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How to deal with mean people
January 11th, 2012
11:01 AM ET

How to deal with mean people

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

Not that long ago I was crossing the street with my daughter when a speeding car almost plowed us down.

“Hey! This is a crosswalk!” I yelled through the passing car’s open window.

“I don’t care!” The driver shot back.

Mean people, like vermin, have been around forever. But for some reason - maybe it’s the economic trials of these past few years - there seem to be more of them than there used to be. And I’m not the only one who thinks so: A 2010 National Civility Survey found that two out of three Americans believe civility is a major issue, and three in four believe the negative tenor in our country has grown worse over the past few years.
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Sleeping through the holidays
December 20th, 2011
12:27 PM ET

Sleeping through the holidays

Last year around this time, my friend Sue called worried about her college-age son Charlie because he seemed to be sleeping away his whole Christmas vacation.

“At first, I thought, OK, he is just catching up because he was up many nights studying for finals. But now two weeks have gone by and he is still sleeping the day away.”

There are a number of reasons that college kids or teens could be sleeping all day. As my friend suspected, we do indeed try to “catch up” on sleep. It seems to work to a certain extent, but we can’t make up for the full amount of sleep lost. FULL POST

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Filed under: Mind and body • Sleep • Stress

Stress we face as children stays with us
December 7th, 2011
09:51 AM ET

Stress we face as children stays with us

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 idea that the adversity we experience as children will go on to wound us forever riles me as being particularly unjust.

But that’s exactly what Dr. Rajita Sinha, director of the Yale Stress Center, explained a few weeks ago, when we spoke by phone about her research on stress, anxiety and addiction.

“The stress and motivational systems in the brain are really susceptible to learning and adaptation,” said Sinha. “As children we begin to adapt to our environment and learn things from it. If a child has a pervasive sense of adversity in his or her childhood for whatever reason, the brain responds to that kind of hardship by becoming more sensitized to stress. It gets hard-wired to react much more strongly than someone else who didn’t experience a lot of turmoil. So, to some extent, you will always have an elevated level of stress.”

“Fascinating.” I replied calmly, when what I was really thinking was: “That is so bloody unfair!”
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A cancer survivor's thanks
Amanda Enayati poses with her older brother in a photograph from their childhood.
November 23rd, 2011
07:01 AM ET

A cancer survivor's thanks

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

In two weeks I am going into surgery to reconstruct my right breast, which I lost to late-stage breast cancer four and a half years ago. The tumor was the size of a baby Godzilla. “Nine centimeters!” I remember my mother wailing. “Your entire breast isn’t nine centimeters!”

When the surgeons performed the mastectomy in 2007, they put in an expander - like a placeholder - to stretch out the skin in preparation for an implant. Back then the plastic surgeon said I had to wait something like three to six months for my skin and body to recover from chemo and radiation before I could have the reconstruction.

I was dying to get back to “normal” and so I used every Jedi mind trick I knew to convince the surgeon to operate faster. I even resorted to my old Iranian negotiation tactic of asking the same question over and over again using slightly different words until the person just breaks down from mental exhaustion. Alas, the Stanford surgeon was an ex-New Yorker. He prevailed.
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Filed under: Cancer • Stress

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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October 18th, 2011
04:14 PM ET

How can I move on after my son's death?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Tuesdays, it's Dr. Charles Raison, an associate professor of psychiatry and behavioral sciences at Emory University, and an expert in the mind-body connection for health.

Asked by Trena, Cerritos, California

My baby boy died January 12, and my life has been a nightmare ever since. I have tried therapy, and I have been prescribed different antidepressants and nothing seems to help. I'm told I have post-traumatic stress disorder due to the nature of his death. Is there any natural alternative? Are there any other options out there, be it holistic or medicinal? How long does the grief last? I want to feel better for the sake of my other kids, but I just feel worse.

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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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Filed under: Exercise • Stress

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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About this blog

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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