Stress Test

Stress! It’s the curse of modern life, or so you might think. Stroll through a bookstore and choose from dozens of titles that promise relief from stress. Try one of the many workshops, spa weekends, tapes and videos to help the stressed. Americans of all ages seem to say stress is real and it is a problem.

Dr. David Bann, chief psychiatrist at Lakes Regional General Hospital and medical director of Genesis Behavioral Health, agrees — stress is real. But he does not agree that stress is necessarily unhealthy — that there are positive aspects.

“There is everyday stress and acute stress,” he says. “When you have a significant task or goal, you will feel stress. There is a heightened awareness; functioning is enhanced. There may be ‘butterflies’ in the stomach, elevated heart rate or other physical responses. Your body is preparing for action.” The stress response evolved because it is essential to survival. A relaxed response to the charging mastodon would have been fatal.

But there is a tipping point. When low or moderate stress becomes acute, function is impaired. “Stress involves both physical and emotional responses,” says Bann. “While some people experience stress with awareness of bodily sensations, others will have emotional responses. In Western culture we tend to think of body-mind as separate but they are not.” He gives an example. A person who is experiencing physical sensations of anxiety sees his physician for evaluation and finds that there is no pathology causing the symptoms. The physician will talk with the patient about other possible causes, such as stress. The patient hears this as “she thinks it’s all in my head.” But that is not what is meant. Rather, the physician is identifying the body-mind connection.

It is this body-mind connection that explains the effectiveness of exercise in reducing stress. “Exercise stimulates the production of endorphins,” explains Bann. “These natural substances are the body’s tranquilizers. Endorphins ameliorate the sensation of pain as well. Exercise ‘works,’ even if the exerciser goes for the walk or visits the health club grouchy and grumbling.” Other body-mind techniques that can be effective include yoga, martial arts and meditation. These practices require one to focus the mind and can lead to reworking one’s physiologic responses.

“What I hope,” he says, “is that people who come to see me can become more comfortable in their everyday lives so they can manage stress more effectively. But often they have avoided dealing with stress for a long time. Perhaps they were afraid to talk about it or felt some stigma. Short-term medication may be used as a last resort.” He notes that some medications are so effective in reducing anxiety that they reduce the ability to manage stress. “There has to be some level of anxiety in one’s life,” he says, “or you lose your ability to cope.”

Jannine Sutcliffe, RN, is director of the Wellness Center, a department of LRG Healthcare with sites in Laconia and Center Harbor. Participants come to the center to address specific medical problems, such as high blood pressure, heart disease or muscular/skeletal problems. Exercise is the basic component of individual treatment plans.

But interesting things happen as participants get acquainted. Sutcliffe says, “We find that people feel considerable stress from other life events as well as from their health conditions. It is stressful to deal with changes in one’s routines. It is stressful to lose the vigor and strength one used to have, or to be fearful of the future.” She notes that older clients are often facing major changes, such as the loss of a spouse or of independence.

The center program includes a monthly support group. It is somewhat informal, yet Sutcliffe has seen that it is effective. “People need emotional support,” she says, “which can sometimes be hard to find. Here, people get acquainted as they exercise and often become friends. They look forward to seeing one another. I sometimes hear them making plans to meet for lunch.”

The effectiveness of the Wellness Center program is supported by statistics. A random survey of participants’ medical records showed 87 percent decrease in blood pressures, declines in resting heart rates and fewer indicators of depression. Exercise is the essential ingredient. When social support is added, it’s a winning combination.

This is a time of year when many people feel stressed. Homeowners, especially those in old New England homes, feel the pressure of the season. There are many tasks to be done and the days grow short. There is a northern culture of preparing for winter, even if one has moved into a condo. Older people may dread the isolation of winter or feel apprehension about safety in the coming season.

Holidays, even if anticipated with pleasure, add to schedules. There are more tasks to prioritize. Routines are disrupted. If there is family disharmony, old grudges and hurts come to the surface. Dr. Bann suggests that family visits at holiday time can send us back to behaving in ways that we thought we had outgrown. We are seen as “the children,” even at age 45, or as the bratty little brother or the troublesome young adult we once were. Mid-life adults may be confronted with the aging of their parents or disappointment in their own children. Bann’s advice for dealing with family stress is simple to say, but can be difficult to follow. Be honest and forgive. Talk about old hurts in a mature way rather than with veiled or caustic comments. NH