130702 stress01

It has been said that the lowest common denominator of mental health is self-esteem.  When people feel better about themselves, they just enjoy life more.  Perhaps a byproduct of good self-esteem is one’s feelings of resiliency toward life.  Einstein is supposed to have said that the most important question a person can answer is, “do I live in a hostile or a benevolent universe?”   This begs the question, “What can I expect from my future?”

Stress is experienced when you feel that environmental demands tax or exceed your adaptive capacity, resulting in psychological and biological changes that may place you at risk for disease.

Note the key word: feels.  My perception of my capacity to handle stress is what matters.  The process of therapy is to align one’s perceptions with the reality of one’s capacity.  In my experience – ironically – most people who come to therapy because of stress are universally underestimating their ability to handle what’s on their plate.

As a starting point with patients, I often administer the Social Readjustment Rating Scale, which is a measure of the relative level of stress in a person’s life.  Created in 1967, psychiatrists Thomas Holmes and Richard Rahe examined the medical records of over 5,000 medical patients as a way to determine whether stressful events might cause illnesses.

130702 stress04 It’s been known for quite some time that your beliefs can actually affect your life expectancy.  Research on stress has a long history with considerable evidence finding exposure to stress to be associated with adverse health concerns including cardiovascular disease, diabetes, obesity, hypertension, major depression and mortality.

Now we’re learning that it’s not just whether stress affects your life, but how you think about it that matters.  If you believe stress is affecting your health, you are probably right, a new study concludes, and that perception may increase your risk for heart disease.

Researchers studied 7,268 men and women, average age 50 at the start of the project, using periodic questionnaires. The aim of this study was to examine whether individuals’ perception of the impact of stress on their health is associated with the risk of incident coronary heart disease.  There were 352 heart attacks or deaths from coronary disease over the 18 years of the study.

The participants rated the effect of stress on their health — none, a little, or a lot — and then researchers controlled for more than 20 variables, including actual stress as measured by psychological tests. The study was published online in The European Heart Journal.  The twenty variables comprised the good (fruit and vegetable consumption, physical exercise) the bad (smoking and alcohol intake) and the ugly (how often one visits relatives, the level of support one feels at work). It also included physical markers of body mass index, blood pressure and cholesterol.

130702 stress03Those who said that stress affected their health “a lot or extremely” were 49 percent more likely than other participants to have a heart attack or die of heart disease.

The authors suggest that the perception of the negative effects of stress may actually increase blood pressure or heart rate, or have indirect effects like increasing smoking or excessive drinking.

What to do about it? “The first step is to identify the stressor and then to take action to manage it — physical activity, relaxation, meditation,” said the lead author, Hermann Nabi, an epidemiologist at Inserm, a public health research center in France. “But for severe cases, you need to look for professional help.”

For local help with managing stress in your life, click here.