Wheeler: I think it's a little bit worse here in the U.S., but that's just my feeling. When you look at obesity rates and rates of heart attacks and other chronic disease, which I think is a good marker of how much stress there is in society, there's a big problem all over the world.
People don't realize that obesity is actually a problem in places like China, Japan, Africa -- places you would normally not expect that to happen. It actually is a worldwide pandemic.
What's causing it?
My theory is it's the high availability of these foods that we aren't meant to consume, like high-fructose corn syrup and bad fat. At least in industrialized countries, I think stress is driving a lot of that sort of mindless consumption.
Why do you say a lot of stress comes from inside our heads?
We've created a very stressful environment. But it's how you cope with those problems that determines how much of a hit your body's going to take from the stress. That's what stress management is about.
You say levels of the stress hormone cortisol stay high for hours after a stressful event. How does that affect the immune system?
Cortisol has a dual effect on immunity. When it's around for only an hour or two in high levels in the blood, it tends to stimulate immunity, but after that it starts to shut it down, to suppress it. If you have a life that is marked by so many hassles that you have maybe three, four, five jolts in the course of a single day, that cortisol is never going to go back down to the normal curve.
Can a chronically stressed person lose the ability to regulate cortisol?
Yes, and this is more in the realm of naturopathic medicine, although it is starting to be studied more in the realm of traditional science -- this idea of adrenal burnout. Then you just become kind of exhausted and it becomes harder to cope. People who have had post-traumatic stress disorder for a long time tend to have abnormally low cortisol levels.
Can that be reversed?
There are some treatments for PTSD but the earlier you start treating it, the better your chances are. The really scary thing about post-traumatic stress is (that) the structure of the brain actually changes. It's not just the chemistry of the brain, but the hippocampus -- certain parts of the emotional center of the brain -- they shrink. The cells actually die. So it's almost like Parkinson's, where you actually lose a part of your brain.
Can that be regenerated?
We don't really know.
How does stress affect aging and mental function?
(There's) a phenomenon called neurogenesis, where we can actually make new nerve cells and rebuild our brains. But stress really slows that down, really makes that hard to do.
So when we make new nerve cells in our brains, that's useful for what? Memory?
Well, it helps keep you from becoming demented as you age, definitely. I went to med school in the '80s, and at that point the dogma was if a brain cell dies, that's it, you're done. Now we know that's not true. And regular physical exercise, mental work like crossword puzzles, all that helps keep you younger. But now we're finding out that it keeps you younger by helping your brain continue to make new cells. It's not just that you're staying spry because you're involved in your life, it's because your body is actually functioning better and aging more slowly.
Does that imply that chronically stressed people are at higher risk of dementia?
Yes. It definitely implies that. And there is beginning to be some evidence of that fact.
One coping strategy you suggest is to assess what's at stake in a stressful event and how much control you have over the situation. That sounds a little like the serenity prayer.
Yeah, it's funny how much of the older thinking -- even all that stuff by "The Power of Positive Thinking" guy, Norman Vincent Peale -- is borne out in science. When people make positive or optimistic appraisals, their immune and stress physiology is improved.
So you're saying to put a positive spin on things.
Yeah. But it's not being a Pollyanna. The most effective form of coping is active-approach coping: You acknowledge that something bad has happened, and you allow yourself to have an emotional reaction, but then you behave in a way that's effectively taking on the problem. Suppression of emotion isn't helpful, and constant denial isn't helpful but wallowing and feeling sorry for yourself is also not helpful.
Describe how stress and eating become a vicious circle.
There's been a lot of research in laboratories lately where you bring people in, you see how stressed they are at baseline and then you make them do something that stresses them out, like math or public speaking. And then when it's over you just casually offer them some food. And the people who are more stressed at baseline tend to get more stressed by this task that they had to do, and they are much more likely to choose food high in sugar and fat than the people without the elevated levels of stress hormones. And this human research comes after 10 years of lots of work on rats. So this is very well documented, physiologically. So then we end up consuming too many calories. And even if it's only 100 extra calories, if you take that in when you're stressed, then your body's going to respond to it in a totally different way than if you're relaxed.
To what extent is our stressful society to blame for the obesity epidemic?
You can't blame an individual entirely for the way they're behaving but you also can't blame the society for it, either. They're all happening at one time. But we don't set up cities and towns that make it conducive to walking, there's not parks. So there are a lot of people who say our society is an obesogenic environment -- it's all set up to make people fat.
And dieting while you're under stress increases the risk of bingeing?
Oh, yeah. We started that whole line of research with dieting rats -- putting rats on a diet and then seeing how they behave when suddenly there's food available. Or you stress them, and then they just go crazy for the lard.
What's the single best thing that people can do to manage stress effectively?
Usually what I tell my students is, "If I could make you do one thing it would be to take a walk every day for half an hour, because there are so many benefits to that." The other thing is, (people) could really benefit by recognizing emotion as something that has a beginning, middle and end. If you are a person who suppresses your emotions, try expressing them a little more freely. And if you're a person who overdoes it, try just "letting it go" when it's done. I suggest to people, give yourself a time frame: "I'm going to be upset about this for 15 minutes." It doesn't always work because sometimes it's a lifelong habit, but it puts it in perspective, like, "Gosh, you mean I have some control over this? Wow."
COMING UP
DR. CLAIRE MICHAELS WHEELER
WHAT: Discussions, signings and workshop
WHEN: Free discussions and book signing Jan. 25, 2008, 7:30-9:30 p.m., and Jan. 28, noon-1:30 p.m.; $40 stress-reduction workshop Jan. 27, noon-4 p.m.
WHERE: Jan. 25-27, East West Bookshop, 6500 Roosevelt Way N.E.; Jan. 28, University Book Store, 990 102nd Ave. N.E., Bellevue
INFORMATION: stresshappiness.com
