Special Event

Millennium 2000: Stress

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

BERNARD SHAW, CNN ANCHOR: Your cell phone jerks, the traffic snarls, your stomach knots, kids, bills, the possibility of thermonuclear war.

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MELISSA MOSS, PRESIDENT, WOMEN'S CONSUMER NETWORK: People have a way of always finding you, and that means that you're sort of always on call.

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SHAW: It's about stress, and how to dial down.

A snapshot of life at the start of the 21st century, an era of high-tech and high stress.

JUDY WOODRUFF, CNN ANCHOR: And, many people are paying for it, from executives with ulcers to kids with migraines.

CNN's medical correspondent Eileen O'Connor begins our focus on why we are so stressed out, and what we can do about it.

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EILEEN O'CONNOR, CNN MEDICAL CORRESPONDENT (voice-over): It's 5:00 a.m., the start of a typical day for Jonathan Silver. First, it's a trip to the gym for a workout. On some days, there's time for a quick cup of coffee with wife Melissa before heading out the door to the office, most days before 7:00 a.m.

JONATHAN SILVER, CORE CAPITAL PARTNERS: I'll start with that, and I'll come in and see about some other stuff.

O'CONNOR: His schedule looks like a strategic bombing mission, everything planned to the second.

SILVER: I have a tendency. I think all the people I work with have a tendency probably to overschedule themselves, and that tends to create stress as well. It means from the moment you get started, you're sort of behind a little bit.

O'CONNOR: It used to be deals were done at dinner; now meetings begin with breakfast. SILVER: Let's just do a quick review of where we are on the various projects.

Hi, it's Jonathan. You do me a favor?

O'CONNOR: Next it's off to a conference. Even the short walk affords time for more business before gathering with fellow venture capitalists. They are just as busy as he, and it shows by the amount of pager and cell phone traffic in the room. The dealing done in Washington, Jonathan heads for the airport for a quick business trip that will bring him back in just a few hours.

Melissa Moss, Jonathan's wife, is starting up a new Internet company. She says while technology is affording a newfound wealth of opportunity, it has its downsides, too.

MOSS: People have a way of always finding you, and that means you're sort of always on call.

O'CONNOR: Experts say their jammed schedules are becoming all too typical. Research shows advances in technology, the movement of more women and mothers into the workplace, and corporate downsizing are factors making employees busier.

LINDA ROSENSTOCK, DIRECTOR, NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH: Not only is there typical too much to do, but the amount of input and the kinds of things people are supposed to respond to and the pace at which they're working have all increased so dramatically, and I don't think we've really calibrated yet what's the right amount and what's the optimal amount.

O'CONNOR: Studies indicate everyone is doing seemingly everything longer every day -- except sleep. Men are working on average four hours a week more than they did 20 years ago. Women are working five hours a week longer than they did 20 years ago. No wonder 62 percent say they'd like to work less at the office, because that's not the only place they're putting in longer hours. Men spend 30 minutes more each day with the children, and one hour more each day working on chores. More work is being brought home from the office. All this, experts say, means something has to give.

ROSENSTOCK: Are there consequences? Certainly, one consequence is that the workers themselves are described as feeling more stress, and when we start to look at how that links to health care and health care costs, we start to find a link, not surprisingly.

O'CONNOR: In fact, three quarters of all employees surveyed say workers today are more stressed than they were 20 years ago.

By studying how different rats react to stress, Dr. Esther Sternberg, at the National Institutes of Health, says she and others are learning more about the positive and negative effects of stress on humans.

DR. ESTHER STERNBERG, NATL. INST. OF MENTAL HEALTH: When you are exposed to a stressful stimulus, your brain starts pumping out stress hormones.

O'CONNOR: That stress hormone triggers a chain reaction in the body that causes the kidneys to produce a hormone called cortisol, one of the most potent chemicals our body makes. Too much can actually kill off brain cells, possibly affecting judgment and memory. That cortisol is also hitting the immune system. It's anti-inflammatory action actually turns down the disease-fighting ability of those cells.

STERNBERG: The end result of that is that people going through chronic stress will be more susceptible to infection, because their immune cells are always tuned down.

O'CONNOR: That means more trips to the doctor.

LINDA ROSENSTOCK, DIR., NATL. INST. FOR OCCUPATIONAL SAFETY & HEALTH: If you do studies and look at people who describe themselves as having high levels of stress, you will find that they tend to use physician services more often and they have higher associated health care costs for a variety of conditions.

O'CONNOR: But, says Dr. Sternberg, there is also an upside to stress. While those hormones are being produced, the liver is producing glucose, giving the body an energy boost from stress. Our ancestors used this extra energy to fight or flee, depending on the situation, making stress a vital component of survival.

STERNBERG: You have to be able to mount a fight or flight response in a threatening situation. So stress is good. Stress -- the stressful event tells the brain, which then tells the body that unless you do something to get out of here, you're toast.

O'CONNOR: No one knows the help and hindrance stress can be better than battlefield commanders.

DR. CLETE DIGIOVANNI, NATL. NAVAL MEDICAL CTR.: Everyone going through combat is stressed, unless they are brain dead.

O'CONNOR: Dr. Clete Digiovanni works with young Marines and their officers, teaching them first how to minimize stress by becoming familiar with situations. That's achieved through training exercises like this one. Genes and experience mean each Marine will react differently to the stressful event. Since even constant drilling cannot eliminate stress, Marines are taught how to channel the energy released in stressful situations and put it to use in battle.

DIGIOVANNI: Combat stress can be a very invaluable ingredient in rapid decision-making and keeping people on edge. It's only when it becomes a disorder does it begin to have harmful effects. Now, how harmful can combat stress disorder be? Combat stress disorder can have as much of an impact on a small fighting unit as combat wounds and injuries.

O'CONNOR: It's not just what happens on the field that affects judgment, it's also stress in the Marine's life that commanders here learn to gauge. Are they worried about family? Did they get enough sleep? All that must be taken into consideration, as the Marines are taught to deal with their reaction to stress. The best way to do that, say their field commanders, is by having them find their own ways to work through it, again through training.

UNIDENTIFIED MALE: Well, you can never completely eliminate it, but you're trying to -- you're trying to not necessarily eliminate it, but to deal with it, and know that, hey, it's going to happen, but, hey, if it happens -- if this reaction happens, what are you -- how are you going to react to it? If this happens, how are you going to react to it?

O'CONNOR: Military training follows the golden rule of stress reduction, familiarity.

STERNBERG: One thing that people can do to reduce their stress response to a given situation is simply become familiar with it.

O'CONNOR: So how do you breed familiarity for those in our society for whom just about everything is new? Children. In addition to the normal stresses of childhood induced by constantly having to cope with new situations, today's children are also subjected to the same technological onslaught as adults. More information, more opportunities, but also more stress.

DR. KAREN OLNESS, RAINBOW BABIES AND CHILDREN'S HOSPITAL: We have too many stimuli in our society. There are just a lot of options. One thinks about just the number of television channels that are available to kids, the numbers of videotapes, the number of video games. All the things they can do that might distract them or take their attention. And as a result, perhaps, cause them not only to be overstimulated, but to lose sleep with many of these additional sources of fun.

O'CONNOR: But it isn't the fun that induces the most stress, it's the work of childhood. Chaya Kessler is a 5th-grade student at this private Jewish school in Cleveland. She is a good student, who strives to excel in everything, like piano. Last year, she increasingly suffered from headaches, even migraines. So her parents took her to see Dr. Karen Olness, a pediatric behavioral specialist at Case Western Reserve's Rainbow Babies and Children Hospital. Using biofeedback and a program she has developed especially for children, Dr. Olness has taught Chaya how to manage her stress.

OLNESS: Just like a switch can turn a light on and off, your brain can turn your body on and off.

O'CONNOR: Chaya can see how stress is affecting her body, through her body's own responses, recorded on this computer. Using mind over body, she can change her physical response.

CHAYA KESSLER, BIOFEEDBACK PATIENT: I relax my body like one part at a time, and then I think of a nice cozy place. It's like on my dad's lap.

O'CONNOR: By using her mind, Chaya has learned to reduce her stress, shown again through the computer. OLNESS: When you relax your heart rate goes down, and that happens when you're changing your thinking, you're in control.

O'CONNOR: Dr. Olness wants a computer program that works in a laptop and uses game-like imagery put into schools. She believes not only children, but society, will benefit from teaching stress management.

OLNESS: I am very concerned when I read these reports about increasing road rage, about increased rage of people on flights. I really don't recall that we heard a lot about that 20 years ago. And I think that it represents, perhaps, people who have not early on learned to self-regulate, have not learned how to control natural perhaps negative impulses that everyone has from time to time.

O'CONNOR: Experts say channeling the stress response is the key, because some stress makes us perform better.

STERNBERG: The stress response pushes you to a point of optimum performance, which is good. Now, if too much stress is coming on to you at the same time, your stress response then can pushed be so high, you're pumping out so much of these hormones that you go over the edge.

O'CONNOR: The challenge for the next millennium will be to use the same technology that has helped make life more stressful to make it less so.

STERNBERG: By understanding how cells of the immune system communicate with cells of the nervous system and vice versa, we can begin to put the body back together again and figure out new drug treatments to improve health.

O'CONNOR: Melissa Moss has found another way to harness that technology. That Internet business she started is designed to help women balance the increasingly complex demands of their lives.

MOSS: What we're trying to do is to find ways to take some of the stress out of women's lives by helping them finding hard to find items, helping them to research hard to research items.

O'CONNOR: She and Jonathan have also found other unique ways to cope, his involves a yearly trip into the wilderness to get dirty and hang off cliffs.

(on camera): Isn't hanging off a cliff stressful?

SILVER: It's abject fear. You don't get that toe hold, you have a serious problem, a much more serious problem than not returning a phone call.

O'CONNOR (voice-over): Melissa prefers a different approach.

MOSS: I'm a big believer in manicures and pedicures.

O'CONNOR: Either way, experts say, one great thing they've learned about stress, its ill effects can be reversed with just that one great vacation.

Eileen O'Connor, CNN, Washington.

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WOODRUFF: I don't know about the hanging off the cliff part.

SHAW: Whatever works.

WOODRUFF: Exactly.

When we return, more on stress.

SHAW: What effects do they have on the human body? We'll ask Dr. Robert Sapolsky, an expert on stress in humans and animals.

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WOODRUFF: Now, a little about the difference between humans and animals and the physical effect of stress on the body.

SHAW: Joining us from San Francisco, Dr. Robert Sapolsky, author of "Why Zebras Don't Get Ulcers."

What can zebras teach humans about stress?

DR. ROBERT SAPOLSKY, AUTHOR, "WHY ZEBRAS DON'T GET ULCERS": A surprising amount, when you basically look at what we get stressed about and they don't. We get stressed about psychological factors, we get stressed long term. They worry about lions. And the main thing about a lion is it's either over with in 30 seconds or you're over with.

SHAW: So we humans walk around with stress inside? We don't know how to let it pass?

SAPOLSKY: Yes, and that's one of the sort of unfortunate byproducts of how cognitively sophisticated we are. We can worry about ozone layers, we can worry about mortality, we can worry about the stock market and blind dates and Y2K meltdowns, and we can worry in a way that turns on the exact same stress response that a zebra would turn on running away from a lion. But we turn on it for 30-year mortgages. And a central punch line of this whole field is if you turn it on chronically, you're more likely to get sick.

WOODRUFF: Dr. Sapolsky, why do human beings have a hard time letting go of stress?

SAPOLSKY: Well, again, it has this thing to do with how sophisticated we are. We can worry about things that are not even conceivable for your average animal out there. You even look at sort of a complex social primate, we can worry about things in the future, we can ruminate about things, we can let our fantasies run wild, we can let our anxieties run wild. We can do things in our heads that nobody else can. Some of the time that gets us wonderful technology and Westernized lifestyles, some of the time that gets us ulcers. SHAW: How do you unlearn stress?

SAPOLSKY: Well, I think one of the key things is understanding what some of the psychological building blocks are of stress. And initially that would sound like sort of a very nebulous subject. People actually have a pretty good idea for the same physical stressor, for the same external reality, what psychological factors make it seem more stressful. And what those generally are is, you're going to feel more stressed if you don't have outlets for the frustration that you feel at that time, if you feel like you have no sense of control, if you feel like you have no predictability about when the stressor is occurring, how bad it's going to be, how long it's going to last for. And probably most importantly, if you don't have somebody's shoulder to cry on, if you don't have a sense of social support. Those factors tremendously powerful in modulating whether the same external reality gets us sick or not.

SHAW: But what about this situation that I worry about sometimes -- I'm not stressed about it -- but what about if you are surrounded by a lot of stressed-out people, but you yourself are calm? Aren't you out of sync? Aren't you out of phase with people in your environment? And can't that be a disadvantage to you?

SAPOLSKY: Well, glad to hear you don't have that personal problem. Punch line is, it depends. There's absolutely no reason to think that one performs better, one's memory works better, when you're under stress. I mean, you need a little bit of it. What we call an optimal amount of stress is stimulation. And certainly our function peaks around that point, whether it's mental, whether it's physical. But way too much of it, and you, in fact, are not going to be doing better, you begin to disrupt performance.

And we all work on this belief that if you can push yourself a little harder, get along with a little less sleep you'll get that much more done. Most of us are way past the optimal point in our curves.

WOODRUFF: Dr. Sapolsky, who are the people who get the most stressed out? Clearly, a number of people can deal with the exact same situation in very different ways. Who are the people who are most vulnerable to stress? Or is there a profile?

SAPOLSKY: Yes, there definitely is. And one first pass at it is there's a number of jargon, a number of neuro psychiatric profiles of people who don't deal very well with stress. And in a broad way, what that's about is your body responds as if there's more of a stressor out there than there really is, as if there's less of one. There's a mismatch between the reality and how you react.

One version of that is people who are clinically depressed. And a way of characterizing depression is you believe you're helpless, you believe you can't control situations that you can, you don't even bother trying to cope with stressors when they occur.

At the opposite extreme are people with anxiety disorders, and those are people who most definitely have trying to cope, but they're coming up with 14 different coping responses at once, and they're all mutually contradictory, and they haven't a clue when there's a signal that things are actually safe. Once again in that case, there's a mismatch between how stressful the world actually is and how much their body reacts as if it's stressful. And what the studies show is people like that, people with type A personality, a couple of other realms of that sort, you pay a price in terms of disease risk.

WOODRUFF: A difference between men and women overall in stress or not?

SAPOLSKY: In a broad way, certain diseases are more -- certain stress-related diseases more prevalent in one gender versus the other. It's hard to make some generalizations. Certainly within our realm of "super moms" and people multi-tasking at everything they do, there are certain pockets of more stressful professions, more stressful sort of strata of society. But in general, there's not a huge amount of gender differences.

SHAW: One, two, three, what should all of us do about stress?

SAPOLSKY: OK, millennial sound bites. Probably most important things, OK, three things: Be able to tell the difference between the big things and the little things. And that sounds wonderfully platitudeness, but that's about 90 percent of what they teach you in stress management.

Don't try to change the unchangeable, don't try to fix something that's already happened. Tell the difference between the things you can change and the things you can't. And if that sounds familiar, that's straight out of the Alcoholics Anonymous prayer. That's an enormously powerful thing. You can't do stress management on something that's out of your control, and that could be an enormously damaging thing to, for example, feel as if you're responsible for something that you could not have possibly had anything to do with, making a victim feel as if they could have had some impact.

And third, and the one I alluded to before, is social support. And that one sounds just idiotically simplistic -- ooh, don't go through life's vicissitudes alone -- and that's the simplest thing in the world to do unless you happen to be one of a large number out there for whom life is more isolating of an experience than you would want it to be. Intimacy is a tough thing to achieve. But once you have it, it's great for health.

SHAW: OK, a very laid back Dr. Walter Sapolsky, author of "Why Zebras Don't Get Ulcers." And he told us. Thank you.

WOODRUFF: And I've I written down everything you said.

Thank you, Dr. Sapolsky.

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