Cause and Effect Essay

Stress isn't just a catchall complaint; it's being linked to heart disease, immune deficiency and memory loss. We're learning that men and women process stress differently and that childhood stress can lead to adult health problems. The worst part is, we inflict it on ourselves.; Stress Adler, Jerry . Newsweek , International ed.; New York (Jun 28, 1999): 48.

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ABSTRACT (ABSTRACT)  

Zen masters, of course, have known this for a long time, and techniques such as yoga are still useful prescriptions

for stress (following story). But orthodox Western medicine long resisted the notion that a purely mental condition

could have measurable effects in the empirical realm of arteries and organs. "When I started studying stress 30

years ago, I was told I was jeopardizing my medical career," says Dr. Herbert Benson, who founded the Mind/Body

Medical Institute at Harvard. It was only in the past few years that researchers came up with a quantifiable

measure of stress, based on the concentration of certain hormones in saliva, and began tracing the complex

neurological and chemical events that lead from a traffic jam on the Santa Monica Freeway to cardiac intensive

care at Cedars- Sinai. Research has revealed that men's and women's bodies process stress differently, and

provided disturbing evidence about how stress affects child development from the earliest weeks of life. And it has

spawned a whole new discipline, psychoneuroimmunology--which, according to Bruce Rabin of the University of

Pittsburgh, has reached the point where research on smoking and cancer was back in the 1960s. "You knew there

was a link because of the epidemiology, but you didn't know the mechanism. Now there's enough epidemiology to

establish the association [between stress and illness]. We're still working out the mechanisms."

The classic study linking stress to immune dysfunction was done just in 1991, when Carnegie Mellon psychologist

Sheldon Cohen and his colleagues showed that people who ranked high on a psychological test of perceived

stress were more likely to develop colds when intentionally infected with a respiratory virus. He repeated the study

last year and this time refined his results: although a single, large, stressful event in the preceding year did not

affect the subjects' chances of getting sick, chronic stress--ongoing conflicts with co-workers or family members,

for example--increased the odds by as much as three to five times. Looking at another measure of immune

function, response to a standard influenza vaccine, immunologist Ronald Glaser of Ohio State found diminished

antibody production (compared with a control group matched for age) among people caring for a spouse with

dementia. "The human body," says Dr. Pamela Peeke of the University of Maryland, "was never meant to deal with

prolonged chronic stress. We weren't meant to drag around bad memories, anxieties and frustrations."

Apart from gender, early childhood experiences seem to have a powerful influence on how people deal with stress.

Children raised in orphanages or in neglectful homes may have elevated levels of glucocorticoids and "hot"

responses to stress later in life. "We're finding," says Frank Treiber of the Medical College of Georgia, "that if you

come from a family that's somewhat chaotic, unstable, not cohesive, harboring grudges, very early on, it's

associated later with greater blood-pressure reactivity to various types of stress." The brains of children up to

around the age of 8 are still developing in response to the environment; cells literally live or die as experiences

impinge on it. "The early brain can become hard-wired to deal with high fear states," says Dr. Jay Giedd of the

National Institutes of Health. "Its normal state will be to have a lot of adrenaline flowing. When these children

become adults they'll feel empty or bored if they're not on edge." Contrariwise, children raised in secure, loving

homes learn to modulate the stress reaction, according to Megan Gunnar of the University of Minnesota.

Newborns typically show a cortisol spike under the stress of circumcision. But as early as three months, well-

cared-for babies can suffer discomfort without evoking a stress response; they'll cry when they get a physical

exam, but their stress hormones don't go up commensurately. "Children who are in secure, emotionally supportive

relationships are buffered to everyday stressors," she says.

FULL TEXT  

It was vital to survival once--an innate response to danger, inherited directly from the primeval veld down to our

own lifetimes, where it causes nothing but trouble. Some people make a virtue of stress, under the mantra "that

which does not kill me makes me stronger." But science shows this to be a lie. A whole new body of research

shows the damage stress wreaks on the body: not just heart disease and ulcers, but loss of memory, diminished

immune function and even a particular type of obesity. That which doesn't kill you, it turns out, really does kill you

in the end, but first it makes you fat.

Zen masters, of course, have known this for a long time, and techniques such as yoga are still useful prescriptions

for stress (following story). But orthodox Western medicine long resisted the notion that a purely mental condition

could have measurable effects in the empirical realm of arteries and organs. "When I started studying stress 30

years ago, I was told I was jeopardizing my medical career," says Dr. Herbert Benson, who founded the Mind/Body

Medical Institute at Harvard. It was only in the past few years that researchers came up with a quantifiable

measure of stress, based on the concentration of certain hormones in saliva, and began tracing the complex

neurological and chemical events that lead from a traffic jam on the Santa Monica Freeway to cardiac intensive

care at Cedars- Sinai. Research has revealed that men's and women's bodies process stress differently, and

provided disturbing evidence about how stress affects child development from the earliest weeks of life. And it has

spawned a whole new discipline, psychoneuroimmunology--which, according to Bruce Rabin of the University of

Pittsburgh, has reached the point where research on smoking and cancer was back in the 1960s. "You knew there

was a link because of the epidemiology, but you didn't know the mechanism. Now there's enough epidemiology to

establish the association [between stress and illness]. We're still working out the mechanisms."

The very concept of stress was formulated only in the 1930s, by the pioneering endocrinologist Hans Selye. It was

Selye's insight that organisms show a common biological response to a wide range of unpleasant sensory or

psychological experiences. These are called "stressors." Stressors are, in shorthand, whatever you're trying to

avoid: an electric shock, if you're a lab rat; the sight of a predator, if you're a prey animal; a 500-point drop in the

Dow, if you're a Yuppie. Those are acute stress events; everyone recognizes the adrenaline rush (pounding heart,

dry mouth, butterflies in the stomach) that marks their onset. Human beings are equipped to deal with it, if it

doesn't happen too often. But when it happens again and again, the effects multiply and cascade, invisibly,

compounding over a lifetime.

The classic study linking stress to immune dysfunction was done just in 1991, when Carnegie Mellon psychologist

Sheldon Cohen and his colleagues showed that people who ranked high on a psychological test of perceived

stress were more likely to develop colds when intentionally infected with a respiratory virus. He repeated the study

last year and this time refined his results: although a single, large, stressful event in the preceding year did not

affect the subjects' chances of getting sick, chronic stress--ongoing conflicts with co-workers or family members,

for example--increased the odds by as much as three to five times. Looking at another measure of immune

function, response to a standard influenza vaccine, immunologist Ronald Glaser of Ohio State found diminished

antibody production (compared with a control group matched for age) among people caring for a spouse with

dementia. "The human body," says Dr. Pamela Peeke of the University of Maryland, "was never meant to deal with

prolonged chronic stress. We weren't meant to drag around bad memories, anxieties and frustrations."

Other studies (chart) have found an association between long-term stress and heart problems. That's also true of

macaque monkeys, favored subjects of stress researchers because they share with humans a hierarchical social

structure and a susceptibility to coronary- artery disease. Wake Forest University anthropologist Jay Kaplan

studied both high- and low-status male macaques in captivity, and found, as expected, that the subordinate ones

showed more atherosclerosis. But when he artificially shook up the social hierarchy, by introducing new animals

into the troop, it was the high- ranking males, forced to fight again and again to establish their dominance, who

showed the most signs of coronary disease.

Yet the stress reaction obviously serves an evolutionary purpose. It is, essentially, a response to danger, in two

distinct phases. The first of these, involving the "sympathetic-adreno-medullary axis" (SAM), is the familiar flight-

or-fight response. Your brain perceives a threat--a lion crouched in the brush is the classic illustration-- and sends a

message down the spinal cord to the medulla, or core, of the adrenal glands (chart), signaling it to pump out

adrenaline. In a matter of seconds, the body is transformed. To prepare for exertion, blood pressure and heart rate

skyrocket; the liver pours out glucose and calls up fat reserves to be processed into triglycerides for energy; the

circulatory system diverts blood from nonessential functions, such as digestion, to the brain and muscles. This is

precisely what you need if your goal is to survive the next 10 minutes.

Civilization, by contrast, gives you the opportunity to experience an adrenaline rush at every traffic light. And--since

all you're doing is sitting in your car--the elaborate preparations your body makes are wasted. Worse than wasted:

every heartbeat at elevated blood pressure takes its toll on the arteries. The excess fats and glucose don't get

metabolized right away, so they stay in the bloodstream. The fats contribute to the plaques that form inside blood

vessels, which can lead to heart disease or strokes; high levels of glucose are a step in the direction of diabetes. "If

you mobilize in the first place for a nonsense psychological stressor," says Robert Sapolsky of Stanford, a leading

authority on stress, "by definition your defense becomes more damaging than the imaginary challenge."

The second phase to the stress reaction kicks in five to 10 minutes later. This "hypothalamic-pituitary-

adrenocortical axis" (HPA) seems more closely associated with emotional and intellectual stress. Researchers

have many clever ways of producing intellectual stress, such as asking subjects to name the color of ink a word is

written in (blue) when the word itself spells out the name of a different color (red). The HPA axis originates in the

hypothalamus, in the middle of the base of the brain. The hypothalamus signals the pituitary to produce a

substance called ACTH, which stimulates the adrenal cortex to produce a set of hormones known as

glucocorticoids: cortisone, cortisol and corticosterone.

The action of these is complex, because hormones almost always work as part of a loop of positive and negative

feedbacks. Glucocorticoids seem to stimulate the hippocampus, a part of the brain vital to memory and learning.

But an excess of these hormones can actually be toxic to the hippocampus. People with above-average

glucocorticoid levels--including those with depression and post- traumatic-stress syndrome--tend to have impaired

memory and cognition. Their hippocampi may actually appear shrunken in an MRI scan. Glucocorticoids also

suppress parts of the immune system. Researchers still don't understand why the body should suppress immunity

during times of stress--if anything, the opposite would seem to make sense. But the negative effects are clear:

chronic stress leaves one more vulnerable to infections.

And, amazingly enough, stress can even change the shape of your body. Since the stress reaction involves

mobilizing the body's fat reserves for energy, Peeke says, it makes sense to store that fat near the liver, which

processes it so it can be metabolized in the muscles. Sure enough, fat cells in the abdomen appear to be especially

sensitive to glucocorticoids, and people with a high concentration of those hormones tend to accumulate fat

around their middles--a potbelly--even if the rest of their bodies are thin. Researchers think that waist-hip ratio, the

relative circumference of those two body parts, could be a useful way to identify people at risk for stress-related

disease.

But not everyone gets all of these diseases, or even any of them. People respond differently to the same objective

stressors. Individuals' cortisol levels vary (in general, the older you are, the higher the concentration), and they go

up by varying amounts in reaction to stress. But, surprisingly, that effect doesn't seem to follow a normal bell-

shaped curve, like most physiological variables. Instead, some studies suggest, people fall into categories of "hot"

or "cool" responders. A 1995 study subjected 20 men to five grueling days of mental arithmetic performed before

an audience. Starting from about the same baseline--a cortisol concentration in saliva of seven to eight nanomoles

per liter--one group, comprising seven men, shot up to an average of 29 in the first day; the rest went only to

around 19. The first group, researchers reported, "view themselves as being less attractive than others, having less

self-esteem, and being more often in a depressed mood." Not surprisingly, they also reported more health

problems.

Catherine Stoney of Ohio State has also found significant differences between men and women. Women's blood

pressure goes up less than men's in reaction to stress (although their response increases noticeably after

menopause or hysterectomy, suggesting a buffering effect from estrogen). But women tend to react to a wider

range of outside stressors than men, according to Ronald Kessler of Harvard, who asked 166 married couples to

keep a daily stress diary for six weeks. Women feel stress more often, says Kessler, because they take a holistic

view of everyday life. A man may worry if someone in his immediate family is sick; his wife takes on the burdens of

the whole neighborhood. "Men take care of one thing [at a time]," he says. "Women put the pieces together again."

Apart from gender, early childhood experiences seem to have a powerful influence on how people deal with stress.

Children raised in orphanages or in neglectful homes may have elevated levels of glucocorticoids and "hot"

responses to stress later in life. "We're finding," says Frank Treiber of the Medical College of Georgia, "that if you

come from a family that's somewhat chaotic, unstable, not cohesive, harboring grudges, very early on, it's

associated later with greater blood-pressure reactivity to various types of stress." The brains of children up to

around the age of 8 are still developing in response to the environment; cells literally live or die as experiences

impinge on it. "The early brain can become hard-wired to deal with high fear states," says Dr. Jay Giedd of the

National Institutes of Health. "Its normal state will be to have a lot of adrenaline flowing. When these children

become adults they'll feel empty or bored if they're not on edge." Contrariwise, children raised in secure, loving

homes learn to modulate the stress reaction, according to Megan Gunnar of the University of Minnesota.

Newborns typically show a cortisol spike under the stress of circumcision. But as early as three months, well-

cared-for babies can suffer discomfort without evoking a stress response; they'll cry when they get a physical

exam, but their stress hormones don't go up commensurately. "Children who are in secure, emotionally supportive

relationships are buffered to everyday stressors," she says.

Many authorities think childhood stress is on the rise. Dr. Barbara Howard, a pediatrician at Johns Hopkins, says a

quarter of her patients are there for stress-related problems, and the proportion has been rising. "They'll come in

with abdominal pain, urinary frequency, headaches... a whole variety of complaints which could be mistaken for

medical problems and often are." Parents are frequently wrong about the sources of stress in their children's lives,

according to surveys by Georgia Witkin of Mount Sinai Medical School; they think children worry most about

friendships and popularity, but they're actually fretting about the grown-ups. "The biggest concern," she says, "was

that the parents are going to be sick, or angry, or they're going to divorce." And "often and somewhat surprisingly,"

says Giedd, "children have very global worries"-- wars, environmental issues and crime, the same things adults

worry about.

Which raises the question no researcher dares answer: is increasing stress an inevitable hazard of modern life? In

many of the ways that count, Kessler muses, life was more stressful 200 years ago, when children routinely died

before reaching adulthood. But life was simpler then, too, he thinks, before "anxiety became a core theme in our

lives." People knew their place in society and lived with the support of extended families, tribes and villages. What

is certain is that people came into the world then, as they do now, prepared by millions of years of evolution for

dangers long gone from our lives. The challenge we face is to master not the threats themselves, but our all-too-

human responses to them.

Graphic: (Graph) The Toll Stress Takes on the Body (Graphic omitted) Graphic: (Chart) Stressed Out? (Graphic

omitted)

Illustration

(Graph) The Toll Stress Takes on the Body (Graphic omitted); (Chart) Stressed Out? (Graphic omitted)

Credit: By Jerry Adler; With Claudia Kalb and Adam Rogers

DETAILS

Publication title: Newsweek, International ed.; New York

Pages: 48

Number of pages: 0

Publication year: 1999

Publication date: Jun 28, 1999

Publisher: Newsweek Publishing LLC

Place of publication: New York

Country of publication: United States, New York

Publication subject: Political Science

ISSN: 01637053

Source type: Magazines

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Last updated: 2017-11-07

Database: Health &Medical Collection