Online Dating and Love Information Articles

Foam neck pillow is ideal for people who often fall asleep on long journeys, that is the reason why they appear almost dead, least bothered about the posture they take to, while sleeping. This results in acute pain in the neck as well as the shoulders later on. The pillow that a person gets to use at the time of traveling may offer some comfort. However, it may develop pain in the neck when the person wakes up finally.

This pillow is the best and innovative solution to address this problem. The advanced, pillow offers maximum level of comfort that no other ordinary pillow can. It takes enough care of the head and neck while traveling and offers great support throughout the trip. It responds well to body temperature and heat. This pillow type conforms to the natural shape of the human structure.

Such is this healthy pillow designed that its flat edge on the backside rests alongside the users back, allowing the user to maintain correct balance of the body. The posh, velour color of that neck pillow is soft to the skin and is machine-washable.

Features:

The newly built, state-of-the-art foam neck pillow relieves people from regular disorders such as neck pain, snoring, insomnia and stress. The pillow cover made of natural medicate cotton is helpful for people suffering from allergy.

The benefits of foam neck pillow:

1. The natural medicate cotton pillow cover is perfect for people whose skin is prone to allergy. The pillow cover is termite resistant.

2. The common size of this pillow cover is 20″L * 11″W. It is four inches in thickness.

3. The passage in the foam allows good exposure to air and absorbs sweat.

4. This unique pillow is sensitive to temperature and connects with the body heat, changing shapes according to use.

5. The pillow positions head and neck in correct order and reduces pressure points for relief from back and neck pain.

Does it seem like going to bed with your partner consists of going right to sleep? You both work and are tired at the end of the day and there is no desire for anything but sleep. Has the fire died, is the passion gone? Probably not. You just need to turn up the heat a little.

The greatest challenge that confronts monogamous relationships today is to maintain the sexual passion once the newness of the initial months or years has worn off. You don’t have to have a sexual problem for sexual desire and excitement to die. Excitement tends to fade for three reasons.

The stress of life in our busy fast paced life today and society. Many of us are so busy with two careers, children, cooking, errands, etc. that we are left exhausted with little quality time left over for sexual or emotional intimacy. In the priorities of life, our sexual relationship gets placed towards the end of the list, sometimes even in last place.

The second interfering factor is the suppression of feelings. When something bothers us, we tend to hold it in — either because we don’t want to rock the boat or because we feel too vulnerable and unsafe to be open.

Unfortunately, you can’t suppress some feelings while leaving others free to grow and expand. If you are holding in angry or hurt feelings, you automatically will be holding in sexual feelings as well. If you don’t feel safe to express yourself or trust that you will be heard and respected, you are likely to protect yourself by holding back from the vulnerability that occurs with sexual intimacy.

The expectation that sex should take care of itself is the third culprit responsible for diminished sexual passion. Many of us grew up in families that taught us to be ashamed of our sexual feelings or to feel embarrassed about sex. We expected great sex to just happen if we were really in love with our partner.

But this is not true. Like other areas of life, if you expect to reap the rewards of sexual intimacy you need to put energy in. You would never consider putting energy into a business for a year and then expect it to support you for the rest of your life. For the same reasons, a sexual relationship requires ongoing attention, expansion, and even risk. It requires that you set aside time to experiment and have fun, thereby prioritizing your partner and your sex life.

So you want it back? Here are some thoughts to try.

Leave a note for him or her to see in the morning, or leave an email, voicemail with clues throughout the day for them to anticipate the evenings outcome. For her, candlelight, soft music, hot bath waiting, rose pedals on the floor leading from the door to the bedroom, and you on the bed waiting for her to come in.

For him, candle light, soft music, aroma of his favorite perfume, you waiting by the fire on a rug with your new sexy lingerie waiting for him to come through the door to find you ready for his taking.

Passion takes work, take the time, put it at the top of your daily list. Other things can take a backseat, let the one you love know that the fire has not extinguished. Start by buying something you know he or she will love and start that fire burning again. The first step is you need to feel sexy. Go to the site below and get started on rekindling that flame by feeling sexy.

Using 970 subjects in an emergency department to measure stress with a life event inventory and drawing from subjects in an early pregnancy study, the odds ratio for spontaneous abortion at [greater than or equal to]11 weeks was 2.9 for association with more life event stress (95% CI 1.4-6.2) vs. those with little life event stress. Women experiencing >one stressful life event used more alcohol and public assistance. Spontaneous abortion at an early fetal age only was associated with stress, implying that life event stress increases the risk of chromosomally normal spontaneous abortion. Tobacco use was also associated with an increased risk of spontaneous abortion.

Boyles SH et al. Life event stress and the association with spontaneous abortion in gravid women at an urban emergency department. Health Psychol 2000 Nov; 19(6):510-14

COMMENT: No organ system is free from pathology associated with stress. Stress has been shown to be related to increased incidence of pre-eclampsia (see below), premature labor and reduced infant weight. The mechanisms underlying these empirical observations are still in question, but hormonal relationships and free-radical chemistry are likely involved. Maybe the Borden Company was right: milk from contented cows is better? Contentedness with little stress is optimal.

? Within three years, I have had four stress fractures in the right tibia. I’m a 40-year-old female with a six-year competitive racing history, plus bike races and triathlons. I weight train weekly as well. I’ve been to an orthopedic surgeon, a podiatrist, a physical therapist, a sports medicine doctor and two chiropractors. I have tried the following solutions: I run on a rubberized track once a week; I run on a treadmill once a week; I run on trails once a week; I take Fosomax, isoflavones and hydro-calcium supplements; I have had orthotics; I wear arch supports; after no impact exercise for six weeks, I had pain immediately while trying to run on grass. Two bone scans revealed some bone thinning, but in my back only. I weigh 110 pounds. I’m running out of ideas.

If you are a highly competitive athlete with the kind of heavy training schedule you indicate, I would ask if you have irregular menstrual cycles, and whether this has been evaluated. Menstrual irregularity affects progesterone/estrogen cycles, which can have a significant and direct impact on your bone mass.

You might want to see an endocrinologist for a work up. I am a board-certified orthopedic surgeon with a sub-specialty in foot and ankle. I have also been running for about 35 years. My experience has been that when you run into this problem there is something else going on that may be endocrine related. You are doing everything right: seeing a number of physicians, trying to crosstrain and running on easier surfaces. You have already addressed the biomechanical possibilities with orthotics, arch supports and altered training. Your underlying problem may be metabolic.

I also feel you may have a metabolic bone abnormality. I had another patient like this two months ago who ended up having an endocrine problem that is being treated successfully. I suggest seeing an endocrinologist interested in metabolic bone diseases. You may need one of several metabolic tests to see how your body is processing bone matrix information. Also, you will need a pituitary and thyroid work up. Usually, a university center near you will have this type of work up. There is an old adage in medicine, “Diagnosis precedes treatment.” I’m not sure you’ve had a complete diagnosis yet.

There are many causes of back pain in children. Doctors at the University of Manchester, United Kingdom, investigated the relationship between low back pain in children and psychosocial stress.

They found 1046 children, ages 11 to 14 years, who, at the beginning of the study, had no back pain. The children attended 39 different schools in Northwest England. The children were followed one year to see which developed lower back pain.

They found that children who reported high levels of psychosocial stress were 1.5 times more likely to develop lower back pain than children who had normal levels of stress. The children with high levels of stress were 2.5 times more likely to have conduct problems, 1.8 times more likely to have abdominal pain, 1.6 times more likely to have headaches, and 1.5 times more likely to have sore throats.

Interestingly, the daily schoolbag weight was not associated with developing low back pain.

Not all children who develop lower back pain are experiencing increased stress, but there’s a good chance they are. Children complaining of back pain should be evaluated for stress problems.

Breath control exercises encourage relaxation and stress reduction. Yoga teacher Sandra Summerfield Kozak, MS (Mahasarasvati) has produced BreathSounds, a series of three CDs that provide timed music patterns to support a fixed inhalation and exhalation rate. This practice of controlled breathing, pranayama, improves respiratory function and oxygen absorption, and reduces stress. Using a combination of musical phrases and chimes, the beginner’s Volume 1 creates a 6-3-12-3 pattern consisting of a 6-second inhalation, 3-second hold, 12-second exhalation, and another 3-second hold. For those who are already familiar with pranayana or who can exhale for 12 or more seconds, Volume 2 provides an 8-4-16-4 pattern: 8-second inhalation, 4-second hold, 16-second exhalation, and 4-second hold. The breathing patterns for the first two volumes may be used while lying down or sitting. The third volume, however, is designed for sitting meditation. Its pattern consists of 4-second inhalation, 16-second hold, and 8-second exhalation. All of the CDs contain two 27-minute musical tracks with a short instructive introduction at the beginning of the first track.

A regular practice of controlled breathing counteracts the tendency to under-breathe during stress. Under-breathing, which is a response to stress, also creates a feeling of tension and an undercurrent of anxiety. In Volume 1’s introduction, Kozak suggests practicing breath control for at least 25 minutes a day for one month to evaluate its effect. Even one 25-minute session decreased tension for me; by the end of that time, my ribcage expanded more easily, and I was more relaxed.

Terrible sadness, a sudden fright, or other emotional stress can bring on heart attack symptoms in people not actually experiencing a heart attack, according to two new reports.

The researchers examined people who showed up at hospitals with chest pain and an impaired capacity to pump blood but no heart-tissue damage or clogged coronary arteries. Rather, the patients turned out to be experiencing physical effects after stressful events, such as the death of a loved one.

Cardiologist Hunter C. Champion of Johns Hopkins Medical Institutions in Baltimore and his colleagues treated 18 women and 1 man with severe symptoms. After initial tests had ruled out a heart attack, bedside talks revealed that all the patients had recently had a stressful experience. These included the death of spouse, a car accident, an armed robbery, a family dispute, a court appearance, and a surprise party.

The patients had blood concentrations of catecholamine hormones that were more than seven times normal and two to three times as great as those in five patients having heart attacks triggered by coronary artery blockages. Catecholamines, which include adrenaline and dopamine, are powerful hormones that regulate heart rate, blood pressure, and other body processes. The researchers report their findings in the Feb. 10 New England Journal of Medicine. In the other study, cardiologist Scott W. Sharkey of the Minneapolis Heart Institute and his colleagues identified 22 women who were brought to a hospital shortly after a stressful incident. “These patients came in with what looked like massive heart attacks,” Sharkey says. But tests of their hearts showed no blockage and no tissue damage. However, magnetic resonance images revealed an unusual abnormality in the movement of the wall of the heart’s strongest pumping chamber, Sharkey and his colleagues report in the Feb. 1 Circulation. This condition prevents the heart from circulating enough blood. All patients in both studies recovered, but some of them received assistance from a machine in pumping blood for a few days. Sharkey points out that heart tissue is rich in nerve endings that can stimulate the release of catecholamines. The flood of these chemicals brought on by stress might cause spasms in small arteries that nourish the heart, he says.

You haven’t been at your desk for more than 15 minutes and already your day is in disarray. The phone is ringing off the hook, the paper pile on your desk has grown, your boss is breathing down your neck and you’re being summoned into yet another meeting. No wonder you’re stressed out!

According to the National Institute for Occupational Safety and Health (NIOSH), job stress is “the harmful physical and emotional responses that occur when the requirements of the .job do not match the capabilities, resources, or needs of the worker.”

NIOSH, the federal agency responsible for conducting research and making recommendations for the prevention of work-related illness and injury, reports that stress in the workplace can also lead to poor health, such as cardiovascular disease, and even set the stage for injuries.

The next time the pressures of work have you all tensed up, take a few seconds to make a conscious decision to not let the situation at hand get the best of you. The key is to respond to each circumstance individually and in a calm manner. To help relieve on the job stress, MayoClinic.com recommends practicing the following techniques:

Simplify your life

Simplify your life. Free yourself of some responsibilities by cutting out activities or delegating tasks to others. This way you concentrate fully on finishing one assignment at a time instead of losing focus and juggling all the tasks at once.

Learn to prioritize.

Learn to prioritize. Even though it may seem like everything is due at once, chances are that’s not the case. Figure out what is most important and do that task first.

Practice relaxing

Practice relaxing. Try to control your breathing by slowly counting from 1 to 10. You can also try to clear your mind by mentally transporting yourself to a place that soothes your spirit. As basic as they may seem, both exercises are effective ways of calming the mind and slowing down an elevated heart rate.

Look for the positive

Look for the positive. Not all work assignments are enjoyable. Instead of sitting at your desk and complaining about it, turn the situation into a positive experience. Challenge yourself to find something new in a routine task so that you can avoid stressful situations and improve your outlook on life.

Molecular and biochemical bases for central nervous system-immune interactions include immune cytokines which activate immune function and also recruit central stress-responsive neurotransmitter systems in the modulation of the immune response and in the activation of adaptive behaviors after injury or inflammation. Peripherally generated cytokines, such as Interleukin-1, signal hypothalamic corticotropin releasing hormone neurons to activate pituitary-adrenal counter-regulation of inflammation through the potent antiinflammatory effects of glucocorticoids. CRH not only activates the pituitary-adrenal axis but also sets in motion a coordinated series of behavioral and physiologic responses in which the CNS coordinates both behavioral and immunological adaptation during stressful situations. The pathophysiological perturbation of this feedback loop, through various mechanisms, results in the development of inflammatory syndromes, such as rheumatoid arthritis and behavioral syndromes such as depression. Thus, diseases characterized by both inflammatory and emotional disturbances may derive from common alterations in specific CNS pathways (e.g., the CRH system). In addition, disruptions of this communication by genetic, infectious, toxic, or pharmacological means can influence the susceptibility to disorders associated with both behavioral and inflammatory components and potentially alter their natural history.

These concepts suggest that neuropharmacological agents that stimulate hypothalamic CRH might potentially be adjunctive therapy for illnesses traditionally viewed as inflammatory or autoimmune. Another way of looking at potential interventions would be to look at the modulating and normalizing effects of cultivating positive attitudes, and participating in inner disciplines such as meditation, mindfulness meditation, and Qi gong.

Of 50 healthy adults, parents of cancer patients experienced more psychological stress than parents of healthy children (p<0.05) and had flatter diurnal slopes of cortisol secretion, primarily because of reduced output during the morning hours (p<0.01). Chronic stress also impaired the immune system’s response to anti-inflammatory signals: the capacity of a synthetic glucocorticoid hormone to suppress in vitro production of the pro-inflammatory cytokine interleukin-6 was diminished among parents of cancer patients (p<0.05).

Miller GE, Cohen S, Ritchey AK. Chronic psychological stress and the regulation of pro-inflammatory cytokines: a glucocorticoid-resistance model. Health Psychol 2002 Nov; 21(6):531-41

COMMENT: Here is another piece of the puzzle. These data suggest a novel pathway by which chronic stress might alter the course of inflammatory disease. Chronic stress appeared to impair the immune system’s capacity to respond to hormonal signals that would terminate inflammation. The stressed body misses and thus fails to respond to anti-inflammatory signals.

Immune function is mediated by the release of cytokines (nonantibody messenger molecules) from a variety of immune and endothelial cells. Cytokine release stimulates the inflammatory response, induced by hormonal changes elicited following activation of the hypothalamic-pituitary-adrenal and sympathetic-adrenal-medullary axes. The experience of stress inhibits natural killer cell responsiveness, T-cell responses and antibody responses in vivo and in vitro. Studies showing little effect on actual disease incidence have been done mainly in healthy young volunteers whose immune systems have much greater levels of reserve. Wound healing is compromised by stress, adding to post-surgical expense. Susceptibility to cold viruses is consistently found to be much greater in stressed populations, and most HIV studies link stress with a diminished prognosis. Stress is also associated with prolonged recovery from infections. Lifestyle changes, including the broadening of interpersonal relational interactions (social and spiritual groups, having a confidant, engagement with friends) enhances greater resistance and immune responsiveness.

Several well-known researchers jointly published this review. The experience of stress significantly distorts normal immunologically mediated inflammatory responses. The stressors inducing these responses may be physical, but in our relatively controlled society are mainly psycho-social. One’s own inner high-level psychic demands and social isolation are both implicit stressors which induce excessive inflammatory responses. Practitioners taking a holistic view of medical practice including recognition of these powerful psychological and social influences, will usually find better outcomes utilizing a multidisciplinary approach.

Meta-analysis of stress/immunity literature showed a very significant inverse relation of stress to immune function including decreased proliferative response to mitogens (p<.001); natural killer (NK) cell activity (p<.001); numbers of WBCs (p<.001) and immunoglobulins IgA and IgM (p<.01, p<.001).

Stress of interpersonal events was significantly more important than stress of nonsocial events.

Herbert TB, Cohen S. Stress and immunity in humans: a meta-analytic review. Psychosom Med 1993 JulAug; 55(4):364-79

COMMENT: I include this brief abstract mainly because of the authors’ conclusion that the greatest stress came from issues surrounding interpersonal relations. The Fetzer Foundation has for some years taken as a major emphasis the funding of studies in Relationship-Centered Care. The importance of such research is emphasized in this meta-analysis. When patients manage to clarify, positivize and enhance their social relationships, immune-related processes including autoimmunity and immune-resistance-related phenomena tend to be more manageable.

Study objectives: To investigate the relationship between the severity of obstructive sleep apnea (OSA) and oxidative stress, which plays an important role in the pathogenesis of cardiovascular disease, and to elucidate the factors contributing to this relationship.

Design: Cross-sectional study.

Participants: A total of 128 consecutive subjects referred to the sleep laboratory of our hospital for screening or treatment of OSA.

Interventions: Not applicable.

Measurements: The severity of sleep-disordered breathing was evaluated by polysomnography. We measured urinary excretion of 8-hydroxy-2′-deoxyguanosine (8-OHdG) as an in vivo parameter of oxidative stress. Known risk factors for oxidative stress (age, obesity, smoking, hyperlipidemia, hypertension, and diabetes mellitus) were also investigated.

Results: Seventy subjects had nonsevere OSA (an apnea-hypopnea index [AHI] < 30), and 58 subjects had severe OSA (AHI [greater than or equal to] 30). Urinary HdG excretion was significantly higher in the severe OSA group (p = 0.03). Furthermore, urinary HdG excretion was significantly correlated with parameters of sleep-disordered breathing, including AHI, the apnea index, the oxygen desaturation index (ODD, the duration of oxygen saturation < 90%, and the respiratory arousal index. However, only ODI was significantly correlated with urinary HdG excretion after adjustment for confounding factors that are considered to be related to oxidative stress.

The severity of OSA is independently associated with oxidative stress. Among various sleep-disordered breathing parameters, ODI is most closely related to oxidative stress.

Key words: 8-hydroxy-2′-deoxyguanosine; ischemia-reperfusion injury; obstructive sleep apnea syndrome; oxidative stress

Abbreviations: AHI = apnea-hypopnea index; AI = apnea index. BMI = body mass index; DBP = diastolic BP; ELISA = enzyme-linked immunosort)ent assay. ESS = Epworth sleepiness scale; Hb[A.sub.1]c = glycosylated hemoglobin; ODI = oxygen desaturation index; HdG= 8-hydroxy-2′-deoxyguanosine; OSA =obstructive sleep apnea; ROS = reactive oxygen species; SBP = systolic BP; SDB = sleep-disordered breathing; T90 = the duration of an oxygen saturation below 90% and expressed it as a percentage of the total sleep time; T-chol = total cholesterol

For fun, my family and I took one of those online tests that predicts how long you’re going to live. It involved about 40 questions covering everything from hometown air quality to diet to cholesterol levels to how you handle stress.

My 10-year-old son Nicky’s score was 92.7 years, and my 9-year-old son, Joey, scored even higher at 97.8 years. I went next and got a ridiculous score of 114.7! But my brother Lorin’s score was a disappointing 69.9. After trying to coax the rest of us to take up smoking and drinking to even the score, Lorin decided to compare tests to see what he’s been doing wrong.

Except for the 10 years he deducts for being a male, the difference in our scores didn’t make sense at first. Lorin and I live in the same city, share the same lineage and are both divorced. He exercises as much as I do (maybe even more). And we have similar diets. However, the more we compared, the more we found differences. His blood pressure is 139 over 89; mine is 90 over 60. His total cholesterol is 240 with a 200 LDL (”bad” cholesterol) level, while my total cholesterol is only 137 with a 61 LDL.

The most telling difference was how Lorin answered one particular question: “How do you handle stress?” He chose answer (D)–”Not very well. Stress eats away at me and I have a difficult time shaking it off.” By contrast, I chose (A)–”No problem. Life is full of stress. I expect it. I prepare for it and deal with it!”

Stress could be the main factor that’s taking its toll on Lorin’s health in a way that overrides his healthy habits. I want to help him, but telling someone to stop being stressed is about as helpful as telling a person to stop being nervous.

Health Concerns

Stress is an important dragon to slay–or at least tame–in your life. Its ill effects have been known for years. Researchers can influence disease and lifespan in laboratory rodents simply by adjusting stress in their environment. In humans, stress is linked to heart disease, cancer, lung ailments, accidents, cirrhosis of the liver and suicide. About 80 percent of all doctors’ office visits are for stress-related complaints. And the stress itself isn’t the only risk to health. Often when a person can’t get past stress, she will turn to overeating, drinking or smoking, which can become a greater problem than the stress itself.

Stress is a fact of life, experts say. No matter who you are or what you do for a living, everybody gets stressed out at times.

Since stress is so prevalent, experts are debating about the results of too much stress, especially among women. What can stress lead to? Can stress cause women to gain weight?

A recent study conducted by researchers at Rush University Medical Center in Chicago and the University of Pittsburgh has found that stress can lead to weight gain in women. Moreover, negative life events can be an important contributor to weight gain in middle-aged women, the study found.

Researchers presented the results from the Study of Women’s Health Across the Nation (SWAN) at the American Psychosomatic Society Annual Meeting in Vancouver, British Columbia, Canada.

“Under stress, people conserve more fat, and we think that is perhaps what’s going on here.” says the study’s lead author, Dr. Tene T, Lewis, postdoctoral fellow/instructor in the Department of Preventive Medicine at Rush University Medical Center. “The research was designed to find out if psychological stress is associated with weight gain over time in middle-aged women. Many people believe that this is the case; however, few studies have actually examined this issue.”

Lewis and her colleagues, including the study’s co-author Dr. Lynda Powell, found that women who reported more negative life events (such as the death of a relative, loss of a job or divorce) at the beginning of the study were also more likely to gain weight over the four-year follow-up.

The effects of negative life events on weight gain were similar for Black and White women of all educational levels.

“Women who are under high levels of stress may be particularly susceptible to weight gain over time,” Lewis states.

Experts across the country agree with the study’s findings.

“Stress can lead to all kinds of things from weight gain to weight loss, from sleeping too much to not sleeping enough,” says Dr. Brenda Hayes, assistant professor in community health and preventive medicine at Morehouse School of Medicine in Atlanta. “Stress can lead to a range of things.”

She notes, “Stress is an issue with African-Americans, women in particular. Racism causes stress; economic challenges cause stress.”

In 52 medical student volunteers taking a major examination, severe deterioration in gingival health from baseline examination 4 weeks before to the examination at test time, was more frequent in the exam students compared to 26 control students not taking the exam (2p=0.014). Six exam subjects and one control student developed gingivitis at the site of teeth that were healthy at baseline.

Deinzer R et al. Increase in gingival inflammation under academic stress. J Clin Periodontol 1998 May; 25(5):431-3

COMMENT: These results support the hypothesis that psychological stress is a significant risk factor for periodontal inflammation and infection. The argument can be made that medical students in the rush of cramming for finals fail to brush and floss their teeth. While this may be true, other studies including the demonstration of slow healing of deliberate wounds at exam time are consistent with immune deterioration rather than changes in hygienic habits as the cause of this type of phenomenon.

Psychoneuroimmunoendocrinology describes the unity of mental, neurological, hormonal and immunological functions, addressing the impact of cognitive images of the mind (whatever its elusive definition) on the central nervous, endocrine and immune systems. It encompasses biofeedback and voluntary controls, impacts on physiology of thought and beliefs, past and present stress, placebos, social relationships and “energy medicine.” This column highlights cogent studies from these arenas regarding holistic medicine in the new millennium.

The cell adhesion molecule, L-selectin (CD62L), serves a crucial role in the migration of naive T lymphocytes and is typically shed on cell activation. Twenty Alzheimer’s caregivers, mean age 74, had their lymphocytes and catecholamine levels sampled at rest and in response to an acute psychological stressor. Ten of the caregivers were classified as susceptible or “vulnerable” based on the large amount of care required by the patient relative to the amount of respite the caregiver received during the previous 6 months. At rest, vulnerable caregivers had 60% fewer L-selectin negative CD8+ T cells (CD8+CD62L-) (p=.01) but no difference in CD8+CD62L+ cells. Vulnerable caregivers also showed significantly fewer CD4+CD62L–T lymphocytes (p=.04) but no difference in CD4+CD62L+ lymphocytes. Resting plasma epinephrine levels were 44% higher in vulnerable caregivers v. nonvulnerable caregivers (p=.01).

Mills PJ et al. Vulnerable caregivers of patients with Alzheimer’s disease have a deficit in circulating CD62L- T lymphocytes.

While all the numbers here may be a bit confusing, these data suggest that caregivers who are more vulnerable to the chronic stress of caregiving show a decrease in circulating CD62L- T lymphocytes, possibly by adrenomedullary activation under acute stress. The data also suggest the precise identity of the lymphocyte subset that undergoes immunological decrease during the chronic stress of caregiving. Put in other words, the subset of Alzheimer’s caregivers who have been more greatly affected so as to lose some of their reserve capacity to handle the never-ending stimuli are “vulnerable.” That vulnerability shows up biochemically in the disparity of different cell adhesion molecules and circulating epinephrine. Selectin molecules encode complement-binding proteins which mediate binding of leucocytes to vascular endothelial surfaces. To bring this home to this month’s discussion, Alzheimer’s caregivers with stress uncompensated with respite periods are likely to have more inflammatory gum disease.

In 211 middle-aged men and women undertaking short-term stressful tasks, NK cell counts increased and were positively associated with heart rate variability responses independent of age, sex, socioeconomic status, smoking, and change in hematocrit. Heart rate 45 minutes post-stress was positively associated with plasma interleukin-6, and with TNF-[alpha] changes from baseline, independently of covariates.

Owen N, Steptoe A. Natural killer cell and proinflammatory cytokine responses to mental stress: associations with heart rate and heart rate variability. Biol Psychol 2003 May; 63(2):101-15

COMMENT: Individual differences in sympathetically-driven cardiac stress responses are associated with natural killer (NK) cell and proinflammatory cytokine (IL-6) responses to psychological stress. To re-emphasize, if the stress is short-term, the immune system’s adaptive response is pro-inflammatory, initiating the first stage of healing.

Robert Anderson is a retired family physician whose practice took a holistic turn as decades passed. He has authored five major books, Stress Power!, Wellness Medicine, The Complete Self-Care Guide to Holistic Medicine (co-author), Clinician’s Guide to Holistic Medicine (McGraw Hill, 2001), and The Scientific Basis for Holistic Medicine, (6th edition 2004), available from American Health Press, holos@nwi.net.Anderson was the founding president of the American Board of Holistic Medicine, past president of the AHMA, former Assistant Clinical Professor of Family Medicine at the University of Washington and is currently an Adjunct Instructor in Family Medicine at Bastyr University.

Hypertension is associated with elevated reactive oxygen species (ROS) and frequently with impairment of endogenous antioxidant mechanisms. Experimental manipulation of the redox state in vivo shows that ROS can cause hypertension. During the development of hypertension, ROS are generated by endogenous sources, notably NADPH oxidase enzymes and uncoupled nitric oxide synthase, due to a mutual reinforcement between ROS and humoral factors. The ROS affect multiple tissues directly or through nitric oxide depletion. In blood vessels they induce both contraction and endothelial dysfunction and cause hypertrophic remodeling in blood vessels and myocardium. Reactive oxygen species promote renal salt reabsorption, decrease glomerular filtration, and lead to tissue damage. Finally, they increase efferent sympathetic activity from the CNS.

Progress in understanding mechanisms of ROS formation and their plethora of pathophysiological effects should lead from simple antioxidant therapy to specific antihypertensive treatments. The grinch here is the almost ubiquitous “reactive oxygen species.” Free radical activity is associated with nearly every chronic degenerative disease. Advancing renal disease and hypertension are related parts of the same picture, and kidney function is compromised, as indicated here, by free radical activity. Although I am not aware of any controlled studies to date, it would seem reasonable to attempt to keep the TEAC (Trolox equivalent antioxidant capacity) high by supplying an adequate level and variety of antioxidants. The TEAC has been found experimentally to be low in several chronic degenerative disease states.

The elevation of cortisol that occurs with stress tends in the young to return to baseline quickly; in the old it has a propensity to remain much higher and return to baseline much more slowly. Chronic stress accelerates the aging process. Stress leads to increased corticosteroid synthesis which simultaneously causes neuronal loss at the same time it down-regulates the neuronal loss in the brain (especially hippocampal), providing negative feedback which decreases corticosteroid synthesis. The stress-related hyperadrenalcorticoidism increases bone calcium loss, increases blood glucose and hyperlipidemia, leads to steroid diabetes, contributes to atherosclerosis, Alzheimer’s disease and for the purposes of our discussion here, suppresses immunity and causes muscle and tissue atrophy.

The suppressed immunity following stress and elevated glucocorticoid responses makes body tissues including the gums, to be more susceptible to infection. The tissue atrophy weakens the gum tissues, aggravating any decreased metabolism which results from deficient nutrients. Psychosocial stress as the initial event in this cascade of events affects all body tissues in the same fashion, leading to accelerated aging mentioned in the scenario above. There is also evidence that the downward spiral of falling dominoes can be interdicted, although not entirely stopped. Thus stress management becomes an integral part of the practice of medicine in dealing with chronic and degenerative problems.

Several recent studies have shown that stress markedly delays wound healing. In 36 women (mean age 57), those with higher perceived stress scores demonstrated significantly lower levels of two key proinflammatory cytokines–interleukin 1[alpha] and interleukin-8–at induced skin blister wound sites. In addition, subjects who had low levels of both cytokines after 24 hours reported more stress and negative affect, and they had higher levels of salivary cortisol than those who had high cytokine levels.

Glaser R et al. Stress-related changes in proinflammatory cytokine production in wounds. Arch Gen Psychiatry 1999; 56:450

COMMENT: Consistent with the evidence that stress delays wound healing, these data suggest a possible mechanism: psychological stress has measurable effects on proinflammatory cytokine production in the local wound environment. At first the implications of this research appear counter-intuitive and inconsistent with my comments above. However, when one remembers that the rise of proinflammatory cytokines is the first step in healing from an injury or insult to the body tissues, it makes sense. When a skin laceration begins to heal, inflammation always initially appears along the margins of the wound. As healing proceeds, the stress of the original insult recedes and inflammation fades. The pro-inflammatory cytokines are superceded by anti-inflammatory cytokines, unless the balance is disturbed and distorted. And there is some evidence that continued levels of high stress interfere with this normal shift to a greater anti-inflammatory cytokine predominance.

Sixteen final-year psychology undergraduate students about to take their final examinations and fourteen controls from research and administrative staff with a similar age distribution were randomly recruited to complete the 30-item Recent Perceived Stress Questionnaire and undergo application to the forearm of the Multitest CMI skin test, which simultaneously imprints the dermis with seven delayed hypersensitivity antigens (tuberculin, tetanus, diphtheria, streptococcus, candida, tricophyton, and proteus). Dermal indurations were read at 48 hours. Mean perceived stress score for the students was 72.7 v. 58.5 for the controls. When stress was defined as the stimulus, there were no significant correlations with immune responses. When stress was defined at the response to the stimulus, the stress group immune response to challenge was significantly weaker than the control group whose stress response was lower (p=.0249).

This highlights the problems with our semantics. In my original writing (Stress Power), 1978, I attempted to circumvent this descriptive conundrum by defining stress as the stimulus and tension as the beginning of the response. Other writers used the term stressor to define the stimulus and stress to define the response. So, to be correct here, it is important to realize that the response to the stimulus was weakened when the student was hard-pressed by the intensity of stimuli (interpreting final exams as potentially threatening). This should be part of the interpretation of any antigenic testing–highly stressed persons will have weaker responses.

Twenty-seven full-time students within the Physician Assistant Studies Program at The University of Texas–Pan American were anonymously surveyed to determine their levels of stress while enrolled in their first semester. The majority of respondents reported that their stress levels at this point in the program tell within the moderate to considerable range. Most indicated that their stress was induced by the academic demands of the program and their financial obligations. In an attempt to manage their stress, the majority of those surveyed indicated they employed passive techniques.

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An under-recognized variable to academic success within physician assistant training programs is the student’s ability to manage stress. The faculty of The Physician Assistant Studies Program (PASP) at The University of Texas–Pan American (UTPA), looking to enhance student academic performance, recognized that stress levels tend to be heightened while in the program. Consequently, they were concerned about the impact of stress upon the student’s physical, emotional, and academic well being. Within the program, the faculty has become aware of the fact that several students have sought medical treatment for stress-induced or stress-related health conditions. In order for the student to adequately cope with these stress-related conditions, the authors felt that the sources of stress must first be identified, followed by the development of an intervention plan that could be successfully implemented.

In this meta-analysis of 24 stress studies and ten relaxation studies vis-a-vis immunity, objective measures of immunity were insignificantly related to stress and relaxation with the exception of greater interleukin-2 receptor expression on lymphocytes and antibody titers against Epstein Barr virus (p<.0001).

Rood YR et al. The effects of stress and relaxation on the in vitro immune response in man: a meta-analytic study. J Behav Med 1993 Apr; 16(2):163-81

COMMENT: There is never 100% agreement on anything in medicine. And just to prove my unbiased nature, I report here that not all researchers agree that the effects are as ubiquitous as most of their colleagues believe. Even so, two laboratory measures were altered by stress in this meta-analysis, so we are discussing the degree to which stress causes negative effects. This study did not measure or analyze psychological and mental/emotional effects.

Many dancers (and athletes) discover that sustained, intense physical activity can halt a woman’s monthly cycle. While this may strike a busy dancer as more convenient than anything else–no bloating, cramps, or exhaustion crimping your rehearsing and performing–it leads to a greater likelihood of stress fractures.

Estrogen provides a necessary component for bone growth. If you miss periods, you have low estrogen, and that means lower or slower bone development. Bone functions as the major storage area for calcium, which the body needs for essentials such as muscle contractions. When the body lacks enough calcium to perform all of its jobs, it harvests calcium from bone.

The resulting diminishment in bone density leads to greater likelihood of stress fractures. Many studies have shown a clear correlation between a lack of periods, low estrogen, and stress fractures. In dancers, they often occur in the second metatarsal area of the foot, because dancers put pressure on their first and second toes in releve and preparations for jumping. While training can help you land with less impact (use your demi-plie, roll through the foot, etc.), dancers are already at risk for repetitive stress injuries from the daily grind of class, rehearsal, and performance. Add to that a weakened infrastructure, and you have an injury waiting to happen. A dancer’s shins are also vulnerable to stress fractures, which will reveal themselves through pain on the involved side while standing or jumping.

Stress fractures, by nature, are hard to diagnose. They tend to occur when a dancer’s normal routine gets derailed by a big work load or a new situation. According to Dr. Peter Lavine, a Washington D.C. orthopedist who has worked with the Kirov Ballet, this can happen when dancers are preparing for an audition or performance, or changing to a new school or program. Even when a stress fracture is indicated, X-rays call be negative, therefore a doctor may often decide to order more sophisticated studies, such as a bone scan or MRI. However, Lavine advises that the best treatment is to prevent them in the first place by maintaining a proper calcium intake and by avoiding amennorehea (a loss of menstrual periods).

Infants born to women who developed posttraumatic stress disorder during pregnancy have, as their mothers do, unusually low concentrations of the hormone cortisol, researchers have found. That could partly explain why such children themselves face a high risk of developing the disorder, called PTSD.

Psychiatrist Rachel Yehuda of the Bronx Veterans Affairs Medical Center in New York and her colleagues studied 38 women who were pregnant on Sept. 11, 2001, and narrowly escaped that day’s terrorist attacks on the World Trade Center. The researchers obtained saliva samples from each woman and each child when the children were 1 year old. The researchers also tested the mothers for PTSD.

Women with the most-severe PTSD symptoms had infants with the lowest cortisol concentrations, and women free of the disorder had children with the most cortisol, the researchers report in the July Journal of Clinical Endocrinology Metabolism.

Past research has suggested that children can develop low concentrations of cortisol, a stress-response hormone, because of neglectful or abusive parenting. Yehuda’s team notes that poor parenting might be common in families affected by PTSD. But according to the researchers, the new finding hints that genetic or prenatal influences are also important, since the link between maternal PTSD and children’s cortisol concentrations showed up before bad parenting could have taken its full toll.

Stress is a natural part of life that effects people differently. Someone making a major life decision such as deciding whether or not to leave his or her job might find the situation overwhelmingly stressful, while another person might see the same circumstance as an exciting and welcomed change.

Don’t let stress get the best of you! When you are constantly reacting to stressful situations without making adjustments to counter their effects, stress can threaten your mental and physical well-being, according to the National Mental Health Association (NMHA).

The key to coping is to determine the stressful situations you can and cannot tolerate. Once you know what these situations are you will be better able to tackle them in an appropriate and healthy manner.

A few of the following suggestions from NMHA can help you keep your cool the next time stress strikes:

You’re Not A Superhero

Even though you may sometimes think that you can take on the world single-handedly, it’s important to be realistic about the tasks you can truly complete on your own. Learn to say no when that overwhelmed feeling hits, and don’t hesitate to ask for help. An extra hand might just be what you need to get the job done.

Start Healthy Habits

Consult your doctor about beginning a regular exercise routine. A workout of approximately 30-45 minutes a few days a week is a great way to relieve stress of both the body and the mind.

One Thing At A Time.

Pick one urgent task and work on it. Once it is finished choose the next one. Checking off one task at a time is not only satisfying but it encourages you to keep going.

Treat Yourself

To help unwind, treat yourself to a good meal at home or at your favorite restaurant. Close off the world by enjoying a bubble bath or a long hot shower. Whatever you do, do it just for you.

Start A Hobby

Escape from your worries by taking time out to do something you enjoy. Whether it’s gardening, participating in a drawing class or learning how to crochet, schedule some time aside in your day to indulge your personal interests.

Keep a Journal

Expressing your thoughts in writing after a hard day is a calm and relaxing way to help you gain perspective and release tension.

Magnesium is depleted under stress through catecholamine-stimulated lipolysis; free fatty acids mobilize tissue magnesium, exceeding the renal threshold and leading to increased excretion. Mineralocorticoids directly increase magnesium renal excretion. Magnesium deficiency and stress mutually aggravate one another. High magnesium/calcium ratio suppresses catecholamine secretion by the adrenal medulla, the secretory granules at the neural synapse and the myocardium.

Sleek MS. Adverse stress reactions in magnesium deficiency: preventive and therapeutic implications. J Am Cool Nut 1992; 11:609(abstr 40)

COMMENT: In this author’s opinion, magnesium deficiency aggravates the development and presence of stress; catecholamine secretion is suppressed in the presence of adequate magnesium levels. So, magnesium deficient individuals are more prone to get caught in the high catecholamine loop and experience overdone and excessive powerful emotions which add to the feedback stress cycle. Magnesium levels should be monitored when stress remains intractably elevated for long periods of time. Magnesium supplementation must always be cautiously administered in patients with advancing renal failure which is associated with less efficient handling of magnesium (and potassium as well, of course).

It is well accepted that psychosocial stress contributes to the pathogenesis of renal disease, hypertension and cardiovascular disease. The molecular mechanisms by which psychosocial events contribute to cellular dysfunction have hitherto been poorly understood. The pro-inflammatory transcription factor NF-kappaB has recently been identified as a potential critical bridge between stress and cellular activation. NF-[kappa]-B activation, in turn, is known to play a pivotal role in vascular and renal disease. Activation of NF-[kappa]-B, evoked by psychosocial stress, appears to directly target blood vessels and kidneys and thus represent an additional risk factor for cardiovascular and renal disease.

Bierhaus A et al. NF-kappaB as a molecular link between psychosocial stress and organ dysfunction. Pediatr Nephrol 2004; 19:1189

COMMENT: Basic science types always emphasize the need to understand the underlying mechanisms in any given disease. Clinical types are more satisfied with empirical results. When pondering over Candace Pert’s “molecules of emotion,” one begins to get the sense of mechanisms by which the mind-brain and physical organ-function interrelate. With awareness of the ubiquitous presence of stress, we here begin to peer through a window of clarity with this demonstration of the elaboration of a measurable pro-inflammatory factor influencing vascular and renal function. It begins to make sense of the early psychosomatic research below and confirm validity for the observations of these early pioneers with the demonstration of a mechanism by which the empirically demonstrated changes might come about. Perhaps now the often-maligned “psychosomatic” research will find acceptance in the medical mainstream.

Stress intensifies release of catecholamines and corticosteroids that increase acute survival of normal animals when their lives are threatened. In the presence of magnesium deficiency, stress paradoxically increases risk of cardiovascular damage including hypertension, cerebrovascular and coronary artery constriction and occlusion, arrhythmias and sudden cardiac death. In affluent societies, severe dietary magnesium deficiency is uncommon, but dietary imbalances such as high intakes of fat and/or calcium can intensify Mg inadequacy, especially under conditions of stress. Adrenergic stimulation of lipolysis can intensify its deficiency by complexing Mg with liberated fatty acids. A low Mg/Ca ratio increases release of catecholamines, which lowers myocardial tissue Mg levels. It also favors excess release or formation of factors (derived both from fatty acid metabolism and the endothelium) that are vasoconstrictive and platelet aggregating. A low Mg/Ca ratio also directly favors blood coagulation, which is also favored by excess fat and its mobilization during adrenergic lipolysis. Auto-oxidation of catecholamines yields free radicals, which explains the enhancement of the protective effect of Mg by anti-oxidant nutrients against cardiac damage caused by beta-catecholamines. Thus, stress, whether physical (i.e. exertion, heat, cold, trauma–accidental, surgical or burns) or emotional (i.e. pain, anxiety, excitement, depression) or endogenous (i.e. dyspnea in asthma) increases need for magnesium. Genetic differences in Mg utilization may also account for differences in vulnerability to Mg deficiency and differences in physical bodily responses to stress.

Performing music is very similar to competitive sports. The long hours of practice, the physical and mental preparation, the nutrition discipline, rest and skill development, all come together on the day of the performance.

Stress is an integral part of the experience. For some, stress equals challenge, but for others it generates fear, tensions and even illness. The bad news is that stress can have a negative impact on the quality of the performance, often creating feelings of anxiety, doubt and despair in the musician.

For those who experience high stress when performing, I have good news: reducing stress to manageable levels and mentally preparing for a peak performance involve simple body-mind skills that most motivated musicians can learn. In this program, participants first receive information, learn basic stress releasing and imagery skills, followed by brief experiences with the four key steps to a mind-body method for performing at their highest level.

First, “stressology” facts inform participants of the impact the “fight or flight” response has on performance. Participants learn to recognize their sources of stress and personal stressors. Since stressors are both external (our environment) and internal (our physical health and cognitions), the goal is to learn to catch the tension as it begins to build and reduce it. Next, information about the effects of the relaxation response prepares participants for an experience with the first key step, a basic relaxation technique.

Self-regulation of stress via relaxation involves sitting quietly, closing the eyes and performing a series of “tense then release” exercises of muscle groups. In just four or five minutes deep muscle relaxation begins to counter the impact of tense muscles generated by the stress reaction.

Following relaxation training, participants learn the psychology of peak experiences. Understanding the Yerkes-Dodson inverted U hypothesis, guides musicians to focus on achieving their peak level of performing. Also, the pitfalls of “trying too hard” are avoided. This information prepares participants for their second key step, using mental recall of best efforts.

Mentally recalling a personal best performance provides a virtual example of how the mind-body connection manages the pressures and tensions of preparing for and performing at one’s highest ability level.

Review: The elevation of cortisol that occurs with stress tends in the young to return to baseline quickly; in the old it has a propensity to remain much higher and return to baseline much more slowly. Chronic stress accelerates the aging process. Stress leads to increased corticosteroid synthesis which down-regulates the neuronal loss in the brain, especially hippocampal; neuroreceptor loss provides negative feedback which decreases corticosteroid synthesis. The hyperadrenalcorticoidism suppresses immunity, causes muscle atrophy, increases bone calcium loss, increases blood glucose and hyperlipidemia, leads to steroid diabetes, contributes to atherosclerotic cardiovascular disease and Alzheimer’s disease.

Sapolsky RM et al. The neuroendocrinology of stress and aging: the glucocorticoid cascade hypothesis. Endocr Rev 1986 Aug; 7(3):284-301

COMMENT: Sapolsky, renowned authority in this field, delineates the mechanisms which support his premise that stress accelerates aging. The pathways involved chronically elevated catecholamines and corticosteroids. Some of the learned behaviors, among many, which neutralize these effects by reducing peak levels of catecholamines and corticosteroids with stress and their baseline levels in times of relative calm, include prayer, meditation, appropriate breathing techniques, reflective time in Nature, humor and laughter, and quiet times of appreciating great art, literature and music. Written prescriptions for the practice of these skills will have an effect on a fairly wide spectrum of patients and will emphasize their importance in the total mix of therapeutic initiatives.

A University of California-San Francisco research team, led by health psychologist Elissa Epel, PhD, has found evidence that prolonged, psychological stress contributes to cellular aging. Fifty-eight healthy mothers, ages 20-50, took part in the study; 39 of them care for a chronically-ill child and the other 19 have a healthy child. The researchers measured telomere length, telomerase activity, oxidative stress levels in peripheral blood mononucleocytes (immune system cells), and the women’s perceptions of their own stress level (using a standardized, 10-item questionnaire).

Telomeres protect the ends of chromosomes, much like the plastic tips found on shoelaces. Each time a chromosome divides, its telomeres shorten. A cell will stop dividing when it lacks sufficient telomere length to ensure genetic stability; it will then die soon after. The health and lifespan of cells and the tissues they form can be gauged by telomere length. The enzyme telomerase rebuilds some of the lost telomere protein after each cell division. Oxidative stress, the third biological factor in this study, is known to speed up telomere loss in cultured cells.

As a group, the three biological markers of the women with chronically-ill children did not differ much from the controls. Caregiving, in itself, does not promote cellular aging. The researchers, however, did find a correlation between the duration of caregiving and the biological markers: “The more years of care giving, the shorter the length of the telomeres, the lower the telomerase activity, and the greater the oxidative stress.” The perception of being stressed was also significant: “… the telomeres of women with the highest perceived psychological stress–across both groups–had undergone the equivalent of approximately 10 years of additional aging, compared with the women across both groups who had the lowest perception of being stressed. The highest-stress group also had significantly decreased telomerase activity and higher oxidative stress than the lowest-stress group.”

Doing more with less wears employees out, say organizational psychologists. Key signs of burnout include physical illness, eroding productivity and fraying workplace skills from otherwise organized employees. Rampant crabbiness is a tip-off, too.

Stress can undermine the productivity and quality you need to boost revenues and profits to the level where you can afford to hire additional people and upgrade equipment. “Often, there are seasonal peaks and valleys, and people learn to stretch during the valleys. But if the stretching is going on all the time because you’re not putting money into the business, tensions win arise,” says Jeff Trautman, vice president of The Brighton Group, a professional services firm in Seattle, specializing in outplacement and leadership coaching.

Despite constant pressure to cut costs, employees crave reassurance that things are essentially going well with the company, and that you, as the owner, are confident that better times are emerging. In addition, taking the time to sit down with employees and sort out colliding priorities can make a huge difference, says Kenneth W. Christian, Ph.D., a psychologist and author of Your Own Worst Enemy: Breaking the Habit of Adult Underachievement (Harper. Collins).

“When people who are normally organized get swamped, they use a panic reaction and become far less efficient than they were. Everything looms at them, and they can’t figure out what is important. They are driven to distraction,” says Christian. “If you start to see these signs, help them redistribute the load.”

“There is no way that a PR firm of our size–nine people, $1 million in billings–can afford to staff up for every new project that comes in,” says Ann Klein, president and founder of Ann Klein & Associates Inc., a PR firm in Marlton, New Jersey.

Klein’s tip-offs that her staff is stretched too thin: Over 80 percent of their hours worked are billable; they no longer have time for professional association work; they get headaches. She also uses her own time as a barometer: When her time devoted to billable hours slips over 50 percent, and she’s not spending as much time on bringing in new business, she knows she’s in trouble.

High concentrations of a stress hormone in newly pregnant women might make them more likely to have miscarriages, a new study finds.

Roughly 30 to 50 percent of pregnancies end in miscarriage, says biologist Pablo A. Nepomnaschy of the National Institute of Environmental Health Sciences in Research Triangle Park, N.C. That number is imprecise because many miscarriages occur within days of conception, before a woman knows that she is pregnant. Miscarriage is a natural process that evicts defective embryos that are unlikely to survive, Nepomnaschy says, but the high rate suggests that other factors also play a role.

A few previous studies examined the relationship between miscarriage and stress, but their results were inconsistent. Nepomnaschy focused on extremely early pregnancies in healthy women and measured a biochemical indicator of stress.

In high-stress circumstances–for example, energy deficit, infection, injury, or social conflict–the body’s adrenal gland produces more of the hormone cortisol. To test whether cortisol concentrations are associated with miscarriage, Nepomnaschy enlisted 61 married women in rural Guatemala who weren’t using birth control. Over a year, each woman collected a urine sample every other morning right after she woke up. Nepomnaschy and scientists at the University of Michigan in Ann Arbor used these samples to assess each woman’s pregnancy status and cortisol concentration. There were 22 pregnancies during the study. In 9 of 10 pregnancies in which a woman’s cortisol concentrations had jumped above her personal average during the first 3 weeks of gestation, a miscarriage resulted. Of the 12 pregnant women whose cortisol concentrations stayed at or below average during these first few weeks, only 4 miscarried, Nepomnaschy and his colleagues report in an upcoming Proceedings of the National Academy of Sciences. The miscarriages in the study occurred an average of 2 weeks after conception. “These findings are eye-opening, suggesting that elevated cortisol levels in early pregnancy [pose] a nearly complete threat to the pregnancy continuing,” says endocrinologist David H. Abbott of the University of Wisconsin-Madison. However, he says, it’s not dear whether outside stressors or some biologic process intrinsic to early pregnancy in certain women caused the increase in cortisol. He notes that some research suggests that cortisol can suppress progesterone, a hormone essential to a successful pregnancy.

“I GET ANTSY IN LONG LINES. Every time I have to wait in a line–for instance, the ones at the supermarket or an amusement park–I get so annoyed I feel as if I’m going to explode. How can I calm myself down?”

SOLUTION

If you concentrate on the negative, you’re inviting misery, says Brenda Wade, Ph.D., a family psychologist in San Francisco who frequently writes about Black women and stress. The key, Wade says, is to refocus: “Repeat to yourself, I am the master of my mind; my mind is not the master of me.” To keep you from reaching the boiling point the next time you’re in line, Wade offers these ideas:

* Drink some [H.sub.2]O. Sipping some water can help keep your body from releasing adrenaline, which can make us feel stressed.

* Distract yourself. Strike up a conversation with someone in line. But make it positive–not a gripe session. For example, at the grocery store you might say something like, “I’m looking forward to preparing this recipe when I get home.” If you’re in line at the airport, you might ask the person in front of you about her travels, Wade says.

* Cultivate an attitude of gratitude. Many people can’t afford to buy groceries or to take their family to an amusement park, so think about how lucky you are to be in that line. “We take so much for granted,” Wade says. “Be grateful that you have the opportunities you have.”

Physiological responses to stress (e.g., increased heart rate, elevated blood pressure, accelerated blood clotting) were once essential for overcoming physical threats to survival (Goldberger & Breznitz, 1993). In today’s world, insidious psychosocial threats and pressures-juggling multiple and often competing demands, navigating hostile commuter routes, working longer hours-are more typical yet elicit the same response (Shields, 2003). When repeatedly evoked, stress damages mental and physical health, and ultimately may lead to premature death (Lazarus, 1999). Over 20 years ago the growing pervasiveness of this threat grabbed headline attention with stress being dubbed the “epidemic of the eighties” and leading health concern in the United States (Stress!, Time, 1983). Since that time, the escalating pace of daily life and pressures to meet a myriad of perceived demands have made stress a worldwide, social and individual endemic (Brisbois, 2003). The volume of research in this area and its appeal in the popular media reflect the ubiquitous nature of stress and the enormity of its impact on people’s relationships, work productivity, health, and life quality, generally. Indeed, stress is recognized as a universal human phenomenon that transcends key social axes such as gender, age, race/ethnicity, social class, sexual orientation, and ability (Garnets, 2002; Iglesias & Cormier, 2002; Noonan et al., 2004). Consequently, it is not surprising that stress management has become a multi-billion dollar enterprise and a common area of research interest in a number of academic disciplines (e.g., rehabilitation medicine, management; Mascott, 2004).

From a research perspective, much of our existing knowledge about stress management, or stress-coping as it is commonly referred to in the literature, is based on studies of white, middle class members of society (Groomes & Leahy, 2002; Waiters & Simoni, 2002). People from different backgrounds and life circumstances have not received a great deal of attention, which leaves significant gaps in understanding. This is problematic as stress-coping is not a singular concept but one that involves highly complex processes that are influenced by multiple factors-individual, social, economic, societal/structural, cultural and political-which often converge and in doing so become increasingly difficult to manage (Janssen, Schuengel, & Stolk, 2002; Turk & Monarch, 2002).

WE ALL HAVE THOSE DAYS–WHEN deadlines are approaching and nothing is going right, when we’ve made dozens of nonproductive calls, when it seems like the odds just aren’t in our favor. All we manage to build by the end of this kind of day is stress.

Stress affects people in different ways. Some of us experience headaches or physical pain. Others, like me, lose concentration and focus. When that happens, if I want to accomplish anything at all, I’ve got to do something to relieve the stress. Here are some suggestions:

* Laugh. That’s not as silly as it sounds. Medical research has shown that laughter decreases blood pressure and heart rate, increases oxygen in the blood, creates an enzyme that protects your stomach from stress, and strengthens the immune system. A study–by researcher Dr. Lee S. Berk of Loma Linda University in Loma Linda, California–reported in USA Today states that the average American child laughs out loud about 400 times each day. The average American adult laughs out loud only about 15 times a day!

When I need a break, I call a friend I know will make me laugh. I call anyone I know who has an upbeat, positive attitude. Afterward, I feel much more relaxed, energized and able to regain my focus and go on with my day.

* Take a 20-minute power nap. Keep an alarm clock with you at work so that, if necessary, you can nap in your office. Studies have shown that 20 minutes is the optimal time for napping–it gives us much-needed rest without making us overtired. More than 30 minutes of sleep will make you groggy.

* Change your activity. Sometimes, repeating the same activity all day–like making sales calls–can cause stress, especially if you’re not achieving spectacular results. If you’ve been inside all day, go outside for awhile. Take an exercise break. Practice a musical instrument. Start a new project. Find something you can do for 30 minutes or an hour that will allow your mind to go in a completely different direction from what you’ve been doing all day. You’ll come back to your work refreshed, renewed and with a significantly lower stress level.

Before daybreak, I crawl out of bed and make my way, sleepy-eyed, to the bedroom balcony of my new home. My reward for this 5:45 A.M. diligence is the awesome sight of the sun rising majestically over the banks of the Hudson River, kissing the tops of rustling trees before taking her place in the sky. Witnessing this, I am humbled by the not-so-distant memories of the mornings when my life was so full of stress and pain that getting out of bed at all sometimes required the quiet, loving cajoling of my mother and girlfriends, who were faithfully on call, stationed strategically to beat off depression before it got the better of me.

But I’m getting ahead of myself. This “rise to greet the sun, write in my journal, work out, get my son’s day started, spend a few hours writing in cafes and weekends hanging with cool, interesting people” is really quite new. It has been four months since I sold my Brooklyn brownstone and purchased what I can only describe as the home of my dreams. Known throughout Kingston, a small city about 100 miles north of Manhattan, as The Big Blue House on the Hill, the Robert D. Dwyer House (as it’s listed in the town’s historical registry) is an exquisite Victorian, built 114 years ago by a New Orleans shipping magnate. Not only is it full of jaw-dropping wood and marble details, but it also has a three-car garage, inground pool, hot tub and Jacuzzi, steam bath, wine cellar and, to my culinary delight, a gourmet kitchen totally tricked out in the most gorgeous green granite I’d ever laid my eyes on. But getting to this space was perhaps my most difficult challenge to date. in fact, the champagne I bought to toast my first night here still remains in the fridge.

Instead of opening it, I bawled, tears reminiscent of a first-time

marathon runner who has won the prize despite her persistent, unspoken fear that she would collapse from sheer exhaustion before finishing the course.

Q I’m always hearing people talking about stress and how bad it is for you, but I don’t really know what it is and if I’m affected by it. I have on occasional headache and some muscle tension sometimes, but I just thought it was a part of getting older. I’m 45. How can you tell if you really are a victim of stress?

A Based on your description of headaches and muscle tension, you could very well be experiencing the effects of stress. Doctors define stress as a complex process of interaction between a person and his or her life. The severity depends on how a person reacts physically, mentally and emotionally to the various conditions and changes in everyday life.

Your headaches and tension could be the result of stress, but you should check with your doctor to be sure. In the meantime, there are various other indicators that someone could be suffering from stress, including rapid heartbeat, stiff neck and/or tight shoulders, rapid breathing, backache, nausea, sweating and sweaty palms. Stress also can cause frustration, irritation, and some people may become irritable and intolerant of even minor disturbances in their lives.

THE hustle and bustle of the holidays–gathering, coming and going, visiting, receiving company–can be energizing. But the holidays can also be stressful, creating new problems and making existing problems worse.

Many African-Americans experience high levels of stress and frustration during the holidays–even more so than during the rest of the year. Whether from overeating or being in poor physical shape or just not taking out enough time for yourself, even the tiniest amount of stress can derail your holiday cheer. It’s crucial in this period to anticipate stress early enough so that you can defuse it. It’s also important to have tools–medicine, an eating plan and calorie counter–on hand to make sure that you can deal with the results of stress quickly.

Stress can also affect the way our bodies digest food and can cause stomach woes, such as indigestion and heartburn. If you eat too little or too much and your body isn’t accustomed to the trauma, you can definitely experience adverse stress effects. Overeating is at an all-time high during the holiday season, and that can wreak havoc with your stomach. A few simple precautions can keep stomach troubles away so that you can concentrate on having fun with your family and friends. First of all, watch what you eat. Slow down and choose smaller portions. Be sure to have Pepto-Bismol on hand for soothing relief of heartburn, indigestion, nausea, upset stomach, and diarrhea. Don’t suffer through the holidays. Know what your options are, and be prepared to deal with them.

And for that delicate time of the month, Sisters know they should always be prepared, especially when they have to sit for a long time, and then stand up. The hectic holidays are stressful enough. So during that uniquely feminine time of the month, Sisters need the Stand-Up Protection[TM] from Always. Available in both Ultra Thin and Maxi, it lets you stand up and keep going with confidence.

You can’t enjoy yourself and make the most of the long holiday season if you’re not at your best physically. Make sure that you and your family take the time to exercise regularly during the holidays and throughout the year. Start monitoring your exercise habits before the holidays even start. Make regular exercise a habit as part of your daily or weekly routine.

“Calling my best friends is my release. My girls help me realize that I need to relax, relate and release.”–Imani Baker, District Heights, Maryland

I manage stress by cooking, believe it or not. I’m so focused on what I’m doing, nothing else bothers me. It’s like meditation.”–Elena Elfe, The Bronx, New York

“I practice breathing, and I also do the mountain pose from yoga–standing and pulling my foot to the side of my leg, holding for eight counts–to help me focus.”–Debra Colquitt, St. Louis

“I go to my exercise classes. The change in environment shifts my thoughts away from whatever is causing me stress.”–Jessica Harris, Monsey, New York

“I feel physically and spiritually at ease whenever I’m running. My mind can focus or wander, depending on what my soul needs.”–Jennifer Walker, Washington, D.C.

During a recent checkup, my blood pressure registered slightly high and my doctor blamed stress. Weeks later, my massage therapist got straight with me: “There’s nothing physically wrong with you,” she said. “You just need to learn to manage stress.”

Manage stress. A simple phrase. A verb and an object. But such an oxymoron. If stress could be managed, it wouldn’t be stressful, would it?

The realization that I wasn’t managing stress very well immediately spiked my anxiety. I started reading up on stress, and each article ended with tidy bullet points: Meditate. Visualize. Repeat a mantra. Imagine your boss in a clown suit. The advice seemed helpful but somehow incomplete.

But I give the techniques a try anyway. I’m at the office and my eyes are closed. I’m breathing like a Lamaze instructor (puff, puff, puff) because I’m not quite sure how I’m supposed to be breathing. And I’m picturing the seashore. A wave comes in. Swish. A wave goes out. Swish.

Then a creature flutters next to my vital organs. It’s my pager. Two seconds later, a head appears over my cubicle wall: My boss (code-named Dilbert, because of a striking physical resemblance) is following up on his page in case I missed it. The seashore vanishes, and my neck muscles make tiny fists.

I decide to consult the most reliable source I can reach before Dilbert opens his mouth: Microsoft Bookshelf Basics. Meditate: To reflect on; contemplate. To plan in the mind; intend. And so I learn meditating isn’t about going blank or pretending to be somewhere else. It’s about using your mind.

This appeals to me. I like my brain. It has served me well most of my life, and I feel more comfortable using it to fight stress rather than trying to shut stress out. My brain hits the “pause” button, and Dilbert’s looming head is momentarily suspended in my mind.

“So what exactly are you feeling right now?” my brain asks me, as Dilbert lurks outside my cube.

“Hmmm, I’d says it’s … tremendous time pressure,” I answer myself.

“What’s he asking for? Something urgent? A defibrillator?”

“A report.”

“A report. No wonder he’s excited. And what are you going to do about it?”