Notes on "The Park Avenue Diet Show: How to Cope With Stress (Part Two)"; March 13, 2011

Stress. You can't live with it, you can't live without it. But what is it?

Stress may be an acute reaction to a traumatic event or the breaking point when multiple challenging issues overwhelm a given individual. Stress varies from person to person, age group to age group, country to country, and continent to continent. It is classically thought of as a psychological disorder yet there is strong evidence for biochemical mediation. Everyone experiences stress at some time in his or her life, with only about 5-10% of the population experiencing severe recurrent symptoms.

What may provoke stress in one person may not necessarily affect others the same way. Yet no one would deny that these are especially stressful times. In addition to the unavoidable personal issues we may struggle with, there are plenty of problems locally and internationally to complicate the picture: terrorism, financial instability, chronic diseases, international conflicts.

While you may not know the names of the areas of the brain associated with feelings of stress (the hippocampus, amygdala, and cerebral cortex) you certainly know the feelings: restlessness, exhaustion, inability to concentrate, labile emotions, insomnia, incessant worrying. Some people may react to stress with emotional detachment, carelessness, and depersonalization. The latter describes a type of flight from reality, where the person temporarily escapes anxiety-provoking situations by retreating into an imaginary world.

Stress, however, is definitely a more serious problem when it creates or worsens medical conditions. Virtually every known illness can be affected negatively by stress. Blood pressure may rise, glucose levels may double, coronary arteries may narrow, and breathing may become difficult. Stress may also create or worsen lifestyle patterns such as overeating (or paradoxically anorexia nervosa) and may unfortunately lead to substance abuse as the individual self-medicates his or her anxiety with alcohol, cigarettes, or illegal drugs.

As you are well aware the primary treatment of stress in the United States is with prescription medication under the supervision of a psychopharmacologist. Supportive psychotherapy is not part of a typical visit to an internal medicine specialist. Moreover, since the average length of such a medical visit is only eight minutes long in 2011, the physician has absolutely no time to discuss his or her patient's life stressors. Not surprisingly, physicians too have stressful lives. If you don't believe me, read Uncle Vanya by Anton Chekhov.

Just like watching your weight and doing structured physical exercises, learning how to cope with stress is a skill that is necessary for optimal health. It is not merely a useful tool, it is a necessary technique for survival. Debilitating stress can derail any of our long-term personal or career goals quite rapidly. And simplistically relying on tranquilizers, sedatives, or antidepressants does not change the nature of the stress or give us guidance in how to resolve challenging issues.

I have been lucky to know Dr. Stanley Krippner since 1967 when I was his file clerk at Maimonides Medical Center during my high school years. As one of the most esteemed humanistic psychologists of the recent past, he has written dozens of books and hundreds of articles about mood disorders and how they affect an individual's thinking, interpersonal relationships, creative work, and community activities. We have discussed this enormous topic in various venues, and although we are seemingly experts in the field, we still experience enormous stress for which we must continually reinvent our own coping mechanisms and positive strategies.

Some of these are explored in our WOR radio interview and our lengthy lecture at the DOROT Institute, both of which you can hear on this website. You will never be able to totally eradicate stress from your life. You will certainly have something stressful happen to you within the next twenty four hours, hopefully minor. But you must not avoid learning and relearning how to cope with stress. And if you are suffering from palpitations, hair loss, insomnia, feelings of worthlessness, extreme sadness, or similar symptoms, the time to learn how to cope with stress is right now.