) are combined with eating re-education and exercise training and integrated with more orthodox drug regimens [13,16,[24][25][26][27][28] whenever so indicated. This method was applied in a working population [13] and was capable of improving stress symptom perception, slightly reducing arterial pressure and improving autonomic cardiac regulation.…”

Hurricane Katrina: The Infarcts Beyond the Storm

“…Common triggers of acute MI included emotional upset, moderate or heavy physical exertion, lack of sleep, or overeating 9, 10. The public appears to accept the concept that PSS, especially anger, anxiety, and work-related job stress, can trigger acute CV events 9–12. This situation could be used by public health experts as motivational “leverage” when educating disaster survivors about lifestyles changes that will affect their health positively after a natural disaster.…”