It seems to be common sense that hard times are associated with developing depressive symptoms. When a personal crisis occurs, many people who had been coping pretty well become clinically depressed.

National Suicide Prevention Lifeline
1-800-273-TALK (8255) Go to the nearest hospital or emergency roomCall your physician, health provider or clergyNational Alliance on Mental Illness
www.nami.org
1-800-950-NAMI (6264)

The two classic examples are losing a relationship or losing a job. However, if a company terminates 100 employees, most of them don't develop a depressive illness. An important question is why one employee manages to cope while another develops a mood disorder.

Seven years ago, an important paper published in one of our most respected scientific journals reported that people with a genetic variant of the serotonin transporter gene were more likely to become depressed when they had experienced stressful situations.

If a person had this genetic variant and wasn't exposed to very stressful situations, they weren't any more vulnerable to depression than if they had the more protective form of the gene. It was only when they had experienced severe personal distress that their depressive symptoms occurred. People without this genetic variant were often able to tolerate quite severe stress and not develop symptoms.

There has been much discussion of this finding. Many studies were done that measured stressful experiences in a variety of different ways. About a year ago, a paper reviewed only 14 of these studies and concluded that people with this genetic variant weren't very much more vulnerable to stress. There were problems with this analysis, but it was published in a good journal and it made some doctors a bit skeptical about the finding.

This week, a new analysis of 56 studies concluded that there was a strong relationship. They demonstrated that people with the less active form of the serotonin transporter gene were more vulnerable to developing depression when they experienced severe stress.

The analysis found:

The strongest relationship was between severe stresses during childhood that then seemed to haunt the person for the rest of their life. This finding supports the view that young children are particularly vulnerable and that early abusive experiences can have a long lasting impact. The next most difficult type of stress was serious medical problems. This also makes sense as we have known for many years that some people become very depressed when faced with the prospect of having to deal with a serious medical illness.The least dangerous kind of stress was the hassles of everyday living that we're all familiar with and that sometimes get out of hand. However, even this kind of stress was associated with an increased risk of depression if a person had this genetic variant.

The bottom line is that this new analysis provides strong evidence that stress can trigger depression and that the onset of depression is far more likely in people who are genetically vulnerable to developing a mood disorder.

Does this mean that if you have the variant, you are doomed to become depressed? Absolutely not. It just means that you're more vulnerable to developing symptoms.

Does the study prove that if you don't have the variant, you won't develop a depression if you're exposed to intense stress? Again, absolutely not. It just means that the risk is lower.

Perhaps the most important point that this analysis makes is that there is a biological vulnerability to depression just like there is a biological vulnerability to diabetes, asthma, or cancer.

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Our institution is in the midst of one of the largest construction projects in our history. It will involve years of construction and hundreds of workers. When you walk by the site, it's obvious that there's a tremendous emphasis on safety. Throughout the complex signs are posted that say safety is everyone's responsibility.

If the stress in your life is more than you can cope with, get help right away.

National Suicide Prevention Lifeline
1-800-273-TALK (8255) Go to the nearest hospital or emergency roomCall your physician, health provider or clergyNational Alliance on Mental Illness
www.nami.org
1-800-950-NAMI (6264)

Each worker is required to wear a construction-grade helmet, protective eyewear when appropriate, steel-toe shoes and a safety harness when working above ground level. Some of the work involves creating pedestrian tunnels, and those workers receive additional instruction in the high-risk aspects of the job.

This experience made me reflect that each of us works in high-risk situations. You may not use heavy equipment or be at risk of falling, but is your work environment one of stress, deadlines and demands that often exceed your resources?

The risks are different but no less real. If you sit back and do nothing, you run the risk of a major injury, which might be a stroke, a heart attack, diabetes, or a host of emotional issues such as anxiety and insomnia. So what can you do to protect yourself?

Taking care of your physical and mental health is your best defense. You can shift the odds in your favor with a few simple rules, such as getting a good night's sleep, exercising and reaching out to others when you need help. No person is an island, and we depend on each other for strength and comfort.

What have I missed from this construction scene?

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An obscure article about a young baseball player caught my attention. It provided a golden teaching moment. Let me explain.

If the stress in your life is more than you can cope with, get help right away.

National Suicide Prevention Lifeline
1-800-273-TALK (8255) Go to the nearest hospital or emergency roomCall your physician, health provider or clergyNational Alliance on Mental Illness
www.nami.org
1-800-950-NAMI (6264)

Because of the astronomical salaries commanded by top professional athletes and because teams have a fixed budget, no coach or general manager can afford to mortgage the franchise by paying millions of dollars to a player who can't perform at a high level for many years.

The situation becomes even more complex because these million-dollar contracts are often guaranteed regardless of the player's performance or professional longevity. Once upon a time, a manager or a coach would sign one of these players based a gut feeling. Today, managers use laptops and spreadsheets to analyze every aspect of a player's strengths and weaknesses.

It's long been an accepted tenet in baseball that once a pitcher exceeds 100 pitches a game, his performance will decrease and his career will be in jeopardy. So the baseball community reacted with astonishment at the news that a high school pitcher had a 100-miles-per-hour fastball — an unheard of speed — and could comfortably throw 200 pitches a game on consecutive days.

Squadrons of scouts with radar guns and video cameras descended on his small community. The rumors were correct. The legend was real, and thus began an arms race of bidding for his services.

After incredible publicity and negotiations with lawyers, agents and representatives, the young man signed a lucrative multimillion-dollar contract. He entered his first game like a conquering hero. For the first half of the season, he lived up to his expectations — throwing a rocket-like fastball and easily exceeding 100 pitches a game. But then biology caught up with him. His speed decreased. His accuracy evaporated, and he was repeatedly injured. And then disaster struck — he tore a major ligament.

So what's the lesson here? Everyone has limits. If you exceed them, you must be prepared for the consequences. Sure you can burn the candle at both ends for a time, but sooner or later you'll pay the price. You only have so much mental and physical energy. If you don't pay attention to your well-being and you allow yourself to be whipsawed by the demands of others, you won't be able to go the distance.

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Relaxation therapies may help alleviate certain symptoms of cancer, relieve side effects of treatment, and improve your sense of well-being.

Many relaxation methods, such as massage therapy, meditation and guided imagery may be helpful in managing stress and anxiety. In addition, research studies show that relaxation techniques can lower blood pressure, reduce pain, and ease some side effects of chemotherapy.

Having cancer is stressful, so it may not be possible to eliminate all sources of stress. But you should consider the sources of stress that you can reduce. For example, ask for help with household chores, social responsibilities or work demands. Seek out effective strategies for coping with stress or simplify your life by saying "no" to the extra demands as much as possible.

Common relaxation techniques include:

YogaTai chiListening to musicExerciseHypnosisGuided imageryMassage therapy

Relaxation techniques involve refocusing your attention from the stress to something calming.

For me, it's taking a daily hike and being mindful of the changes in nature around me. It might be the sound of the birds chirping, new leaves on the trees, the beauty of the clouds against the blue sky, or a neighbor, cat or dog that welcomes me along the way.

I return refreshed and ready to take on the rest of the day. Choose a relaxation technique that works best for you and incorporate it into your daily routine. Share with others through this blog what has worked for you.

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Stress as a Contributing Factor Stress as a Contributing Factor

Stress changes the body's normal state, but we need a degree of stress in order to be alert and active to prepare and deal with outside stimuli. Stress causes a natural 'fight-or-flight' reaction in our bodies - we become immediately responsive by either running away or fight­ing back, and this protects us from danger or difficult situations.

The body reacts to stress by sending a hormone called adrenaline to the legs (to enable us to run away) or to the shoulders and upper torso muscles (to enable us to physi­cally fight the enemy). This was good for our cave man ancestors, whose problems were not those of deadlines or traffic jams but those of hunting food or being eaten themselves! They used up all this adrenaline quickly, but when we are put under pressure today we stay in a prolonged state of alertness which, if it continues without rest, will have a damaging effect on our bodies.


At this time of stress the body needs all its resources and so all the other bodily systems temporarily slow down or cease. Blood, for instance, moves away from the diges­tive system to the muscles in order to prepare for physical action, the bowels empty, the heart rate increases, blood pressure increases, sweating occurs, the pupils dilate, the mouth becomes dry as food is not required — in short, the body has turned away from the essential processes of digestion and absorption of foods and nutrients for repair and maintenance in favour of self-defence.

Remaining in a prolonged state of stress will result in undigested food, the secreting of toxins by the body, and slow and inefficient processing of the waste products in the body. All this causes excess and overload which, if not dealt with quickly, will simply build up each time the body is subjected to further stress.

Part of the Detox Programme involves getting rid of, or
at least managing, some of the stress in our lives in order to minimise the unnecessary disturbance of our bodies.