Don’t let stress make you worried sick -- or worse

Stress can kill. That may seem overly dramatic, but multiple studies support what my colleagues and I see so often: Emotional stress is taking its toll on the physical health of our patients.

One woman who visited our office recently had two children in the armed forces in Iraq. They were supposed to come home weeks earlier, but had been ordered to remain for a while longer. She had had a case of the flu for over two weeks.

We ran tests to be sure there was nothing more seriously wrong, but it appeared that her immune system was just not doing the job it needed to do.

I told her that chronic stress causes a prolonged state of inflammation that depletes the immune system’s resources. I recommended that she try yoga or relaxation techniques such as deep-breathing exercises, adding that meditation has been shown to strengthen the immune system.

She began to feel better after joining a support group for people with relatives serving abroad in the military.

Another patient had recently been laid off. He was worried about paying the bills and taking care of his family. He had also noticed that his irritable bowel syndrome had worsened, even though he was eating the same diet and taking his medications as always.

Many medical conditions -- such as irritable bowel syndrome or eczema -- get worse during times of stress. This didn’t mean that the symptoms were “all in his head.” It meant that the biological effects of stress cause certain conditions to worsen. I recommended increasing his intake of fruits and vegetables, foods that have antioxidants that can help protect the body from the effects of stress.

Another woman had just been diagnosed with leukemia. Her husband had died a year earlier. She wondered what the relationship could be between his death and her cancer diagnosis.

Certainly it cannot be proved that the stress of dealing with her husband’s death contributed to her cancer, but we do know that specific cells in the immune system help fight cancer cells and that the activity of those cells is decreased in times of stress.

I tried to emphasize the importance of dealing with her loss in a way that minimized her continued pain, so that her body could start to heal -- both emotionally and physically. She took up yoga and meditation to help her body relax.

Stress has been implicated as a factor in heart disease, cancer, asthma, chronic fatigue and a propensity for infections. It is so pervasive a part of our lives in 21st century Los Angeles, that I try to discuss it with all of my patients.

I depend on them to share with me what is going on in their lives -- even things they may not think are related to their physical complaints. It is important for me, as their primary care doctor, to understand what they are dealing with in their lives -- only then can I make an accurate diagnosis and realistic recommendations.

When patients express doubt about the ability of emotional feelings to affect them physically, I ask them to consider what happens when they get nervous. Maybe the heart races, maybe the palms start to sweat -- either way, they are experiencing physical symptoms in response to stressful thoughts. When such stressful thoughts are chronic, there are ongoing physical effects that wear down the body.

Obviously it is important to minimize our feelings of stress and anxiety by dealing with the root causes. But we also have to work to reduce the physical impact of stress when it cannot be controlled. After all, a certain amount of stress is unavoidable.

Whether it is war in Iraq, a traffic jam, or financial difficulties and a weak economy, there are times when we cannot control the causes of stress in our lives. What we can do is prevent stress from making us sick, by checking in with a health-care provider and learning about ways to protect the body from the effects of stress.

Exercising regularly, maintaining a healthy diet, getting enough sleep, talking out problems, practicing yoga or meditation -- even simply taking five to 10 deep breaths in a row -- all have been shown to decrease the stress response in the body. Even though no one can avoid stress entirely, we are not powerless to prevent that stress from making us sick.

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Myles Spar is a clinical instructor at UCLA, a staff physician at the Venice Family Clinic and the medical director of the Akasha Center for Integrative Medicine in Santa Monica.