Stress--everyone talks about it, and for good reason. The national statistics are frightening. It is estimated that 75 percent of all medical complaints are stress-related. Approximately $15 billion are lost by industry annually because of stress-related absenteeism. About 5 billion doses of tranquilizers are prescribed each year. It has long been believed that stress might contribute to heart disease. Until recently this notion has been supported only by anecdotes: the wife who never had a heart problem, but suffered a heart attack soon after the death of her husband; the surge in heart attacks after such traumatic experiences as earthquakes or personal crises. But several medical studies conducted in countries around the world, including the united States, Israel, and Sweden, have provided evidence that emotional stress precedes the onset of heart disease symptoms.



What is stress? This question crystallized for me one day when two of my patients individually asked me the same question: How were their highly demanding jobs affecting their health? I responded with my own question to each of them: "How do you feel about your job?" The first said, "I hate it! I can't stand the environment or the people. And my work bores me." The second answered, "I really like what I do. The atmosphere in the office is exciting, and the work is challenging. Of course, there are times when I'd rather be elsewhere, but you can't expect everything or everybody to be perfect." Needless to say, their jobs were affecting the health of these two patients very differently. The first had job stress, while the second had job satisfaction. What fascinated me most was that these two people were partners in the same business!

As the above example illustrates, stress is not just "out there"; it is not simply a result of circumstances. Stress also depends on how an individual interprets circumstances, on what your own thoughts and feelings tell you about the circumstances. If you look at stress from this perspective, you have more possibilities for dealing with it effectively. You need no longer be limited to being a victim, and letting a particular situation control your emotions. It is worthwhile to evaluate your situation, but if you understand your thoughts and feelings about it, you can discover sensible approaches to handling specific problems.

What causes one to view a circumstance as stressful? Generally, stress is triggered by any situation or event that might appear to control, limit or undermine your power. Frustration and anger develop when you sense that you are not getting what you want or deserve.

People tend to become upset when they feel powerless or helpless, unable to change their circumstances. Recent research has shown that hostility in people increases their risks for heart disease and a heart attack. The Framingham Heart Study demonstrated not only that high levels of hostility increase the risk of heart attack, but also that people married to overly demanding spouses have an increased risk.

Such emotions as anger and hostility, translated into stress and turned inward, have significant consequences on the body. Stress brings with it a sense of resistance and diminishment, of contraction and closing down. When under stress, you may feel constricted, stuck, and irritable. This is precisely how stress is communicated to and by your body, especially your cardiovascular system. How to keep perspective and cope?

Many people tend to become stressed by anticipating being obsessed with situations over which they have no control. Whenever such stress-provoking thoughts arise, ask yourself these questions:

* What is the worst thing that can happen?

* Even if the worst happens, how important will it be to me a year from now? Five years from now?

* If a friend came to me with this problem, what advice would I offer?

* How can I change my thoughts and approach the situation more objectively, more dispassionately?

Take five slow, deep breaths. For each, inhale to a count of 4, pause for a second, and exhale to a count of 4. As you inhale, visualize a soothing blue vapor filling your body; as you exhale, visualize red-hot tension leaving your body. To help relax, picture a scene in nature, the seashore or mountains. Imagine its beauty and serenity. When you feel sufficiently wound down, ask yourself the reality-based questions above.

The key is understanding that it is within your power to control stress rather than having stress control you.