'Tis the Season for Holiday Stress From last-minute gift shopping, to preparing for family celebrations, being of good cheer isn't always easy during the holidays. Health experts discuss the effects that stress can have on your health, and offer some suggestions for keeping your cool during this frantically festive season.

'Tis the Season for Holiday Stress

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You're listening to TALK OF THE NATION: SCIENCE FRIDAY. I'm Ira Flatow.

Could this be you perhaps at this very moment? It's your lunch hour and you decided to - you need to go a little shopping to the mall, get a little - why don't you get little leg up, and everybody is going to be rushing out there this weekend, or maybe you're taking off early and you're stuck in traffic on your way to the entrance to the mall. And, you know, you find yourself inside and you waited half an hour in line only to discover that you've already maxed out your credit card by buying holiday gifts, and now it's time to go home and wrap them, perhaps cook dinner in time for your in-laws to arrive for the weekend, but you're back in traffic once again and you're running late. Your palms are sweaty. You're feeling jittery, your patience is running low.

And then there was this final straw. Tell me if this hasn't happened to you. Some self-entitled road hog yakking on a cell phone squeezes their SUV right in front of you because, of course, waiting in line is for suckers. Well, that's it. Suddenly you're making hand gestures your kids aren't supposed to see, you're using words they aren't supposed to hear, your face is red, your heart is raising. Happy holidays. A little tune comes on the radio, which to a lot of people seems to go hand in hand with stress. The holiday season is filled with stress.

In this hour, we're going to find out why stress can take a heavy toll on your health and offer you some tips for managing that holiday stress, you know, if it isn't already gotten to you too much. What do you do to relieve stress? Give us some of your hints. What do you do? What do you do in traffic or at the mall or while you're entertaining relatives in those stressful arguments from 30 years ago keep coming up over and over again?

Our number 1-800-989-8255, 1-800-989-talk, and always you can surf over to our Web site at sciencefriday.com and you can always go to "Second Life" where the science folks for SCIENCE FRIDAY. Look for the folks with the science T-shirts on in Science School in "Second Life."

Let me introduce my guest.

Esther Sternberg is the author of "The Balance Within: The Science Connecting Health and Emotions." She is the director of Integrative Neural Immune Program at the National Institute of Mental Health. She joins us from our NPR studios in Washington.

Thank you for being with us today, Dr. Sternberg.

Dr. ESTHER STERNBERG (Director, Integrative Neural Immune Program, National Institute of Mental Health): Well, it's a pleasure to be here.

FLATOW: You're welcome.

Andrew T. Creagan is a professor of medical oncology at the Mayo Clinic College of Medicine. He is board certified in hospice care. He's also the author of "How Not to Be My Patient: A Physician's Secrets to Staying Healthy and Surviving Any Diagnosis." He also moderates the spress blog - the Stress blog. I'm just getting stressed thinking about - the Stress Blog for MayoClinic.com.

Thank you for being with us today, Dr. Creagan.

Dr. EDWARD CREAGAN (Professor of Medical Oncology, Mayo Clinic College of Medicine.): Oh, thank you very much, Ira. It's a tremendous opportunity to be here.

FLATOW: Well, is it - Dr. Creagan, let me begin and ask you, is this a big stressful time of the year out of the ordinary?

Dr. CREAGAN: Absolutely. And Ira, what you've just described is the perfect storm.

(Soundbite of laughter)

Dr. CREAGAN: The perfect storm.

FLATOW: We've all been there, haven't we?

Dr. CREAGAN: Absolutely. And without exception, the individual that you're talking about is sleep-deprived, is not exercising, is eating too much, and has dramatically unrealistic expectations.

FLATOW: You mean about - I'm going to get this done and, you know, not figuring out what the real situation is in traffic and in the mall and things like that?

Dr. CREAGAN: Absolutely, trying to recreate a myth - the all-American family, (unintelligible) picture - it simply does not exist. We're searching for the Holy Grail, and we're going to have a heart attack trying to find it, as Dr. Sternberg's books have eloquently pointed out.

FLATOW: Dr. Sternberg, let's talk about your book, and let's talk about what stress is. You talk about four parts to stress.

Dr. STERNBERG: Yeah, well, stress has many parts, and I think what you described, I certainly agree is the perfect storm. Part of stress is the bad thing that happens to you, and we can't do anything about that. You've talked about the car that cuts in front of you and so on.

The feelings that you have - that your heart beating fast, feeling anxious, feeling sweaty, feeling like running to the bathroom, all of that is your physiological stress response. Those nerves and nerve chemicals and hormones that your brain starts pumping out when you are exposed to these stressful events that's what gives you those feelings.

And there's something very important that happens between the bad thing that happens to you and the stress response, and that's perception. And that's where what Dr. Creagan said comes in if you are - if you perceive that event as stressful, if you're trying to achieve this impossible Christmas-card Christmas, and you just can't get there. That's where your stress response kicks in.

So the thing you can do something about - you can't do anything about the bad things that happen to you. You can't do a whole lot about your stress response, but I'm sure that Dr. Creagan will have some suggestions. But what you can really change is that piece in the middle - perception.

FLATOW: What is - what actually goes on in your body when stress happens?

Dr. STERNBERG: Well, when a bad thing - when something bad happens, immediately there's part of your brain that's called the hypothalamus. It's the brain stress center, and it starts pumping out the brain stress hormone, CRH or corticotrophin-releasing hormone. It doesn't matter. The names don't matter. The point is that we know a lot about the molecules of the stress response. At the same time, your nerves - adrenalin-like nerves - start pumping out adrenalin-like chemicals and your adrenal glands start pumping out adrenalin. And all this happens within milliseconds, you know, you're driving down the street and the car comes out from nowhere and you put your foot on the break…

FLATOW: Right.

Dr. STERNBERG: …you don't have time to get a Ph.D. to figure out whether or not you should put your foot on the break. It's your stress response that makes you do it. So the stress response is not a bad thing. It actually is lifesaving. You need that stress response to give you the energy to react and get out of danger. That's what we call the fight or flight response. But the problem occurs when it goes on too long or when it's occurring at the wrong time.

So, for example, if you're pumping out your stress hormones when you're trying to prepare the dinner for Thanksgiving and all the relatives are around and you become overly stressed, then you can no longer perform the task. There's something we call the inverted U-shaped curve of the stress response.

So, if you imagine a rainbow, and at one end of the rainbow you're completely relaxed and you're dozing and your stress response is very low. If you start performing at peak, if you start performing a task, your stress response turns on. So now you're in the middle of the rainbow. You need that stress response in order to perform. I need to have my stress response turned on right now so that I can talk and answer questions, if I, you know, if weren't, I'd be falling asleep, you'd be, you know, bored and the audience would be bored. Maybe you'd be stress, actually. And if - but, however, if that stress response keeps on going too much too long, you fall over the edge of the rainbow, and you can no longer perform.

FLATOW: Dr. Creagan, you're an oncologist. Can stress cause cancer?

Dr. CREAGAN: No, Ira, it does not. I think that's a popular misconception. But as Dr. Sternberg has eloquently pointed out, stress can cause all sorts of miseries. I think it's profoundly symbolic that some study suggests that the majority of heart attacks occur on a Monday morning specifically between 5 and 8 a.m. and the least common day to die of a heart attack is Saturday. I think there's a message there. And I might add, just a few minutes ago…


Dr. CREAGAN: …I Googled the word stress to give us an idea of the magnitude. In .1 seconds, 235 million citations came out.

(Soundbite of laughter)

Dr. CREAGAN: Merry Christmas.

FLATOW: Let's talk about stress reducing, Dr. Creagan. Give us some hints about what people - they find themselves and I'll ask you - both of you, what do you do? You said - you gave me a hint at the beginning you said, make sure your expectations are correct.

Dr. CREAGAN: Absolutely. Ira, what I'd like to share with our listeners is that this future belongs to the fit.

FLATOW: Uh-huh.

Dr. CREAGAN: The future belongs to the fit. And if we don't have a fundamental level, a physiological resistance and resilience, I think, it's very difficult to go the distance in a current techno-digital environment. So what are three things we can do? Number one, get a good night sleep. Number two, exercise. For most of us, it might be 20 minutes of walking on most day of the week. And equally importantly have some understanding about dietary guidelines - fats, saturated, unsaturated, carbohydrates. We need to know how to read a label. It will save our lives.

Dr. STERNBERG: I would…

FLATOW: Dr. Sternberg?

Dr. STERNBERG: Yeah, I would certainly second that, and especially the piece about exercise. I think that that's really, really important. There's very interesting, exciting new data that's coming out about how regular exercise, not extremes, you're not going out and shoveling the snow once, but just regular exercise - and like Dr. Creagan said, walking 30 minutes a day, swimming - whatever your exercise, whatever you like to do that actually helps attenuate, sort of, temper the brain stress centers. So you're no longer as twitchy when you're exposed to a stressful event.

So what I would recommend - when I talked about that rainbow, that inverted U-shaped curve of the stress response, one important thing that I think that in this self-help society people miss is they think that they have to be relaxed all the time. And that's not the goal. What you want to do is move your stress response to the appropriate level that you need at that time. And how do you do it? Well, part of it is control - the amount of control you feel over a situation. So whether you feel stressed or stimulated by an event depends upon the ratio of demands to control that is placed on you.

FLATOW: So you could…


FLATOW: …you could be on an exciting event and stressful, but because you're in control, it doesn't feel (unintelligible) of being stressful.

Dr. STERNBERG: Exactly, exactly. And the example I usually give is I fly a lot and I don't particularly like to fly, but I talked to pilots who - and I asked them, how do you feel when you're landing, you're, say, fighter plane in the middle of a storm, in the middle of the ocean, in the middle of the sea of Japan onto a little aircraft carrier down below. Do you feel stressed?

And one pilot told me, well, we feel all those things, we feel our heart beating fast, we feel sweaty, but we've learned to control our stress response and make it work for us because it gives you that energy to accomplish the task. So what you need to do is fool your brain into thinking you're in some degree of control because the fact is, you'll never be in control.

FLATOW: Interesting.

Dr. STERNBERG: But you can do certain things to - make a list, to check off the things that you can accomplish, that you can do in the list, pace yourself, exercise is great, social support if really important. You can't do it all on your own. If you're…

FLATOW: Yeah. Let me go the phones because there are a line of people who are looking for advice here. Tim(ph) in Westminster, Maryland.

Hi, Tim.

TIM (Caller): Hi, how are you guys doing?

FLATOW: Hi, there.

TIM: Good. I'm a yoga teacher and I have a stress reduction technique that is useful for anyone who breathes, that is…

FLATOW: That takes a lot of people into account.

(Soundbite of laughter)

TIM: Take a natural breath in, release the breath out naturally and at the bottom of the breath as it's run out completely, count two seconds - one thousand one, one thousand two. Over the course of the day, as you find yourself sitting in traffic, standing in line, waiting on the cell phone, if you remember to do this, there will be accumulative effect that will reduce your heart rate, your breath rate and your stress levels. Because yoga teaches us that the breath has a direct response to stress and the breath is something that we can control.


Dr. STERNBERG: Yeah, I'd like to comment. That is a great - a great technique and certainly, yoga, meditation, tai chi, all of these approaches, labyrinths - walking a labyrinth, involve a regular slow breathing. And when I talked about all those bad - well, not bad - the stress chemicals, the stress hormones and nerve chemicals, the adrenaline-like nerve chemicals, what is happening when you are doing that slow breathing is you are triggering an opposing part of the nervous system that is kind of like putting the break on the stress response.

It's the vagus nerve. When you get punched in the stomach, in the solar plexus and you feel faint, what's happening is you're overreacting, you're pushing on your vagus nerves, so you faint. But if you can, with the breath - what you do is you gradually bring that vagus nerve up into control and it blocks that negative effects of the stress - of the adrenaline-like nerve.

FLATOW: We're talking about stress this hour on TALK OF THE NATION: SCIENCE FRIDAY from NPR News. Talking with Esther Sternberg, author of "The Balance Within: The Science Connecting Health and Emotions" and Edward T. Creagan, who is author of "How Not to Be My Patient: A Physician's Secrets for Staying Healthy and Surviving Any Diagnosis."

Dr. Creagan, what about finding time, you know, I - for yourself. We are so bombarded with these queues these days. You know, we are always doing something that we, you know, there's no time to de-stress.

Dr. CREAGAN: Ira, we don't find the time, we make the time.


Dr. CREAGAN: If we don't carve out the time for introspection prayer, meditation, exercise, it'll be taken from us. And what Dr. Sternberg said is right on the money. I make a list everyday for the things that I need to do for myself. And my dad, we heard a few minutes ago about social connections. On our Web site, which is MayoClinic.com, we have stress blog which continuously amasses us in terms of the community and the connectedness of people struggling with stress. So each of us has 168 hours and we can determine within reason how we will use those hours. Otherwise, they will be taken from us.

FLATOW: Elizabeth(ph) from Tempe, Arizona. Hi, welcome to SCIENCE FRIDAY.

ELIZABETH (Caller): Hi, thank you for taking my call.

FLATOW: Hi. Go ahead.

ELIZABETH: I just had a suggestion for road rage. When someone will cut me off in traffic or go speeding away, I usually kind of make up a story about them that…

(Soundbite of laughter)

ELIZABETH: …for - it doesn't make them seem so evil. That maybe they are a surgeon rushing to do an emergency surgery on, you know, a child from, you know, Guatemala or something. But that makes me feel it's okay that they cut me off because I want them to rush and save the person.

Dr. STERNBERG: I think that's a brilliant idea. And that goes straight to what I was talking about before - perception. Because what you're doing is taking a bad situation and turning it around and changing your perception of that event. And, you know, the previous caller talks about yoga and I want to bring in here meditation and these kinds of approaches. Often, if you care trained in a meditation technique or if you've undergone psychotherapy, you're more able to take that situation and look it with amusement, actually, with humor or certainly writing about it is a good thing. I'm not…

FLATOW: Or what she has done also she's taken control like you mentioned before.

Dr. STERNBERG: Yes, exactly.

FLATOW: She has taken control of her own - right Elizabeth? Your own situation because you've decided what's going instead of being the victim.

Dr. CREAGAN: Ira, if I could just might jump in for…


Dr. CREAGAN: …I mean, on this control issue. There've been many studies done about stress and burnout among medical professionals. And the most consistent predictor of stress is a perception of a lack of control over our schedules. So perception creates the stress of the reality.

FLATOW: So if you're going to the mall, you have to go into the situation knowing I'm going to lose control of the traffic situation. I'm going to decide I'm not in control, then that way, I'll be in control by not rushing.

Dr. CREAGAN: And lastly, I'm not willing to give up my serenity and my peace of mind over someone who cuts me off either on the road or at the mall. My serenity is mine, it's precious, I don't want to give it up.

FLATOW: All right, we have to take a - we have to give up our segment for this side of the break. We're going to take a short break and come back and talk lots more with Esther Sternberg, author of "The Balance Within: The Science Connecting Health and Emotions." Also, Edward Creagan, who is author of "How Not to Be My Patient: A Physician's Secrets for Staying Healthy and Surviving Any Diagnosis."

1-800-989-8255 is our number. Also in "Second Life," Science School, we'll take your questions. Stay with us. We'll be right back after this break.

I'm Ira Flatow. This is TALK OF THE NATION: SCIENCE FRIDAY from NPR News.

(Soundbite of music)

FLATOW: You're listening to TALK OF THE NATION: SCIENCE FRIDAY. I'm Ira Flatow talking with Esther Sternberg, author of "The Balance Within: The Science Connecting Health and Emotions." Edward Creagan, author of "How Not to Be My Patient: A Physician's Secrets for Staying Healthy and Surviving Any Diagnosis."

We're talking about stress this hour. Our number, 1-800-989-8255 is the number. Let's go to the phones. To Eric(ph) in Decorah, Ohio.

ERIC (Caller): Decorah, Iowa.

FLATOW: I'm sorry.

ERIC: Thank you for taking my call.

FLATOW: It's close.

(Soundbite of laughter)

ERIC: I'm a performing classical musician and so I encounter regular stress each time I'm up onstage. And I'm wondering if there's any evidence that this regular encounter immunizes me somehow against other stressful situations in my life?

FLATOW: Yeah, a little bit of stress here and there.

Dr. CREAGAN: Eric, that's a wonderful question. I should jump in, I started playing the piano a year and a half ago as an adult. And I had my first recital about six months ago. It was the most terrifying experience of my life.

(Soundbite of laughter)

ERIC: Yeah, you know, you were talking about the pilots earlier and I have to say, I have a similar experience. I mean, the stakes aren't as high, only you're ego is at stake in a music concert, but it is also very stressful at times.

Dr. STERNBERG: (Unintelligible).

Dr. CREAGAN: And my teacher said I should keep the day job.

(Soundbite of laughter)

FLATOW: Well let's talk about his question.

(Soundbite of laughter)

FLATOW: Does a little bit of stress immunize you against stress later on?

Dr. STERNBERG: Not really. Well, if you learn to deal with it, that can help. But if you look at animal studies, for example, a loud noise - if we're going to talk about music - a loud, unexpected noise is a stressful thing. Actually, it's a stress for anyone, we jump, right? We have a startle response. And if you hear several loud noises one after the other, you will gradually have an attenuation of your startle response. You won't startle as much and finally, you won't startle at all.

If at that point, suddenly there's a big puff of air that you're exposed to, then you will startle again. So the stress response is actually very specific. That said, if you learn these stress management techniques, you can apply them in many different situations.

FLATOW: How long does a fight with your spouse hold over for? Or some - when you're arguing with your kids, or suddenly…

Dr. STERNBERG: That is a great question. And actually, the people who've done that are in the state that you thought the gentleman, the caller was from…


Dr. STERNBERG: …at Ohio State University. Jan Kiecolt-Glaser and Ron Glaser have actually done studies on marital - on couples undergoing marital discord. They were given - they took couples and said, pick an argument, but it - they didn't say argue about money or the in-laws or whatever, they said, you know what your problems are. You pick that argument and have it in front of us and they were hooked up to all sorts of measures, immune measures, stress hormone measures, and so on. And they found that the pattern of arguing is what had something to do with how long the stress response lasted. And the kind that lasts longest is the confront-withdraw kind.

So when they had a - usually the females spouse confronting the male spouse and the male withdrawing, it was the female stress response that stayed elevated long after that argument was over. So it really has to do more with the style of that conflict as to how long it was. But it can last for hours. And if it lasts for hours, that's when it can affect your immune response. We didn't actually talk about that how stress can make you sick. But it's that stress that goes on chronically and lasts for hours that can dampen your immune cell's ability to fight infection.

FLATOW: Can you walk it off or do some exercise to get rid of it somehow?

Dr. STERNBERG: Sure. Yes, absolutely. You can do - exercise is absolutely a wonderful way of doing it. And walking is great. There have been studies - a number of studies, actually many studies showing that moderate exercise really improves mood whether on an acute basis, a single exercise bout or whether - and certainly when it's on a regular basis.

FLATOW: Last words, Dr. Creagan?

Dr. CREAGAN: Yes, sir.

FLATOW: Any final hints for us?

Dr. CREAGAN: I think the final hint is that we need to take charge of our own health and well-being. We need to make lists and we need to recognize that resources like MayoClininc.com empower us to make responsible decisions about health and well-being.

FLATOW: Dr. Sternberg, any last words?

Dr. STERNBERG: Well, I think that…

FLATOW: For the holiday season here?

Dr. STERNBERG: For the holiday season is don't feel guilty. If you can't do it on your own, if you can't take control, if you're still feeling stressed and agitated, don't feel guilty. It's not your fault. Seek help from a professional, from a health care professional who knows how to handle this, who knows how to help you because you can't do it on your own. It's your biology. And in some cases, it may have even - it may be symptomatic of something more going on, like depression. And so you really need to seek help from the qualified health care professionals.

FLATOW: I want to thank you both for taking time to be with us and have a stress-less holiday season to you.

Dr. STERNBERG: It's been a pleasure.

Dr. CREAGAN: Great. Likewise. Thank you, Ira.

FLATOW: You're welcome. Esther Sternberg is author of "The Balance Within: The Science Connecting Health and Emotions" and Edward Creagan is author of "How Not to Be My Patient: A Physician's Secrets for Staying Healthy and Surviving Any Diagnosis."

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