How to Chill Out

Tips for improving your response to stress.

by Shari Miller Sims

“Women in their forties face an invisible but very real hormonal storm,” says Stephanie McClellan, MD, an obstetrician and gynecologist in California. “At perimenopause, the body is going through virtually the same degree of turmoil as at puberty, but it’s happening without any direct physical cues such as budding breasts.”

This estrogen upheaval, McClellan explains, has a direct effect on the hippocampus, or emotional midbrain, which controls how you perceive a situation (as stressful versus not). Couple this hormone roller coaster with brain-chemical swings brought on by physical, psychological or emotional pressures, and what you end up with is a woman who is So Stressed, which is the title of a new book co­written by McClellan and ob-gyn Beth Hamilton, MD.

Drawing on the work of leading researchers, McClellan and Hamilton have come up with four different stress-response patterns and their concomitant health effects. These patterns are based on the hypothalamic-pituitary-adrenal pathway and the autonomic nervous system, two stress-response systems that link the mind and body. “If a woman can catch her reaction style before it spirals out of control, she can take steps to bring her ­system back in balance to improve her current and future health,” Hamilton says. Here are the four response styles; see if you recognize yours.

Style: On Hyperdrive
You’re always on the move, can barely sit still, often have trouble falling or staying asleep or wake up too early to feel truly rested.

The physiology: It’s as if your body’s sympathetic nervous system, the automatic initiator of the “fight or flight” response, can’t turn off. Levels of the stress hormone cortisol can rise way too high, contributing to the abdominal fat that’s connected to heart disease and diabetes.

Breaking the pattern: Start, or step up, a vigorous exercise program. “High-powered aerobic exercise will in essence close the stress loop before too much damage is done,” ­Hamilton explains.

Style: Fried and Frazzled
The slightest stress can provoke a huge emotional response, but you stay calm on the outside, rarely letting
on that you’re bothered.

The physiology: Chronic stress has caused your hormonal and sympathetic nervous systems to get out of sync. Usually, for instance, cortisol levels rise in the morning as a body-wide wake-up call, but here the body’s response seems to be blunted. An out-of-rhythm cortisol release pattern can overstimulate your immune
system, cuing symptoms that include aches, fatigue and ­allergic rashes.

Breaking the pattern: Try a Mediterranean diet, which emphasizes olive oil, fish, vegetables, nuts and legumes. Its steady release of fuel may put energy and emotions on a more even keel.

Style: Dash and Crash
You plow through a stressful situation, achieving your goals, but the prolonged period of overdrive depletes your body’s supply of the energizer norepinephrine. The parasympathetic “restoration” then goes unchecked longer than it ideally should.

The physiology: “This pattern is an exaggeration of the healthy response: Your body can sustain energy via norepinephrine release when the stress is on, which is good, but for some reason does not adequately replenish the supply,” McClellan says. This response does not raise your health risks much in the short term, though it
is not a pleasant way to live.

Breaking the pattern: If possible, limit the stress overoad phase so you can then shorten the recovery phase.

Style: Detached and Shut Down
You’re so overwhelmed that you draw into yourself. You never feel fully engaged.

The physiology: Your hormonal and nervous systems are both functioning at a chronically low level, which can lead to low energy and gastrointestinal symptoms.

Breaking the pattern: Since time can seem to slip away, adopt fixed routines to put body and brain cues back on track. Keep a journal that links emotional reactions and physical symptoms; this is known to alleviate problems.

Originally published in the May 2010 issue of More.

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