The symptoms of stress can show up mentally, physically, emotionally or behaviorally, and within each category they cover a wide range of symptoms. There is no one list of symptoms that describes stress because the symptoms themselves are highly subjective and as varied as we are.

Stress Symptoms show up differently for each one of us.

This is because each of us experiences stress differently. A steep roller coaster dive might be enormously distressful for some of us yet the same ride can be pleasant for others. Our stress responses are also widely different. Some people blush others pale, some eat more, some less.

As you look over this abbreviated pie chart of body, mind, emotions and behavior symptoms you may begin to realize that your stress symptoms fall more into one group more than another. This may give you helpful clues for choosing stress management techniques and knowing how to handle stressin your individual situation.

THE OFFICAL LIST OF SYMPTOMS OF STRESS

There are numerous symptoms of stress from each of the four groups, as illustrated by the following list of dozens of common signs of stress as listed by the American Institute of Stress.

• Frequent headaches, jaw clenching or pain
• ·  Gritting, grinding teeth
• ·  Difficulty concentrating, racing thoughts
• ·  Stuttering or stammering
• ·  Trouble learning new information
• ·  Tremors, trembling of lips, hands
• ·  Forgetfulness, disorganization, confusion
• ·  Neck ache, back pain, muscle spasms
• ·  Difficulty in making decisions.
• ·  Light headedness, faintness, dizziness
• ·  Feeling overloaded or overwhelmed.
• ·  Ringing, buzzing or “popping” sounds
• ·  Frequent crying spells or suicidal thoughts
• ·  Frequent blushing, sweating
• ·  Feelings of loneliness or worthlessness
• ·  Cold or sweaty hands, feet
• ·  Little interest in appearance, punctuality
• ·  Dry mouth, problems swallowing
• ·  Nervous habits, fidgeting, feet tapping
• ·  Frequent colds, infections, herpes sores
• ·  Increased frustration, irritability, edginess
• ·  Rashes, itching, hives, “goose bumps”
• ·  Overreaction to petty annoyances
• ·  Unexplained or frequent “allergy” attacks
• ·  Increased number of minor accidents
• ·  Heartburn, stomach pain, nausea
• ·  Obsessive or compulsive behavior
• ·  Excess belching, flatulence
• ·  Reduced work efficiency or productivity
• ·  Constipation, diarrhea
• ·  Lies or excuses to cover up poor work
• ·  Difficulty breathing, sighing
• ·  Rapid or mumbled speech
• ·  Sudden attacks of panic
• ·  Excessive defensiveness or suspiciousness
• ·  Chest pain, palpitations
• ·  Problems in communication, sharing
• ·  Frequent urination
• ·  Social withdrawal and isolation
• ·  Poor sexual desire or performance
• ·  Constant tiredness, weakness, fatigue
• ·  Excess anxiety, worry, guilt, nervousness
• ·  Frequent use of over-the-counter drugs
• ·  Increased anger, frustration, hostility
• ·  Weight gain or loss without diet
• ·  Depression, frequent or wild mood swings
• ·  Increased or decreased appetite
• ·  Insomnia, nightmares, disturbing dreams
• ·  Feeling Tired all the Time
• ·  Increased smoking, alcohol or drug use
• ·  Excessive gambling or impulse buying

As demonstrated in the above list, symptoms of stress can show up in a mind bogglingly wide range, and have huge impact and effects on our sense of self, our emotions, moods and behaviors.

HOW STRESSED AM I?

You may see a number of symptoms that describe you, and yet have trouble grasping that stress is their cause. It may be hard to think of stress as their direct cause, when often the symptom is in itself a cause of stress, and perpetually locked into a vicious cause-effect cycle.

Another reason it is hard to tell if you are “really that stressed”, is because mental disorders, even full blown mental, mood and emotional dysfunctions, that were rare have now become the norm and worrisomely we have come to accept them as normal.

How would we know what freedom from stress is like it we have never experienced any other kind of existence?

We may also have trouble grasping the seriousness of stress because, well, stress is a brain killer. It impairs our judgement, memory, and much more. Neuroscientists are warning us about disregarding the fragility of our brains with regard to stress.

And our brain is only one of the systems that we can be unaware of, or worse oblivious to, being heavily affected by stress overload.

11
THE STRESS SOLUTION
RELAX YOUR BRAIN TO REDUCE YOUR WRINKLES AND IMPROVE YOUR IMMUNE SYSTEMStress is nothing more than a socially acceptable form of mental illness.–RICHARD CARLSON, PH.D.

Maria was in her forties when she came to our offices for help. She was unhappy because her belly had gotten fat, and she had been struggling for years to lose the weight. She was also under constant stress. Her mother had suffered a stroke several years earlier, and Maria had taken on the role of caretaker. On top of that, her son had started acting out. Maria was spending so much time caring for the others in her family that she had been neglecting her own health and well-being for too long. I told her something that I tell many of my patients, “You need to put on your own oxygen mask first before you help others.” What I mean by this is you need to look out for yourself first so you can be healthy enough take care of the people you love. Thanks to some stress-management techniques and a renewed focus on her own needs, Maria lost the abdominal fat and fared much better in taking care of her mother and son.

Stress is a normal part of everyday life. Bad traffic, a big deadline at work, a fight with your spouse–there are hundreds of things that can make us feel stressed out. When the event passes, so does the stress, and we can breathe a big sigh of relief. With chronic stress, however, there is no relief. Stemming from family discord, financial hardships, health issues, work conflicts, or school trouble, chronic stress can be unrelenting. And it affects far too many of us. In a recent poll by the American Psychological Association, a whopping 80 percent of Americans said the weakened economy is causing them significant stress. That spells trouble for your brain and body.
THE BRAIN-BODY RESPONSE

Don’t get me wrong. A little stress can be a good thing. When stress hits, the brain tells your body to start pumping out adrenaline (epinephrine) and cortisol, two hormones released by the adrenal glands (located above the kidneys). Within seconds, your heart starts to pound faster, your breathing quickens, your blood courses faster through your veins, and your mind feels like it is on heightened alert. You are ready for anything–running away from a would-be mugger, giving a speech in front of a roomful of peers, or taking an exam.

These stress hormones are the primary chemicals of the fight-or-flight response and are especially useful when you face an immediate threat, such as a rattlesnake in your front yard (which happened to me once). What’s amazing is that the human brain is so advanced that merely imagining a stressful event will cause the body to react to the perceived threat as if it were actually happening. You can literally scare your body into a stress response. The brain is a very powerful organ.

Brief surges of stress hormones are normal and beneficial. They motivate you to do a good job at work, study before a test, or pay your bills on time. The problem with stress in our modern world is not these short bursts of adrenaline and cortisol. The problem is that for many of us, the stress reactions never stop–traffic, bills, work, school, family conflict, not enough sleep, health issues, and jam-packed schedules keep us in a constant state of stress. Take note that it isn’t just the bad stuff in life that makes us stressed. Even happy events, such as having a baby or getting a promotion, can be major stressors. Take a look at the following lists of just some of the many events and situations that can cause stress.

Negative Events That Cause Stress

Death of a loved one

Getting laid off

Getting divorced

Unwanted pregnancy

Miscarriage

Financial problems

Being involved in a lawsuit

Having health problems

Having a sick relative

Caring for an ailing family member

Having a mental disorder or living with someone who has one

Problems at work

Problems at school

Positive Events That Cause Stress

Getting married

Having a baby

Starting a new job

Getting a promotion

Moving to a new home

Transferring to a new school

Going to college

Having a bestselling book
HOW CHRONIC STRESS HARMS THE BRAIN

Chronic stress constricts blood flow to the brain, which lowers overall brain function and prematurely ages your brain. A series of studies published in the journal Psychoneuroendocrinology looked at long-term exposure to stress hormones, especially cortisol, and its effect on brain function in people of varying age groups. The research showed that older adults with continuously high levels of cortisol performed worse on memory tests than older adults with moderate to low cortisol levels. The older adults with high cortisol levels also had a 14 percent smaller hippocampus, the area of the temporal lobes involved with memory. The hippocampus is part of the stress response system and is responsible for sending out signals to halt the production of cortisol once a threat has vanished. But when the number of brain cells in the hippocampus is depleted, it no longer sends out this signal, which results in the release of even greater amounts of cortisol.

Researchers found that short, temporary spikes in cortisol had a negative–although temporary–effect on young adults’ thinking and memory skills. In young children and teenagers, the research showed that kids with lower socioeconomic status had higher average stress hormone levels than the other children. As a group, these studies reveal that chronic stress impairs the brain function of people of all ages.

Excessive amounts of cortisol affect other areas of the brain, too. Canadian researchers used functional brain imaging studies to show that exposure to stress hormones is associated with decreased activity not only in the hippocampus, but also in the amygdala, part of the emotional brain and the prefrontal cortex. As a result, chronic stress has negative consequences for both cognitive function and emotional balance.

It gets even worse. An ongoing overload of cortisol reduces brain reserve, which makes you more vulnerable to the many physical effects of stress. When stress hurts your brain, it can also ravage your body.
HOW CHRONIC STRESS MAKES YOU LOOK OLDER

If you have crow’s-feet, wrinkles, sagging jowls, or thinning skin, don’t blame it on your parents. New research shows that environmental factors–including chronic stress–rather than genetics, may be at fault. In a fascinating study involving identical twins, environmental factors were found to make people look older than they really are. For the study, which was published on the Plastic and Reconstructive Surgery journal’s website, a panel of plastic surgeons examined digital photos of 186 pairs of identical twins who had attended the Twins Festival in Twinsburg, Ohio, in 2006 and 2007. The physicians attempted to determine the age of each individual based on their facial features. What they found is that individuals who had experienced stressful events tended to look older than their siblings who had led more stress-free lives. For example, twins who were divorced looked almost two years older than their siblings who were married, single, or even widowed. One of the study’s authors cited the presence of stress as one of the common denominators in the twins who looked older. ACTION STEPBefore you spend hundreds of dollars on wrinkle removers, consider that your skin problems may be due to stress as opposed to the natural aging process.

Other scientific evidence shows that chronic stress can mimic the effects of aging to make you look and feel like you’ve aged beyond your years. According to a 2009 study of 647 women, the physical effects of chronic stress were found to be similar to the effects of smoking, being obese, or being ten years older than their actual age. The study looked at the association between perceived stress levels and the length of telomeres, the protective caps located on the ends of chromosomes. The longer the caps are, the more protection they provide. The shorter they are, the less protection provided.

Telomeres naturally shorten over time as we age, eventually becoming so short that they trigger cell death. In this study, the women with higher levels of perceived stress had shorter telomeres than women with low-level stress, indicating premature aging.

You can see the effects of stress-induced aging by simply looking in the mirror. With natural aging, your skin begins to lose collagen and elastin, two proteins that provide support and elasticity for a more youthful appearance. Stress causes collagen and elastin to break down prematurely, which leads to sagging skin and wrinkles. Unfortunately, wrinkles aren’t the only skin problem that comes with unrelenting stress. Since chronic stress toys with your hormones, it can also lead to acne breakouts regardless of your age.
HOW CHRONIC STRESS MAKES YOU SICK

Your body responds to the way you think, feel, and act. Because of this brain-body connection, whenever you feel stressed, your body tries to tell you when something isn’t right. For example, high blood pressure or a stomach ulcer might develop after a particularly stressful event, such as the death of a loved one. Chronic stress weakens your body’s immune system, making you more likely to get colds, flu bugs, and other infections during emotionally difficult times. It has also been implicated in heart disease, hypertension, and even cancer. In fact, too much stress can actually kill you.

In a 2004 issue of Psychological Bulletin, a team of psychologists published findings from a thorough review of nearly three hundred scientific studies linking chronic stress and the immune system. According to their analysis, the studies, which dated from 1960 to 2001 and involved 18,941 test subjects, show incontrovertible evidence that stress causes changes in the immune system. What they found is that short-term stress temporarily boosts immunity, but chronic stress weakens the immune system, making people more vulnerable to common ailments and serious diseases. In particular, the elderly and people who are already suffering from an illness are more susceptible to changes in the immune system due to chronic stress.

A recent study in the Journal of Immunotoxicology reported that it isn’t just the stress you are feeling today that harms your ability to fight off disease. It indicates that exposure to chronic stress early in life makes you even more vulnerable to a depressed immune system throughout your lifetime.

Also, when you are feeling stressed, you may not take care of your health as well as you should. You may not feel like exercising, eating nutritious foods, or taking medicine that your doctor prescribes. Abuse of alcohol, tobacco, or other drugs may also be a sign of chronic stress. These behaviors stand in the way of your goal to get a body you love.
HOW STRESS STRETCHES YOUR MIDSECTION

Your boss is handing out pink slips. You just had a fight with your teenage daughter. You are late for an appointment. How do you react? You may try to calm your nerves with chocolate, ice cream, French fries, or potato chips (or all of the above). And there’s a scientific reason why. Stress and the stress hormone cortisol are linked to increases in appetite and cravings for carbs and sweet stuff that can make you fat.

Two studies that appeared in Physiology & Behavior investigated the effect of stress on the foods people choose to eat and the amount of food they consume. The results were just what you might expect. The first experiment found that stress causes people to turn away from healthy low-fat foods, such as grapes, in favor of high-fat fare like M&Ms. In the second experiment, researchers looked at changes in food consumption among men and women. They found that people on a diet–especially women–were the most likely to eat more when they were stressed out.

Animal studies show us that chronic stress is a recipe for dangerous weight gain. One study out of Georgia State University showed that when hamsters faced repeated stress over a thirty-three-day period, they overate, gained weight, and in particular, gained a significant amount of abdominal fat, also known as visceral fat. This type of fat, which gives people an apple shape rather than a pear shape, is the worst kind of fat because it surrounds vital organs and is associated with a number of serious diseases, such as cardiovascular disease and diabetes.ACTION STEPIf you are having trouble losing weight, consider stress as a factor. In addition to eating a nutritious diet and exercising, learn some stress-management skills.

Another study, conducted by re searchers at Georgetown University Medical Center, found that chronic stress combined with a high-fat, high-sugar diet leads to abdominal obesity in mice due to a neurotransmitter called neuropeptide Y (NPY). The brain releases NPY directly into the fatty tissue in the abdomen. The researchers exposed the mice to cold water or aggression to create a stressful environment. The chronic stress stimulated the release of NPY in the abdominal fat and increased its growth by 50 percent in just two weeks. After three months, an expanding belly wasn’t the only physical change the mice experienced. They also displayed symptoms typically associated with metabolic syndrome, including high blood pressure, inflammation, high cholesterol, glucose intolerance, and more. What this study shows us is that chronic stress packs on even more abdominal fat than you might experience from a high-fat, high-sugar diet alone–and it does it faster.

Adolescents and teens are also vulnerable to weight gain from stress. A study in the Journal of Adolescent Health that looked at data from 1,011 adolescents and their mothers found that the more stressors in their lives, the more likely they were to have weight troubles.

Living with stress on a daily basis makes you more likely to have issues with your weight for a number of other reasons. For example, chronic stress usually goes hand-in-hand with a lack of sleep, something that pumps up cortisol production and throws your appetite-control hormones out of balance. This leads to overeating, cravings for sugary treats, and a greater tendency to store fat. The fact that chronic stress can make you feel tired and achy means you are less inclined to exercise, which can make the numbers on the scale start to rise. Stressful situations also make many of us reach for comfort foods as a way to soothe our emotions. All of these things make it harder to beat the battle of the bulge.
IS STRESS MAKING YOU INFERTILE?

As mentioned, I have been interested in medical hypnosis since medical school. When I was a psychiatric intern, I hypnotized many of my patients and staff who requested help. My favorite story from that year was when I helped a nurse get pregnant. As my reputation for using medical hypnosis grew, a very pretty nurse came to me and asked if I could help her get pregnant. That was an interesting request, I thought to myself. She told me that she and her husband had been trying to get pregnant for four years, and it wasn’t happening. Every time they had sex, she would start to cry and get really upset at the thought of not being pregnant. She figured that her stress was interfering with conception.

ACTION STEP

If you are having trouble conceiving, make stress reduction your first step before seeking pricey fertility treatments.

I explained to her that her fallopian tubes (the tubes between her ovaries and uterus) were wrapped in smooth muscle and that stress hormones were probably clamping shut the tubes, making it much harder for her to get pregnant. I put her in a hypnotic trance with deep relaxation suggestions focused on her lower abdomen and also made a hypnosis tape for her to listen to after she made love with her husband. Three months later she was pregnant.

It was such a joyful experience to see that healing the brain-body connection could be so helpful to this couple. The one mistake I made was telling my wife that I helped a really pretty nurse at work get pregnant. Just kidding.

It is clear that too much stress affects the way your body functions, including its ability to reproduce. Scientific evidence shows that chronic stress causes hormonal changes that disrupt reproductive function.

The same way that stress prematurely ages your body and skin, it also speeds up the aging process of your reproductive system. For women, it is harder to conceive as age advances, whether the aging is natural or stress induced. Women aren’t the only ones who suffer from infertility due to stress. Researchers in India have found that emotional stress damages sperm cells. In addition to causing problems for natural conception, elevated stress levels also impact the success of fertility treatments, such as in vitro fertilization (IVF).

A 2005 study published in Human Reproduction investigated the effects of stressful life events on IVF treatment. The researchers asked 809 women to complete a questionnaire about stressful and negative life events during the twelve months prior to undergoing fertility treatment. Women who became pregnant following treatment reported fewer stressful events than women who didn’t conceive. The researchers concluded that stress may reduce the chances of a successful outcome following IVF treatment.

There’s a commentary I love in the same journal from a psychologist on the faculty at UNED University in Madrid, Spain. He is convinced that stress is to blame for many cases of infertility and suggests that stress reduction should be the first course of treatment for infertility rather than expensive and invasive treatments, such as IVF. It makes sense to me–stress reduction poses no side effects and doesn’t involve any of the ethical or religious quandaries that come with some fertility treatments.
HOW STRESS PLAYS TRICKS WITH YOUR MENTAL HEALTH

Chronic stress drains your emotional well-being and is associated with anxiety, depression, and Alzheimer’s disease, all of which can affect your body. Stress activates the limbic system of the brain, which is your emotional center. If you experience some form of emotional trauma–say, you are involved in a car accident or you are raped–your emotional system becomes very active, which can make you more upset and depressed. After experiencing a trauma, some people develop post-traumatic stress disorder (PTSD), which means the stress never goes away.

On July 16, 2003, thirty-three-year-old Steven was working in a bike shop in Santa Monica, California. The bicycle repair mechanic decided to visit the local farmers’ market for lunch. As Steven arrived at the market, eighty-seven-year-old George Russell Weller lost control of his 1992 Buick LeSabre and plowed through the open-air market. Hearing the screams and commotion, Steven looked up and saw Weller’s car heading straight for him. Steven thought he was going to be hit, but at the last moment, he managed to jump out of the way of the oncoming car.

Steven was one of the lucky ones that day–ten people were killed, and more than fifty were injured. A former Gulf War veteran, he used the medical skills he had learned in the military to help save the wounded around him. In spite of his efforts, one woman died in his arms. Traumatized, Steven headed back to work. For months after the horrific accident, he couldn’t sleep and he couldn’t stop shaking.

To help Steven, we used a treatment technique called eye movement desensitization and reprocessing (EMDR). This technique involves patients bringing up emotionally troubling memories while their eyes follow a trained therapist’s hands moving horizontally back and forth. Following a specific protocol, the clinician helps the patient minimize negative thoughts and reactions about the traumatic event. After just one treatment, Steven started showing improvement, and after only eight hours of treatment, his shaking subsided and he felt significantly better.

The concept of EMDR sounds simple, but it is not a do-it-yourself therapy. It is important that EMDR be performed by a trained therapist. You can contact the EMDR International Association at http://www.emdria.org for more information and a list of certified EMDR therapists.

A 2008 study from the Rand Corporation reported that one in five soldiers returning from Iraq and Afghanistan have symptoms of post-traumatic stress disorder or major depression. As more of our soldiers begin returning from Iraq, we can expect many of them to suffer with this chronic stress disorder.
Common Signs and Symptoms of Stress

Frequent headaches or migraines

Gritting or grinding teeth

Stuttering or stammering

Tremors or trembling lips or hands

Neck ache, back pain, or muscle spasms

Light-headedness, faintness, dizziness

Hearing ringing, buzzing, or popping sounds

Frequent blushing or sweating

Cold or sweaty hands or feet

Dry mouth or problems swallowing

Frequent colds, infections, or herpes sores

Rashes, itching, hives, goose bumps

Unexplained or frequent allergy attacks

Heartburn

Stomach pain or nausea

Constipation or diarrhea

Difficulty breathing or sighing

Sudden panic attacks

Chest pain or heart palpitations

Frequent urination

Poor sexual desire or performance

Excessive anxiety, worry, guilt, or nervousness

Increased anger, frustration, or hostility

Depression, frequent or wild mood swings

Increased or decreased appetite

Insomnia, nightmares, or disturbing dreams

Difficulty concentrating, racing thoughts

Trouble learning new information

Forgetfulness, disorganization, or confusion

Difficulty in making decisions

Feeling overwhelmed

Frequent crying spells or suicidal thoughts

Feelings of loneliness and worthlessness

Little interest in appearance or punctuality

Nervous habits, fidgeting, or feet tapping

Increased irritability or edginess

Overreaction to petty annoyances

Increased number of minor accidents

Obsessive or compulsive behavior

Reduced work efficiency or productivity

Lies or excuses to cover up poor work

Rapid or mumbled speech

Excessive defensiveness or suspiciousness

Problems in communication or sharing

Social withdrawal or isolation

Constant fatigue or weakness

Frequent use of over-the-counter drugs

Weight gain or loss without diet

Increased smoking

Increased alcohol or drug use

Excessive gambling or impulse buying

Source: The American Institute of Stress
WHO’S VULNERABLE TO STRESS?

Unfortunately, everyone is vulnerable to the effects of chronic stress. It can attack you at any stage of your life. When chronic stress hits you or someone in your circle, everybody suffers. You’ve heard of the trickle-down economic theory; there’s also a trickle-down stress theory. When the boss is stressed out, everybody at work is stressed out. When your spouse is stressed out, everybody in the family is stressed out.

It happened in my own family when I was growing up. My father owned a chain of grocery stores with a colleague. When I was fourteen years old, he decided to sell the stores to a much larger grocery group, Arden-Mayfair. Going to work for someone else was a big mistake for my dad. He is a very independent person. He hated it and was under a lot of stress. He was miserable and not a lot of fun to be around. Stress often runs downhill.
CALMING THE STRESS IN YOUR LIFE SO YOU CAN HAVE A BETTER BODY

In my practice, I deal with so many patients who suffer severe stress. Most of the time, it is because no one has ever taught them stress-management skills. When I show them that there are better ways to deal with stress, they do a much better job at it. Here are sixteen different ways to help you calm stress so you can have better skin, better immunity, and a trimmer figure. Pick four or five ways that you like the best.

1. Meditate or pray on a regular basis. Decades of research have shown that meditation and prayer calm stress and enhance brain function. At the Amen Clinics, we performed a SPECT study on a Kundalini Yoga form of meditation called Kirtan Kriya in which we scanned eleven people on one day when they didn’t meditate and then the next day during a meditation session. For the meditation, the participants recited the following simple sounds known as the five primal sounds: “sa,” “ta,” “na,” “ma,” with “aa,” the end of each sound, considered to be the fifth sound. The meditation involved touching the thumb of each hand to the index finger while chanting “sa,” the middle finger while chanting “ta,” the ring finger while chanting “na,” and the pinkie finger while chanting “ma.” The sounds and fingering were repeated for two minutes out loud, two minutes whispering, four minutes silently, two minutes whispering, and two minutes out loud.

Figure 11.1

Kirtan Kriya Fingertip Movements

The brain imaging scans taken after the meditation showed marked decreases in activity in the left parietal lobes, which showed a decreasing awareness of time and space. They also showed significant increases in activity in the prefrontal cortex, which showed that meditation helped to tune people in, not out. We also observed increased activity in the right temporal lobe, an area that has been associated with spirituality.

My friend Andy Newberg at the University of Pennsylvania also used brain SPECT imaging to study the neurobiology of meditation, in part because it is a spiritual state easily duplicated in the laboratory. They scanned nine Buddhist monks before and during prolonged meditation. The scan revealed distinctive changes in brain activity as the mind went into a meditative state. Specifically, activity decreased in the parts of the brain involved in generating a sense of three-dimensional orientation in space. Losing one’s sense of physical place could account for the spiritual feeling of transcendence, being beyond space and time. They also found increased activity in the prefrontal cortex, associated with attention span and thoughtfulness. Meditation seemed to tune people in, not out. Another functional brain imaging study of transcendental meditation (TM) showed calming in the anterior cingulate and basal ganglia, diminishing anxiety and worries and fostering relaxation.

The benefits of meditation go far beyond stress relief. Studies have shown that it also improves attention and planning, reduces depression and anxiety, decreases sleepiness, and protects the brain from cognitive decline associated with normal aging. In a study from researchers at UCLA, the hippocampus and frontal cortex were found to be significantly larger in people who meditate regularly. Meditation has also been found to aid in weight loss, reduce muscle tension, and tighten the skin.

Many people think it takes years of practice to learn how to meditate. It doesn’t. A fascinating Chinese study from my friend neuroscientist Dr. Yiyuan Tang showed that people who received just twenty minutes of daily meditation training for five days showed a significant decrease in stress-related cortisol. You don’t need to devote big chunks of time to the practice of meditation, either. In my clinical practice, I often recommend meditation as an integral part of a treatment plan. Many of my patients have reported back that they feel calmer and less stressed after just a few minutes of daily meditation.

If the whole concept of meditation seems a little too New Age for you, take note that you can do it just about anywhere anytime. You don’t have to sit cross-legged on the floor or burn incense or any of those things you might associate with meditation. If you are at work, you can simply close the door to your office, sit in your chair, close your eyes, and relax for a few moments. At home, you can sit on the edge of your bed after you wake up and spend a couple of minutes calming your mind. Try the following Relaxation Response for a simple introduction to meditation.

The Relaxation Response

One of the simplest ways to meditate and reduce stress is a technique called the Relaxation Response, developed by Herbert Benson, M.D., at Harvard Medical School. I encourage you to set aside ten to twenty minutes today to try it. The following is the technique outlined in Dr. Benson’s book The Relaxation Response.

DirectionsSit quietly in a comfortable position.Close your eyes.Deeply relax all your muscles, beginning at your feet and progressing up to your face. Keep them relaxed.Breathe through your nose. Become aware of your breathing. As you breathe out, say the word “one” (or some other relaxing word you choose) silently to yourself. For example, breathe in … out, “one,” in … out, “one,” etc.

Continue for ten to twenty minutes. You may open your eyes to check the time, but do not use an alarm. When you finish, sit quietly for several minutes, at first with your eyes closed and later with your eyes opened. Do not stand up for a few minutes.

Do not worry about whether you are successful in achieving a deep level of relaxation. Maintain a passive attitude and permit relaxation to occur at its own pace. When distracting thoughts occur, try to ignore them by not dwelling upon them and return to repeating “one.” With practice, the response should come with little effort. Practice the technique once or twice daily, but not within two hours after any meal, since the digestive processes seem to interfere with the elicitation of the Relaxation Response.

Prayer, too, offers many of the same health and stress-relief benefits as meditation. Physicians Larry Dossey (Healing Words), Dale Matthews (The Faith Factor), and others have written books outlining the scientific evidence of the medical benefits of prayer and other meditative states. Some of these benefits include reduced feelings of stress, lower cholesterol levels, improved sleep, reduced anxiety and depression, fewer headaches, more relaxed muscles, and longer life spans. People who pray or read the Bible every day are 40 percent less likely to suffer from hypertension than others.

A 1998 Duke University study of 577 men and women hospitalized for physical illness showed that the more patients used positive spiritual coping strategies (seeking spiritual support from friends and religious leaders, having faith in God, praying), the lower the level of their depressive symptoms and the higher their quality of life. A 1996 survey of 269 family physicians found that 99 percent believed prayer, meditation, or other spiritual and religious practice can be helpful in medical treatment; more than half said they currently incorporate relaxation or meditation techniques into treatment of patients.

2. Take a yoga class. Yoga is an ancient and venerated form of stress relief. Many yoga classes promote mental calmness, self-awareness, and a focus on being in the present moment–all of which bring about a sense of relaxation and well-being. Yoga has solid scientific evidence that it can be helpful for reducing high blood pressure, altitude sickness, anxiety, arthritis, asthma, carpal tunnel syndrome, depression, epilepsy, heart disease, lung diseases, substance abuse, and boosting your quality of life. Yoga has become so popular that you can find classes geared to all ages and all ability levels.

3. Learn to delegate. People often have jam-packed schedules that leave little or no breathing room. Trying to race from one activity to the next while meeting work, school, and family obligations can become overwhelming. In our modern society, it seems like being busy is a sort of badge of honor. Ask anyone what they have planned for the day, and it is likely they’ll respond by telling you how incredibly busy they are. “I’m finishing a project for work, hosting a dinner party, making the kids’ costumes for the school play, volunteering at church, and going to my book group.” Phew! It can make you stressed out just thinking about all that.

News flash! You don’t have to accept every invitation, take on every project, or volunteer for every activity that comes your way. Two of the greatest life skills you can learn are the art of delegation and the ability to say no. Too often, just to please others, we agree to do things without first asking ourselves if the request fits into our own lives. Many people say yes without first processing the request through their prefrontal cortex. When someone asks you to do something, a good first response would be “Let me think about it.” Then you can take the time to process the request to see if it fits with your schedule, desires, and goals. When you have too much on your plate, delegate.

4. Practice gratitude. If you want your brain to work better, be grateful for the good things in your life. Psychologist Noelle Nelson and I did a study on gratitude and appreciation. She was working on a book called The Power of Appreciation and had her brain scanned twice. The first time she was scanned after thirty minutes of meditating on all the things she was thankful for in her life. After the “appreciation meditation,” her brain looked very healthy.

Then she was scanned several days later after focusing on the major fears in her life. One of her fears was about what would happen if her dog got sick and she couldn’t work. She had a string of frightening thoughts: “If my dog got sick, I couldn’t go to work because I would have to stay home to care for him. … If I didn’t go to work, however, I would lose my job. … If I lost my job, I wouldn’t have enough money to take my dog to the vet and he would likely die. … If the dog died, I would be so depressed I still wouldn’t be able to go back to work. … Then I would lose my home, and be homeless.”

I scanned her brain after she mulled on these thoughts. Her frightened brain looked very different from her healthy gratitude brain and showed seriously decreased activity in two parts of her brain. Her cerebellum had completely shut down. The cerebellum, also called the little brain, is involved in physical coordination, such as walking or playing sports. New research also suggests that the cerebellum is involved in processing speed, like clock speed on a computer and thought coordination or how quickly we can integrate new information. When the cerebellum is low in activity, people tend to be clumsier and less likely to think their ways out of problems. They think and process information more slowly and get confused more easily.

The other area of her brain that was affected was the temporal lobes, especially the one on the left. The temporal lobes are involved with mood, memory, and temper control. Problems in this part of the brain are associated with some forms of depression, but also dark thoughts, violence, and memory problems. In Noelle’s scans, when she practiced gratitude, her temporal lobes looked healthy. When she frightened herself with negative thinking, her temporal lobes became much less active. Negative thought patterns change the brain in a negative way. Practicing gratitude literally helps you have a brain to be grateful for.

Images 11.1-4

Notice low left temporal lobe activity decreases with bad thoughts (arrow).

Notice marked decreased cerebellar activity with bad thoughts (arrow).

Focusing on the good things in your life can make you happier regardless of your circumstances, according to decades of research from Dr. Martin Seligman, the renowned director of the University of Pennsylvania Positive Psychology Center. Seligman promotes the fascinating concept of positive psychology, which is based on the theory that happiness isn’t the result of good genes, rather that it can be cultivated. In his book Authentic Happiness, he writes that showing gratitude on a daily basis is one of the keys to increasing your sense of joy, happiness, and life satisfaction.

Here is a quick gratitude exercise you can try. Write down five things you are grateful for every day. Use the form provided, make copies of it, or just use a notepad to write down the things you are grateful for. The act of writing helps to solidify them in your brain. In my experience, when depressed patients did this exercise every day, they actually needed less antidepressant medication. Other researchers have also found that people who express gratitude on a regular basis are healthier, more optimistic, make more progress toward their goals, have a greater sense of well-being, and are more helpful to others. Doctors who regularly practice gratitude are actually better at making the correct diagnoses on their patients.

Five Things I’m Grateful for Today

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5. Get enough sleep. Getting adequate sleep enhances your ability to fight stress. Read Chapter 10 to review the many ways sleep helps the brain.

6. Get moving. Physical activity is a big stress reliever. Read Chapter 5 to learn more about why exercise is the single most important thing you can do for your brain.

7. Learn to warm your hands using only your mind. See Chapter 8, “The Heart Solution,” for more details.

8. Practice diaphragmatic breathing. The simple act of breathing delivers oxygen to your lungs, where blood picks it up and takes it to every cell in your body. Breathing also eliminates waste products, such as carbon dioxide, from the body. When there’s too much carbon dioxide in your system, it can cause stressful feelings of disorientation and panic. Brain cells are particularly sensitive to oxygen, as they start to die within four minutes when they are deprived of oxygen. Even the slightest changes in oxygen content can alter the way you feel.

Diaphragmatic breathing, in which you direct and control your breathing, has several immediate benefits. It calms the basal ganglia, the area of the brain that controls anxiety, helps your brain run more efficiently, relaxes your muscles, warms your hands, and regulates your heartbeat.

Here’s how you do it. As you inhale, let your belly expand. This pulls the lungs downward, which increases the amount of air (and oxygen) available to your lungs, body, and brain. When you exhale, pull in your belly to push the air out of your lungs. This allows you to expel more air, which in turn encourages you to inhale more deeply. Keep breathing in this fashion, and stressful feelings may diminish.

Diaphragmatic Breathing Exercise

Try this simple three-step exercise to make sure you are breathing deeply enough.

Lie on your back and place a small book on your belly.

When you inhale, make the book go up.

When you exhale, make the book go down.

Here’s another breathing tip that can soothe stress. Whenever you feel stressed out, take a deep breath, hold it for four to five seconds, then slowly blow it out (take about six to eight seconds to exhale completely). Take another deep breath (as deep as you can), hold it for four to five seconds, and blow it out slowly again. Do this about ten times and odds are that you will start to feel very relaxed.

            9. Listen to soothing music. Music has healing powers that can bring peace to a stressful mind. Of course, it depends on the type of music you listen to. Listening to music that has a calming effect, such as classical music or ambient sounds, has been shown to reduce stress and calm anxiety. Other types of music may be stress-inducing and destructive. I believe it is no coincidence that the majority of teens who end up being sent to residential treatment facilities or group homes listen to more heavy-metal music than other teens. Music that is filled with lyrics of hate and despair may encourage those same mind states in developing teens. What your children listen to can hurt them or help them. Teach them to love classical music when they are young. ACTION STEPI use music in my own life to help calm stress. Here’s a list of some of my favorite recordings that I personally find healing. You may want to try listening to them too.

            Don Campbell, Mozart as Healer: Classial Healing for the New Millennium, Essence: The Ambient Music of Don Campbell, and Healing Powers of Tone and Chant

            Compiled by Joan Z. Borysenko and Don Campbell, Inner Peace for Busy People: Music to Relax and Renew

            Michael Hoppe, Solace

            David Lanz, Beloved

            Dean Evenson, Arctic Refuge: Gathering of Tribes (with various artists), Ascension to Tibet, Healing Dreams (with Scott Huckabay), Healing Sanctuary, Music for the Healing Arts, Native Healing, Peace Through Music (with various artists)

10. Surround yourself with the sweet smell of lavender. Your deep limbic system is the part of your brain that directly processes your sense of smell. It is also the emotional center of your brain, which means that smells can have a big impact on your mood. The scent of lavender has been used since ancient times for its calming, stress-relieving properties. This popular aroma has been the subject of countless research studies, which show that it reduces cortisol levels and promotes relaxation and stress reduction.

One remarkable study that appeared in the journal Early Human Development examined two groups of mothers giving their babies a bath. The first group used lavender bath oil; the second didn’t. The first group of moms appeared more relaxed, smiled more, and touched their babies more often during the bath than the second group of moms. Their babies cried less and spent more time in deep sleep following the bath. The first group of moms and their infants also had significantly lower cortisol levels than the second group, which didn’t use lavender bath oil.

You can find this natural stress reliever in the form of oils, candles, sprays, lotions, sachets, and potpourri. Many other scents, such as geranium, rose, cardamom, sandalwood, and chamomile, are considered to have a calming effect that reduces stress.

11. Rehearse or practice situations that cause stress. Nobody is completely immune to stress. Everybody gets stressed out about something from time to time. For many people, things like speaking in public, going on a job interview, or going to an event where you don’t know anybody can make your palms sweat and your heart race. In these cases, you can benefit from a little practice. The more you do something, the less stress inducing it becomes.

12. Live in the present. The notion of living in the present is a simple concept, but it is one of the hardest to implement. Many of us dwell on the past, holding grudges about things that happened years or even decades ago, stewing over a fight with a colleague, or feeling bad about things that happened to us in high school. You could be lying on a warm, sunny beach while on vacation, but inside your head, you are fuming about a comment your significant other made the week before. Equally common are those of us who fret about the future, worrying about bad things that might happen. In Eckhart Tolle’s extraordinary book The Power of Now, he encourages readers to shed the pains of the past, stop fearing the future, and live in the present moment. He believes that the present is all we really have, that we can’t change the past, and that it is what we’re doing right now that shapes our future.

13. Practice self-hypnosis. Like meditation and prayer, self-hypnosis is a powerful tool to balance brain function and decrease stress. When I’m feeling overly stressed, I use the same self-hypnosis exercise I wrote about in Chapter 10, “The Sleep Solution.” However, instead of drifting off to sleep at the end of it, I stay in my “special place” for about ten or fifteen minutes, then come back to full consciousness. It usually makes me feel very refreshed and relaxed. This is one of my favorite stress busters. ACTION STEPIn principle, I agree that it is a good idea to live in the present. Worrying about the past and fretting about the future only add to your stress. However, through SPECT imaging, I have found that when people think about happy memories from the past, it enhances brain function. Instead of erasing your past completely, make sure the version of it that runs through your head has a positive spin.

14. Avoid substances that harm your brain. Consuming caffeine, eating sugary snacks, drinking alcohol, and smoking are some of the most common–and unfortunately, some of the worst–ways to deal with stress. Duke University researcher James Lane, Ph.D., has been studying the effects of caffeine on stress for more than a decade. According to his findings, caffeine disrupts a natural process that keeps stress under control. When ingested, caffeine prevents the release of adenosine, a chemical that regulates bodily functions. Normally, when we get stressed, adenosine levels rise to reduce the body’s response to stress.

With caffeine, however, adenosine is suppressed so your body’s response to the stress is heightened. Lane’s body of research shows that consuming caffeine increases stress hormone levels when people are faced with stressful events or tasks. Basically, this means that drinking a large caffe latte before a test or a big meeting will only amplify any feelings of stress you might have experienced normally.

People often reach for a glass of wine or alcohol to calm the effects of stress. Research, however, shows that in many people, drinking actually induces stress and elevates stress hormone levels. Alcohol also lowers overall blood flow and activity in the brain, which diminishes your ability to cope with stress.

The same goes for smoking. When smokers get stressed, they tend to light up in search of relief. But inside the body, it is another story. Nicotine causes your blood pressure to rise and your heart rate to increase, which are signs of increased stress. And like alcohol, smoking causes blood vessels to constrict, which reduces the amount of oxygen going to the brain and subsequently lowers brain function.ACTION STEPWhen you feel stressed, skip the alcohol, cigarettes, and candy. They lower brain function and ultimately increase stress.

Numerous studies have shown that when unrelenting stress hits, it causes many of us to look for solace in a big bowl of Ben & Jerry’s Chunky Monkey, a fistful of M&Ms, or a bag of Oreo cookies. Unfortunately, high-fat foods can also trigger stressful reactions. Researchers at the University of Calgary examined stress reactions in two groups of students. The first group ate a high-fat breakfast while the second group noshed on a low-fat meal. Two hours later, the test subjects went through a series of stressful tasks. In each of the tasks, the group that gorged on the high-fat meal showed higher stress reactions than the second group.

15. Laugh more. There is a growing body of scientific literature suggesting that laughter counteracts stress and is good for the immune system. It is no joke! One study of cancer patients found that laughter reduced stress and improved cell activity associated with increased resistance to the disease.

According to the University of California, Irvine’s Professor Lee Berk, “If we took what we know about the medical benefits of laughter and bottled it up, it would require FDA approval.” Laughter lowers the flow of dangerous stress hormones that suppress the immune system, raise blood pressure, and increase the number of platelets, which cause clots and potentially fatal coronary artery blockages. Laughter also eases digestion and soothes stomachaches, a common symptom of chronic stress. Plus, a good rollicking guffaw increases the release of endorphins, which makes you feel better and more relaxed. Laughter truly may be the best medicine when it comes to stress relief.

The average child laughs hundreds of times a day. The average adult laughs only a dozen times a day. Inject more humor into your everyday life. Watch comedies (this could be a helpful form of TV), go to comedy clubs, go to humorous children’s plays, read joke books (my favorite is The Far Side by Gary Larson, which is pretty sick, but I am a psychiatrist after all), and swap jokes with your friends and coworkers.

I can’t stress enough (pun intended) how important it is to learn to laugh at yourself too. When you drop the milk jug and it goes splashing across the kitchen floor, when you call a business associate by the wrong name, or when you stumble over your words while teaching a class, be the first to chuckle at yourself. When you stop taking yourself so seriously, your stress levels will subside.

16. Seek help for chronic stress. If you are chronically stressed, it may be a good idea to see a psychotherapist to talk about your problems and learn better stress-management skills. Many people have a negative attitude about seeing a psychotherapist, but I think of them as life consultants. When a great business has troubles, it is likely to deal with the problems head-on and find the best consultants to help. We should behave the same way in our personal lives. In dealing with stress, I often refer people to biofeedback therapists, hypnotherapists, and people who do a form of psychotherapy called eye movement desensitization and reprocessing, or EMDR, which helps them deal with anxiety, past traumas, and performance enhancement.
SUPPLEMENTS THAT CALM STRESS

Some supplements may be helpful in soothing stress, including B vitamins, L-theanine, GABA, St. John’s wort, 5-HTP, magnesium, and valerian. Take these under the supervision of your health-care professional. Just because something is natural does not mean it is completely innocuous. See Appendix C, “The Supplement Solution,” for more information. You can also get more detailed information online at http://www.amenclinics.com/my-brain-health/.

The Stress Solution
Stress InducersStress Relievers Any brain problems Brain-healthy lifestyle Poor sleep Adequate sleep, at least seven hours Alcohol/drug abuse Freedom from alcohol or drugs Caffeine Limited caffeine Depression Treatment for depression Anxiety Meditation for relaxation Lack of exercise Physical activity, including yoga Smoking Quitting smoking Diaphragmatic breathing Soothing music Calming scents like lavender Self-hypnosis Laughter Stress-reduction plan B vitamins, L-theanine, GABA, St. John’s wort, 5-HTP, magnesium, and valerian