Is It Worth Dying For?: How To Make Stress Work For You - Not Against You - Softcover

Robert S. Eliot, MD, FACP, FACC, was director of the Institute of Stress Medicine in Denver, Colorado, and professor of cardiology at the University of Nebraska Medical Center. He was a medical consultant to major corporations and foreign governments and his work received wide national media coverage, including The New York Times, Time magazine, ABC TV's 20/20, The MacNeil/Lehrer Report, Good Morning America, and USA Today.

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Stress: The Modern Epidemic
 
We all have colds. We all have stress. Colds, however, go away. Stress can be with us for months, years, decades. It can cause tension and illness. And, over long periods, stress can kill.
 
You are not alone if you think you are under too much stress. More than 80 percent of those responding to a recent national poll said that they “need less stress” in their lives. And my colleagues in family medicine have consistently told me that the majority of their patients’ visits are related to unrelieved stress.
 
Modern stress is due, in part, to modern lifestyles. Our circuits are overloaded. Alvin Toffler called it “future shock.” Technology has radically altered our everyday lives—what we need to know, the problems we have to solve, and the threats we have to meet. We are bombarded with constantly changing mental challenges. The mass media, the jet plane, the knowledge explosion, and the computer have all expanded our personal worlds enormously. Researchers estimate that we encounter a thousand times more events per year than our great-grandparents did, but the time available for decision-making remains the same or even less. And personal relationships, which might help us find our place in a huge, impersonal world, are themselves complex, fragile, and ever-changing.
 
Our society offers few buffers against all this uncertainty and mental overload. Instead, we feel we must manage it all, keep on going, and come out on top. But sometimes it’s tough to keep going, and our bodies protest against the struggle. Consider:
 
Painkillers are the leading over-the-counter drugs in this country.
 
The tranquilizer Valium for years has been one of the top five brand name drugs prescribed in America.
 
In addition to alcohol, perennially America’s most abused drug, the current recreational drug of choice is cocaine, a stimulant that relieves stress by artificially causing the kind of high someone gets right after doing something great in life. Unfortunately, this high only lasts for ten minutes or so and then leaves the user flat and can be fatal.
 
13 million Americans are problem drinkers.
 
One out of every four American adults has high blood pressure, potentially a very serious disease that can be caused or aggravated by stress.
 
America’s number one killer, heart disease, can be caused or aggravated by stress.
 
According to the American Medical Association, half of this nation’s annual $425 billion tab for medical services is due to unhealthy lifestyles.
 
Stress—Cause and Effect
 
Until recently, stress management has been largely the concern of psychologists and other mental health professionals. But many physical complaints are caused or aggravated by stress—in fact, stress may be the greatest single contributor to illness in the industrialized world. The mind and body are astonishingly interrelated, and explaining or treating stress-related conditions in terms of one or the other alone just doesn’t work. This is certainly true in the special area of cardiovascular (heart and blood vessel) disease.
 
The major traditional risk factors—high blood pressure, high cholesterol, diabetes, obesity, and smoking—fail to explain approximately half of the worldwide cases of coronary heart disease. There is good reason to believe that stress is a major missing piece in this puzzle. Moreover, researchers are increasingly recognizing not only that stress is an independent contributor to heart disease, but also that it is closely interwoven with the five traditional risk factors. Controlling unnecessary stress may therefore be the single most important key to preventing heart attacks. Realizing this has led medical researchers to look beyond the heart and blood vessels to the brain.
 
 
The Russians have a proverb, “The brain is capable of holding a conversation with the body that ends in death.” I began to understand the wisdom of this saying when I went to Cape Canaveral in 1967 as a cardiovascular consultant to the U.S. government. Young aerospace workers, some as young as twenty-nine, were dropping dead of heart attacks at an alarming rate.
 
The problem, I found, was not the firing of rockets but the firing of people. The government had started making the space race a lower national priority, and each time there was a successful launch, 15 percent of the workers who made it happen were fired. From 1965 to 1973, the work force at the Cape was cut in half, from 30,000 to 14,000. One month these highly trained young professionals were putting in sixteen-hour days in critical, highly paid jobs. The next month they were out of work. Worse, they had no transferable skills. I found them repairing TV sets, sacking groceries, and working as ticket-takers at Disney World.
 
Physical and laboratory exams of engineers at the Cape showed no unusual levels of the standard coronary risk factors. What I found instead were anxiety and depression and a universal, pervasive feeling of hopelessness and helplessness. Cape Canaveral families led the nation in drinking, drug-taking, divorce, and sudden heart attack deaths. The space workers were a whole population suffering from the acute stress of knowing that at any moment they could lose their work, income, status, and identity as skilled professionals.
 
At the lab, I analyzed autopsies of workers who had dropped dead without warning. What I found suggested that adrenaline and other stress chemicals had spewed into their bodies with such strength that they had literally ruptured the muscle fibers of their hearts. It appeared that the brain had the power to trigger heart-stopping emotional reactions to stress.
 
What I had found fell right in with the trail of animal-research evidence linking stress to disease:
 
Mice flown from Boston to Seattle took three days to recover from dangerously high levels of adrenaline, cortisol, and other body chemicals that the stress of the flight had activated.
 
White rabbits which were alternately housed alone and then in densely crowded quarters—but never long enough in either to allow for adjustment—dropped dead within six months of their introduction to the stressful environment.
 
Squirrel monkeys restrained as an experiment displayed a familiar pattern. Six pairs of the animals were kept in chairs for eight hours a day, and once a minute one of each pair had to push a lever to turn off a light or both animals would receive a tail shock. The “executive” monkeys assigned to push the lever every minute developed high blood pressure and heart disease. That’s bad enough. But of the six “helpless” partners who could neither control the situation nor cope with it, four collapsed and died of heart-rhythm disturbances.
 
In a series of experiments with adult male tree shrews, a submissive animal was introduced to an experienced fighter shrew. The dominant animal attacked but was removed before harm could be done. Separated, but still within view, the two shrews were left to stare at each other. What happened next shows the high price paid for the stress of chronic vigilance. The subordinate shrew lay absolutely still and for 90 percent of its waking time did nothing but anxiously watch the dominant animal. Within 2 to 16 days—an agonizing period for the scared subordinate animal—the threatened shrew fell into a coma and died. During the death watch, its tail hair stayed erect, indicating sustained stress.
 
One of the most compelling cases for the adverse effect of long-term stress is what I call the “fourteen-foot risk factor” for heart disease. The hamadryas baboon forms a strong lifelong attachment to its mate. Russian researchers removed male baboons from their mates and placed them some distance away—perhaps 14 feet—in a separate cage and in full view of the mate. A new male was placed in the female’s cage. The displaced baboon was forced to observe his long-term mate with a new lover. He was helpless to change the situation, yet had to endure it. With no alteration in diet or any other factor, within six months the baboons experienced the whole spectrum of heart disease in the modern industrial world: some developed high blood pressure, some had heart attacks, and some died of sudden cardiac death.