Seventy years ago, physiologist Walter Cannon, Ph.D., proposed that feeling threatened or anxious—what we now call “stressed”—triggers two reflexive reactions: attacking the threat or fleeing it. Cannon’s “fight-or-flight” concept has dominated scientific thinking about stress ever since. But the latest research shows that fight-or-flight describes men’s reactions to stress more than women’s. Most women react to stress differently, according to University of California at Los Angeles psychologist Shelley Taylor, Ph.D. Women are more likely to seek comfort in nurturance and companionship. Women “tend and befriend.”
In one noted study, stressed-out parents were observed as they returned home. The fathers often yelled at a family member (fight) or withdrew to spend time alone (flight). The mothers usually focused on their children (tend) or reached out to friends (befriend).
This gender difference makes evolutionary sense. As hunter-warriors, men would be most likely to reproduce if they knew when to fight and when to flee. But in a threatening world, how would a proto-human woman be most likely to pass on her genes? She might attack a predator or flee, but it would make more sense for her to hold her children close and congregate with other women, finding strength and protection in numbers.
Fight-or-flight versus tend-and-befriend also makes biochemical sense. When stressed, both sexes produce a hormone, oxytocin, which calms the body and promotes interpersonal bonding. But men’s testosterone counteracts oxytocin’s effect, priming men to fight or flee. Women’s estrogen amplifies oxytocin’s effect, making them more likely to tend and befriend.
Of course, at times men find comfort in friendship, and sometimes women fight or flee. However, the discovery of the tend-and-befriend coping style puts a decidedly different spin on traditional stress-management advice, a new perspective you can use to stay mellow in a crazy world.
Herbal teas: “Care to join me for a cup?”
A cup of chamomile (Matricaria recutita) tea is calming whether you’re alone or with others. Yet in the context of tend-and-befriend stress management, why drink alone if you can brew a pot to share with friends? Several herbs have scientifically verified calming and anti-anxiety effects. Enjoy them with friends.
Kava (Piper methysticum). The most popular herbal stress reliever, kava has suddenly become the most controversial. There’s no question that kava calms tense nerves. Recently, British researchers reviewed three rigorous studies that pitted kava (100 mg of extract, standardized to deliver 70 mg of the active kavapyrones, three times daily) against a placebo. In all three studies, those taking kava reported significantly less anxiety than the placebo group—and unlike pharmaceutical anti-anxiety drugs, kava does not cause dependence, drowsiness, or confusion.
But last year, German researchers announced that occasionally, kava causes serious liver damage. The report cited twenty-four cases in long-term kava users. In most of the cases, the victims also took pharmaceutical medications that might have caused or aggravated their liver damage. But in six cases, the only drug used was kava. Of the twenty-four cases, one person died, and three required liver transplants.
Herbal medicine expert Jerry Cott, Ph.D., former chief of psychopharmacology research at the National Institute of Mental Health, says the German figures show that kava is about as likely to cause liver damage as pharmaceutical anti-anxiety medications. He calls that risk small enough to be acceptable for people who have serious anxiety problems. Many kava users suffer only minor anxiety. For them, he says, short-term use of kava is probably all right, but long-term, the herb’s risks probably outweigh its benefits.
The situation is still sketchy, and until it is clarified, the American Botanical Council in Austin, Texas, the nation’s leading herb education organization, recommends the following guidelines:
• Kava should not be used by anyone with liver disease (cirrhosis, hepatitis, elevated liver enzymes, liver failure), by anyone taking pharmaceutical medicine that might cause liver damage, or by anyone who drinks alcohol regularly (more than five drinks a week).
• Anyone using kava should not use it daily for more than four weeks.
• Stop using kava if symptoms of liver damage appear, notably jaundice. Symptoms include dark urine and yellowing of the whites of the eyes.
• If you have any history of liver problems, consult your physician before using kava.
• When using kava, follow the package directions.
Gotu kola (Centella asiatica). Gotu kola, an Ayurvedic herb, is the newest herbal stress tonic. Recently, Canadian researchers gave either a placebo or gotu kola (12 g of powder, about 8 teaspoons) in grape juice to forty healthy adults. Subsequently, they measured participants’ acoustic startle reflex (ASR), the extent to which a sudden loud noise made them jump. Compared with the placebo group, those taking the herb showed significantly less ASR, meaning that the herb kept them calm. Gotu kola is safe, although allergic reactions (such as rash) are possible, and unusually large amounts may have a sedative effect. For anxiety relief, try the amount used in the study—about 8 teaspoons of powder per cup of juice.
Tea (Camellia sinensis). Tea for relaxation? To most Americans, this may sound unlikely. After all, tea contains caffeine—not as much as coffee, but enough to have stimulant action. But Asians consider tea to have a paradoxical effect, promoting both alertness and relaxation. Recently, Japanese scientists unraveled this apparent contradiction. In addition to caffeine, tea contains the amino acid L-theanine, which promotes relaxation by blocking the action of certain neurotransmitters in the brain. Japanese research suggests that L-theanine helps reduce blood pressure and counteracts the irritability induced by caffeine. Brew a pot of tea—green, oolong, or black—and see if you feel more stimulated or more relaxed . . . or both.
Chamomile. When Peter Rabbit ate himself sick in Mr. McGregor’s garden, then got chased out at the wrong end of a hoe, his mother gave him chamomile tea. She was a wise herbalist—chamomile helps relieve stress. Argentine researchers discovered that the bioflavonoid apigenin in chamomile oil binds to the same cellular receptors as pharmaceutical tranquilizers and has similar effects, but without sedation, a hangover, or risk of addiction. Japanese researchers exposed laboratory animals to chamomile oil. Compared with unexposed animals, the ones that inhaled the vapor showed lower stress-hormone levels. British researchers tracked the moods of twenty-two people before and after exposure to chamomile oil or a placebo. The chamomile group reported greater mood elevation. Finally, the bisabolol in chamomile relaxes the digestive tract, which relieves a common stress symptom, indigestion. To make chamomile tea, use 2 to 3 heaping teaspoons of flowers per cup of boiling water. Steep for 10 minutes. Or add a cloth bag full of chamomile flowers to a hot bath, and inhale its calming aroma.
Lemon balm (Melissa officinalis). The renowned eleventh-century Arab physician Avicenna wrote, “Balm causeth the mind and heart to become merry.” He prescribed it for anxiety. Animal studies show that lemon balm oil has tranquilizing properties. In Germany, lemon balm is widely used in combination with valerian as a sedative. In one study, German researchers gave either a placebo or a valerian-lemon balm combination to ninety-eight people. In the placebo group, 9 percent reported improved sleep; in the herb group, 33 percent did. For a relaxing bath, run your bath water over a cloth bag full of leaves and flowers for a delightful, lemony aroma. For a light, lemon-tasting tea, use 2 teaspoons of leaves per cup of water. Steep for 10 to 20 minutes. For stress relief, herbalists often recommend mixing lemon balm with passionflower (Passiflora incarnata).
Passionflower. This herb’s name comes not from sexual passion but from the Passion of the Crucifixion. Native Americans from the Andes to the Gulf Coast used passionflower to soothe their nerves. Many animal studies show a tranquilizing effect. French researchers gave either a placebo or a combination of passionflower and valerian to 182 people with anxiety problems. In the placebo group, 25 percent showed significant anxiety relief based on psychological tests. In the herb group, the figure was 43 percent. In Europe, passionflower is an ingredient in many tranquilizing preparations. It’s non-narcotic and nonaddictive. For a pleasant-tasting tea, use 1 teaspoon of dried leaves per cup of boiling water, steeped for 10 minutes. Try mixing it with lemon balm.
Hops (Humulus lupulus). Famous for adding bitterness and complexity to the taste of beer, hops is also a stress-relieving tranquilizer in small doses and a sedative in larger ones. Folktales abound about hops pickers dozing on the job. Animal studies show that hops’ effects range from calming to sedating, depending on the dose. Recently, German researchers gave either a placebo or a valerian-hops combination to twelve healthy adults, then recorded their brainwaves. The herb group showed brainwave changes consistent with relaxation and anxiety relief. Try 1/2 to 1 teaspoon of hops per cup of boiling water, steeped for 10 minutes. Try mixing it with passionflower and lemon balm.
Decaffeinated coffee. If you often feel anxious, or if your fuse is short, consider weaning yourself from caffeinated coffee. Don’t quit cold turkey or you’ll suffer caffeine withdrawal syndrome, several days of headache and constipation. Instead, taper off slowly. Add a little decaf to regular coffee, and over a few months, change the mix until you’re drinking all decaf. Also, consider switching from regular colas to caffeine-free. (Cocoa and chocolate also contain caffeine, but small amounts. If you’re very sensitive to caffeine, consider eliminating them.)
Aromatherapy: “Mmm, that’s so-o-o relaxing.”
Pleasant floral, fruit, and herbal fragrances have subtle but profound emotional power. Their mood-elevating power is the basis for the billion-dollar-a-year perfume industry. Both perfumes and aromatherapy massage products are based on essential oils, the compounds that give plants their fragrances. Essential oils are small molecules that quickly reach the brain either by inhalation or through skin penetration. Many studies, notably several by Duke University Diet and Fitness Center psychologist Susan Schiffman, Ph.D., show that using aromatherapy for stress relief makes “scents.”
Emotional upsets. Using standardized tests, Schiffman rated the anxiety levels of fifty-six women. She then exposed them to pleasant aromas—chamomile, jasmine, lavender, lemon balm, and rose. Subsequent testing showed mood elevation and less anxiety.
MRI anxiety. Magnetic resonance imaging (MRI) peers inside the body, revealing things that remain invisible to X-rays. But having an MRI is nerve-racking. You lie still on a narrow gurney that gets rolled inside the cigar-tube-shaped MRI machine. The fit is tight and claustrophobic. And the machine is noisy, which causes anxiety. At Memorial Sloan-Kettering Cancer Center in New York, researchers compared anxiety levels in two groups receiving MRIs. One had their MRIs after exposure to heliotropin, a vanilla-like scent. Compared with the no-fragrance group, the aromatherapy group experienced 63 percent less MRI anxiety.
Weight control. Studies show that many people eat not because they’re hungry but because they feel stressed. Schiffman taught relaxation techniques (deep breathing, meditation, etc.) to one group of emotional eaters and afterward had them inhale whiffs of apricot oil to associate the aroma with feeling calm. Schiffman instructed them to carry a vial of the oil with them and inhale it whenever they felt anxious. The oil calmed more than half of them and helped them avoid compulsive eating.
Anxiety of hospitalization. Hospitalization is stressful. Admission to an intensive care unit (ICU) is even more so because the diseases that send people there are life-threatening, and because ICUs employ so much technology. At a hospital in England, researchers divided 111 ICU patients into three groups. One group received standard care, the second, standard care plus up to three massages, and the third, standard care plus aromatherapy massages with relaxing lavender oil. The aromatherapy massage group experienced the greatest anxiety relief.
You can find aromatherapy oils and massage lotions at most health-food stores.
Visualization: “Wish you were here.”
If you like movies, visualization is a great way to relax. Visualization, also known as guided imagery or self-hypnosis, is directed meditation. As in meditation, you sit quietly, eyes closed, breathing deeply. But instead of emptying your mind, you focus intently on vivid story-like imagery (often with music), Many people find this more relaxing than classic meditation.
For maximum benefit, a visualization should be multi-sensory. For example, if you visualize a beach scene, imagine white sand and blue water, the pounding surf, the salt spray, the sun’s warmth, the sea breeze, the unique smells, and the sand between your toes.
Visualization can be so powerful that proponents such as Karen Olness, M.D., a professor of pediatrics at Case Western Reserve University in Cleveland, have actually had surgery without standard anesthetics. During surgery for a thumb injury she suffered while skiing, Olness used visualization as her only anesthesia.
In the context of tend-and-befriend stress relief, include people you love in your visualizations.
For good visualization cassette tapes, contact The Imagery Store, PO Box 2070, Mill Valley, CA 94942; (800) 726-2070; www.interactiveim agery.com.
Another contact is Source Cassettes, 131 E. Placer St., PO Box 6028, Auburn, CA 95603; (800) 528-2737; www.drmiller.com.
Exercise: “Let’s go for a walk.”
In addition to its many other benefits—weight control and reducing the risk of heart disease, stroke, several cancers, diabetes, osteoporosis, and insomnia—exercise is a powerful stress reliever. Exercise releases endorphins, the body’s own feel-good compounds, the source of “exercisers’ high,” the feeling of well-being after a workout. Exercise has also become a standard prescription for anxiety.
Yet only 25 percent of American adults exercise sufficiently (for thirty minutes at least five days a week), according to officials at the Centers for Disease Control and Prevention. One reason is the misconception that exercise must be aerobic to do any good, despite the research that debunked this notion twenty years ago. Yet Americans’ slavish belief in the primacy of aerobics has endured—because of the general sentiment that to obtain exercise benefits, you have to sweat and suffer. Wrong.
If you’re a competitive athlete and want to attain maximum cardio-respiratory fitness, then aerobic exercise is the way to go. Aerobic exercise is also stress-reducing. Do it if you enjoy it.
But if you just want health benefits and stress reduction, nonaerobic exercise works fine. Some of the seminal studies proving this were performed by researchers at that citadel of aerobics, the Cooper Institute of Aerobics Research in Dallas. “We made a mistake,” says Steven Blair, Ph.D., director of epidemiology at the Cooper Institute, “saying everyone had to engage in strenuous, twenty-minute aerobic workouts at least three times a week to obtain health benefits. Regular, moderate exercise is enough.”
In a classic study, Cooper Institute researchers divided 102 women into four groups. One group remained sedentary. Another took leisurely strolls, one mile five days a week. The third walked briskly. The fourth race-walked and reached aerobic heart exertion. Aerobic capacity increased with the speed of walking. However, health benefits, notably cholesterol reductions, were the same for all of the walkers.
The nation’s favorite nonaerobic exercise is also a major stress reliever. “Walking is one of the best ways to get fit, healthy, and relaxed, and stay that way,” says Glenn Gaesser, Ph.D., an associate professor of exercise physiology at the University of Virginia in Charlottesville. “I can’t recommend it enough. Walking requires no special training, clothing, or equipment. It’s low-impact, so injury risk is minimal. It’s low-cost—free if you have a good pair of walking shoes. And it’s great fun with friends or kids.”
Next time you feel stressed, call a friend and make a date to take a walk. The exercise will relax you, and from a tend-and-befriend perspective, the company will enhance the benefits.
Companionship: “Be with me.”
Over the past twenty-five years, many studies have shown that social isolation releases a flood of stress hormones that strain the heart, impair immune function, and contribute to depression and anxiety. At the same time, well-developed social networks have been shown to help dam the flood of stress hormones, allowing the body to remain more relaxed.
David Spiegel, M.D., a professor of psychiatry at Stanford University, once scoffed at the health-promoting value of companionship. Then his own research changed his mind. In the late 1970s, he theorized that support groups might help people cope with the stress of terminal illness. He divided eighty-six women with advanced breast cancer into two groups. One received standard medical care, the other, standard care plus participation in a weekly ninety-minute support group. Spiegel theorized that the group would improve participants’ coping abilities, and it did. But it also did something he never expected: It extended their lives. After ten years, eighty-three of the eighty-six women had died, but those in the support group survived twice as long—an average of thirty-seven months compared with just nineteen months for those who received only standard care.
Many other studies have corroborated this finding, showing that compared with loners, people with strong social ties—including good marriages, pets, extensive friendship networks, and participation in religious and community organizations—are healthier, happier, less depressed, and less anxious.
Of course, there are many effective ways to de-stress. But no matter which one(s) you choose, remember to tend-and-befriend. Take a look at your teapot. Perhaps it’s time to get a larger one, so you can brew relaxing herb teas for a larger group.
San Francisco health writer Michael Castleman is the author of ten books, including The New Healing Herbs (Rodale, 2001). Visit him at www.mcastleman.com.