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Many factors are associated with reducing your probability of developing heart disease. You need to stopping smoking, improving your exercise and changing your diet. However it has to be acknowledged that stress management is crucial for cardiac well-being. Indeed it is probable that you will not be able to stick to an exercise program or a diet regime if you are under chronic stress. Uncontrolled stress can have a terrible impact on the heart. It:
increases heart rate and blood pressure,
increases cholesterol and homocysteine levels,
increases artery wall inflammation,
constricts the arteries which can result in a heart attack,
creates heart rhythm irregularities - which can trigger a sudden cardiac death and
increases blood clotting.
What is stress?
Stress has many definitions including anything that causes us to change, anything that throws us off our equilibrium or when we are under unusual or excessive pressure. Some stress is necessary - it is what stimulates us and without some stress we become bored and frustrated. Stress can be seen as the 'spice of life' or the 'kiss of death' and what one person considers to be stressful another person will see as a challenge and interesting. There are some events which all experience as stressful of course. These include divorce, death of a loved one, terrorism and sudden unforseen events such as car accidents, for example. However there are other events that are seemingly trivial that can be experienced as stressful such as being delayed in a queue or doing something that is 'fun' like going on a vacation. There is evidence to suggest that 'little stressors' are often harder on health than some of the big stress events. It seems that the body was not designed to deal with prolonged chronic stress. We aren't meant to drag around bad memories and feelings of anxiety and frustration.
The fact that stress is a serious health problem can be seen in the following figures:
89% of adults experience high stress levels
60 - 70% of all disease and illness is stressed related
one in four people experience sleep loss as a result of stress
more than 25% of adults have high blood pressure due to or aggravated by stress
75 - 90% of visits to medical practitioners are stress related
The physical response to stress is what has been called the 'fight or flight' syndrome. This is where the body sends messages to your body in the form of stress hormones (cortisol, adrenaline and noradrenaline). The message is that we need to take quick action and our body's response to these hormones is to:
send stored fats and sugars into our blood stream to provide the energy for action,
increase the rate of our breathing so that we have the oxygen needed,
increase our heart rate and blood pressure so that the extra oxygen can be carried to the muscles,
our digestive system action is slowed down to make extra blood available for the muscles,
activate the blood-clotting mechanisms in anticipation of injury.
In short, all our systems are ready to go. This is a healthy response if we are in physical danger, but it is not a healthy response to the majority of stressors that we face in our modern society. In the modern world we do not physically fight the nagging boss we grin and bear it. The stress is not soon over and it can be continual and chronic.
In addition to the physical responses to stress we have emotional responses. When we are unable to act - that is no, fight or flight, our reaction can be internalised. We tend to 'bottle up' our feelings and 'stew' over things. There is also the possibility that we develop long term vigilance where we look into the future with fear - watching and waiting for something disastrous to happen. This is a response to lack of control and the attitude of 'there is nothing I can do about it.' This in turn can lead to feelings of self-doubt, a sense of failure, depression and feelings of entrapment.
Stress Warning Signs
Chronic stress, anxiety and feelings of pressure are common with modern Western lifestyles. When does this stress become a problem for our health? Some of the physical, emotional and behavioural warning signs of over stress are:
increased muscular tension in the neck, back and shoulders,
chest pains or a feeling of pressure in the chest - like a brick being placed on the chest,
shortness of breath,
numbness or tingling, especially in legs, feet, fingers or hands,
stomach and digestive problems,
irregular menstrual periods, increased menstrual cramping and more severe premenstrual tension,
skin eruptions and cold sores,
feeling there just isn't enough time to get everything done,
difficulty meeting deadlines,
difficulty making decisions,
low self-esteem and feelings of worthlessness,
increased sensitivity to criticism,
feeling that everything and everyone is against you,
fatigue and boredom, unhappiness and sadness,
difficulty with concentration or being creative and productive,
difficulty controlling your temper and a tendency to criticise and be argumentative,
difficulty in remembering things,
overeating, abusing alcohol or drugs, being too tired or busy to exercise, smoking, and
oversleeping or not getting enough restful sleep.
A person under excessive stress can show many of these signs. Unfortunately the reactions to stress often create further stress. If you are showing the signs of overstress outlined above talk to your health professional and begin to make serious changes in your life.
What You Can Do About Stress
It is not possible to avoid stress - indeed this is not desirable as stress can add to the variety and spice of life. However, it is necessary to manage the stress that we feel. To effectively manage the stress we need to know the level of stress that we are under. We need to know the amount of stress that we can comfortably handle and then what we can do about any stress that goes above that level.
So what can we do about our excessive levels of stress? There is no one approach to stress management and there are many different ways that you can go about dealing with the stressors that are a part of your life. The most effective way is to evaluate your life, what your goals and values are and then work on aligning what you do with you life and time to what you want. However, the question of how to go about doing this is beyond the scope of this article. The approaches presented below can be used to help you cope with the stress you face.
The following list is a compilation of suggestions that you may find useful. Examine the list and see if there is something that you can implement to help you to deal with the stress that you feel.
Relaxation - you need to be able to relax your mind and body on a regular basis so that you can deal with stress. Make time to go for a walk, read a book, listen to some music, soak in a warm bath, practice yoga, meditate, get a massage or whatever activity will assist you to relax and let go of the tension that stress brings. This can also include learning progressive relaxation techniques.
Redefine the stressful situation. An event in itself is generally not stressful but it is our perception of the event that makes it stressful. Piscatella and Franklin have a story about an elderly lady who was woken in the middle of the night by 'noise' coming from the apartment next door. She stressed over this and rang the night manager of the apartments to complain. The offender was a famous pianist who was apparently disappointed by his performance at Carnegie Hall that night and was replaying the entire concert. The woman redefined the nature of the stress and moved a chair close to the wall so that she could listen to the music from the concert. Is there some way that you can redefine the things that are causing you stress?
Focus on problems or things that can be changed and do something about these situations. For example if you are always stressed because you often run late for work - try setting the alarm for 15 minutes earlier and so forth.
Write in a journal. Keeping a journal is a great way to write about the things that are stressing you - it is like having a non-judgmental friend to talk to. You can focus on your feelings and not the facts of the situation. Getting to your feelings will help you to look at your feelings in relation to your personal rules, values and beliefs. You need to write every day or most days and try to use the same space and time. Even if the words don't come easily keep at it and it will soon become second nature to you.
Build a cushion of time into your daily schedule for the things that unexpectedly occur. Leave about 20% of the time available for the unexpected - for illness, traffic jams, an opportunity that comes your way and so forth.
Work out your values and goals. This will provide you with direction and meaning for your life, especially when the goals are concerned with being as much as having.
Exercise frequently. We have in previous newsletters talked about the benefits of exercise for your heart. Exercise will reduce your anxiety, depression and tension and the stress hormones. Exercise will make you feel more powerful and in control and generally better about yourself.
Use deep breathing to provide a calming effect. It can be done in a stressful situation or twice per day to break the hold that tension can have. In stressful situations most people breath in short shallow breaths. This constricting can actually increase the feelings of stress. Try instead to use your abdominal muscles to help you to take in a deep breath and to slowly exhale the air. Find a comfortable position - it can be sitting, standing or lying. Take a deep breath through your nose. As you inhale push out your stomach - this will lower the diaphragm. Hold your breath for a couple of seconds and then breath our slowly - taking about twice as long as when you inhaled. You will need to practice away from the stressful situation so that you are able to use it when you are stressed.
Learn to laugh. Try to put humour into situations that you find stressful.
In addition to these you also need to:
Avoid the intake of stimulants (such as caffeine) or depressants (such as alcohol) and refined foods.
Avoid smoking - if you do smoke, for goodness sake give it up!
Eat fresh, whole food and plenty of fruit and vegetables.
Herbs, such as chamomile, verbena and valerian can help relive some of the symptoms of stress.
Take the time to enjoy life and replenish your energy levels.
Find a support group or person who can help you work through the issues underlying the stress.
Vitamin and Mineral Supplements to Help Deal with Stress
The following vitamins and minerals can assist in dealing with stress:
Vitamin B complex. The B group vitamins are often depleted by stress and these vitamins are important for ensuring the nervous and immune systems are able to function effectively.
Vitamin C will provide the immune and nervous systems with a boost during stress. This will make you feel fitter and healthier.
Coenzyme Q10 helps to improve energy production.
Zinc is an important mineral which can help restore and maintain a healthy immune system.
This list is not considered to be all that you could do to help manage your stress levels. It is a place to start and you can add others ways that you find to relax.
So far in our prevention of heart disease series we have looked at your risks of developing heart disease and ways of dealing with these risks. This has included stopping smoking, making exercise a habit, changing your diet and this month managing your stress level. In the next issue we will provide additional information that you will be able to implement to directly tackle any artery clogging problems that you may have. I hope that you have been having success in implementing your exercise program and changing your diet. Even if you are unable to make all of the changes suggested, that's OK. Keep heading in the direction of implementing a lifestyle that will support your heart and remember that every positive change that you do make is change for improved health.
References
Cromie, C. 2005, Smoking and Drinking. Good medicine.
Davies, S. and A. Stewart., 1997, Nutritional Medicine. Pan.
Holden, S., Hudson, K., Tilman, J. & D. Wolf, 2003, The Ultimate Guide to Health from Nature. Asrolog Publication.
Piscatella, J.C. and Franklin, B.A. 2003, Take a Load off Your Heart. Workman.
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