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The Physical Side of Stress

The effects of stress on your emotional and physical health may be worse than you thought.

By Clare Kittredge

Medically reviewed by Lindsey Marcellin, MD, MPH

      

Although female sex hormones and brain chemistry offer some protection from stress, women are more deeply affected by the physical and emotional effects of stress than men.

Women’s reactions to stress are rooted in their body chemistry. Men have higher androgen levels, while women have higher estrogen levels, says Paul J. Rosch, MD, FACP, president of the American Institute of Stress (AIS). “Their brains are also wired differently,” says Dr. Rosch, who is also a clinical professor of medicine and psychiatry at New York Medical College, and honorary vice president of the International Stress Management Association. “Women tend to react to stress differently than men. They don’t respond with the fight or flight response — they’re more apt to negotiate.”

Stress: How Women Are Affected 
The effects of the anti-stress hormone oxytocin, produced during childbirth, breastfeeding, and in both sexes during orgasm, are enhanced by estrogen and reduced by testosterone, which helps women more than men, Rosch says. And nurturing activities boost oxytocin levels in women. The catch-22 is that women need more oxytocin than men to maintain their emotional health. For example, Rosch explains, women are more negatively affected when they’re not touched, and also feel more stress than men in relationships.

According to the American Academy of Family Physicians (AAFP), stress is an expression of the body’s natural instinct to protect itself. While this may warn a woman of immediate danger, like a fast-approaching car, prolonged stress effects can negatively affect your physical and emotional health.

“Our stress response was exquisitely honed over millions of years as a protective mechanism,” said Rosch. “That was OK for our ancestors who ran into saber-toothed tigers. The tragedy is that today, it’s not that, but hundreds of things like getting stuck in traffic jams. Our bodies respond in the same unfortunate fashion, with hypertension, strokes, and ulcers.”

Stress Effects: The Physical Side 
“Your stress may vary, but if you have stress with your work, your kids, your neighbors, and marriage all at once, that’s a big deal,” said Lori Heim, MD, president-elect of the AAFP and a hospitalist (a family physician who works only in a hospital) at Scotland Memorial Hospital in Laurinburg, N.C. “In women, I see this in changes in menstrual patterns — nothing else is going on except a huge increase in stress, and all of a sudden, they may be losing their hair or having menstrual irregularities, and everything points to stress as a factor.”

The AIS reports that some surveys show 75 to 90 percent of visits to primary care physicians are for stress-related complaints. According to the National Women’s Health Information Center, the effects of stress on women’s physical and emotional health can range from headaches to irritable bowel syndrome. Specific stress effects include:

• Eating disorders. Anorexia and bulimia are 10 times more common in women than in men, says Rosch, and this may have something to do with stress levels. Like depression, this illness has been linked to low levels of serotonin and is often treated with serotonin-boosting antidepressant drugs.
• Stomach ailments. Stress can make you reach for junk or comfort foods, or upset your stomach to the point that you feel like you can’t eat. Common stress-related stomach troubles include cramps, bloating, heartburn, and even irritable bowel syndrome (IBS). Depending on how you respond, these can lead to weight loss or weight gain.
• Skin reactions. Stress can lead to breakouts and even itchy rashes and hives in some people.
• Emotional conditions. From being in a blue or irritable mood to more serious mental issues like depression, your emotional health suffers when there’s stress in your life. Women are better than men at hiding some emotions like anger and aggressiveness because the parts of their brains responsible for these emotions are larger than men's, but depression strikes women twice as often as men, says Rosch, adding, “The emotional effects of stress on women can range from postpartum depression after pregnancy to depression after menopause.”
• Sleep problems. Trouble falling or staying asleep is common in women affected by stress, and this is particularly counterproductive since a good night’s sleep can help ease stress.
• Concentration difficulty. Stress makes it hard to focus and be effective in your responsibilities at home or work, and that can compound your problems if your stress comes from your job to begin with.
• Heart disease. The stress of competing in today’s job market has increased women’s heart disease risk, Rosch says. Stress can negatively affect the entire cardiovascular system, and lead to high blood pressure, stroke, and heart attack.
• Lowered immune response. One of the more complicated physical reactions to stress is your body’s lessened ability to fight off disease, whether it’s a cold or a flare-up of a chronic condition.
• Cancer. Some studies have suggested a link between stress and the development of breast and ovarian cancer. In one study, researchers found that the risk of breast cancer was increased by 62 percent in women who had experienced more than one highly stressful life event, like divorce or the death of a spouse.

Stress Effects: Stress-Lowering Techniques 
Rosch points out that working women who are also raising families are smoking and drinking more than ever before — these aren’t healthy ways to deal with stress. He suggests the following three tips to help reduce the effects of stress:

• Improve your diet. By eating well-balanced meals and skipping junk food, you can improve your physical well-being and, in turn, your emotional health.
• Make time for exercise. “We do know that exercise is a phenomenal way of dealing with stress and depression,” said Dr. Heim. Research shows that getting active can lift your spirits and increase the release of endorphins, a natural chemical associated with mood.
• Find fun ways to relax. Connect with family and friends and people you enjoy being around. Rediscover favorite hobbies; recent studies link a resurgence in knitting and needlepoint to their stress-reducing effects. Other popular stress-busters include yoga, meditation, and tai chi.

Finally, if you feel overwhelmed by stress and its effects, talk to your doctor about ways to deal with it. You may learn new techniques for managing stress on your own, or you may find that therapy with a mental health professional will better help you to get it all under control.

For information on Amyen Evert's Bay Area Stress Reduction Therapy Practice please visit: http://Therapists.PsychologyToday.com/rms/70217 or www.amyen.com

Health Benefits of Pet Ownership

If you're considering adopting a puppy, kitten, or other pet – or if you already own one – then you know about the companionship and fun pets add to your life. But in addition, owning a pet can boost your health.

Pets: The Physical Benefits

According to the Centers for Disease Control and Prevention,pets are good for cardiovascular health: Owning a pet can decrease your blood pressure and lower your cholesterol and triglyceride levels. Studies have also found that pet owners are more likely than people without pets to survive after hospitalization for a heart attack, and that owning a pet lowers anxiety and decreases feelings of loneliness and depression.

Pets also help keep their owners fit, since they increase opportunities for exercise and outdoor activities. In a study conducted by the University of Missouri in Columbia, researchers encouraged dog owners to walk their dog for 10 minutes three times a week, and gradually increase to 20 minutes five times a week over the course of a year. The dog walkers lost an average of 14 pounds.

The Pet-Human Bond

Pets can increase the opportunity for socialization — they're a natural topic of conversation and offer a chance to connect with other pet lovers. "Having a pet increases your mental acuity," says Kelly Connolly, M.S., a companion-animals specialist with the Humane Society of the United States. "Remembering to walk and feed your pet exercises your brain, and it increases your sense of responsibility, which is important to people."

The emotional bond between an owner and a dog, cat, or other pet can be as intense as those between humans, and it may offer many of the same psychological benefits. Caring for an animal offers a sense of purpose and fulfillment. Many pet owners believe their pets express a range of emotions. Dr. Stephanie LaFarge, senior director of the American Society for the Prevention of Cruelty to Animals Counseling Services, says it is "normal and natural to project human emotions onto animals, even if you know better."

Choosing The Best Pet For You

"Before you get a pet, decide honestly what you want in one," says LaFarge. Some people want to have a more active lifestyle, some desire companionship, and others are looking for protection. In any case, you as the owner should work to foster a genuine relationship with your pet. Take into account what you will be able to handle, in terms of time, attention, and activity. "Regardless of your age and abilities, you will reap the benefits of a pet if you pick the right one for your lifestyle," says Connolly.

By Erica Patino

How to Boost Your Self-Esteem

You can relearn how to feel good about yourself by following your depression treatment plan and taking better care of your needs.

Almost everyone experiences a bout of low self-esteem at some point in life. But for some, especially those suffering withdepression, chronic low self-esteem can be a debilitating symptom that spirals out of control, keeping you from enjoying life and accomplishing the things you want to do.

Low Self-Esteem: How Does It Happen?

A person can create his own low self-esteem cycle, or events that occur can bring it on. The former happens when you judge yourself harshly, telling yourself that you are worthless. As for the latter, dealing with a stressful situation such as a disability or a loss of a job can make it hard to feel good about yourself. How others treat you, as well as how you get along with others, can also affect your self-esteem.

It may not always be possible to control your inner thoughts. And you often have no control over the events that unfold in your life. But if you suffer from low self-esteem, there are things you can do to boost your self-image.

Low Self-Esteem: How to Fight It

Often, traditional treatments for depression, such as medication and psychotherapy, can help. Getting into a therapy or support group is the first thing people who are depressed should do to boost their self-esteem, says Julie Walther Scheibel, a counselor at Concordia Seminary Counseling and Resource Center in St. Louis.

Besides following your doctor’s recommendations, here are other steps to consider that may improve low self-esteem:

• Get some exercise. Walther Scheibel recommends exercise for people who are dealing with low self-esteem as a symptom of depression. Making exercise a part of your regular routine can help you feel better emotionally and physically.
• Eat a healthful diet. Avoiding foods high in sugar, fat, or salt, and eating fruits, vegetables, whole grains, lean proteins, and low-fat dairy products is an important part of taking good care of yourself — the healthier you feel, the better you will feel about yourself.
• Make the time to participate in activities you enjoy. Carve out time each day to do something you really like, such as listening to music, playing a musical instrument, or working on a craft project. Enjoyable activities can make you feel better, thereby improving your low self-esteem.
• Be productive. Completing everyday tasks like cleaning your kitchen, organizing your junk drawer, getting your laundry done, or paying your bills on time will give you a sense of accomplishment.
• Stay connected socially. Even though it can sometimes be difficult just to get out of bed when you are depressed, it can help to spend time with people who are good to you and who can make you feel good about yourself.
• Practice good self-care. Shower regularly, brush your teeth, dress in nice clothes, keep your hair trimmed, and do other things that make you more confident about your physical appearance. Feeling better about how you look on the outside will leave you feeling better inside.

Depression can make it hard to find the energy and motivation to take care of yourself. But taking time to focus on you can improve your self-esteem and make you feel better all around.

By Krisha McCoy, MS

Medically reviewed by Pat F. Bass III, MD, MPH

Affirm Your Worth With Affirmations

If you spend your day telling yourself that you're worthless, don't be surprised if you end up depressed. Affirmations — speaking positively to yourself — can induce change in you.

How you talk to yourself matters. Repeating positive and uplifting statements, known as affirmations, can be beneficial to both your physical and emotional health.

Affirmations: The Power Within

There is strong evidence that repeatedly thinking about negative events or personal qualities can increase stress and depression and worsen physical health. In contrast, repeatedly thinking about positive qualities can:

• Improve your mood
• Ward off depression and stress
• Protect your physical health
• Give you the confidence to solve a problem
• Instill hope for the future
• Reduce anger or angry responses

Affirmations: Important Antidote

“Affirmations definitely have a pretty major impact, and [they're] one of the most popular ways of inducing situational change in people’s thoughts, ways, and behaviors,” explains Harry Wallace, PhD, assistant professor of psychology at Trinity University in San Antonio, Texas.

In a way, affirmations are an antidote to negative self-talk. Negative self-talk involves focusing on your weaknesses, failures, less attractive qualities, and so on. These kinds of thoughts are more likely when you are already feeling down or in a tough situation, such as after losing a job. At these times, negative thoughts are normal, but they can speed some people towards depression and make it hard to take action.

Affirmations: Using Them in Your Life

Affirmations can help you get through stressful times.

“If [you use an affirmation] prior to having encountered some kind of threatening feedback, it creates a buffer where you are able to tolerate it,” says Wallace, who adds that people who are "self-affirmed" are more willing to accept or even invite feedback about themselves because "they can handle it." Similarly, people who must perform under pressure can benefit from affirmations, which ease some of the stress.

Affirmations: A Caution

While it’s a good idea to consider your positive qualities and the positives in your life, even in difficult circumstances, remember that some “negative” thoughts can actually be helpful as well. Worry is one of those. A little bit of worry can spur you to take action, so you don’t need to counter productive worry with affirmations.

Wallace points out that, as with worry, there are times when a realistic assessment of your situation is helpful. For example, while an appropriate affirmation (such as “I am prepared for my speech and my audiences generally respond well to my style”) can get you through the pressure of public speaking, you may want to prepare the speech without affirmations that could slightly distort your ability to see what changes need to be made.

Affirmations: Creating Them

Affirmations are personal to your situation and your needs. When creating an affirmation, think of the positive message that you need to hear based on your situation. Here are some examples:

• Affirmations that help to prepare for stress. Wallace says that if you are about to receive feedback from an employer or client that you suspect might not be as good as you’d like, try an affirmation like, “I am a valuable person regardless of what happens with this situation.”
• Affirmations that conquer stress. Use three or more affirmations that you repeat daily to get through a difficult time, such as job loss and job seeking, such as, "I am valuable" or "I have something to contribute."
• Affirmations that support an overall goal. If you are having a hard time achieving a specific goal, affirmations that remind you of positive aspects of yourself related to that goal can make success more likely. For example, if you are trying to write a novel, you might want to use affirmations like, “I am a creative person” or “I am capable of meeting my deadlines” as positive and encouraging thoughts (instead of negative observations like, “I'll never finish this novel!”)
• Affirmations should be abstract or concrete as the situation requires. A statement that supports an abstract positive quality (“I am a valued team player”) is helpful in getting you to look beyond an immediate frustration, but an affirmation of a concrete skill (“I am an excellent translator of French”) can be helpful if you need confidence in a particular area.

With practice, you will be better able to craft the kinds of affirmations that are most helpful to you, says Wallace. Be kind to yourself. Focus on your strengths and abilities when you are feeling vulnerable.

By Madeline Vann, MPH

Medically reviewed by Pat F. Bass III, MD, MPH