Stress myths and reality

June 16, 2014

Jonathan Sackier
Jonathan Sackier

  • Surgeon, Clinical Professor 
  • 30 years of healthcare experience 
  • Author of the “Fly Well” column in AOPA PILOT 
  • Flying since 15 years old, owns a Columbia 400 

Firstly, let’s dispense with the obvious, flying an airplane while dealing with a major life stressor is not a good idea. Aviation requires mental acuity, focus and dashing good looks….okay, maybe not the latter, but if approaching the concept of leaping into the sky does not make your heart leap, consider what life events might be doing to your mood and keep your feet on the ground, at least until your head is not up where the sun don’t shine. You know what I mean. 

Lots of things can induce stress; work or money problems, the death of a loved one, a divorce or other relationship issue and such woes have been imbued with almost magical powers, black magical powers, to harm our bodies physically. So before jumping in to confirm or refute such issues, let me categorically state that I am a firm believer in the power of the mind to influence physical symptoms. Who does not recall going into an exam at school and feeling that creeping sense of doom? Okay, maybe you were better prepared than me. The pounding heartbeat, desire to pee, sweaty palms, dry mouth and so on; all symptomatic of the surge of neurotransmitters organizing your body for the coming battle, diverting blood to the brain and muscles and away from the digestive system, a primitive response to a threatening situation. The dry mouth is real, the sweaty palms, real. So why is it not feasible that other emotional overlays might not cause a range of physical changes?

Here is a slightly contentious analogy – and ladies, if any of you take offense please forgive me, I am just trying to keep everyone’s attention and have some fun. Fact; women are more likely to develop gallstones than men – that is undeniable. Also likely to pass muster is the following, women are more inclined to have the urge to rearrange the furniture --politically correct disclaimer-- in my experience! Obvious, but incorrect conclusion? Ipso facto, rearranging furniture causes gallstones!  

So how does this relate to stress and the range of problems ascribed to it? When one is sad, under the gun, emotionally confused, many things change – diet, exercise patterns, increased substance abuse for instance and all of these can have dramatic impacts on health. I am not saying that stress, especially if severe, long term and unremitting cannot have a negative impact as it absolutely can, but one has to take other factors into account. 

So let’s dispel a few mythologies starting with one dear to my heart – I am going gray and like everyone else, have some stressors in my life. How much nicer to attribute my eminence gris to an outside influence instead of the march of time! True? Not a bit of it. Losing your hair or going gray is a function of genetics and the passage of time. There are about 130,000 hairs on the average head and at any given time about 90% are actively growing at the rate of about ½ inch/month. After two years or so a hair takes a well-deserved rest which lasts a few months, then it falls out and a new one pops up. Or not. On average we lose about 100 hairs a day and many things can increase this loss in addition to the aforementioned aging and genetic profile; a poor diet, long term fever, major surgery, serious infections and hormonal changes such as menopause. Given the rate of hair growth and pigmentation, there is a lag time of several months before any change is seen. So a long term stressor may have an effect, but much of it will be due to secondary factors.

What about the old chestnut that stress can cause ulcers? Well that was debunked by Barry Marshall and Robin Warren in the very low stress Australian medical ecosystsm. They ascertained that peptic ulcer disease is, in fact, caused by a bacteria called Helicobacter pylori and won the Nobel Prize for their efforts in 2005. Maybe people in high stress environments are more likely to contract this infection, but dealing with stress de facto does not cause ulcers.

Ulcerative colitis is a relatively rare and quite nasty condition that causes the large bowel to be inflamed leading to numerous episodes of bloody diarrhea. Back in the day, some of my colleagues thought that these patients needed to poop twenty times a day because they were anxious and so recommended electroconvulsive therapy. We now know that they are anxious because they poop twenty times a day and we address their illness with a more rational approach.

What about diseases where stress does have a direct impact? Heart disease, the major killer in first world countries, does link to stress. We have shown that people who meditate or have other ways of achieving a calm demeanor, such as by petting dogs, can lower their blood pressure, thereby impacting heart disease risk. Additionally, there seems to be a link to lower blood lipids. Certainly, people who harbor and embrace their stress are more likely to engage in heart-damaging activities such as smoking and leading a sedentary lifestyle, so it is complex to unravel.  

Headaches, asthma, diabetes, Alzheimer’s disease, premature aging and death also seem to be impacted by a high stress lifestyle so there are some tangible reasons to avoid the darn thing.

What about things you can do to deal with stressors? Some people advocate yoga or meditation and if that works for you, great. I challenge anyone who is not physically active and dealing with stress to start taking long walks; the effect can be dramatic. Is it due to brain chemicals being released creating a natural “high?” Who knows, as long as it works, and it does.

Diet can make a big difference also. Alcohol is actually a depressant and all its other risks aside is not a good way to deal with life’s problems. In small doses “comfort” foods like chocolate, ice cream or meat loaf might help, either from the sugar and taste “high” or because they rekindle memories of pleasurable times. Additionally, some carbohydrate foods cause the release of serotonin, a brain messenger associated with good feelings. Oatmeal, spinach, oranges and pistachios work too.  

I was sitting with some friends discussing how we deal with stress, one pronounced the benefits of juicing, whereupon my other friend said he also liked to do that-- “cabernet sauvignon, merlot, chardonnay…..” As above, alcohol is not the answer but spending time with good and caring people and finding ways to laugh is.

I wish you a stress-free and healthy start to your summer. 

Jonathan Sackier