The Truth about Stress, Emotions, and Your Heart
Excerpt from Chapter 5

Stress simply is not taken seriously enough as a health threat to women. You may not know that stress even affects your ovaries. It can cause ovarian failure, which results in lower levels of estrogen in premenopausal women and increases their risk for developing atherosclerosis.1 Women who have a lifelong history of menstrual ir­regularity, a by-product of stress, may also be at higher risk for devel­oping heart disease.

I tell my patients that they must reduce their stress because it does create the risk for heart disease. Prolonged stress can lead to permanent feelings of helplessness and ineffectiveness, and it can produce physical changes in the body that can affect the heart. For example, an acute or prolonged state of tension can cause your heart rate and blood pressure to increase. You may have dry mouth, en­larged pupils, sweaty palms, and fast, shallow “chest” breathing. Talk with your doctor or a professional therapist about ways to iden­tify your stressors.

Are You All Stressed Up with No Place to Go?

I treat many women, who exhibit the signs and symptoms of stress and have other risk factors for heart disease. Many of these women are actually young mothers; some are trying to balance the challenge of raising children with other family demands or with work­ing in high-stress careers. Others are older or middle-aged women who care for aging or ill parents and their husbands, and are also the only breadwinner in the family. No matter what the source of your stress may be, too much of it can increase your risk of heart disease. Many women today are so busy caring for others that they ignore their own health.  “I used to think I was immortal,” Shelly, age forty-four, told me, “Until I started having health problems. And I think they all came just from the ongoing stress of daily life.” This young mother of four came to see me when she experienced ongoing palpitations and shortness of breath, even with little exertion. She also reported an unshakable fa­tigue. Although she was very petite, Shelly’s blood pressure was sur­prisingly high. After she gave me a rundown of her “typical day,” it was apparent why she was short of breath and exhausted. Shelly got up at five A.M every day to make school lunches for her children. She then did two loads of wash and a few household chores before the children awakened. While the children ate break­fast, Shelly took a quick shower and got dressed for work. She then wiped mouths, piled all four kids into the van, and picked up a few more children in their school car pool. Shelly worked full time as a nurse practitioner at a family plan­ning clinic and was devoted to her patients. On many days, she worked without taking a break or even eating lunch, so she could help someone with a problem. At exactly four P.M. each day, Shelly got back in her van, picked the children up at school, then dropped them off at various extracurricular activities. Two days a week, she helped coach the girls’ soccer team at her oldest daughter’s school. Shelly could have told me much more about her daily responsi­bilities, but after hearing all of this, I too was exhausted! While Shelly had it all -- family, career, and commitments -- she, like so many women, simply did not have the energy to take care of her own health. She needed to start by getting some more control over her schedule to make time for herself. That would result in her actually having more energy to deal with the rest of her day. I’ve seen this happen time and again with my patients, and I want to show you how to do this for yourself too.

 

 

Lack of Control Adds to Stress

Empirical studies confirm that a strong sense of control is vital for our health and stability.2Yet studies also show that women tend to have to balance more life roles and responsibilities than men but have less control at home and in the workplace. The stress of having no control contributes to increased blood pressure and higher cho­lesterol, so it is not surprising that it is associated with a greater risk of heart disease. You might think that work outside the home is asso­ciated with a higher rate of heart disease, but that’s not true. While women who have jobs with little control, such as clerical positions, are at higher risk for heart attack, women in managerial positions do not have increased risk. Other findings associated with a risk of heart attack include suppressed hostility (holding in anger) and not having a supportive boss.  A recent study done in Sweden showed that women with heart disease who also had marital stress had a threefold increase in recur­rent heart attack.3In that study, work stress did not have an associa­tion with increased risk for a second heart attack, but anger and anxiety did increase the heart attack risk. Stress levels measured among working mothers sometimes ap­proach those of combat! Working women and mothers, juggling kids and career, are all greatly stressed from overwork, lack of time, or no energy. Some respond by becoming more sedentary, smoking ciga­rettes, eating or drinking too much, and becoming apathetic about their own health.“Stress is nothing new to me,” forty-six-year-old Mira said, ac­counting for her sudden rise in blood pressure. “In one week, my sixteen-year-old son had an accident with my car, my husband lost two major accounts at work, and my mother had a breast biopsy that was positive and is scheduled for surgery. On top of that, the wash­ing machine broke, and our property taxes went up. What else do I need? My life is a roller coaster with no end in sight.” We can all easily relate to Mira’s feeling of being on an unending roller coaster. I also try to balance caring for my patients with family responsibilities and caring for family members who are ill, doing vol­unteer work, giving speeches to women across the country, and re­searching and writing. I know it’s not easy for you to find time for yourself, even when you have a family history of heart disease, which I also do. But my one sure de-stressor is my regular aerobic exercise. No matter how stressed I am with commitments and chaos, I never miss my regular time at the gym. It allows me to do something good for myself, and the heart-pumping exercise reduces all symptoms of stress. I want to work with you to help you find your best de-stressor and work it into your daily life.

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