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The vicious physiology of stress
November 16th, 2011
03:27 PM ET

The vicious physiology of stress

Editor's note: CNN contributor Amanda Enayati ponders the theme of seeking serenity: the quest for well-being and life balance in stressful times.

One of my favorite parts of this job is stalking busy scientists researching different aspects of stress.

I recently tracked down the brilliant Dr. Rajita Sinha, director of the Yale Stress Center, and spoke to her about what she’s working on. In this first part of our conversation, we discussed the physiology of stress and its connection to maladies, ranging from addiction to chronic disease, diabetes and obesity.

How did you come to study stress?

Early on I was working with different types of emotions - anger and sadness - and how they affect the body and change our responses to different stimuli in the environment. One of the things I observed was that generally people don’t have pure emotions, like anger or fear.

They mostly have mixed emotions. If you ask them about it, they will say they’re stressed and upset. I wanted to understand how emotions work together - both to protect us and to feed into things that wear us down.

Is there such a thing as good stress?

Think about good stress in terms of adaptation. Every time you overcome a challenge and learn something from it, it leads to cognitive and behavioral adaptation. It’s like skill building. When a challenge is frustrating but within our ability to handle it, you are talking about a good stress. It’s stress that is sustained, uncontrollable and overwhelming, where people can’t figure out options to solve their problems, that is damaging.
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Can you tell me about the link between stress, chronic disease and addictive behavior?

We’ve known about the link between stress and addiction, and increased susceptibility to chronic diseases for a long time. But we have not fully understood the biological mechanism until recently.

When we experience something threatening or stressful, two things happen immediately. The first thing is what we call the "fight or flight" arousal response. The whole body is gearing up to move quickly to get out danger. And the second thing is that the body releases the stress hormone cortisol. The body gears up immediately in the face of stressful stimuli. It goes to our energy stores, and releases glucose and insulin so that our muscles have the energy to deal with the stress.

Here’s where the rubber hits the concrete, in terms of our choices. Drugs like alcohol, nicotine and cocaine, and also high-fat, high-calorie comfort foods, are powerful modifiers of the stress system. They will change our stress pathways and affect the way our body is able to control our stress response. And so, after a period of bingeing, your body’s stress system eventually just wears out.

Your adrenal gland, which is responsible for releasing the stress hormone, becomes weak or sputters out. Then it doesn’t signal properly to help us cope. That, in turn, starts to affect us adversely - not just our biology, but also our emotional response.

Can you reinvigorate worn-out adrenals?

There is evidence that you can reinvigorate your adrenals. Once alcohol dependents start recovering, after some time has passed, you start seeing adrenals returning to normal. We know less about how long it takes.

The problem, though, is that while your adrenals are still recovering, you are more likely to be stressed. And stress affects abstinence and increases chances of a relapse. So then you are caught in a vicious cycle of quickly degenerating health because both the stress and the substances are working together to wear down your body systems—your stress axis, your liver, kidney, heart, blood pressure.

Then you get a double whammy in terms of risk for heart disease and certain types of cancer. It’s what we call the feed-forward effect. It’s not going to happen immediately, but it does become a vicious cycle.

Which comes first, the stress or the addictive behavior?

We don’t really know which comes first, but we do know that these are all complex multi-factoral diseases. That means they don’t have one single factor that leads to the disease state. And there are factors that can make a person even more vulnerable to stress-related diseases and addiction: early trauma suffered in childhood, cumulative adversity, socio-economic status, education and also things like genetics and personality traits.

Which aspect of your research are you most excited about right now?

We’re about to release a paper about how cumulative adversity - the number of bad things happening in one’s life - appears to have an effect on the size of the brain’s prefrontal cortex.

What does that mean? Is that a good or bad thing?

It means the higher number of bad events, the smaller the size of the prefrontal cortex. And our animal studies show that less volume in the prefrontal cortex is not good behaviorally. Neurons start shrinking and lose their branches and dendrites. Those animals don’t do well in different kinds of cognitive tasks. So what that means is that higher levels of adversity affect our ability to respond to acute stress situations.

It has two effects: There is less brain volume and the regions that help us adapt and cope are underactive.The more lifetime adversity, the higher amount of chronic stress that a person feels. Then the risk for stress-related disorders go up: heart disease, diabetes, certain types of cancer, psychiatric and neuropsychiatric disorders like depression, anxiety and addiction.

Well, that’s depressing for those of us who’ve been through a lot in life through no fault of our own.

An interesting follow-up is that the brain is very dynamic and there may be potential for normalizing or regrowth. The studies we did are with people between 18 and 50. These are our most generative years, so we hope we can intervene, through treatments, to turn the course.

How can we train ourselves to respond better to stressors?

We live in a society where there are multiple demands on us almost all the time. We need to put greater emphasis on protective factors like sitting down with the family or exercising or putting away all the electronic devices.

I am also a big believer in mindfulness. I think we need to be able to turn things down and off, and build in protections so that we don’t get overwhelmed - even something as simple as a hobby.

I was on a show once where someone had joined a drumming class to relieve stress. It’s a matter of taking the time to build in positive aspects to our life, our actions and our exposure. That’s like money in the bank.

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Research shows that childhood stress can hardwire the brain for a lifetime of higher stress levels. Early traumatic experiences can increase children’s susceptibility to a range of high-risk behavior, such as tobacco use, binge eating, and earlier onset of alcohol consumption. Next week, in the second part of my conversation with  Sinha: childhood stress and the lifelong havoc wreaked by early trauma, as well as protective factors that may counteract the damage.


Thrive under pressure like a pro athlete
November 2nd, 2011
12:49 PM ET

Thrive under pressure like a pro athlete

Editor's note: CNN contributor Amanda Enayati ponders the theme of seeking serenity: the quest for well-being and life balance in stressful times.

The young entrepreneur walked in and sat down. She was focused and calm, with wonderful posture, her hands casually in front of her, just so.

“I looked at her and thought, ‘I wish I had that much poise,’” said my friend Jenna, a communications coach who works with MBA students to help them perfect the art of interviewing and presenting ideas.

“We talked for five minutes, had a normal conversation.” Then the woman started to explain how she has trouble speaking in front of people. “Out of nowhere everything about her started to change: her face began flushing, her hands were shaking, her voice was trembling.”

The entrepreneur’s metamorphosis under pressure was so dramatic, Jenna was still thinking about it days later when we spoke.

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Biofeedback: Can you teach your body to lose stress?
October 19th, 2011
03:39 PM ET

Biofeedback: Can you teach your body to lose stress?

Editor's note: CNN contributor Amanda Enayati ponders the theme of seeking serenity: the quest for well-being and life balance in stressful times.

When it comes to stress relief methods for me, the devil is in the execution. More likely than not, I will stack whatever it is (or an article or book about it) on my bedside table and expect it to sink in through magic and osmosis. Alas …

I got a call early last week from my friend Parvathi, who works for a Washington clinical psychologist specializing in cognitive therapy for patients with anxiety and obsessive-compulsive disorder. “You need to check out some of these biofeedback devices for stress,” she said. “My doctor has a few of them in the office. He lends them out to patients who are having anxiety."

I was skeptical. When I actually saw a picture of one of them, the question was obvious: How do you reduce stress by sticking your finger into a socket thingy and breathing for a while?

“Biofeedback is remarkable,” said Erik Peper, a San Francisco State University professor who has been involved in self-regulation and stress management for decades as both a teacher and a clinician.

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Quick stress busters and how they work
October 5th, 2011
05:03 PM ET

Quick stress busters and how they work

Editor's note: CNN contributor Amanda Enayati ponders the theme of seeking serenity: the quest for well-being and life balance in stressful times.

I have been examining stress from every which angle for the past six months.

And since, by now, I have sufficiently stressed out my editor and probably some readers with essays that often run well over  my assigned length, this week I'm offering up a lightning round of some of the most compelling stress-busting strategies I’ve come across.
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Never too late to find your path in life
September 22nd, 2011
10:27 AM ET

Never too late to find your path in life

Editor's note: CNN contributor Amanda Enayati ponders the theme of seeking serenity the quest for well-being and life balance in stressful times.

“Late bloomers? Late for what? What is it we’re late for?”

I had called Shilloy to discuss late bloomers, chiefly because last year, in her early 40s, she made a dramatic shift in her career as a marketing exec and went back to school to become a therapist. But as I began our interview, it was clear that something was putting her on edge.
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Don't let others stress you out
September 7th, 2011
02:35 PM ET

Don't let others stress you out

Editor's note: CNN contributor Amanda Enayati ponders the theme of seeking serenity - the quest for well-being and life balance in stressful times.

When I tell Pam, my stressed-out lawyer friend, that stress is contagious, she seems unimpressed.

“I have always kind of suspected that,” she says, “ever since in 'Ghostbusters II,' when the guys discover that people’s nonstop negativity has created an evil slime that threatens humanity. Then they find out the slime reacts to both positive and negative emotions, so they have a bunch of New Yorkers hold hands and sing ‘Kumbaya’ to it in Central Park or something. And boom! The slime dissolves.”

I’m sort of speechless, though the comparison is oddly compelling.
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Seeking Serenity: Chilling in the back-to-school chaos
August 10th, 2011
05:07 PM ET

Seeking Serenity: Chilling in the back-to-school chaos

Editor's note: CNN contributor Amanda Enayati ponders the theme of seeking serenity - the quest for well-being and life balance in stressful times.

It has become inevitable that each year, at some point in August, my husband will begin talking about new classes, new wardrobes, new gear and the very long list of things we need to do in preparation for the kids to go back to school.

And every year, this is all I hear him say: “Blah blah blah blah kids go back to school.”

My own early school years were spent in Iran and several Western European countries (after I fled the revolution), where back-to-school just meant you got up early one morning in the fall and went back to school.
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Seeking Serenity: Serious illness won’t get off my back
July 26th, 2011
05:15 PM ET

Seeking Serenity: Serious illness won’t get off my back

Editor's note: CNN contributor Amanda Enayati ponders the theme of Seeking Serenity: The quest for well-being and life balance in stressful times.

One of the most stressful things about having a health crisis, aside from the fear of death, is the lingering paranoia.

It’s like that houseguest from hell who invites himself for a visit and then decides he will never leave. Because here you are, trucking along for 30-some-odd years, assuming that that the achy back is from the Kundalini yoga move gone awry and that lingering cough is from the cold you caught from your frenemy.

But once you’ve sparred with a serious illness like cancer, almost overnight you start seeing conspiracies to off you everywhere. Joyful, grateful and almost giddy you are to have survived at all, you bob up and down in constant waves of stress and anxiety. They can build to near-tsunami proportions each time you lose another friend who got her diagnosis at the same time as you or sat there beside you while you both received chemo or chatted with you in the waiting room during radiation.

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Seeking serenity: How high-achievers chill
July 13th, 2011
07:19 AM ET

Seeking serenity: How high-achievers chill

Editor's note: CNN contributor Amanda Enayati ponders the theme of Seeking serenity: The quest for well-being and life balance in stressful times.

Happiness - or rather, the quest for happiness - was in the air at this year’s Aspen Ideas Fest as the topic was examined rather earnestly from every angle: the history of happiness, its psychology, neuroscience, economics and geography.

There was even a session on how to recognize happiness, though fairly certain of my abilities on that front, I played hooky in favor of pedaling around town on a bicycle.

And truth be told, Aspen in the summertime is rather easy to be happy in: 360 degrees of opulent white-flecked mountains covered with shocks of gorgeous green in at least a dozen shades, vast sweeps of vivid wildflowers swaggering on every corner, the freshest air completely devoid of frizz-inducing humidity and rather frequent sightings of chipmunks and celebrity types.

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Seeking Serenity: A life less cluttered
June 16th, 2011
10:59 AM ET

Seeking Serenity: A life less cluttered

Editor's note: CNN contributor Amanda Enayati ponders the theme of Seeking Serenity: The quest for well-being and life balance in stressful time.

I vowed that I would not sit down to write this piece until I cleared some of the clutter around my house. Alas, two weeks passed and the piles remained. With a deadline and the wrath of my editor looming, I swallowed the angst of potential hypocrisy and began writing.

I’m no hoarder, mind you, just your average run-of-the-mill pack rat. And it is quite likely that to a lesser or greater degree, you are one too.

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.

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