Ask Dr. K: Stress can be managed, not stopped

Dr. Komaroff


Dear Reader: Your body reacts to acute stressors with a "fight-or-flight" response. Thirty thousand years ago, the acute stressor for your ancestors may have been the sight of several lions heading in their direction. Today, the acute stressor might be a bus rushing toward you as you cross the street.

Following an acute stressor, the brain triggers a cascade of chemicals and stress hormones that speed the heart rate, quicken breathing, increase blood pressure and boost the amount of energy supplied to muscles. All of these changes enable your body to rise to occasions and events that reward heightened awareness and abilities. (I've put a detailed illustration of the stress response on my website,

Unfortunately, the body does a poor job of discriminating between grave, immediate dangers and day-to-day stressful situations.

Sometimes, even when a situation isn't life or death, a jolt of stress can be a good thing. As you mentioned, stress can enhance performance and efficiency. However, acute stress or anything that generates a sudden surge of emotion can occasionally cause a catastrophe.

In a person who has heart disease — dangerously narrowed arteries of the heart — a sudden rush of adrenaline can make the heart work harder. The insufficient blood supply to a hardworking heart can trigger life-threatening irregular heart rhythms.

Sudden surges of fear and anger can cause sudden death. For example, following the Northridge, Calif., earthquake in 1994, heart attacks increased greatly. The same happened after 9/11 — not just in New York, Washington and Pennsylvania, but all over the United States.

The more important negative effect on our health comes from chronic stress. The constant drip-drip-drip of worry — from financial fears, say, or a troubled marriage — tends to build up as the days roll on. This constant stress doesn't find a quick physical release (like running across the street to avoid being hit by a bus); the stress recurs throughout the day. It is so constant that even when you have a moment when nothing is happening to worry you, you worry that something is waiting for you just around the corner.

When the fight-or-flight response is chronically in the "on" position, the body suffers. Stress can bring on or worsen many health conditions, including depression, diabetes, headaches and insomnia. Stress is a prime risk factor for high blood pressure and a major risk factor for heart disease. It also affects the immune system, making you more susceptible to colds and other common illnesses.

It's impossible to sidestep all sources of stress — and you wouldn't want to. Challenges add zest to life and sometimes deliver satisfying rewards.

But if stress is starting to wear you down, you can learn to perceive and manage it in healthier ways. Exercise, meditation, yoga and deep breathing are just a few relaxation strategies to look into. They really work.
