Stress Factor: How Economic Turmoil Affects Women

Gas prices go through the roof. The stock market implodes. The jobless rate hits a new high. It's hard to find a household unaffected by the current economic turmoil, and the consequences extend beyond the family budget. Although we're all anxious in rough economic times, women may feel the most stress, and, ultimately, that's bad for our health. So just when you thought you had enough to worry about, we're going to add to the list: worrying too much.

According to the American Psychological Association's recently released Stress in America survey, conducted in June and August, more women than men (84 percent to 75 percent) expressed fear about the economy, and many reported new physical and emotional symptoms, such as headaches, irritability, insomnia, fatigue, overeating and chest pain. The gender difference is probably attributable to a combination of the extra family responsibilities carried by women, especially working women, and the fact that "women are just more open about reporting stress," says Katherine Nordal, the APA's executive director for professional practice.

Women 44 and older reported feeling the most anxious about finances, and that could have a real impact on their long-term well-being, according to Nordal. "Women lose their biological competitive edge for heart disease when they pass menopause," she says. "We no longer have the hormonal protection we have at younger ages." Because heart disease is the No. 1 killer of women and prolonged stress significantly raises your risk for heart disease, older women in particular need to take action to reduce their stress. But younger women are not immune. In the APA survey, 89 percent of Generation-X women, a group the APA defined as women 30 to 43, rated money woes as a source of stress. And even 75 percent of women in their 20s were very troubled by one aspect of the financial crisis: housing costs.

The role of stress in women's health is complicated. It has long been thought that women's doctors are more likely to blame stress for almost everything, from headaches to heart palpitations, while the same description of symptoms coming out of a man's mouth often got more serious attention—women were told their symptoms were all in their heads, while men got a referral to a cardiologist.

A new set of case studies of women with classic coronary heart disease presented this week at the annual scientific symposium of the Cardiovascular Research Foundation bears that out. Symptoms such as chest pain, shortness of breath or fatigue that were presented to physicians in the context of a stressful event in the women's lives were much less likely to get properly investigated, diagnosed and treated than they were in case studies of male patients with exactly the same symptoms. "When we added a stressor to the description of a woman's symptoms, suddenly, there was a 'meaning shift'," says lead researcher Gabrielle Chiaramonte, a psychology postdoctoral fellow at Weill Medical College of Cornell University. "The inclusion of a stressor precluded doctors from making a coronary heart-disease diagnosis in women," but not in men. Blaming stress for symptoms makes it too easy to ignore them—and these symptoms can also be signs of trouble other than heart disease.

But researchers are making progress in understanding the interplay between stress and overall health. Stress is no longer seen as an isolated emotional issue, but rather as an integral part of the body's response to dangers and threat. "Most of us do fairly well when we are exposed to short-term stress," says Karina Davidson, a clinical health psychologist at the Columbia University College of Physicians and Surgeons. "Our bodies are physiologically wired with adrenaline to get us to fight or to run or to debate vigorously for short periods of time." When the threat passes, the body wants to slow down and rest. But, says Davidson, many modern stressors, such as the continuing economic crisis, are not short term. They can go on for months or even years. And it's that long-term exposure that increases the risk of long-term problems.

So what can you do to protect yourself? The first step is to learn the warning signs of stress, the physical symptoms that indicate that your body is reacting to unusual pressure. Everyone responds differently. Some women get headaches and muscle pain; others have trouble staying or falling asleep. For a complete list of warning signs and a quiz to determine your risk, visit the APA's Web site.

Think of these symptoms as a kind of language; they're your body's way of telling you that you need to change. And in order to change, you need to respond in the same language. When you are stressed, your body is prepared for action, and if you don't act, the stress reaction remains. Researchers think that may be why exercise helps many people by triggering a relaxation response. You don't have to spend hours at the gym. Even a brisk 10- or 15-minute walk several times a day can make a big difference. Certain kinds of yoga, especially when accompanied by deep breathing, are also very effective in bringing down stress levels.

Maintaining supportive social connections is particularly useful during times of prolonged stress, Davidson says. She also suggests giving yourself permission to engage in one relaxing and healthy activity each day, like taking a long walk or a long bath or reading a good book. Watching TV is not on her list, however. No matter what the show, you can't escape the possibility that stressful news will intrude.

If these simple efforts don't help, you should seek professional assistance. For many women, the first step is an appointment with your primary-care physician. Your doctor may want to examine you to make sure that your symptoms don't signal another underlying problem. That's a good thing, because, as mentioned above, too many doctors still may misdiagnose as stress potentially more serious symptoms in women. If your doctor doesn't suggest an exam, ask for one, but be very clear in your description of exactly what's bothering you so he or she knows what to look for.

If you feel your doctor is not taking your concerns seriously, get a second opinion. "My experience is that when a woman knows there's something wrong, she's always right," says Alexandra J. Lansky, director of the women's health initiative at the Cardiovascular Research Foundation and a cardiologist at Columbia University Medical Center. "Sometimes you need to be extremely proactive. I can't tell you how many women I've seen who have already seen two or three other physicians before they came to me."

If the ultimate diagnosis is stress rather than another physical or emotional problem, many doctors today may simply prescribe an anti-anxiety medication or an antidepressant. While medication can be very helpful, research has shown that a combination of medication and talk or behavioral therapy is the most effective treatment. Ask your doctor for a referral to someone trained in psychological issues, such as a psychologist or social worker. There's information about how to find a mental-health professional and tips for fighting stress on the APA's Web site. And for more general information about dealing with stress, go to the help center at the APA's Web site (www.apa.org). Most of us aren't in a position to fix the financial crisis, but we can improve our own responses to the mess. Now, let's hope that politicians and bankers do their jobs so we can all relax.

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