Recent research links stress to depression and heart disease—take steps to stay relaxed and healthy

Alleviate stress to protect from disease: recent research links stress to depression and heart disease—take steps to stay relaxed and healthy

Accumulated psychological stress increases your risk for depression and cardiovascular disease, according to an Oct. 10 study in the Journal of the American Medical Association (JAMA). It also examines claims that stress may influence the progression of HIV/AIDS as well as cancer.

Persistent, chronic stressful events (such as unemployment or caregiving) or an overwhelmingly traumatic event that haunts you can depress the immune system and activate inflammatory mechanisms, leading to serious illness.

“That doesn’t mean the patient actually causes her own illness,” cautions Susan Evans, PhD, professor of psychology in clinical psychiatry at Weill Cornell Medical College. “I want to be very clear about that because I’ve met patients worried they may have caused their own cancer because of stress. Scientifically, we can’t categorically say that stress causes illness. But managing stress can improve your body’s ability to cope with disease onset and progression.”

Stress, depression, and heart disease

The JAMA article, a meta-analysis of studies exploring the connection between stress and disease, found the most convincing links between stress and depression, and stress and heart disease. The authors write, “Approximately 20 percent to 25 percent of persons who experience major stressful events develop depression.” Increased stress can also prolong depression, exacerbate symptoms, and increase relapse odds.

The findings were similar for cardiovascular disease (CVD). “An approximate 50 percent increase in cardiovascular disease risk is associated with high levels of work stress,” says the study.

Exploring the connection

The body responds to psychological stress by releasing more cortisol (the fight or flight hormone) and catecholamines (adrenaline, norepinephrine, and dopamine, dopamine, which help the body respond to emergencies). These, in turn, increase inflammation in the cardiovascular, pulmonary, blood, skeletal muscle, and immune systems, resulting in increased risk for physical and psychiatric disorders. “While we are certainly equipped to handle episodic stress, chronic and prolonged stress may damage the mind and body,” says Dr. Evans.

Stress may also precipitate lifestyle changes known to trigger disease. Unable to cope, we may smoke more, sleep and exercise less, and fail to follow doctor’s orders.

Studies published since 2000 suggest “that an accumulation of negative life events over several years of follow-up predict worse AIDS-related outcomes,” according to the JAMA study. While some also believe that stress has a similar effect on progression and recurrence of cancer, the research is inconclusive.

Are you at risk?

Everyone copes differently with stress; some are more vulnerable because of their psychological make-up or genetics. But exposure to stress isn’t a definitive or even necessarily an automatic predictor of future illness. The good news, say the authors, is that “the majority of individuals confronted with traumatic events and chronic serious problems remain disease-free.”

“To build our resilience and increase our sense of well-being, it’s worth taking positive steps to buffer the effects of stress,” says Dr. Evans.

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WHAT YOU CAN DO

To help protect yourself from disease:

* short-circuit loneliness, a depression trigger, by doing volunteer work and making new friends.

* Do aerobic exercise at least several days a week.

* Eat a healthy diet, reduce alcohol consumption to no more than one drink per day, and stop smoking.

* Engage in regular relaxation exercises like yoga, meditation, and stress-reduction courses (such as Mindfulness Based stress reduction (MBsr) programs offered at some hospitals).

THE DASH DIET

The DASH (Dietary Approaches to stop hypertension) diet is specifically formulated to reduce blood pressure. The DASH diet includes the following types of foods and number of servings for a person who consumes an average of 2,000 calories per day:

* Grains and grain products (at least 3 whole-grain foods each day): 6-8 daily

* Fruits: 4-5 daily

* Vegetables: 4-5 daily

* Low-fat or non-fat dairy foods: 2-3 daily

* Lean meats, fish, and poultry: 6 ounces or less daily

* Nuts, seeds, and legumes: 4-5 per week

* Fats and oils: 2-3 daily

* Sweets and added sugars:

5 or less per week For more information, visit www.nih.gov or call 1-800-575-WELL.

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