By MICHAEL PAINTER, MD
I am here in California at the Health 2.0 conference with 2,000 health care innovators. One of the most popular Health 2.0 sessions is called The Unmentionables—where speakers discuss those important things that affect our health but we’re often afraid to address. I participated in thisyear’s session where we talked stress—what it is and how it’s making us sick.
I’m an avid cyclist. That means I train a lot. Training on a bike means purposefully and intensely stressing your body—sometimes ridiculously hard—in order to make your body stronger, fitter and faster. In that sense stress can be really good. You can’t get stronger without it.
But here’s the key: as you ratchet up that stress—the miles, the hours on the bike, the intensity— you must work just as hard on the flipside, the buffering. The more you train, the more you have to focus on the rest, the sleep, your social supports, the yoga, the nutrition—whatever it takes.
If you don’t buffer you will burn out, get injured or sick, or all of the above. Without buffers, the stress will crush you.
The Robert Wood Johnson Foundation has been thinking about stress and its connection to health for quite some time. We’re finding that in many ways we have a culture of stress rather than a culture of health. We need to understand that and work together to fix it.
I’m a family doctor and used to practice at a community health center in Seattle. I recently came across a story that reminded me of many of my former patients. Jeanette is a young mother living in Connecticut experiencing major stress in her life: she just had baby, was suffering postpartum depression, lost her job, was facing eviction, and her relationship was in trouble. Not surprisingly, her stress also affected her baby, Shiloh—just weeks old. Shiloh wasn’t smiling, didn’t play, and didn’t communicate.
When we’re under stress, our bodies produce an increased amount of cortisol. A certain amount is healthy, but too much over a long period of time can have very negative effects—especially in a developing brain. That is likely what was happening to Shiloh. Stress can exacerbate or cause lifelong illness like diabetes, depression and heart disease.
At RWJF we wanted to understand how the public perceives and manages stress, so we conducted a public opinion survey on stress with NPR and Harvard’s School of Public Health.
Here’s some of what we found:
• Half of those we surveyed had a stressful experience in the past year.
• Most who reported high stress were already in poor health—including many who have chronic conditions or illness.
• The vast majority said that stress negatively affects their family and social lives, how they perform at work—as well as their health.
• Over half of those with a great deal of stress and a chronic illness or disability said stress made their symptoms worse and their condition harder to manage.
• Over 90% said they manage or buffer stress by spending time with family and friends, exercising, eating well, or doing outdoor activities,
• Unfortunately, only 50% said they do things to buffer their stress.
The numbers, of course, are important, but the stories are even more powerful. Jeanette and Shiloh did get help from an RWJF-funded initiative, Child First—a home visiting program that helps stabilize families with young children. But that’s just one story; there are many, many more. When NPR asked people to share stories about the stress in their lives, they received an overwhelming number—6,000 responses when they typically only get about 500.
Why? Americans are stressed; they know it, and they want to talk about it.
Health isn’t just a lack of illness. It’s so much more—it’s enjoying and embracing life—that includes successfully managing life’s stress.
The goal of our work is health and well-being for everyone. We can’t get there unless we address the stress in our lives. (See our infographic about how to move from a culture of stress to a culture of health.) That means we must try to reduce it where we can and learn to directly manage it where we can’t.
What we’re finding: stress is making us sick.
The good news: we don’t have to let it.
To be clear, that example was overt. I had another patient encounter that was quite different. I remember seeing an elderly patient who came to the ER with a medical problem. Both the patient and a relative were present in the room the first time I saw him. I came into the room a second time to give the patient and the relative some test results. As I walked into the room, I noticed that a cell phone was on a chair in the room; it was seated in the middle of the seat cushion, sort of like an invited guest. I paid no further attention to it.
