Stress makes us depressed, fat, sick - and we do it to ourselves Too much pressure can cause autoimmune disorders, depression and other problems - and doctors say we're doing it to ourselves

We're so stressed out it's making us ill. We're so stressed out it's making us ill. Image 1 of / 1 Caption Close Stress makes us depressed, fat, sick - and we do it to ourselves 1 / 1 Back to Gallery

A sensible person might argue that at 74, Connie Berto should be enjoying the quiet luxuries of retirement, like afternoon naps and baking pies. But like most Americans, Berto has picked the rush of an active, nonstop lifestyle over peace and quiet.

"I'm always on the go, go, go," said Berto, who lives in the Sleepy Hollow community in Marin County. "My husband and I have a lot of interests and volunteer work and grandchildren - 2-year-old twins that I babysit all the time. I have two horses in the backyard, and I do all the cleaning and the cooking myself."

And don't get her started on the holidays. "With five kids and their spouses and trying to get Christmas presents for everybody, well, we're always on a tight schedule," she said.

There's no doubt, Berto said, that Americans are more stressed out than ever before. Doctors agree. In fact, they say, Americans are so riddled with stress these days that it's making them sick.

An office worker develops a strange rash from the daily pressures of dealing with a demanding boss. A child complains of a stomachache from too much homework or grueling daily soccer practices. A teenager lives on coffee and energy drinks in order to squeeze in more time for social activities.

Chronic stress has been linked to depression, heart disease, autoimmune disorders, premature cell aging, and obesity and diabetes. It can cause hives and numbness, gastrointestinal problems and acne. It can make people more susceptible to the flu.

The really frustrating part for doctors is that much of the stress patients experience is manufactured - the result of an increasingly connected society that has everyone expecting instant gratification, and instant results. Very few people are making the time to unplug and relax, even for just a few minutes every day.

"Our being connected to everyone all the time is a good thing and a bad thing," said Dr. David Spiegel, a professor in the department of psychiatry and behavioral sciences at Stanford University School of Medicine. "I can be in touch with colleagues around the world, but all that seems to do is enhance expectations for productivity. We work harder, and we're never disconnected.

"A long time ago, when it got dark, you ate dinner and went to sleep. Now we've turned night into day. We're getting a lot less sleep. It all adds up to a lot of stress, and our minds and bodies are not prepared to deal with it."

There has been much research into the effects of chronic stress on the body. Most of it comes down to a hormone called cortisol, which is released by the adrenal gland when people are under stress. Cortisol stimulates systems that put the body in a "fight or flight" mode, said Dr. Don Mordecai, chief of psychiatry at Kaiser Permanente's Santa Teresa Medical Center in San Jose. It diverts blood to critical areas like the heart, lungs and muscles that make people better able to deal with an emergency.

"You breathe more, you get more oxygen to your muscles so if you have to flee your legs are ready. Your pupils contract so that you're seeing things more sharply. Your brain is ready to process things more quickly," Mordecai said.

That's great if you're about to get eaten by a grizzly bear - or rear-end someone on the freeway - but it can be damaging when people experience that kind of stress day in and day out for long periods of time.

Cortisol can weaken the immune system, or, alternatively, send it into overdrive. People can become more vulnerable to sickness, or autoimmune disorders flare up, leading to stress-related symptoms like skin problems.

Relatively new evidence suggests that cortisol also makes people crave fatty, sugary comfort foods, which can lead to obesity and insulin resistance.

"We think stress plays a large but hidden role in the obesity epidemic," said Elissa Epel, an assistant professor of psychiatry at UCSF and an expert on the physiological effects of stress. "We are surrounded by an abundance of this high-caloric food and our brains are hard-wired to eat it. It's very hard for people to not become overweight, especially if they're stressed."

The point, researchers say, is that there's no doubt that chronic stress is unhealthy.

The hard part for many people is figuring out how much stress is too much. Everyone experiences daily frustrations and anxieties - rush-hour traffic, looming deadlines at work, petty office politics.

"We're so used to it that we don't even think about stress anymore. It's just life," Spiegel said. "We think if we're really tough we'll work through these limitations. We're not very respectful of our bodies and that creates the real problem.

"Listen to your body. It's smarter than you are, and it's telling you you're taking on too much."

But with increasing pressure to perform and meet higher and higher expectations - make more money, send the kids to better schools, lose weight, make sure everyone in the family has their best Christmas ever - it's becoming harder and harder for people to let go.

For many people, just giving themselves a break, literally and figuratively, can make a huge difference in how they handle stress. That could mean deciding that this year's Christmas party is a potluck instead of a dinner for mom to slave over.

Doctors also suggest taking a few minutes several times a day to meditate, or finding a quiet spot to sit down and relax. Exercise helps a lot, doctors say, and taking a brisk walk before or after work can clear the mind.

Judy Moskowitz, an adjunct assistant professor in the department of medicine at UCSF, is doing research into positive thinking, with the deliciously simple premise that focusing on a few good thoughts during a stressful time can make a big difference to a person's health. She said she's studied people with serious and frightening medical diagnoses, and found that those who were able to think positively from time to time were healthier overall.

"It's this ability to notice and sort of capitalize on positive events that happen in your life, so you don't get consumed by stress," Moskowitz said. "I don't mean to minimize stress by saying 'just think positive.' It might sound very Pollyanna, but it really isn't. It's the ability to not be totally consumed by the negative, to broaden your perspective and open your eyes."

Of course, people with chronic stress may need professional help to control. Psychiatrists say that if people are having a physical reaction to stress, they should at least check in with their primary care doctor. They might also want to see a psychiatrist or get therapy if relationships are suffering or they're no longer able to do their job because of stress.

Medication can help for anxiety disorders or depression, which can occur when stress leads people to feel hopeless and out of control. Behavioral therapy is also available to help people learn coping mechanisms. Mordecai said he sees many patients who "catastrophize" events in their life - they stress over worst-case scenarios to the point where they can't function. It can take a lot of work, but learning to think through a stressful situation can alleviate symptoms of stress.

"I see people who say, for instance, that they have a party to go to and they know they're going to say the wrong thing and embarrass themselves and lose their job," Mordecai said. "They are bringing stress upon themselves from a hypothetical situation. But we can take a look at their thought patterns and replace them."

For Berto, who can't avoid stress even in retirement in the quiet enclave of Sleepy Hollow, the best solution to stress has been prayer. It's partly her faith that helps her put things in perspective, she said, but she also gives herself time every day to step back and take a deep breath.

"Sometimes you wake up at night and the words start rolling around in your brain and you just can't turn them off. You get the 'what ifs' and worries about everything, and it robs you of your sleep," Berto said. "The Buddhists have their chants, some people meditate. I say a Hail Mary."

Online resources

Learn more about stress at:

vaden.stanford.edu/library/stress.html

members.kaiserpermanente.org/kpweb/healthency.do?hwid=rlxsk&rop=MRN

osher.ucsf.edu/Classes/StressReduction.aspx

The lowdown on stress What happens to the body under stress: -- The adrenal gland produces the hormone cortisol, which puts the body into "fight or flight" mode. In situations of acute stress - a car accident, for example - the cortisol diverts blood to critical systems such as the heart and lungs. Some of the problems associated with chronic stress: -- Continual stress often leads to sleep loss, irritation and despondency, causing problems in relationships and an inability to think clearly. -- A variety of health problems can result, including heart disease, obesity, diabetes, autoimmune disorders and premature cell aging. Chronic stress also can weaken the immune system and leave people vulnerable to illness. Ways to deal with daily stress: -- Take regular daily breaks to relax and clear your head. -- Meditate, even for just a few minutes at a time. -- Exercise. -- Spend time with close friends after work or make the effort to sit down to a family dinner as often as possible. Doctors say the holidays - often perceived as a time of extra stress - can actually help people unwind by forcing them to take time off from work and focus on family.