The Stress-Busting List
by Roberta Lee, MD (topic expert: health)

The holiday season comes with great expectations. Visits from far-away friends and family, delicious meals, and festive parties are often widely anticipated for months. But for some, the holidays bring feelings of stress and depression. Unfortunately, most people don't think stress has much impact on their health. That's because they've assumed that emotions have little impact on the body's ability to maintain health. But the truth is it is hard to overlook symptoms such as neck and back pain, headaches, indigestion, heightened irritability, pessimism or an overly sensitive frame of mind.

Indeed, there is mounting evidence to support a connection between emotional stress and health, specifically, cardiovascular disease. This year the Journal of the American Medical Association reported that emotional stress can heighten the risk of a life-threatening condition called heart arrhythmia. This condition can reduce the heart muscle function in those people who may have silent heart disease [1]. Rates of heart attacks during the holidays and during catastrophic events also increases during these periods. One of the most significant triggers appears to be psychological stress [2]. Additionally, medical students given vaccinations under stressful conditions show diminished immunity when compared to their more relaxed counterparts. Even in instances when we are attempting to prevent disease, stressful situations can reduce the effectiveness of our efforts [3].

To help you manage the impact that holiday stress has on your health, I've complied a list of eight things you can do to take care of yourself.

1. Make a realistic to-do list.If your holiday is packed with "to dos" that keep growing as you complete each task, ask yourself how essential each task is to the big picture. Divide your task list into two categories: those that are essential to your wellbeing and those that aren't. Seeing a list of those things that are essential to your wellbeing (likely a very short list) should help put things into perspective.
2. Create a calendar.Sometimes situations feel out of control simply because you're disorganized about what you need to do and when you need to do it. This leaves a lot of room for our imagination to amplify the urgency of our tasks and make them seem larger and more difficult than necessary. To mitigate those thoughts and feelings, make a giant calendar for the holiday period and break down your tasks in to little projects which are grouped week by week from the event day.
3. Schedule downtime. We often tell ourselves we don't have enough time to sufficiently rest to refuel ourselves. In the end, our overall endurance is whittled away. To avoid such a situation, take a mental vacation. Plan five to ten minutes daily to sit in a quiet area of your apartment or home and simply observe your breath or imagine yourself in a favorite place with no distractions. Allow your imagination to recruit your senses -- hearing sounds and smells of this favorite place. Are there birds chirping if you are out-of-doors? Notice what time of day it is and if there are other people there, etc. Make sure to set a pleasant alarm (like a quiet egg timer) so you don't have to keep watching the clock to finish your "mind get-away."
4. Exercise.Exercise raises endorphins, the natural "feel good" brain chemicals. It also shuts off the hunger drive. Make sure you keep your routine up - even if you have to get up a little earlier in the morning. On the days where you can't do the whole routine, make sure you have a contingency routine that is fifteen minutes in duration. I use a pedometer to "add mileage" during the day by counting my steps and taking the longest route from one destination to the next. By the end of a busy day I find that I have worked up somewhere between 50-75% of my expected daily routine - not bad compared to the old days when I would have just thrown up my hands and given up because I didn't have time. My goal is 8,000-10,000 steps per day.
5. Eat right.Over-eating is very common during the holidays. It's usually because we're not paying attention to what we are eating and we are distracted by company or by things that still need to be done. Don't go to a party hungry; eat a little something before you go. Decide what "off limits" foods you will allow yourself to eat, portion control your meals at the party, and focus on foods that naturally have lots of water in them (bell peppers, radishes etc).
6. Nuture gratitude.Remind yourself of the abundance that you have. Reach out and appreciate those who contribute to making your life pleasant. It's what the holidays are really about, isn't it? Pin up a picture of your family that makes you smile or put up a quote on your refrigerator that inspires you.
7. Honor loss.Many who have lost a dear one or who suffer from a serious chronic illness experience a sense of loss and become painfully reacquainted with the feelings surrounding that difficult situation, especially during the holidays when families gather together. Find someone you trust and share your feelings with them, start a journal and write about this or find professional help if your grief is significant. Sharing the burden can leave room for healing.
8. Try alternative therapies. Schedule an acupuncture, massage, or energy medicine treatment. Use the essential oil of lavender. One or two drops of lavender in a teaspoon of olive oil or sesame oil left placed on gauze to diffuse thru the room can help reduce stress or you can buy a diffuser at your health store.

Resources:

Websites for relaxation tapes, CDs and DVDs:

• www.spiritualityandpractice.com - great source for meditation and contemplative practices
• www.soundstrue.com - great source for breathing and meditation tapes
• www.healthjourneys.com - Bella Naparastek tapes/
• www.learnoutloud.com - source for generic stress reduction tapes/CDs
• www.mindfulnesstapes.com - a source of Jon Kabat-Zinn mindfulness based stress reduction tapes/CDs (MBSR)
• www.healfaster.com - Peggy Huddleston tapes/CDs great for pre- surgery stress reduction preparation and general post operative healing

Books: Stress Reduction /stress physiology:

• Why Zebras Don't Get Ulcersby Robert Sapolsky. This is an easy-to-read book on how stress affects your health.
• Ultrametabolismby Mark Hyman. This is an introductory book on detox and re-structuring your lifestyle.
• Eight Weeks to Optimum Wellnessby Andrew Weil. This is another book on how to distress and restructure your lifestyle simply.
• Where Ever You Go There You Are by Jon Kabat-Zinn, and Full Spectrum Catastropheby Jon Kabat-Zinn. These are practical books on discussing how we make stressful lifestyle choices and how to avoid this again by understanding our patterns of behavior.
• Who Moved My Cheese? By Spencer Johnson

Sources:

1. Ziegelstein RC . Acute emotinal stress and cardiac arrhythmias. JAMA 2007 298;3: 324-9
2. Kloner RA. Natural and unnatrual triggers of myocardial infarction. Prog Cardiovas dis. 2006;48(4): 285-300.
3. Kiecolt-Glaser, J.K., Garner, W., Speicher, C. E., Penn, G., & Glaser, R. (1984). Psychosocial modifiers of immunocompetence in medical students. Psychosomatic Medicine, 46:7-14