By Kevin Lamb
Besides her painful and swollen joints, Barbara Townsend had endless fatigue
and trouble catching her breath. An ordinary stairway looked like a boot camp's
obstacle course. A preliminary blood test showed a good chance she had lupus.
But there was no time for rest. Townsend was completing her doctoral
dissertation and working a high-pressure job as operations director for Huber
Heights schools. Take time off? What did they think she was? Some kind of wimp?
``We don't even notice how hard we're pushing,'' said Janet Byars, a clinical
counselor whose A World of Solutions practice focuses on stress relief for
people and businesses. ``No wonder her immune system shut down.''
The damage unbridled stress can do to immune systems is way past the
theoretical stage. Evidence surfaced 20 years ago that stress was ``an important
risk factor for infectious disease,'' and maybe cancer, too, said Janice Kiecolt-Glaser,
who has researched the subject for two decades at the Ohio State University. Yet
Americans tend to pride themselves on how much stress they can pile on
themselves, as if it's a collectable ornament instead of a health hazard
comparable to smoking and obesity.
``You see it on people's faces every day,'' said Scott McGohan of the
employee benefits support firm McGohan Brabender. ``Companies are doing a lot
more with less right now, and people just keep taking their pills for acid
reflux or headaches. If you've got chronic headaches, that's a real bad warning
sign that something's wrong.''
Stress helps account for two-thirds of family doctor visits and, according to
the U.S. Centers for Disease Control and Prevention, half the deaths to
Americans under 65. It has been implicated in heart, stomach and mental
disorders, along with the more ordinary headaches, backaches and high blood
pressure and cholesterol. Kiecolt-Glaser's 10-year study of medical students
found decreased levels of the body's natural killer cells, which fight
infections and tumors, during even the familiar stress periods of exams.
More recently, imaging research at the University of Florida showed how
mental stress can decrease someone's blood flow to the heart. The report last
month in ``Circulation: Journal of the American Heart Association'' equated
stress with bad cholesterol and smoking as risk factors for coronary heart
Nobody seriously expects people to do away with stress entirely. Life without
any stress is a scarecrow without its cross. What makes stress toxic, Byars
said, is the different ways people process it - just as a body's ability to
process sugar makes the difference between being energetic and diabetic.
A common example is when people see they're running late for something. It
can prod them to become focused and catch up, or frazzled and later.
Among Kiecolt-Glaser's med students, the ones who practiced relaxation
techniques diligently ``showed significantly better immune function during
exams'' than those who did not. University of California-Irvine researchers
found regular laughter to improve heart attack patients' prospects about as much
as beta-blocking drugs. Duke University found a 74 percent reduction in cardiac
events among patients who were taught stress management along with their medical
``We can do something about stress,'' Byars said. Controlling it isn't just
about breathing deeply and moaning odd syllables, either. One of the first
things Byars taught Townsend was how to prioritize her overloaded schedule, and
how the sun still rose tomorrow if the bottom of her list went undone.
Proper diet, physical activity and rest are part of stress management, too,
Byars said, as are forgiveness, filtering out past or future chores and working
toward well-defined goals.
``If you have a very clear and definitive focus on what it is you're looking
for, then all those distractions that are causing stress aren't distractions
anymore,'' said Bruce Stapleton, the Lifegevity health and fitness consultant
whose program places stress management at the core. When Stapleton's Elan Vital
center was open in Centerville, he found rigorous dieting and exercising alone
didn't improve health as effectively as moderate diet and exercise along with
stress reduction, replicating 15 years of findings at the Canadian Institute of
Part of his center was a relaxation room where people could tune out the
world. ``We had a guy once who stayed in there a long time, and we were worried
so we opened the door and asked if he was about done,'' Stapleton said. ``He
said, 'No, I'll be off my phone in a few minutes.'
``I hadn't even thought to ban cell phones from the relaxation room. But the
society's basically taught people that they always have to be doing something
One reason American culture doesn't take stress seriously, Byars said, is
that conventional medicine views illness and injury as inflicted externally, not
from within a person. ``Patients were seen more as a car needing a tune-up''
after antibiotics were discovered, he said. Yet the immune system's capacity for
self-repair is hardly controversial, from torn muscles to paper cuts.
``Most people with lung cancer have been smokers, but the majority of smokers
never develop lung cancer,'' Byars said. ``Why don't they? Their bodies did
On a more everyday level, all people are constantly exposed to germs but few
come down with infections. It must not be the presence of germs that causes
illness, she said, but the absence of an adequate defense from the immune
system. As Kiecolt-Glaser and others have found, stress can be the saboteur.
Byars realized the difference when she lived in Switzerland 10 years ago.
``This is no third-world country, but they took two-hour lunches, they took
walks every afternoon and they ate foods that made me think,
0h-my-God-you're-kidding. But they weighed 20 pounds less than us. It's not just
about calories. I know one reason so many Americans are fat is we're always
What Americans saw as productive multi-tasking, Europeans at the Swiss NCR
office saw as wasting time. ``Why are those Americans moving so fast?'' they'd
say. ``They're making mistakes.''
They're keeping their edge, they'd say, but it's a state of aroused anxiety.
From cardiologist Dr. Herbert Benson a generation ago to psychologist Joan
Borysenko in the 1980s, researchers at Harvard Medical School and elsewhere have
confirmed the physiology of the fight-or-flight response to heightened stress or
alertness. Conditioned through prehistoric millennia that stress signals
physical danger, humans react instinctively with increased heart and breathing
rates, and higher blood pressure diverting resources to critical muscles.
Among hormones instrumental in that response are adrenaline and cortisol,
Borysenko found in lab experiments. Those energy boosters ``are also potent
inhibitors of our immune system,'' Byars said. ``This constant activation of the
fight-or-flight response causes various systems of the body to develop chronic
problems, such as high blood pressure or a strained heart.''
Benson famously developed the relaxation response of focused, deep breathing
to counteract the fight-or-flight response. Townsend had heard of the concept
when she first met Byars, but frankly, ``I thought it was kind of hocus-pocus
stuff. If someone had said I was going to learn to meditate, I would have
thought they were crazy.''
How could she possibly make time for such trivial activity? Slowing and
focusing her mind and not thinking? What was the point? Who could actually do
``When I started, I lasted maybe 15 seconds,'' Townsend said. ``I had to
think of something - what am I going to have for dinner, or what did I leave at
the office? But now I can get myself into a relaxing mode and just kind of leave
the cares of the day behind.''
She found herself getting more things done as she pared back her to-do list.
There was time in her week for massages again. She learned what she calls the
one-year rule, which says if it won't be important a year from now it's not
really so important now. She learned she could take a few deep breaths when
someone cut her off in traffic, using oxygen to clear her mind instead of fan
``When you start examining the reasons stress is coming into your life, you
look around at how unimportant they truly are,'' Townsend said. As her
temperament yielded from stressed alertness to focused awareness, her stress
became intermittent instead of constant. She noticed how it changed her, how she
tended to eat when stressful.
By that time, Townsend felt better and a dozen or so blood tests had ruled
out lupus, but her joints still hurt and her hands and feet still swelled.
``Janet was the one who suggested I might have food allergies,'' she said, ``and
by golly, that's what it turned out to be. As soon as I started laying off corn
and yeast, I really started picking up.''
She couldn't have noticed it without the stress relief, she said. She no
longer needs two meditations a day, but she wouldn't give up the one after work.
``It's a closing down of the stress and a refocusing of my energies,''
Townsend said. ``What works for me is the visualization of my body parts, and
the tension going out. I see the muscles lengthening, the blood flow increasing,
that kind of thing. I get more energy in 15 minutes of meditation than I
sometimes do sleeping all night.''