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Yeah, a toxic day at work or a major fight with your boyfriend can give you a killer headache. But did you know that other symptoms like painful periods, memory problems, and hives could also be due to stress? "Anxiety can cause hormonal, immunological, and muscular changes that can occur silently at first," explains Bruce Rabin, MD, PhD, medical director of the University of Pittsburgh Medical Center Healthy Lifestyle Program. "People often aren't aware of them until they produce uncomfortable, disruptive symptoms." Don't ignore the seven signs; they're your body's way of telling you to relax.
Tension weakens your immune system, which can allow bacteria in the mouth to gain more of a foothold and eventually cause gum irritation and inflammation, explains Kimberly A. Harms, DDS, consumer advisor for the American Dental Association.
Nix It: Now is not the time to slack off on the brushing twice a day and flossing once, so be sure you do both. For extra protection, use a bacteria-killing mouth rinse to reduce bacteria levels in your mouth. To boost immune function, exercise regularly, get plenty of sleep, eat a balanced, healthy diet, and take a multivitamin. If you're under prolonged stress and your gums are bleeding often, consider seeing your dentist three or four times yearly for a cleaning and checkup instead of just biannually.
Hormones released during an acutely stressful experience (like being in a car accident) can suppress short-term memory. Fortunately, these effects are usually temporary. But chronic stress can produce similar, longer-lasting impairments by altering the structure of nerve cells and their connections with the brain, explains Bruce McEwen, PhD, head of the neuro-endocrinology lab at Rockefeller University in New York City and author of The End of Stress As We Know It (Dana Press, 2004). These changes, which eventually reverse once the stress subsides, can lead to glitches with recalling names or directions, among other things.
Nix It: Use lists, calendars, and organizers, and place them in strategic, accessible places. "Research has found that for reminders to be effective, they have to be available in the moment you'll carry out the action," says Daniel L. Schacter, PhD, a professor of psychology at Harvard University and author of The Seven Sins of Memory (Houghton Mifflin, 2002). For example, to make certain you make an important phone call, post a note directly on the phone. To learn new information when you're under stress, focus on what you most need to recall, write it down, and link it to what's already in your memory. For example, say your new neighbor Elizabeth Baker asks you to collect her mail while she's on vacation: To remember her name and the association, work it into your conversation with her, then visualize her making cookies with all the other Elizabeths you know, packing the baked goods in a tin and mailing them.
Women under high stress are more than twice as likely to experience severe menstrual pain during their period as those with generally low stress, according to a study at the Harvard School of Public Health. "Stress intensifies the discomfort that already exists," explains Diana Dell, MD, an assistant professor of psychiatry and obstetrics-gynecology at the Duke University Medical Center in Durham, North Carolina. Chemicals called prostaglandins cause uterine contractions and cramps; and when you're anxious, these "normal" cramps will feel much worse.
Nix It: To block the production of prostaglandins, take a nonsteroidal anti-inflammatory drug such as ibuprofen or naproxen at the first twinge of pain or one or two days before you get your period, recommends Dr. Dell. If this doesn't help, talk to your doctor about taking a prescription muscle relaxant. Research suggests that monthly acupuncture and acupressure may alleviate intense menstrual pain. Applying a heating pad to your lower abdomen can also ease discomfort.
When your mind gets overloaded with anxiety and doesn't know how to process it, a bad dream can be its way to work through the stressful experience so it becomes less threatening, explains Barry Krakow, MD, medical director of the Maimonides Sleep Arts and Sciences in Albuquerque, New Mexico.
Nix It: Think of the dreams as free psychotherapy, a possible clue to what's making you tense, and a suggestion on how to deal with it. Focus on how you felt in the dream. If you were afraid or embarrassed, consider why. Then ask yourself what makes you feel the same way in real life. For example, you might realize you've said or done something embarrassing at work and need to apologize to someone or be more careful. If bad dreams are starting to interfere with your sleep, occur nightly, or are truly disturbing, you may need professional help to sort things out, says Dr. Krakow.
"In adults, stress is one of the most common causes of hives," says John F. Romano, MD, a clinical assistant professor of dermatology at the Weill Medical College of Cornell University in New York City. Experts think that anxiety sets off a cascade of immunological events that can lead to the release of a compound called histamine, which causes hives. Unfortunately, there's no way to tell if they're caused by an allergic reaction or anxiety, says Dr. Romano.
Nix It: Talk to your doctor about whether you should take an antihistamine at the first sign of hives or an anti-anxiety medication during stressful periods as a preventive measure. Biofeedback sessions can also stop the immune-system response that triggers anxiety-related hives. Otherwise, Dr. Romano recommends taking an oral antihistamine and applying a topical anesthetic or anti-itch cream to relieve discomfort. Applying cool compresses and taking oatmeal baths can also soothe the itching until the hives clear up.
Many people, asleep or awake, tend to clench their jaw muscles or grind their teeth when they're tense.
Nix It: See your dentist -- if you grind your teeth, she can create a mouth guard to prevent it. In the meantime, pay attention to your jaw position during the day. "There should always be a small space between your upper and lower teeth [when you're not chewing]," explains Micah Sadigh, PhD, an assistant professor of psychology at Cedar Crest College in Allentown, Pennsylvania. To relax your jaw, gently open your mouth to the point where you notice tension in the muscles of your jaw but no pain. Take a deep breath, and as you exhale, allow your jaw to go completely slack.
The physical and emotional toll of tension can zap your energy. One theory is that when you're under stress, your immune system erroneously responds the way it does to fight off infection, explains Monika Fleshner, PhD, an associate professor in the department of integrative physiology and director of the neuro-immunophysiology laboratory at the University of Colorado at Boulder. This can cause fatigue or fever, which force you to slow down and rest, just like you need to do when fighting off a cold or flu. Anxiety can also cause insomnia, which may lead to fatigue: When you're tense, you may wake up more easily and often have a hard time going back to sleep, explains Richard Schwab, MD, co-director of the University of Pennsylvania Sleep Disorders Center in Philadelphia.
Nix It: "Reduce mental stress by talking out your worries," Sadigh says. Unload to a trusted friend or set aside 20 minutes (no more) to write down your feelings and thoughts. Exercising for 20 to 30 minutes can also counteract fatigue by oxygenating the blood, promoting the release of feel-good brain chemicals, and distracting you from worry and anxiety, Sadigh says. Also, cut back on caffeine. It may boost alertness in the short term, but excessive amounts can exacerbate the physiological symptoms of anxiety. In fact, research at Duke University Medical Center found that consuming 500 milligrams of caffeine -- the equivalent of about four cups of coffee -- during the workday increases a person's blood pressure and reactivity to stress.
Originally published in Fitness magazine, January 2006.