Stress is a Killer, But Here is What You can do...

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Can Stress Literally Kill You?

Stress can cause a heart attack among other diseases and ailments. Find out practical, drug-free ways to manage and eliminate stress

For years, I have educated my patients on the two things that cause all disease: poor nutrition and chemicals. Your typical M.D. does not comprehend this fact. But over time I came to realize physical inactivity, sleep quality, and mental disorders may be equally as important.

I know the label mental disorders brings Jack Nicholson to mind in "One Flew Over the Cuckoo's Nest," but symptoms may be more subtle. Mental disorders include stress, depression, anxiety, anger, and social isolation. It is not a secret that in today's society of information overload, political turmoil, and financial unrest, the health of America is suffering. Some amount of mental distress is normal and probably healthy. Our ancestors no doubt had some of the same feelings. But clearly the problem is worsening. 80% of respondents reported an increase in stress over only one year, according to a survey by the American Psychological Association. The fact is, the rise of cardiovascular disease parallels the increase in mental health disorders.

A recent patient told me how a fight with her boss triggered a heart attack. Yes, can you believe it! The boss had been coming down on her for quite some time. Unfortunately, a significant outburst led to chest pain a few minutes later. She didn't think much of it, but as the tightness didn't go away, she decided to leave work. In the emergency room, an acute myocardial infarction was diagnosed and an angiogram was performed. Stress can lead to a heart attack or even worse.

Conventional Docs Don't Get It

During my ten years of medical training, I cannot recall ever discussing mental disorders and their relation to physical health. Even on my psychiatry rotation as a third year student, the focus was on medications. Mental problems, and how to deal with them, are rarely discussed in the short office visit with a primary care doctor. If the subject comes up, going after the cause is not likely—the pharmaceutical approach is always first in line. One nation under Prozac has to stop. 

In a bizarre circle, poor mental health often leads to bad food, alcohol, drugs (prescription and over-the-counter), tobacco, little exercise, and numerous other unhealthy lifestyle choices. All of these factors alter the gut microbiome, the bacteria crucial for health. Many studies conclude the variety of probiotics in your intestines influences mental health. Lousy nutrition clearly contributes to poor mental health. Eating sugar and fast food cannot prepare you for the rigors of life as effectively as an organic, Paleo diet. Gluten, for example, destroys the intestinal barrier; therefore, nutrients are not absorbed and inflammation is rampant. Some of those critical nutrients include B12 and fatty acids, both vital for brain health. Omega-3 fat from seafood is necessary for our brain. There is exciting research using probiotics to improve mental health.

Could poor mental and physical health actually start in the womb or even before conception? So many young women eat junk food, ingest pharmaceuticals like ibuprofen and psych meds, and are drowning in chemicals. Because of this toxic burden, the developing mind of a child has little chance. Sadly, many children are not breast fed, which increases the risk of mental health problems. Additionally, children are given antibiotics for the slightest fever, leading to a loss of healthy gut bacteria. Then, when the child acts out at the age of 5, drugs are prescribed and a lifetime of pharmaceuticals begins.

Stress Kills

Most of us would consider ourselves to be under stress, but what does that word really mean? Stress refers to both physical and emotional challenges, some of which may be transient and rather harmless such as short-duration exercise, test taking, or a work deadline. These scenarios may be positive and are considered similar to our caveman brethren who ran after food, and ran away from becoming food. Dealing with Mother Nature was usually not a difficult task and most likely our ancestors led a relatively peaceful existence. But modern stress may be chronic and uncontrollable (e.g., caregiving for a loved one with a terminal illness, financial issues, relationship problems), leading to body dysfunction and ultimately symptomatic disease. Searching the words "stress" and "coronary artery disease" reveals over 17,000 studies on the health journal site PubMed.

Over the last few years as a natural cardiologist, I have asked my patients about stress levels prior to a heart event or symptoms. Almost always, the patient admits to something which could have been the trigger. Unsurprisingly, there are well-established connections between stress and cardiovascular disease. A study from 2002 looked at men and women correlating stress with metabolic syndrome (MetS) and heart disease. MetS is the group of findings, including hypertension, obesity, abnormal lipids, and elevated blood sugar, associated with a marked increase in cardiovascular problems. The authors found that caregiver men (those taking care of another person) had twice the risk of heart disease compared to non-caregiver men. The women caregivers with sleep issues, distress, anger, and hostility also had worse outcomes. The MetS association is not surprising, given the fact data shows increased blood sugar and fasting insulin levels in those with perceived stress. These are significant predictors of heart and neurologic issues. Markers of inflammation rise during acute stress.

Heart attacks are 50% more common in those complaining of stress versus those who don't. Heart attack survival is lower in those experiencing high stress. Patients with high psychosocial stress in cardiac rehabilitation were almost four times as likely to die as those with low stress. Caretakers of people with chronic health conditions maintain higher resting heart rates, higher blood pressure, and a greater incidence of the metabolic syndrome. Inflammation markers are also higher. The loss of a spouse doubles the risk of a heart attack or stroke in the following 30 days, according to a recent report. There are many stressful categories in a Life Event Scale and all are likely to increase the risk of cardiovascular events. This ranges from getting married to getting divorced, losing a job to getting a promotion. Job stress is reported to increase the risk of a cardiac event by four-fold; it also increases the risk of carotid atherosclerosis. Subjecting coronary disease patients to mental stress actually made their heart function worse, concluded another recent study.

It is well known Monday mornings and return from a vacation or holiday are popular times to suffer a heart attack. I saw these scenarios play out for many years. The morning after Daylight Savings time in the spring leads to more cardiac events. Heart attacks are more common during the Super Bowl. One thing I noted was a rise in hospital admissions after basketball playoff games in Chicago. Watching Michael Jordan and the Bulls in the 90's make their run for another title proved to much for some people.

A scary trend over the last ten years is the rise of Takotsubo syndrome, also known as "Broken Heart Syndrome." In this scenario, a stressful event leads to a heart attack and damaged heart muscle. When an angiogram is performed, no blockage is found. An artery spasm from an epinephrine surge is the likely culprit. This was a rare diagnosis during my training, but it appears to be on a rapid rise. Middle-aged women are the most frequent victims.

What to Do About Stress

1)     Eat healthy. It stands to reason people who eat the healthiest have less stress, and cope with stress better than fast food junkies. Give Paleo a try for a few weeks and see the benefits on your psyche.

2)     Kick the caffeine. Drink plenty of purified water instead.

3)     Sleep your stress away. 8-9 hours is ideal.

4)     Choose a career path that will make you happy.

5)     Exercise. According to Harvard Men's Health (and about a million other sources), exercise reduces stress. Exercise, of course, lowers cardiac risk.

6)     Get sunshine. The sun is the source of all life. Seasonal affective disorder is a type of depression, and sun exposure is the answer.

7)     Practice relaxation techniques, yoga, tai chi, etc.  One of my favorite smartphone apps is called Relax Lite from Saagara. I recommend it to all my patients and find those who do the program daily improve blood pressure.

8)     Social media is a good way to engage with other people and cultivate relationships. Pen pals, email partners, and text messaging are excellent ways to stay in touch with people from afar.

9)     Go meet your neighbors. Seek out healthy relationships and end troublesome ones. Seek counseling if needed. Join a club, get a hobby, or even go to the library. Do what it takes to find friendship in society. Your heart will benefit immensely.

10)   Take the right supplements. Vitamin C and D are stress relievers as are L-theanine and ashwagandha. Omega-3 fats, as documented in The Omega-3 Connection, produce a similar effect. 

Get Dr. Jack Wolfson's New book on his website!


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