There is no longer a question regarding whether the quality of
health can be impaired when an individual experiences stress that
exceeds their ability to cope with the stress.
Coping
is the ability to manage and to overcome the problems and difficulties
associated with the stress. If the ability to cope is unsuccessful,
biological changes occur which have a negative effect on health.
The perception of something in an individuals environment
as stress is associated with activation of areas of the brain
that cause an increase in hormones, called 'stress hormones' in
the blood. These hormones interfere with the ability of the immune
system to resist infection, increase the likelihood of cholesterol
deposition in the walls of the blood vessels of
the heart, and possibly, over a long period of time, interfere
with mental function.
However, there are behaviors called 'stress buffers'
that increase the ability of an individual to cope with stress.
Individuals who utilize the stress buffers will have a lowered
risk of stress induced health impairment.
STRESS BUFFERS
Friends
Most studies of stress related infectious disease
are of upper respiratory viral infection. Research studies that
infected human subjects with viruses that cause upper respiratory
tract infections indicate that high levels of stress in ones life
increases the susceptibility to infection. However, individuals
who have a lot of friends and social support, even though they
have high levels of stress in their lives, are less susceptible
to infection. Social interactions through marriage, close friends,
and group associations promote a better quality of health than
occurs in individuals without such social support.
Religion/Spiritualism
Is involvement in religious activities capable of
contributing to a better state of health and increased longevity?
All of the data suggests that the answer is Yes! The emotional
feeling provided through religion of greater satisfaction with
life, personal happiness, and fewer negative psychosocial consequences
associated with traumatic life events, are all likely to be
important factors in the health promoting influence of religion.
Indeed, older adults, particularly women, who attend religious
services at least once a week appear to have a survival advantage
over those attending services less frequently.
Religion is something that can be measured in the
sense of being able to count how many times an individual attends
a place of worship or prays. Spirituality is something that is
very personal, that cannot be measured, but which helps a person
relax and calm their fears and anxieties. One may feel spiritual
when they look at a beautiful painting, or a tree, or a
waterfall, or read as book they enjoy, or pray. Individuals who
are high in spirituality have a better quality of both mental
and physical health than those who are not.
Optimism
Is the glass half-empty or is it half-full, the
standard question asked when evaluating optimism. Although a simple
question that may seem humorous, the answer to the question has
significance in regard to health. Those who are optimistic will
have a better quality of both mental and physical health. To an
optimist, the experience of a stressor is only a temporary inconvenience
while to a pessimist it is a persistent problem. Optimists get
over it and
move on. Optimists have a better quality of physical health. You
should try to see the glass as half-full.
Sense of Humor
A sense of humor appears to an important buffer
of stressor induced immune alteration. Hearty laughter has been
found to decrease blood levels of stress hormones and humor tends
to reduce the stressor induced elevation of heart rate.
Exercise
A regimen of regular exercise modifies the response
of the body to psychological stress with less elevation of stress
hormones than occurs in individuals who are not physically fit.
There are numerous studies that show that exercise is capable
of minimizing the effect of stress on altering the function of
the immune system and that exercise has a beneficial effect on
health by reducing cardiovascular disease, cerebrovascular accidents,
and malignancy.
By physical fitness I do not mean that one has to
be an elite athlete. Rather, one simply has to engage in mild
amounts of movement that are more than they are currently doing.
As a general rule we say that if you are doing something for exercise,
such as walking or climbing a flight of stairs, and you can whistle
while you are doing it, you should do it a little more vigorously.
If you cannot hold a conversation while you are doing it, you
are doing it too vigorously. If you can hold a conversation, that
is the correct level of intensity.
Do you have to do whatever you are doing for a set
period of time, say 30 minutes? If you can that is fine but not
necessary. Several brisk walks of 10 minutes a day is sufficient
to achieve the benefit. Even as you go about your daily activities,
doing them with a little more vigor than usual is beneficial to
health.
Summary
It is not stress alone that is a determinant of
an individual's resistance to an infectious disease, autoimmune
disease, or malignancy. Rather, it is the balance between the
amount of stress in an individual life (both acute and chronic)
and the ability of an individual to cope with the stress. Thus,
a high stress level with excellent coping skills may result in
minimal effects on immune system function and health. A low level
of stress in an individual's life, with poor coping skills, may
produce alterations of immune function with a resultant altered
susceptibility to disease. The actual amount of stress is only
part of the information that is needed in
evaluating the effect of stress on immune function. However, the
association between increased levels of stress and the potential
of disease development is now well established and is assuming
an increasingly important role as a concern of preventive medicine.
Your utilization of the coping skills described above will help
you to achieve a healthier and happier life.
Bruce S. Rabin, M.D., Ph.D.
Professor of Pathology and Psychiatry
Medical Director, UPMC Healthy Lifestyle Program
200 Lothrop St.
Pittsburgh, PA 15213-2582
Phone: 412-647-6150
FAX: 412-647-7741
E-mail: rabinbs@upmc.edu
