July 1999
One such study was reported last month in the CDC HIV/STD/TB Prevention News. Researchers at the University of North Carolina at Chapel Hill found that HIV-positive men in stressful situations with little social support were two to three times more likely than individuals with lower stress and more support to develop full-blown AIDS.
Other studies have also suggested that stress can accelerate the progression of the early stages of HIV disease.
Prolonged and excessive stress depresses our immune, digestive, circulatory and respiratory systems, and can become the underlying cause of a multitude of physical and emotional illnesses.
Some stress will always be a part of your life, but you can learn to manage it better, become more productive and enjoy the challenges life throws your way. Fortunately, most stress can be alleviated simply by understanding its source and developing a plan of action.
Start by identifying the particular stressors in your life. Why does your social, family or work situation make you feel anxious, angry, frustrated, burned out, depressed or moody? After you come up with a list of answers, begin to address them. Look at each answer one at a time. Managing stress is a slow and ever-changing process.
No matter what causes your tension, aerobic exercise, yoga and meditation help protect against the ill effects of stress (See "Tips for Reducing Stress"). Social support is another way to work out stress-induced emotions, instead of holding them inside where they put wear and tear on your organs and immune system. Changing your own outlook and actions, rather than trying to change others whom we may deem the causes of our stress, is almost always beneficial.
Keeping a journal, engaging in regular exercise and practicing assertive communication are three potential strategies to reduce stress in your life. Some stress-reducing techniques may work better than others. Find ones that work for you.
Each day this week, write about something that made you feel stressed, or something that made you feel good. Consider purchasing or making a diary or notebook to record your thoughts and feelings over a longer period of time. Writing freely for several minutes a day can help you feel refreshed and ready to tackle new challenges.
If you need help getting started, try answering some of these questions:
There are many health-promoting and stress-reducing benefits of aerobic activity. Most notably, aerobic exercise strengthens two vital organs: your lungs and, especially, your heart. These organs bear the brunt of the body's physiological stress response. They are constantly being called upon to "fight or flee" from job, school, family, financial, relationship, and every other kind of stressor we confront daily.
Exercise improves blood flow to your brain and can cause release of chemicals called endorphins into your blood stream. Endorphins give you a feeling of happiness and well-being. Exercise also relieves tense muscles and helps you to sleep.
Another perk of exercise is weight loss and maintenance. For many of us, looking good also means feeling good. Exercise improves physical appearance, enhances self-esteem and self-confidence, and offers other mental health benefits. Regular exercisers report having more energy, greater ability to concentrate, improved quality of sleep, reduced stress reactivity (not getting as stressed out about things as you usually do), and even slowing the aging process.
The National Heart, Lung and Blood Institute recommends increased and sustained cardiovascular elevation for 15 to 30 minutes, three to four times a week. The American College of Sports Medicine recommends 20 to 60 minutes of aerobic exercise (same thing), three to five times a week for optimal fitness, with two to three strength workouts per week. Consider walking, swimming, dancing, cycling, etc. Even activities such as raking, shoveling and housework count as exercise. Talk to your health-care provider before starting an exercise program.
Suppressed anger, for example, has been linked to heart disease. Stress may be exacerbated by how we communicate with people. One health-promoting form of communication is assertive communication.
When people are not assertive, their needs are not met. Resentment can build up, creating enormous stress on the immune system. During these times, our skills in direct, assertive communication are most necessary.
Many of us confuse assertive behavior with demanding that we should be given what we want immediately. Along with blame, threats and insults, this behavior is considered aggressive. Behaving aggressively usually results in barriers between people.
On the other hand, when we operate as if we are doormats, not asking that our needs and desires be recognized (passive communication), we rarely get what we want. Passive behavior includes giving in, making excuses, not saying how you feel, and being indirect.
Often, the result of being non-assertive is anger and frustration, which creates unnecessary stress. When we are assertive, we are being direct, respectful, honest and clear. Rather than demand that our needs be met, we work together to reach a compromise, thus creating a healthier surrounding.
Nancy Wongvipat, M.P.H., a health education specialist in APLA's Education Division, can be reached by calling (323) 993-1511 or by e-mail at nwongvipat@APLA.org.