Part 1 SuperStress and You
SuperStress in Your Body and on Your Mind
Stress is a word we toss around every day, but what does it really mean? There are probably as many definitions as there are people you ask for them. Stress is both a physiological and a psychological response to events that upset our balance. Stress is what happens when the demands and daily challenges of the outside world are greater than our ability to cope with them. But stress is related to internal factors as well-factors that include how healthy we are, our emotional well-being, what we eat, and how much sleep we get. It's also strongly dependent on how we interpret what comes our way-that is, how we perceive what's happening to us.
Each person interprets a prospectively dangerous situation differently. Let's say, for example, that six-foot-two-inch Anthony runs out of gas in the middle of a dark street in a not-so-safe neighborhood. While walking to the nearest filling station, he notices a group of four burly guys heading in his direction. He barely pays attention to them and continues on his way, never changing his pace. If his sister has the same experience with her car, when she sees the men coming her way she might a) cross the street, b) duck into the nearest open store, or c) pull out the pepper spray that she has in her handbag "just in case." For Anthony, this nonevent creates nothing more than a blip on the stress radar screen. But his sister, who perceives that she might be in danger, has a much more pronounced stress response. The stress response is about protecting ourselves and it's about having control over a situation. How much stress we feel as a result of our perception of things determines how much control we think we have.
Anything that triggers stress is known as a stressor. Anything that forces us to adjust to the degree that it strains our coping skills is a stressor. Stressors can range from small aggravations to fear of something or someone that might pose a threat to your well-being. Large stressors include major life events, such as a divorce, a child leaving home, an unexpected pregnancy, a move to a new town, a career change, graduating from college, or a diagnosis of cancer. But while major life changes are stressful, it's the stressors that come at us-and consequently at our nervous systems-all day long that affect us the most. These include:
• Environmental stressors, such as noise pollution (from blaring radios, barking dogs, or police sirens) or living in a crime-ridden neighborhood where you never feel safe.
• Work stressors, such as job dissatisfaction, overwork, disagreements with your boss, low pay, or nasty office politics.
• Relationship stressors-defined as a fight with a friend; problems with partners, children, or other family members; or loss of a spouse.
• Social stressors that occur when you're trying to keep up with the Joneses or trying to be the Joneses.
• Spiritual angst, which can come from loss of a purpose in your life. Loss of community. Loss of control. Loss of meaning. Fear as a Stressor
Fear is one of the great stressors of all time. Fear heralds many dangers and yet it can save us by keeping us in fight-or-flight mode. Our ancestors-long ago-had no choice but to be faster, stronger, and more cunning than the predators that waited for them to make a mistake. The fact is, a guy going out alone on the savanna in search of food knew well that when he came face-to-face with a beast, he was either going to get lunch or be lunch. In those days, if you didn't have enough you were going to die of starvation or hypothermia. If you were successful, you might be alone. The last one standing. And then what?
Today, our fears are more socially related and can almost always be broken into different categories: fear of failure, fear of not having enough, fear of not being enough, fear of losing what you've got, fear of success. Do I have enough to keep up with the neighbors? Am I pretty enough for the guy I have a crush on? It seems almost banal to label some of these trivial things "fears," but the threats are very real to the person who experiences them. The problem is that the brain doesn't understand enough to think: Are you kidding me? You call this a threat or a danger? The brain interprets fear as Oh, my God, we're under siege! It immediately signals a meant-to-be-protective cascade of hormones: epinephrine, or epinephrine and cortisol. So whether you fall off a cliff or dream you're falling off a cliff, your neurological response will be precisely the same.
Stressors are cumulative, so the more life changes or daily hassles you're dealing with at any one time, the more intense the symptoms of stress. With our twenty-first-century lifestyle, the hassle factor of everyday life has grown exponentially. Bear in mind that a series of small hassles can eventually combine to become several dangerous ones. Chronic Stress and the Load You Carry
Our bodies are hardwired to respond to stress the same way our ancestors did, and under acute conditions that response did (and still does) protect us. It helped our ancestors out of dangerous situations when the best course of action was to literally get out of harm's way. Acute stress can have positive benefits. It has been shown to improve certain body systems, such as the immune system. The skin is more able to fight infection and our five senses and short-term memory are often enhanced during acute stress situations. However, in today's world, most of the stress we feel is in response to chronic rather than acute threats. Unfortunately, the brain, for all its majesty, can't distinguish acute from chronic. In that respect, it's a lot like Chicken Little, assuming the worst-case scenario every time it senses a threat. And when the stress doesn't go away-when your project deadline is two weeks away and that seems like less than half the time you need to complete it-then the hormones dispatched by the brain in an effort to mount a defense just keep coming. Dr. Bruce McEwen of Rockefeller University, an expert on the physiological effects of chronic stress, describes this crossover from acute to chronic stress as a journey from allostasis to allostatic load.
Allostasis is the body's way of keeping all systems in balance, particularly as we move from one situation to another. For example, climbing stairs sets our heart working harder for the extra effort our legs need, but at the top of the stairs, the pumping slows down again. The same adjustments work when you leave your walk in the snow and head inside for a chat by the fire; your body temperature automatically adjusts itself. Last example: Imagine you are crossing the street. You see an out-of-control car coming at you; your brain senses the danger and thinks, Get out of the way! In a split second, your body produces stress hormones that fuel your sprint to the other side of the street and safety. Ten minutes later, the incident is all but forgotten and you're happily trying on shoes in Target. Your stress hormones, no longer needed, have stopped surging and all systems are back to normal. This is allostasis in its finest hour.
It's one thing to dash across a street to avoid an oncoming car, but when there are too many such threats in a relatively short period of time or when any one stressor goes on too long-as when a person stays in a bad marriage-then we begin carrying what is known as an allostatic load. If allostasis is the body's ability to maintain balance under stress, allostatic load refers to the factors that threaten to destabilize it.
McEwen cites several different types of allostatic load:1
1) When multiple stressors lead to elevated stress hormones that continue over a long period of time. Perhaps you lost your job, and as a result had to sell your car, can't afford your mortgage payments, and to top it all off you have to explain to the kids why they can't go to camp this year. 2) When you can't seem to adapt to a stressor even though it repeats itself again and again. Let's say you're one of the many people terrified by the thought of public speaking. You've been invited to present at a prestigious conference and so you suck it up, feel the stress-and give a great talk. It goes so well that you're asked to make the same presentation at ten other events. If you fail to adapt to the stress-if you're just as scared the tenth time as the first-that situation is going to register as allostatic load.
3) When your body turns on the stress hormones and doesn't turn them off after the stressor has gone. In other words, you experience too much stress to cope with in a given time. For example: You have a conflict at work that has been resolved, and yet when you come home that night you're still agitated, replaying the conversation over and over again in your head.
These examples all showcase forms of chronic stress, and over the years, we've all had our share. But today's society has increased chronic stressors to assault proportions, and we're left dealing with the fallout. We're surrounded by technology, all-news-all-the-time, noise pollution, job stress, unnatural food, in-office competition, relationship and parenting challenges-all coming at us from all sides, 24/7/365. It's a relentless attack that permeates to the bones. It's allostatic load-only more so. While stress in the old days was an annoyance that you eventually could manage-kind of like a gnat flying around your head-today's stress is like a bullhorn that's two inches away from your ear. Today's stress is the kind of stress that defaults your nervous system to agitation rather than rest, with serious consequences for both mind and body. Accumulated Chronic Stress-SuperStress
Today's stress is of such magnitude that it can only be called SuperStress. The levels of complexity in SuperStress are much more insidious than we've ever seen in chronic stress. SuperStress is layers and layers of stress piled atop one another so subtly that sometimes we don't even notice what's happening.
SuperStress is damaging to the body in many ways. For one, continuous or repeated surges of stress hormones are detrimental to the cardiovascular and immune systems, potentially increasing your risk of coronary heart disease, stroke, cancer, recurrent infection, and other chronic diseases. For another, you are more likely to turn to destructive behaviors to deal with it-such as excessive smoking, drinking, or overeating. Finally, the more often the stress response is activated, the harder it becomes to shut off, so that eventually you find yourself responding to a relatively mild stressor as if it were a life-threatening one. Less is more, but not in a good way.
This latter point was brought home recently when I had dinner with an old college friend I hadn't seen in years. We were on our second course when she started to tell me about her niece, Laura, a young woman of twenty-nine who had just returned from business school and was now getting ready for a new job far from home. "We didn't ever think we'd see the day when she'd leave home," my friend said, adding, "My sister was concerned for years about her-she seemed so high strung and skittish most of the time. Frankly, I was surprised she went away to college."
Laura's Story Laura's story started out innocently enough. When she was fourteen, she took her beloved English spaniel, Gus, for a walk. She tied Gus's leash to a parking meter while she went into a store to get a package of mints. When she came out, Laura saw that the dog had slipped its collar and was nowhere to be found. She scoured the neighborhood, checking every store, and after two traumatic days of posting fliers and soliciting help from friends, was relieved when a stranger found the dog and returned him. Stress resolved; crisis averted.
Three years later, however, when Laura was seventeen, her best friend was killed in a skiing accident. She was as devastated-emotionally and physiologically-as she'd been when she thought her dog was lost to her forever. Even more so. And this time, because her friend was not miraculously brought back (as her dog had been), her anxiety persisted as her body continued to churn out stress hormones. Eventually, she had difficulty sleeping, lost her appetite, and had problems concentrating at school. Four months later she had lost ten pounds, still wasn't sleeping well, and found it harder and harder to get out of bed in the morning.
When she left for college the following year the separation triggered a similar biological stress response. Though leaving home was far from a tragedy, it felt like a crisis to Laura, and her eating and sleeping problems started up all over again. Every time she got her period she would go into a funk, miss class, and feel despondent. With stress layering upon stress, Laura soon found herself reliving the dramatic impact of each incident until she finally crossed the line from chronic stress to SuperStress. Her brain had learned to default to crisis mode even when there was no crisis.
The fact that Laura eventually came around successfully demonstrates that even though you may currently be suffering from SuperStress, there's no reason that it must persist. A brain that has learned to default to an agitated state can unlearn it just as easily. Four Hallmarks of SuperStress
Here are four hallmarks that illustrate how SuperStress differs from chronic stress. Although Laura's experience touches on all of them, you don't have to have more than one to be SuperStressed.
Stress is compounded. With chronic stress you may experience a stress-provoking situation over a period of time, maybe even two such experiences at a time, but it's not until you have a cluster of symptoms that you reach the proverbial tipping point and slide over to SuperStress.
You can't get a handle on it anymore. With chronic stress, you can have one symptom or more-including memory loss, persistent insomnia, fatigue, anxiety, or depression. But because they're compartmentalized, you can deal with each and with some work get those issues under control. It's SuperStress when you no longer feel that you can separate those symptoms. When the strain of dealing with them colors every moment of your day, when the life you're living is out of control, it's SuperStress.
Life has lost its luster. You've lost your sense of humor and your motivation. With chronic stress, you may feel this way some of the time, but with SuperStress, you feel like this more often than not. Sure, you can numb yourself by eating a hot fudge sundae, watching TV, taking a pill to go to sleep, or extending happy hour well into the night. But when you finish self-medicating your stress is right there waiting for you.
Anxious is the new normal. On a physical level, SuperStress is waking up and feeling exhausted, as if your body is desperately fighting off an attack from an enemy that never lets up. Your default mental state is a state of depression, anxiety, or apathy. You simply don’t feel safe
. In that way, SuperStress is very much like posttraumatic stress; the condition that plagues soldiers who manage to survive life and death encounters on the front and come home to later pay the price.From the Hardcover edition.
Excerpted from The SuperStress Solution by Roberta Lee, M.D.. Copyright © 2010 by Roberta Lee, M.D.. Excerpted by permission of Random House, a division of Random House LLC. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.