High Anxiety

Your head hurts, your back aches, and the scratchy feeling in your throat indicates there's a cold coming on. You're still running behind on the same projects you were running behind on last month, if you don't sit down to pay the bills tonight they're all going to be late, but it's your daughter's open house so you have to be there. Put it all together and it's enough to make you want to go to bed, pull the blankets over your head and put the world on hold.And if you don't do something soon, you may be forced to do exactly that.If you're lucky, you'll be laid out temporarily by a cold or the flu. If you're not so lucky, you'll be staring at the inside of a coffin lid.Increasingly, researchers have been tying physical health to mental health -- the better you feel, the better you are. If you're feeling stressed -- overwhelmed, overworked and underloved -- even the hardiest body is more susceptible to all the little, and not-so-little, ailments that come along.There are some estimates, in fact, that 70-80 percent of all visits to the doctor are directly or indirectly stress related.Clearly, we'd be a healthier, happier society if we could just get rid of the things that have us worked up in knots. But in a society that's doing nothing but speed up, there are inevitably increasing demands on our time and our resources. So what's to do?A growing number of people are turning to mind/body health practitioners who make it their business to relieve stress. What used to be defined as "alternative" therapies are becoming more and more mainstream.The Root of All Evil?In many situations, stress is a good thing. It's at the core of the "fight or flight" reflex that allowed our ancestors to make decisions about whether to do battle with the big-fanged monster they just found sunning itself on the savannah or to get the hell out of the neighborhood. A mellow cavedude could very quickly become a dead cavedude.Basically, stress is a body reaction that increases heart and breathing rates while pupils dilate, dumps adrenaline into the system, floods the bloodstream with sugar and fat to provide the fuel for quick energy, and tenses muscles. Then the brain has to figure out what to do with this hyper-alert, ready-for-action machine. Take the caveman for example:He walks into the clearing and sees the monster. His body immediately reacts, then his brain kicks in to assess the situation. "Oh, wow, man! The monster's asleep -- I can run over, stab it with my pointy stick and the girls will go ape over my new monster-skin cape." Or, "Holy mastodon turds! That monster's staring right at me! Feet don't fail me now!"With his body at the ready, our caveman is able to respond to the instructions given by his brain.In such physical situations, stress is still a good thing. If you're speeding to work on the highway and a big rig suddenly changes into your lane, you want your body instantly prepped to take action -- whether it's changing lanes or slamming on the brakes.Physically, stress is a relatively simple reaction that helps a person resolve relatively short-term problems. You kill the monster or you escape, then you take a nap and your body returns to its normal state.But in today's increasingly complex world, the problems that confront us on a daily basis are neither simple nor are they short-term.Your boss doesn't like you, and you think she's just looking for any reason to fire you. Every time she walks past your desk, your body warps into stress mode. But you can neither physically fight nor flee because you still have to pay the rent and put food on the table. There's no resolution to the problem and this monster walks past you five times a day, five days a week. Even when you're not at the office, you know the same situation will exist when you walk through the door tomorrow morning. There's neither relief nor release from this kind of stress and it's beginning to take its toll -- not just on individuals, but also on society at large.The numbers about stress are startling. According to the American Institute of Stress:* 43 percent of all adults suffer adverse health effects due to stress.* 75-90 percent of all visits to primary care physicians are for stress-related complaints or disorders.* Stress has been linked to all the leading causes of death, including heart disease, cancer, lung ailments, accidents, cirrhosis and suicide.* An estimated 1 million workers are absent on an average workday because of stress-related complaints. Stress is said to be responsible for more than half of the 550,000,000 workdays lost annually because of absenteeism.* Nearly half of all American workers suffer from symptoms of burnout, a disabling reaction to stress on the job.And it's a situation that seems to be getting worse. As the world speeds up, real income goes down for many people and expectations (from job performance to cosmetic appearances) rise, people are appar- ently feeling less and less adequate to kill or escape the monsters that confront them. In 1996, Prevention Magazine found that 73 percent of adults feel "great stress" on a weekly basis -- that's nearly a 20 percent increase from 1983, when the magazine found that 55 percent of the adult population indicated they felt regularly stressed. And the National Center for Health Statistics in 1991 found that 46 percent of the population felt "highly stressed;" in 1985, the figure was a mere 20 percent.Of course, here in the U.S., we don't take our illnesses lying down. When we can afford it, we run to the doctor and take rainbows of little pills. By the middle of the 1990s, we were spending $1.6 billion on anti-anxiety medications.But those pills didn't stop the body count from growing. Of all the major killer-diseases, stress has been most closely linked to cardiovascular disease. While there are physical components connected to heart disease (some of which, such as diet and smoking, are themselves stress-related), stress has an intrinsically deleterious effect on the heart and blood vessels. According to the American Heart Association, cardiovascular disease kills about 1 million people per year -- approximately 52 percent of deaths from all causes.With numbers like these, it's becoming impossible to ignore the high cost of stress to society at large. But, without wholesale changes in the way we structure society and do business, what's to be done?Making ChoicesMillions of us elect to do nothing about the levels of stress in our lives or how we choose to manage it. At best, we narcotize ourselves with nicotine, alcohol and other drugs, or we find ways -- television, computers, video games, eating, magazines -- to distract ourselves from the causes of our stress. And, although any of these might provide temporary relief, they may ultimately increase the levels of stress that we feel.Stress becomes debilitating when we feel powerless to overcome a problem. By employing short-term solutions to avoid or mask the bigger problem, we're putting ourselves in a situation where we're at risk of spiraling deeper into the heart of despair. Drugs can be addictive -- creating more obstacles that we feel helpless to address; the media barrages us with a host of problems worldwide over which we have little power; overindulgence in food can lead to health problems and poor self image. Ultimately the short-term solutions may themselves turn into problems that we can't overcome, further undermining our ability to confront other challenges we face.Joy Colangelo, supervisor of occupational therapy at a California hospital, teaches stress management to members of the hospital staff and at workshops. She says the hospital offers considerable support to its employees, especially during predictable times of stress -- such as when a new technology is introduced, or when a new patient is introduced on a particular floor.Colangelo says typical indicators that a department is under stress are an increase in activity but a decrease in productivity, a lack of prioritization, a decrease in cooperation, and an increase in blaming others.She says that although people generally are capable of addressing issues in both their personal and work lives, they sometimes don't quite know where to begin. In particularly entrenched cases, Colangelo says it's important to start at the beginning, with the little things."I teach that you have to start with making good, easy choices. Then you might be able to make some choices about yourself that might need fixing. Practice on objects in your home, then on other people, and then on yourself."One of the beginning exercises that Colangelo suggests is for a person to select a particular shelf in their home, and begin by evaluating each object on that shelf. Do I really like this trinket? How much do I want to keep this picture? By getting rid of the things that have no meaning, a person learns a lesson about control and decision-making, a lesson that can then be transferred to interpersonal relations. Do I really need to talk with that person? Do I want to talk with him about that?Empowered from there, a person may be able to turn their attention to the bigger problems they confront. People who feel powerless may never even attempt to slay the monsters that confront them. But once they are convinced they have some degree of power, they may decide they can defend themselves from and overcome the daily sources of stress in their life.And just as there are many sources responsible for the creation of stress, there are many methods being employed to reduce stress levels.Changing PrescriptionsThe grimoire of treatments for stress management ranges from prescription drugs to aromatherapy, acupuncture and massage. On the one hand, pills such as Prozac and Valium (the most prescribed drug in the U.S.), treat stress and its close relative, depression, as a chemical problem.On the face of it, both drugs seem to treat the symptoms of stress, rather than the problem itself, but there's a deeper intent behind their use. If, the theory goes, the symptoms can be neutralized long enough, the person suffering from depression can gain enough time and relief from the symptoms to work on the source of the problem. This can be a costly approach, involving not only the use of medications but of a psychologist and psychiatrist to help the patient work through problems.The high cost of this approach to improving mental health has lead some insurance companies to consider paying for alternative, less-expensive treatments. Twenty years ago, it would have been nearly impossible to find an insurance company to reimburse a client for getting needled by an acupuncturist or rubbed by a massage therapist. Today, insurers such as Blue Cross have decided it may be cheaper to promote mental health and reduce stress before it forces a person into the hospital or the arms of pedigreed health professional.Through its Healthy Extensions program, Blue Cross provides "alternative medicine and wellness resources" for its members. In addition to providing reduced-cost physical checkups and memberships with some fitness centers, it also offers a list of "health and wellness practitioners." Included in that group are hypnotherapists, yoga instructors, and massage therapists.If the insurance business is beginning to warm up to the idea of relaxation as a way to prevent more serious problems from occurring, the general public is boiling over with enthusiasm.Brian Day, general manager of Blackthorne Pools and Spas, a company that's been installing hot tubs for 25 years, says business is booming."Over the last two years, there's been an increase of almost 35 percent," says Day. "The year before that it was about 20 percent. Over the last three years, especially, it's been record-breaking year after record-breaking year after record-breaking year."Massage therapists also report a tremendous upsurge in the number of new clients they're seeing. According to Linda Lundy, a 23-year veteran in the field, about a third of her current appointments are made with clients who have never before been massaged.It's obvious that people have begun to take relaxation seriously.Go With the FlowFor thousands of years, a basic building block of Eastern medical philosophy has been the flow of energy (qi or chi) throughout the body. When someone is ill, it reflects a blockage of energy somewhere in the person's body. These blockages may be caused by either physical injury or mental processes. Staying well, and healing, is the art of keeping the energy channels running free throughout the body clear.In acupuncture and certain deep-tissue forms of massage, elaborate maps of energy points -- meridians -- have been identified, and skilled practitioners are able, with the prick of a needle or the application of pressure, to clear blockages from the energy channels. With energy flowing normally, the body is better able to heal itself.David Fuess, an acupuncturist and teacher of yoga, tai chi and meditation, sees an intrinsic link between stress and the flow of energy."I see stress in terms of constriction. When you're stressed all different parts of your body are constricted -- your cojones, your stomach, your brain, your face. And every time you have constriction you impede the flow of qi. That can be translated as you get less blood or oxygen to the brain, but I see it in terms of qi."Similarly, meditation works to relax both the body and the brain so that energy may flow more cleanly throughout. Whether it's yoga or transcendental meditation, the goal is to achieve a state in mind and body integrated through the flow of energy in a state of relaxation."It's a given fact that the body is energy," says Fuess, "so the idea is you want to find out how the energies in your body work and how you can affect them. Yoga means union. It can mean union of yourself with god or it can mean union of your right brain with your left brain. It has to do with the balanced free flow of qi."Related to energy flow, is massage, perhaps the most accessible method for mellowing-out. Similar to acupuncture, a practitioner releases tension by applying pressure at various points of the body. And similar to meditation, the hands-on treatment offers a time when people are encouraged to let their brains slip away while they get back inside their relaxing bodies. Long a staple treatment for athletes, the growth in the number of spas and people practicing massage speaks to its growing popularity with people in all walks of life.According to Lundy, massage works on a couple of different levels. On the one hand, there's a mechanically measurable effect on the body. The lymph system is cleansed, endorphins are released, muscles are relaxed, and deep breathing increases the flow of oxygen to the brain.But something else happens, too. "There's something about a caring touch that talks to the soul as well as the body," says Lundy. "That's what we always emphasize around massage, that there is this special ingredient beyond the mechanical. "We spend more time with the patient than a doctor or a nurse. We get more information about the whole person -- their psychology, what's going in their life. Did their mother just die? Did they just lose their job? We're a little bit of a nurse/doctor, psychologist, surrogate wife, etc. We fill a lot of roles. Massage has the quality of just its function and the quality of the person administering it. It just cannot be duplicated by drugs or mechanical devices."Do Your Own ThingUltimately, of course, individuals must make the choice for how they want to manage their own stress. For each person, there's probably a unique combination of meditation, medication and massage that will cure what ails them. And, for the most part, once introduced to the array of possibilities, each individual will know what works best for them.Diana Case, a licensed psychologist, counsels patients about stress management. She says finding effective treatment is a function not only of person's given situation, but also of the person him or herself. Some people are generally less prone to stress than others, the things that provoke a stress reaction differ from person to person, and the ways we've been conditioned to handle stressful situations determine how we are affected. She says because the causes of stress are so variable, and because we are such complex animals, there is no single way to manage stress that will work for all people."I feel there are hundreds and thousands of ways to handle stress," says Case. "Although I am not spiritual, there are people who find spiritual ways work. I try to work on helping people develop their own stress management technique."But, before a person can develop ways to cope with the stress, it's important to be able to identify the onslaught of stress. In a handout that Case uses, she identifies 27 common signs of stress, including "lack of concentration; feeling pressured or keyed up; loss of zest for living; strong urge to cry, run or hide; tightness in chest; too little or too much sleep; accident proneness; and general fatigue or low energy."In another handout, Case lists more than 20 ways to cope with stress, including breathing exercises, meditation, massage and soothing music or sounds.Once someone learns a few basic techniques for reducing stress, it becomes possible for them to activate those techniques whenever a problematic situation arises. Instead of being overwhelmed by that initial rush of feelings, a person may choose, quite literally, to take a deep breath and shrug it off.In the end, it's probably immaterial which technique a person uses to manage the inevitable stress that affects our lives. But what is becoming increasingly obvious is that that if you don't voluntarily figure out some way to slough off tension, your body might not make the healthiest decisions about how to handle the overload.And if that happens, you might never make it to that open house.

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