Taming Toxic Stress

Four years ago, Heather Coleman knew something had to give. As the head of a consultancy division for a Fortune 50 technology company, she worked late into the night at least once a week, trouble-shooting staff issues for her employees and managing the expectations of both her bosses and her clients. She wasn’t sleeping well, which meant she sometimes reacted poorly to unexpected events. She had knots in her back and shoulders and a pit of anxiety in her stomach. Plus, she’d been struggling with bouts of stomach pain and cramping.

But she didn’t make a change until, she says, “I realized I’d lost my personality.” She was at a friend’s wedding, surrounded by people she valued, and found she couldn’t carry on a non-work conversation. At the same time, her then-boyfriend insisted she stop e-mailing during dinner.

“This is ridiculous. No job is worth this,” Coleman, now 37 and living in Riverside, California, remembers thinking. “Work shouldn’t be the focus. Life should be the focus, and the job should support that.”

Coleman didn’t quit her job. What she did was wrangle her stress. Indeed, even when women love their jobs, work stress can make them sick. Stress contributes to everything from headaches to back pain, stomach trouble, and even heart disease and stroke. A forthcoming study from a Harvard Medical School professor found that women executives with high-stress jobs were twice as likely as those with low-stress jobs to have heart attacks, ischemic strokes, and clogged arteries that required surgery.

“We’re all human, we all experience stress,” says Michelle Albert, MD, MPH, director of behavioral and neuro-
cardiovascular cardiology at Brigham and Women’s Hospital in Boston. “That’s not the question. The question is, ‘Does the stress you experience overwhelm your body’s basic ability to manage that stress, and thus result in some kind of biological outcome?’”

The Biology of Stress

Work stress is made up of two components—demand and control, says Dr. Albert, an assistant professor of medicine at Harvard and author of the study on job stress and heart disease. Demands on your energy and attention mean lots of responsibility and pressure. Stress is also measured by the amount of control you have in your job. Jobs with high demand and low control—think waiting restaurant tables or assembly line work—are the most stressful.

The stress experienced by executives like Coleman falls into another category, called active stress. That means she faces high demands—pressure to meet revenue and margin goals, manage her team, and keep her clients and her employer happy. But she also has a high amount of control. She sets her own hours, has control over staffing and the numbers, and is treated like the CEO of her division.

Research shows that control mitigates stress. “But no one has ultimate control,” says Margaret A. Chesney, PhD, director of the UC San Francisco Osher Center for Integrative Medicine.

So high pressure and high control mean that people like Coleman are still at the high end of the stress spectrum. When you reach a certain level of stress, it seeps into your biology: Your system becomes inflamed, which is associated with increased risk of cancer and heart disease. Your fight-or-flight response gets triggered, which clouds thinking. Blood pressure rises. Levels of the hormone cortisol increase, which is associated with higher incidents of diabetes, even more inflammation, and a weakened immune system.

Digging Your Way Out

Fortunately, you can fight off stress and its toxic health effects, says Dr. Chesney, who has coauthored a number of studies on what’s called coping effectiveness training, a type of behavior modification that addresses stress by retraining our reactions to it.

“There are things we can’t control and things we can,” she says. “What we do have control over is our responses.”

Consider these techniques for stress reduction.

Report on Yourself

“Study your patterns, and see what’s causing you stress,” says Dr. Chesney. Do you obsess about decisions you aren’t in a position to influence? Do you find yourself in the more-work-is-better camp, even when you hit diminishing returns at 3 a.m.? Do you use excessive caffeine in the morning and wine at night, or excess eating, to modulate your mood? These are patterns you can change.

Turn Off the Faucet

Likewise, you can close the leaky faucet of demand: You can control how many times a day you check e-mail, for instance. You can choose when you shut down your computer, whether you leave your office door open and what time you go to bed. You can decide, like Coleman, whether you’ll sit with your laptop on the couch on weekends, watching the never-ending flow of
e-mails and mini-crises.

Meditate

Sometimes you just need to turn off your brain. That, in part, is what meditation does. Studies suggest that meditation may reduce blood pressure, improve attention spans, temper the fight-or-flight response, and reduce heart rate. You don’t need any special skills to meditate. Just close your eyes, deepen your breath, and concentrate on your breathing.

Breathe

“We’re all familiar with the fight-or-flight response,” says Chesney. “The other response is the freeze response. It’s something that women do more than men, and often it means that women hold their breath in conversation.”

Deep breathing soothes stress responses and slows the heart rate. Chesney is currently studying whether deep breathing is why yoga and meditation are such good stress fighters.

Move

“Physical activity is a huge stress buster for a lot of reasons,” says Dr. Albert. “All those biological things that get triggered when we’re stressed—inflammation, increased blood pressure, and cortisol levels—are downregulated when we exercise.” Research shows that just 20 to 30 minutes of activity three times a week can affect mood, sleep, stress, and various other conditions.

Prioritize Me Time

Dr. Albert admits that getting more down time is a commonsense suggestion, not an evidence-based one, but she insists that taking time out for yourself is good for stress management.

“Women, more than men, get pulled in multiple directions every day,” she says. “We tend to want to be our best for
everyone but ourselves.” Carving out just 10 to 15 minutes a day to do something you love—knit, read, play with your dog—can calm and refocus you.

Seek Support

“As women in executive positions, it’s difficult to find places where you can go and share,” says Chesney. “So many of the people you’re interacting with are subordinates. You need one or two people with whom you feel safe to share what’s happening.”

Coleman found this with her boyfriend, now her fiancé. He has worked in a similar position and understands the stress of the job.

“I look at my fiancé and say, ‘Look, I’m just venting. I’m not asking you to fix it,’” she says. “Sometimes I just need to unload it.”

You can use social support effectively and ineffectively. When you’re worried over something you can’t control—the actions of a client or board of directors, the economy, the future—venting helps you express your feelings and move on.

But when it’s something you can control—how you react, changes you have the power to make—enlist friends as problem solvers.

“Meditation may calm you,” she says. “But then you need to call on a friend who’s good at helping you brainstorm solutions.”

Four Years Later

Today, Coleman is light years from the self-described “little ball of stress” she was in 2008. It’s taken years and lots of focused attention, but she’s finally sleeping through the night, turning off her computer after work, and asking herself, “Do I really need to address this now, or can it wait until morning?” She usually eats healthy and exercises. She finds that a good night’s sleep helps her solve problems more quickly—30 minutes in the morning instead of three hours in the middle of the night.

Though she still has stiff muscles, the stomach trouble disappeared almost as soon as she started making changes. She has her life and her health back.

“I try to let my work stress go at the end of the day,” she says. “I try not to let the job get in the way of my life anymore.” DW

Heather Boerner is a San Francisco–based freelance writer who writes about health and medicine, among other topics. Visit her at www.heatherboerner.com.

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