STRESS/SLEEP
Okay, test time. What's the "mind-body connection" really called in medicine? It's psychoneuroimmunology (PNI) and it refers to how stress robs your body of its ability to ward off disease and illness. Allow stress to build up and you can not only develop a physical disorder, you can make one you already have worse. Yes, it may actually all be in your mind in that how you live and what type of lifestyle you lead, in other words, how you approach life, may lead to physical illness. Skip a vacation, forget about keeping joy and laughter (one of the best medicines) in your daily life and you've begun the journey to dancing on a wire between health and illness.
One word of caution, however. Stress comes from both the good things in our lives and the bad ones. So, everything is stressful, but it's the way that we learn to manage it and put it in perspective that helps us survive it. Try this test and see how stressed you are: The Holmes-Rahe Scale. Information on scoring is contained on the site to which this is linked and there’s also the reference for the journal article in which it contained..
A recent National Geographic documentary discussed the topic of stress. What we learn from this documentary is that stress causes real, possibly permanent, damage to the body. It attacks a vital area of the DNA in our bodies, makes us vulnerable to disease and stress-related disorders (the autoimmune disorders), clogs our arteries, shrinks our brains (the vital memory centers), causes fat to deposit around the waistline (an indicator of potential cardiac problems) and can shorten our lives. The one problem with this excellent documentary is that it doesn't do enough to tell us how to reverse these problems or what major or small steps to take right now to, literally, save our lives. I think they need to do a part 2 of this to offer meat-and-potatoes solutions we can all implement. So, it's left to you, the reader, to search the internet, look at the links below and begin to make a life plan that does mean "life" in the truest sense of the word. Begin today and concentrate on your real life's work and that is to save your life so that you can enjoy it with those you love and doing the things you love to do. Got a hobby? Go to it. Haven't got one? Find one because it's one step you can take immediately.
See what a famous neurobiologyist (Dr. Robert Sopolsky) thinks about stress and what we can learn from animals about it. We have a video interview with Dr. Sopolsky on our Videos page.
Parenthood, the Common Cold and Stress
Stress has taken center stage in just about everyone's life and that's no surprise to any of us who know a little bit about the workings of stress and how it can undermine our best efforts. How many times have you been told that the reason you've caught a cold is because you've been suffering from stress? Well, I suppose it's more times then you care to have heard about. How many more people have to tell us that stress is bad for us? The research is in, we have the results and we know the culprit.
So why are so many people in both the corporate world and the medical community failing to address this thief that robs us of our health, our ability to work to our fullest potential, our joy, and even our economic lifestyle?
Medical schools don't address stress. Do law schools address stress? I doubt it. Colleges try to address stress when a student implores them and that student is in dire need of help. They even have workshops and groups for entering freshmen to try to help them cope with the demands of college and the incidence of stress and its symptoms. Despite all their best efforts, we still see kids failing, dropping out and getting sick.
Not being able to do enough for the people who are currently experiencing stress means that many people will reach out for either a new therapy or new drug. The hope is that either of these, or possibly both of them together, will enable them to ward off this danger. New research on the benefits of parenthood have proven quite interesting, if not totally definitive, in explaining how just being a parent may help with stress reduction or, perhaps more aptly, stress coping.
In a study of 795 subjects who were exposed to various viruses, I'm assuming it was the common cold virus, parents over the age of 25 were "less likely to develop colds after they were exposed to viruses than were people with no children." The study appeared in the journal Psychosomatic Medicine (2012) and was quoted in the February 2013 issue of the APA Monitor on Psychology.
Interestingly enough, the author of the Monitor article indicates, "older parents were less susceptible to colds regardless of whether they were married or whether their children still lived at home." Parenthood, it was surmised, somehow has a positive effect on producing a life outlook that was more purposeful and full of positive emotion. Of course, it would be interesting to find out whether or not there was some biological test which would have supported the results. But it's interesting just the same.
Positive outlook on life was also hypothesized to help in resisting susceptibility to colds. The authors note that there is a huge pool of research pointing to the effect stress has on the immune system. However, it's also interesting to note that parenthood can be quite stressful and they looked at that also. The thinking was that older parents are more experienced and have a different outlook on life because of this life experience, while younger parents didn't have his beneficial experience effect.
Sticking to the topic of the common cold, the author also indicates that work that was done in the mid-to-late 1990s found long-term interpersonal stressors "such as a bad marriage or work conflicts" were two and a half times more likely to develop colds than people who were not in similar situations. Anyone who was either unemployed or underemployed, and this has particular relevance in today's economic climate, were five times more likely to develop a cold. So if there are a lot of people in your office with colds, it might be due to the stress in the environment.
Chronically stressed individuals, we know, have dysfunctional immune systems which lead them to be vulnerable to illness. For this reason, the fairly new field of psychoneuroimmunology (PNI) would seem to be in a good position to establish itself more prominently in healthcare. Recently, I wrote a blog which indicated that many people said their physicians provided no help in stress management for them. The reason, of course, may be that too few physicians have any training in this or even adequate access to referral resources in their area. It's something I have found similarly lacking in the medical specialties of geropsychiatry and even Geriatric Medicine. Too few, too far and too little is done for the stressed and the elderly.
The common cold really seems like something that all of us should just take in stride, but it has other effects on us besides causing us to have runny noses, sore throats and headaches. Colds affect our cognitive abilities, bring on sluggishness, working memory decreases and lowers reaction times. All of these it is suggested are caused by the cold viruses’ damage to the functioning of several important neurotransmitters; noradrenaline, choline and dopamine. So when you have a cold, you really are sick and impaired. There's no two ways about it and research is supporting you.
Physician Help Heal Thy Stressed Patients
The American Psychological Association released their 2012 survey of Stress in America and in it are some pretty interesting statistics, considering the current state of stress in our culture and its newly-appreciated place within the mind-body model of medicine.
Currently, I find that medicine shares something with truffles; you pay a lot and you get a thin slice. The current state of affairs in many medical practices is determined by the reimbursement the practice can get per day. It's also very much like what restaurants do and their philosophy of having to "turn the table" every half hour or 20 minutes or whatever. In medicine, it's 15 minutes for a regular visit, many times, or 30 minutes for what will be coded as an extended office visit. This means you said something more than "Good morning, Dr. I'm here for…"
How long have we known that stress is incredibly important in our maintaining our health, both physical and mental? How long have we known about the mind-body connection? How many times have we been told that stress is a killer and that the Japanese even have a word for work stress that kills? How much more information do we need on stress? Well, obviously, we don't need more information. What we do need is more time with our healthcare providers in terms of helping us manage stress.
A number of years ago, while I was working for a major public relations agency that had multiple pharmaceutical accounts, I had to pitch a project and to prepare myself I needed to do a bit of research. The project dealt with diet and obesity and I wanted to find out how much training physicians receive in medical school on diet and weight maintenance. So, I called a few of the major authorities in the field and I was shocked to discover that out of something like 40 medical schools many of them gave a one hour lecture on the topic and the rest just left it out of their curriculum. Now, to whom are we sent when there is a problem regarding diet and obesity? Don't we always hear the recommendation, "Call your doctor." If your doctor doesn't know, of what use is it to call? And if your doctor does know something about it, where did that information come from?
So, if we accept the fact that stress must be a component of any healthy lifestyle and that physicians should be very much involved in helping us manage it, what is happening? The APA report indicates 53% of Americans "say they receive little to no support from their healthcare provider in managing their stress." Not only that, but 35% of adults "say their stress has increased in the past year and 33% say that they never discuss ways to manage stress with their healthcare provider.”
If stress kills or causes major medical illness, and we do know that it undermines the efficiency of the immune system, what is happening in the wonderful world of healthcare? Why isn't there more consideration and effort put into helping patients with the incredible stress in their lives? Is it a question of reimbursement? If it is, can't patients be referred to stress management programs? Or is there no reimbursement code for that unless someone has a chronic heart condition? I know I'm being a bit acerbic here, but I think it's called for.
Not only did people not have an opportunity to share with health care providers, the topic was never broached, even those living with chronic illness (51% of them) see their healthcare provider three or four or more times per year. That would seem to present adequate time for stress management information.
What are the areas that cause the greatest amount of stress in people's lives according to the survey? Sixty-nine percent indicated it was money, 65% said work, 61% pointed to the economy, 57% said it was from family responsibilities, 56% indicated relationships, family health problems were noted by 52% and personal health was a concern of 51%.
So how are people trying to manage stress on their own, since they are not receiving any help from their healthcare providers? Many of them indicate they suffer from insomnia (not actually a way to manage stress), 36% engaged in overeating or unhealthy eating (we know that fatty foods and carbohydrates can be soothing).
But some of them have come across things that really do work and that are not unhealthy. Listening to music (48%), reading (40%) and 34% said they watched TV or movies more than two hours per day. Thirteen percent turn to alcohol to manage their stress and 52% now turn to some form of exercise. This new-found interest in exercise is up from 47% in 2011.
Remember the last time you had to go to your physician's office and you had to wait for a real long time? Perhaps it's because they are double or triple booking in order to make sure that, if someone doesn't show up, they will still be able to make their allotted income for that day. While you're sitting around waiting, maybe it's a good opportunity to do some of that simple exercise that can help with not only that stress of waiting but the rest of the stress in your life. Walk around the office, walk in place, walk up and down the stairs. They may, of course, think you're a bit hyperactive, but just tell them you're trying to manage your stress since you're not getting information from anyone else on this. See how that goes.
The Baboon in All of Us
2008 American Psychological Association Stress Survey
Self-help resources (doc.)
Stress a Major Health Problem in the US Warns APA
Enhancing Worker Well-Being (stress doc)
Does Stress Cause Disease? It Doesn't Help, Reviewers Say
Commuting and All That
The “commuting paradox” and what that entails was detailed in an article a few years ago in Business Week. How much benefit do you really get from commuting long distances in the belief that it will provide a better life for you and your family? Perhaps in today’s economy, commuting any distance may be worth it just to have a job. But in the long run, sitting in a car or on a bus or train, even if you’re actively working on your laptop means you’re working all the more and your quality of life may not be much better. It’s worth a read for the things it may bring to mind. Unfortunately, the page has lots of ads on it, but the content of the article is worth the reading.
Stress statistics
Breast Cancer: What Psychiatrists Need to Know
Results of Mind-Body Meditation Study
Risk of a Second Heart Attack Doubled With Chronic Job Strain
Scent of Warm Cookies Can Ease Stress of Chemo
Inborn Stress Response Triggered by Carbon Dioxide
Less Power=Less Ability to Get Ahead (study)
Post-traumatic Stress Disorder (PTSD)
Stress clinical trials
Psychological stress and related disorders
Stress in early life
Managing stress in school
What to do if you don't like school
5 Tips for coping with grad school
Job Stress Network
Stress at work
Job stress, burnout on the rise
Mind, body, health: Job stress
Managing job stress
Job stress raises blood pressure
Surviving job skills
Protecting the heart
From family stress to family strength
Family stress management
Farm and ranch family stress
Family stress test
Helping your family cope
Family stress and autism
State Missing Children Clearinghouse
Stress Management (WebMD)
Children and Stress
Do kids really have it better today than their parents or grandparents did a few decades ago? When you consider the “over-scheduled child” with all the school and school-related activities, it doesn’t seem like childhood is what it once may have been. When parents begin to put their children on lists for preschool even before they’re born or aim for college when they’re still in kindergarten, the stress is major. Also, when a child is average and the parent wants them to be “special” and to get into advanced classes when the child doesn’t want it or can’t do the work, what damage is done?
I’ve seen kids being taken to psychologists to see if they can get their scores up or to get a favorable report that their child meets the entrance criteria for advanced schooling. How sad the kids appear as they are dragged around in search of that golden goose that supposed to provide those mythical eggs that guarantee their parents will have produced a super kid. Children shouldn’t be seen as status symbols. When they’re used as some vicarious means to prove a parent’s worth, what has the parent done and what will they reap?
Children and Stress
Caring Strategies to Guide Children
Are You Pushing Your Child Too Hard?
Helping Gifted Children With Stress Management
Children and Stress: Understanding and Helping
Children and Trauma: Reflections on the WTC Disaster
Stress During Pregnancy
Abuse During Pregnancy
Abuse Disclosure in Privately and Medicaid-Funded Pregnant Women
Traumatic Stress Symptoms in Children of Battered Women
Predicting Posttraumatic Stress Symptoms in Children After Traffic Accidents
SLEEP
How much sleep do you need? Do you really need to sleep? Is it okay to skip sleep and get by on three or four hours a night? How does shiftwork affect sleep? The mysteries of sleep are now beginning to be revealed and sleep has assumed an ultra-important place in medicine. There is now, in fact, a subspecialty in medicine and it’s called Sleep Medicine.
Any of the 70 (yes, there are now 70 of them at last count) sleep disorders may cause problems in daytime functioning, so depriving yourself of sleep is like depriving yourself of food. You wouldn’t do that, so why would anyone boast that they “don’t need that much sleep?” You do need sleep and building up a large “sleep debt” can lead to physical and mental problems. Simply put, you can’t do without a sufficient amount of sleep. How much is that? Check out the links below and find out more about sleep. Don’t fool yourself; you need sleep and you can’t put it off.
Take the Epworth Sleepiness Scale and see how you score on sleep. You may be surprised at just how sleepy you are.
Sleep Deprivation Leads to Emotional Instability Even in Healthy Subjects (doc)
National Sleep Foundation
Sleep Disorders Guide
Sleep Restriction
Sleep Myoclonus (muscle jerk) Fact Sheet
Bruxism
Emory Sleep Center
Sleep: Teacher's Guide
Shift Work Sleep Disorder
Shift Work (Sleep Channel)
The Hazards of Shift Work Sleep Disorder
Shift-Work Sleep Disorder: The Glass Is More Than Half Empty
Heart Disease Linked to Shift Work
Science Explores Shift Work-Linked Fatigue
Sleep (journal)
Sleepnet
NINDS - understanding sleep
Neuroscience for kids and adults
BBC on sleep
Sleep Medicine
How to sleep well
Sleep disorders
The Sleep Well
Sleep information for patients and public
Canadian Center for Occupational Health & Safety
Police Shiftwork Guide (UK)
Shift work, sleep quality and worker health
Effects of shift work on Air Force Security Police Personnel
Biology and shift work
Rotating shifts vs. fixed shifts in police work
Police shifts
Hard work on shift work (nurses)
Shift work and well being
A wake-up call for nurses
Your child and sleep
All about sleep (kids)
Children and sleep disorders
Geriatric sleep research program