The Experts Talk About Stress

May 15, 2010

We went to experts for answers -- Surita Rao, Chair of the Department of Psychiatry at St. Francis Hospital and Medical Center in Hartford, CT, and Ellen Dornelas, Director of Behavioral Health Programs at Hartford Hospital's Henry Low Heart Center.

What is stress?

-- Rao: "Stress can really mean different things for different people. Not only the level of stress that people are able to absorb and not only just tolerate, but survive and also sometimes thrive in, but also what might be perceived as a stressful job or situation for one person, another person might actually thrive on it and really like that set of circumstances. So it's really, to some extent, individualized."

-- Dornelas: "Stress is an umbrella term but generally refers to negative feelings [worry and anxiety] as well as physiological reactions of the body."

How does stress manifest itself?

-- Rao: "People can develop things that sound simple but can really impact their health in a big way. They can develop insomnia [where] they just don’t sleep well because they never disconnect from all their day-to-day anxieties or they feel very stressed and don't wind down. That, in turn, can have a whole host of health impacts... Then there are certain illnesses that we do think of as being fairly connected to stress, like the mind-body connection: Things like high blood pressure, irritable bowel syndrome, bronchial asthma, ulcerative colitis, depression, anxiety."

-- Dornelas: "Stress manifests in terms of acute physiological responses [increased blood pressure, rapid heart rate, sweating, dry mouth, nausea, vertigo] that can cause or exacerbate medical problems. Stress clearly impacts mood."

How can a person cope with stress?

-- Rao: "People have to tailor their life and even given external circumstances which we may not be able to change, we can still tailor certain things like our career or job choice, family circumstances, how many outside commitments we take on. We can fit that to what we feel we're best equipped to have for our best sense of physical and mental health."

Is age a factor in how susceptible one is to feeling stress?

--Rao: "Both young people and older people, they both come with certain strengths and certain areas of weakness in dealing with stress. Older people, they have more life [experience]. They’re not as reactive, necessarily, to stressful situations because they’ve been through many things in their life. So they have better coping skills and they’re more seasoned."

-- Dornelas: "When stressors are normative for the age, it is sometimes easier to adjust to such stressors. For example, a person who has a heart attack at age 35 may have more adjustment issues and feel more isolated in dealing with their health problem than a person who has a heart attack at a much older age."

Can a history of health problems make one more vulnerable?

-- Rao: "Definitely. There are illnesses, things where there is a clear correlation like heart disease, hypertension, high blood pressure. But also things that have a softer correlation where maybe a clear line has not been drawn. There is some question about how stress affects our immunity and how often we get sick."

What role does personality play?

-- Dornelas: "Twenty years ago, early studies pointed to the Type A personality, the classic competitive, hard-driven personality with hyperarousal, hostility and aggressive behaviors as being linked to heart disease. However in later studies, it became clear that the elements of Type A that are most linked to heart disease is a tendency toward hostility. There is some evidence that dominance or the tendency to be very controlling might be linked to heart disease under certain conditions."

Does a public and high-profile job such a college basketball coach attract an added level of stress?

-- Rao: "Yes, A job like that comes with a certain amount of stress because it's tied in to certain outcomes which are very public."

Copyright (c) 2010, The Hartford Courant, Conn.