Women and Stress: The Endless... Health Article

Women experience symptoms of stress 30 percent more often than men, research has shown. And according to one study, women are more likely than men to maintain elevated levels of stress hormones in their system -- even at night when they are sleeping.

You may think that being a woman and being stressed is a given. You're worrying about your kids -- or about trying to get pregnant or whether you should have kids. You're worrying about your marriage -- or about trying to find a mate or about your divorce. You're worrying about your career -- or whether you should have a career. And you're worried about aging parents, volunteer work, keeping up with friends, paying bills...and the list goes on and on.

And you end up getting stressed out just by thinking about -- well -- stress.

Physical effects of stress

So why think about stress? It's because if stress gets out of control, it can make you sick. Stress has been linked with heart disease (the leading cause of death in the United States), high blood pressure, stroke, ulcers, a weakened immune system, a reduced ability to heal, fertility problems and chronic colds. It may even play a role in some cancers and diabetes.

"You need to take stress seriously -- it is significant, and it is real," says Tracy W. Gaudet, M.D., director of the Duke Center for Integrative Medicine. "It has very real physiological effects. You can either pay attention to stress and its effects now, or pay attention later, with interest. If you pay attention now, your life will be more enjoyable and productive. If you stay stressed, you're putting your long-term health at risk."

Dr. Gaudet, whose specialty is obstetrics/gynecology, also serves as the medical expert for Oprah Winfrey's Lifestyle Makeover Team, which helps women take control of their lives so they can be healthier and happier in pursuit of their dreams. On a recent "Oprah" show, Dr. Gaudet said that 90 percent of women live their lives disconnected from their bodies.

Dr. Gaudet notes that stress in of itself is not harmful -- it's being in a chronic state of stress that is damaging. "Stress is the body's reaction to a perception of danger or threat and provides us with safety and protection," she explains. "Our blood pressure goes up, as does our blood sugar and heart rate -- all things that maximize our energy and responses.

"But our bodies were not designed to function this way all the time," Dr. Gaudet continues. "Yet today, it seems we spend more and more time in a crisis mode."

Gadgets galore

Technology is a major contributor. It used to be that if someone phoned you, and you weren't home, they'd call you back. Now most people have answering machines, as well as cell phones, pagers and email. Younger people, especially, find the idea of not answering the phone or a page alien.

"This increased access means we're `on' to our demands all the time," Dr. Gaudet says. "But the body needs downtime when you're doing nothing, and we have very little of that any more. Women are especially vulnerable because they often juggle multiple demands, and our culture makes them feel a greater need to respond to those demands. They are the caregivers, and are pulled in many more directions than men, who tend to be better about setting boundaries. All this puts women at high risk for stress-related health problems.

If you never think it's OK to be "off," then you are setting yourself up for a stress-related problem, according to Dr. Gaudet. "You need to make mindful choices about giving yourself time off, and you need to be as disciplined about scheduling it as you are about the other things you do. It's not selfish or self-indulgent, and it's not a luxury -- it's essential. If you want to be around to take care of the people you love, you need to take care of your health. You need to create quiet time for yourself."

Taking action against stress

So before stress sends you to the doctor, what should you do?

First of all, Dr. Gaudet advises, remember that stress is about perception -- it is how you perceive circumstances that make them stressful. This will help when you take the first step, which is writing down all the stressors in your life. Include everything from obvious, serious ones like a dying parent to things that may seem silly, like dirty dishes piling up in the kitchen. "The 'size' of the stressor doesn't matter -- all your body knows is that it needs to go into overdrive to deal with it," she says.

Once you've put your list together, analyze it. Maybe some of the stressors belong to others. "Maybe you decide you're still going to worry about a friend's marital problems, but just creating awareness can help. Remember, the body only responds to perception," Dr. Gaudet says.

Then decide what you can get rid of or hand off. Let your kids load the dishwasher or walk the dog, let a co-worker chair a committee. Say no to a volunteer commitment. "But if you hand it off, you really have to let it go," Dr. Gaudet says. You haven't relieved any of your stress if you reload the dishwasher or look over your co-worker's shoulder.

Change your attitude

Then there are things you can't do anything about -- a child's serious illness, a difficult marriage, a project deadline at work, getting caught in traffic. But you can change your perception of it. There are a number of ways to do this; for example, reflect on what's the worst that could happen. By naming your fear, you can begin to cope with it. Another way to deal is through laughter. In fact, researchers have found that laughter helps your immune system fight invading viruses and cancers. It lowers levels of the stress hormone cortisol and can lower your blood pressure and decrease heart strain. It also reduces stress by helping to relax muscles.

You should also design releases for yourself. Be disciplined about stress reduction and do it every day. It can be as simple as deep breathing exercises during the day, a 10-minute stretch in the morning, walking, listening to music or taking a hot bath. Try meditating or yoga. Maybe you can't exercise for an hour, but you could move around and dance to your favorite music for a short time. Read a book. Get a massage or a pedicure. Adopt a pet. ("It's true -- people who have pets live longer," Dr. Gaudet says.) Develop connections with people who care about you.

Dr. Gaudet also suggests keeping a journal. A journal can help you release anger ("better than holding emotions and anger inside or venting them on those you love"), shake off worries, get in touch with your body ("scan your body to see how you're feeling every day"), and figure out what's important to you and where your passions lie. It doesn't have to be a long missive -- just a paragraph or a few lines a day can make a difference.

"The mechanism doesn't matter, it's the release," Dr. Gaudet says. "It's a matter of living in the moment."

And that means feeling better -- not just for the moment -- but for a lifetime that is longer and healthier.

Laugh about it

"Laughter is a great way to release stress!" says Dr. Gaudet.

So the next time you find yourself on overload, humor yourself with these thoughts:

• "All stressed out and no one to choke!"

• "Don't treat me any differently than the Queen!"

• "Well, this day was a total waste of makeup."

• "You just have to accept the fact that some days you're the pigeon and some days you're the statue."

• "Some day we'll look back on all this and drive into a parked car."

• "Chaos, panic, disorder -- my work here is done."

• "Allow me to introduce myselves."

• "I'm not tense -- just terribly, terribly alert."

• "How do I set a laser printer to stun?"