Five strategies—from meditation to exercise to psychotherapy—for managing stress.
When we lament that we feel stressed, we have a Czech biochemist to thank. Around 1950, Hans Selye was the first to use the term “stress,” borrowed from metallurgy, to refer to the mental and physical pressures that tie the stomach in knots and thwart the mind from slumber. Since then, scientists’ understanding of the mechanisms of stress and its impact on humans has evolved, with a growing body of evidence confirming that unchecked stress is a significant health risk.
“Stress produces a complex physiological response,” says Michael Irwin, MD, the Norman Cousins Distinguished Professor of Psychiatry and Biobehavioral Sciences at the UCLA David Geffen School of Medicine. Stressful thoughts trigger the release of corticotrophin-releasing hormone in the brain, a signal that activates the sympathetic nervous system and the famous fight-or-flight response. Not only does blood pressure and heart rate rise, but scientists say inflammation increases, as well. “If we were on the savanna and running away from a lion, that would be very helpful: The inflammation primes the immune system in case we get injured,” Dr. Irwin says. “But when we are stuck in a car or an office, that kind of response just becomes maladaptive and puts us at risk for chronic diseases.”
Among the factors that can age the body and shorten one’s life, such as smoking or eating poorly, uncontrolled stress is by far the most powerful, says Michael Roizen, MD, chief wellness officer at the Cleveland Clinic and author of This Is Your Do-Over. “Unmanaged stress is the leading cause of heart attack,” he says. “It is the leading cause of cancer and a leading cause of accidents. There is not a [bodily] system that it does not affect in an adverse way.”
To be clear, some amount of stress is motivating and even beneficial to one’s health. What makes stress unhealthy is our reaction to it, says Dr. Roizen, when we respond, say, with anxiety or unhealthy behavior. But stress is relatively easy to manage, he says. He helped launch a Cleveland Clinic program that teaches participants multiple stress-taming practices, not to squelch all stress, but to give them tools to manage their reactions to it. In a study of the program, participants reported a 30 percent decrease in stress levels after learning meditation. “Stress is something that ages you, but by managing it you can obliterate almost all of that effect,” Dr. Roizen adds.
Here is a guide to five effective stress-taming practices. Researchers recommend performing a combination of them regularly so when that late-night email arrives, traffic comes to a screeching halt, or an angry client snarls, we are ready.
Meet and train with Erika Bloom in person at the 2016 Robb Report Health & Wellness Summit in Deer Valley, Utah, from July 14 through 17.
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No. 1 – Mindful awareness
Of all the stress-busting tools available, meditation and mindful awareness are among the best studied. In the 1970s, Herbert Benson, MD, of Harvard Medical School, discovered that meditative practices can halt the body’s fight-or-flight response with a phenomenon that he termed the relaxation response.
Benson says any practice that focuses attention—such as observing one’s breath or listening to the patter of rain—can trigger the relaxation response, decreasing heart rate and blood pressure and easing emotional distress. Mindfulness includes the act of paying attention to one’s thoughts, emotions, and physical sensations without judging them or reacting to them.
Dr. Irwin and his UCLA colleagues tested mindfulness strategies on older adults with severe insomnia, a condition associated with high stress levels. “When people undergo stress, one of the first symptoms is a disturbance of sleep,” he says. Participants were divided into two groups: One completed a six-week course on sleep and stress reduction and the other meditated 15 minutes daily before bed. Compared with the first group, the meditating seniors showed greater improvement in sleep quality and experienced less fatigue and depression. Other studies by Dr. Irwin reveal that the practice of tai chi, which involves a series of deliberate, flowing motions, also improved insomnia. Further research indicates that these meditative practices produce physiological changes like reduced inflammation, which, as Dr. Irwin points out, underpins multiple conditions, including depression.
Such calming and anti-inflammatory benefits can come from surprisingly small doses of meditation. A study led by Dr. Irwin’s colleague Helen Lavretsky, MD, at UCLA found that 12 minutes a day of Kundalini yoga meditation for eight weeks reduced stress and slowed cellular aging. Participants in Dr. Irwin’s sleep research used smartphone reminders throughout the day to momentarily notice their breathing and “check in” with their bodies in so-called micro-meditations, which neutralize the effects of stress chemicals during the day and make sleep easier later, he says. He emphasizes that micro-meditations work best when combined with a regular daily meditation period of about 15 minutes, which “cements” the practice. “Having that memory of what [meditation] feels like allows you to go there very quickly,” explains Dr. Irwin, who is pilot-testing these methods for implementation.
Mallika Chopra, founder and CEO of intent.com and daughter of alternative-medicine authority Deepak Chopra, first learned to meditate at age 9, after her parents adopted the practice. “My parents were young immigrants to the U.S.,” she says. “My dad was a medical resident with a very stressful lifestyle, and my early childhood memories are very much of a stressful home. I clearly remember when my dad started to meditate and the [positive] shift that happened in my family.” In her recent book Living with Intent, Chopra describes her efforts to build a more intentional life, which included resuming a regular meditation practice. She admits that her meditative sessions do not last as long as some practitioners recommend, but “if I can find 10 to 15 minutes once a day, for me that is a big win.”
One of Chopra’s favorite meditations involves sitting comfortably in a quiet place, closing her eyes, and repeating a soothing sound like “I am.” “You just repeat it,” she says. “Your mind will wander. You will think about what you had for lunch, or the dry cleaning. When you notice that, you refocus on the sounds.”
When leading group meditations, Chopra often hears that people’s minds continue to race and the practice can seem fruitless. “Trust that those shifts are going to happen, even if you just sit there every day for 15 minutes and think you are doing nothing,” she urges. “It really does have benefits.”
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No. 2 – Exercise
In the 2015 film Learning to Drive, writer Wendy Shields (played by Patricia Clarkson) says she longs for “something to take my mind off my mind.” Exercise may well be the answer. A workout can elevate one’s mood, in part, researchers say, because it provides a distraction from anxious thoughts.
Research supports the conventional wisdom that exercise triggers the release of feel-good endorphins and boosts one’s tolerance of pain. But other scientists have focused on the role of norepinephrine, showing that exercise increases concentrations of this neurotransmitter in areas of the brain that regulate the stress response. This helps the brain deal more efficiently with stress and buffers it against the effects of anxiety and depression.
George Foreman III, founder of boxing fitness brand EveryBodyFights (everybodyfights.com), owner of the exclusive Boston boxing gym known as The Club, and son of world heavyweight champion George Foreman, views exercise as a vital way to expend the stress chemicals that can build in the body each day. Himself a former professional boxer, Foreman sees certain types of exercise as the perfect antidote to the fight-or-flight response. “There is something about throwing a punch; about squeezing your fist tight and throwing it with all your might,” he says. “Your body knows what is up and releases that pent-up fight hormone. Nothing is more cathartic.” He sees similar calming results from running and fast walking, which he believes satisfy a stressed body’s urge for flight.
While some forms of exercise might free the mind from anxiety by letting it relax and wander, other forms of exercise, such as yoga and Pilates, combine the benefits of movement with those of mindfulness. Pilates, says Erika Bloom—founder of Erika Bloom Pilates Plus in Manhattan, N.Y.; Greenwich, Conn.; the Hamptons; and Turks and Caicos—“teaches us how to focus deeply and singularly on listening and speaking to our bodies.” One must focus intensely on isolating a particular muscle (hello, psoas!) for the pose to be executed correctly and the practice to be effective at toning and strengthening. That intense focus keeps one present in the moment, she says; one cannot think about travel plans for the holidays and simultaneously zero in on the gluteus medius.
Bloom, who will lead fitness classes at the 2016 Robb Report Health & Wellness Summit, calls Pilates a “moving meditation” and says focusing on the strength of the core can help one center one’s life. “The core engagement in Pilates is based on the deep muscles of the torso that also assist with breath. Learning to properly facilitate these muscles is not isolated to achieving a flat or even strong midsection,” she says. “The education of the core is about finding a pure strength from which to move with ease. Moving from our center facilitates proper joint function, which reduces tension and strain throughout the body.” By centering the mind in and on the body, Pilates—as Clarkson’s character so desired—may indeed take one’s mind off one’s mind.
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No. 3 – Nutrition
Stress can lay waste to a healthy diet, and not just because long days at the office increase opportunities for surrendering to vending-machine fare. A recent Swiss study showed that stressful situations can alter brain chemistry in ways that make self-control more difficult.
Researchers put men in a stressful situation, then showed them a series of two food choices, asked them to choose the healthier option, and told them they would later eat the foods they chose. The stressed participants were more likely than unstressed people to choose less-nutritious foods, such as cookies and chips. When scientists scanned their brains with functional magnetic resonance imaging, they saw that the stress hormone cortisol boosted activity in a part of the brain that registers tastiness, suggesting that cake is more likely to win over kale at crunch time.
This is problematic, given that poor food and beverage choices can exacerbate stress in different ways, says Donald Hensrud, MD, medical director of the Mayo Clinic Healthy Living Program. He gives the example of coffee: The antioxidant-rich beverage has many health benefits, including a decreased risk of diabetes mellitus and liver disease, but large quantities can cause anxiety and jitteriness, making it harder to think clearly and make calm, rational decisions. Another pitfall is simple carbohydrate foods (think doughnuts and bagels) that are absorbed quickly, causing blood sugar to rise rapidly and some people to not feel well. Dr. Hensrud instead recommends foods that offer a combination of slow-digesting complex carbohydrates and protein, which will “stick with you” and provide more consistent energy. Good options like whole-grain toast with peanut butter or a bowl of old-fashioned oats topped with walnuts can help the body to better withstand stressful spikes throughout the day.
Eating an abundance of foods containing omega-6 fatty acids—found in vegetable oil, muffins and cookies, fast food, and junk foods like chips—could also make one more vulnerable to stress. Capt. Joseph Hibbeln, MD, a captain in the United States Public Health Service and a nutritional neuroscientist with the National Institutes of Health who studies essential fats and depression, says too many omega-6s promotes inflammation throughout the body, including the brain, and ultimately stimulates the overproduction of corticotrophin-releasing factor, a molecule critical in activating the stress response. He advocates switching to a Mediterranean diet that features plenty of olive oil and fish, rich in omega-3 fatty acids, to optimize brain health.
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No. 4 – Psychotherapy
Feelings of stress are based on our reactions to challenging events, and Dr. Irwin says working with a therapist can provide relief by allowing us to explore what the events mean to us and learning to change our patterns of thought. When his team conducted interviews with widows, he says, “Some women became depressed and very sad. Others believed that their [loved ones] were released to heaven. Their experiences diverged physiologically depending on their perception. Those who perceived profound loss experienced the suppression of their immune system,” while those who were not depressed did not show those physical changes.
Besides helping the bereaved sort through and understand their feelings, therapy can also root out thought patterns that contribute to distress like obsessively rehashing past events, which can have real consequences, Dr. Irwin explains. “Experimental data on that is unbelievable. One might think that over time people are no longer affected by a stressor in the past, but they can [still] think about it and it produces almost identical changes in the body as when the stressor was fresh,” he says. Cognitive behavioral therapy (CBT) offers a range of strategies to change old ways of thinking, and Dr. Irwin’s lab has also tested a modality known as Cognitive Behavioral Stress Management, a type of CBT with a mindfulness component.
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No. 5 – Social Connection
In 2000, researchers at UCLA identified an interesting pattern: Some women react to stress not with the fight-or-flight response but with what they called the “tend and befriend” response, by nurturing and protecting children and seeking support from other women. Scientists suggested that the urge could be driven by oxytocin, a hormone that generates a sense of belonging and eases anxiety. They theorized that these connections help people feel safe and provide others to talk to, both of which are valuable in times of stress. Similarly, a recent study at Car-negie Mellon University found that stressed people who received hugs were less likely to catch colds when exposed to a virus.
“When we feel connected, not only to ourselves but to the planet and to everyone around us, the experience of threat
becomes very different,” Dr. Irwin says. “Even if we are experiencing things that can be very difficult, such as the death of a spouse, that connection allows us to hold that experience of loss without such a depth of distress.”
So the next time you feel your mind skittering across the landscape of physical or mental obstacles that lie ahead, schedule a Pilates session with a friend, dine on a healthy meal together, and later devote 15 minutes to saying ohm before bed. Make it a regular practice and those obstacles will shrink to mere bumps in the road. Your neurotransmitters will thank you.