The most likely truth about stress sensitization is that it is not a simple alteration in the amount of any single stress hormone. "It takes finely-tuned amounts of many neurohormones for the hypothalamic-pituitary axis to remain in balance," says Georgia Witkin, Ph.D., director of the Stress Program at Mt. Sinai Medical Center in New York. "No one thing is going to explain stress because there is not just one chemical reaction to stress. And it also does not mean that everyone who loses a parent or is the victim of a violent crime will suffer from stress the rest of his life. There are things about individuals—genetic susceptibilities, pre-existing medical conditions, the environment they were brought up in, any alteration that may have taken place in their HPA axis—that must all be factored in.
"But the first pieces of the puzzle are being put into place. Looking at stress as a chemical reaction and realizing that this reaction, if strong enough, can change how we react in the future, offers the possibility of explaining many things we have witnessed regarding stress. For instance, the reactions we see in rats that are exposed to early trauma may give us a biological perspective on the phenomenon of learned helplessness. Perhaps what we call learned helplessness is biologically-programmed helplessness. If these animals become physically unable to respond to stress because trauma has altered their biology, we can't really call that learned behavior."
If this new picture of stress is not yet quite in full focus, that's because it requires the melding of disciplines ranging from genetics to psychology to medicine, and demands a new theory of mind/body interactions. But it holds the promise of entirely new strategies to combat stress.
Roosevelt's Smith envisions the day when "we may be able to develop drugs that can retune the entire neurochemical system. I think it's going to take years more research to better understand how an early trauma actually alters the neurochemical system. What is the mechanism by which psychological stress changes the way the brain communicates with the body? Does the same stress cause the same changes all the time? When are the developmental periods during which stress may be most harmful? As we continue to unveil the complex interactions between the mind and body, we may be able to isolate these reactions. That raises the possibility we can develop drugs to change them."
For now, says UMass's Jean King, "we have to remember that the reason some people deal poorly with current events is because of a past trauma. We must remember that there are physical reactions in our bodies when we are under stress and the extent to which we endure these reactions may be dictated by our past. Telling someone to 'just take it easy' is of no help. We are still a long way from knowing just what to say, but we are getting there.
A Smorgasbord Of Stress-Stoppers
The future may hold specific ways of desensitizing brain and body so that they do not automatically hyperrespond to minor provocations. But for now, recognition of stress sensitization requires one all-important change in the way most of us approach de-stressing.
"If you wait until you're feeling stressed before you employ some technique for managing stress," contends psychologist Robert Epstein, Ph.D., "it's already too late. You need to have a bag of tricks that you can deploy proactively. If you turn to them throughout the day, that changes your threshold of stress tolerance."
Epstein, director emeritus of the Cambridge Center for Behavioral Studies and a researcher at San Diego State University, insists that "it's more important than ever to learn as many antistress techniques as possible, as young as possible."
"What we can now get out of the notion of sensitization is that people being treated for stress need individualized therapies," adds Saki F. Santorelli, Ed.D., associate director of the Stress Reduction Clinic at the University of Massachusetts Medical Center. "If we are saying that everyone responds to stress differently because of past experiences, then as therapists we need to be flexible and allow each person to focus on the part of therapy that works best for them. The only way to find that out is by trying different stress-reduction techniques."
There is no one-size-fits-all way to reduce stress. For example, "study upon study has shown that simple relaxation does not work in many people," says Rachel Yehuda, Ph.D., of Mt. Sinai Medical Center in New York. "Telling someone who has been sensitized to stress to just relax is like telling an insomniac to just fall asleep."
"What you don't want to do is resort to quick fixes that have no staying power," says Santorelli. "Smoking cigarettes, drinking alcohol, binging on food; these are sure-fire stress failures. They may give the impression that they are relieving tension, but they will not work over time and sooner or later you will be right back where you started." He also advises those who feel stressed to avoid coffee and high-fat foods. "Caffeine is a stimulant and foods high in fat make the body work overtime to digest them, so both will probably add to your level of stress."
Mindfulness Meditation
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