Juggler’s Syndrome

As a physician involved in preventive medicine, I often ask my
patients how they rate their current level of stress. Few ever say
their stress levels are low. Most admit they’re completely stressed
out. In the process of exploring why, I’ve discovered a common
denominator. These people feel overloaded. Most of us are trying to
do too much. And it’s a hard habit to break, because our age views
multitasking as the normal way of getting things done. If we’re not
juggling a dozen different commitments at once, we tend to think
there’s something wrong with us.

From a medical perspective, however, the opposite is true.

Scientists are studying what happens to us when we try to do too
much for too long, and the results are eye-opening.

There’s no doubt that the human body is exquisitely adapted to
deal with stress in brief doses. Our ‘fight or flight’ response is
one example of the way that short bursts of heightened energy and
vigilance can actually save our lives. But we aren’t well adapted
to deal with surges of adrenaline and cortisol — two major stress
hormones — day after day. In evolutionary terms, traffic jams,
two-career marriages, and kids involved in six after-school
activities were not part of the plan.

Bruce McEwen, director of the neuroendocrinology lab at
Rockefeller University, has studied the wear-and-tear effect of
chronic stress on rats. As he describes in a book he co-authored,
The End of Stress as We Know It (Joseph Henry Press,
2002), McEwen and his colleagues began restraining lab rats during
their normal resting period. The resulting surge in stress hormones
began to drop off earlier each day as the rats seemingly grew
accustomed to the ordeal. But within three weeks the chronic stress
began catching up with them. They grew anxious and aggressive.
Their immune systems weakened. In their brains, the nerves in the
hippocampus, a region involved in memory, began to shrink and
stopped regenerating. The rats were burning out.

It appears that humans respond in much the same way. Chronically
high cortisol levels lead to a number of health effects, including
insulin resistance and poor sleep patterns. This reinforces bad
eating habits, which then can trigger a fatigue that saps our
desire to exercise. It’s a vicious cycle. High cortisol levels can
also lead to the production of cytokines, a protein that promotes
inflammation. Cytokines have been linked to heart disease,
depression, and inflammatory illnesses like arthritis and
fibromyalgia.

Eventually, chronic stress can overtax the endocrine glands that
make cortisol and other hormones, including the adrenal glands
(atop the kidneys) and the thyroid (in the neck). Given that the
endocrine system controls so many crucial processes in the body,
depleted hormone levels can seriously disrupt our health.

I saw a man not too long ago who could only get five or six
hours of sleep. We ruled out the obvious causes for insomnia,
including sleep apnea, restless leg syndrome, depression, excess
caffeine, and chronic pain. He was a doctor who often found himself
lying awake at night thinking about his responsibilities. Along
with his sleep problem, he had begun having bouts of atrial
fibrillation, a disorder marked by an irregular heartbeat. He had
begun to feel very ‘old.’

Endocrine tests revealed low thyroid activity as well as
extremely low levels of testosterone and cortisol. Thanks to a look
into his brain via MRI, we noted that his pituitary gland, a key
regulator of the endocrine system, had shrunk as well.

The treatment was two-pronged: We put him on hormone
replacements, and he retired. In his words, ‘the stress was just
too much.’ Within six months he reported feeling well, his dentist
noted that his gums were ‘rejuvenated,’ his sex life improved, and
so did his heart irregularity. Even more interesting, he started
getting the restorative, undisrupted sleep he badly needed.

What started his troubles? We had no definite answer. His sleep
problems may have been caused by his endocrine disorder, but there
was another possibility. It could be that his overloaded life led
to chronic stress, and the resulting cascade of ill effects
included a withered endocrine system. If I had to hedge my bets,
I’d go with the latter explanation.

Chronic stress has been shown to weaken our immune system,
strain the heart, damage memory cells in the brain, and cause the
insulin resistance that leads to type 2 diabetes. It has been
implicated in cancer, depression, and even rheumatoid
arthritis.

The bottom line is that we need to take responsibility for
slowing down. To a stressed-out patient (or friend) I’d say: Try to
limit your commitments. Give yourself time to rest, to exercise,
and to eat sensibly. Stop at one drink, limit the caffeine, and
definitely don’t smoke cigarettes. Here’s one more: Control your
impulse to multitask! In the effort to do too much, we actually
accomplish less. Rediscover the pleasure and surprising efficiency
of doing one thing at a time. Most of us harbor a nagging belief
that a slower life is a luxury we can’t afford. Our bodies tell us
otherwise. Slowing down is essential to our health.

Dan Beskind, M.D., M.P.H. is medical director of Southwest
Preventive Health, an integrative health center located in Tucson,
Arizona
(www.southwestpreventivehealth.com).
He also lectures on preventive health and hosts a radio show on
KNST in Tucson called
An Ounce of Prevention.

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