A groundbreaking book by two physicians revealing how stress devastates women's bodies and revolutionary treatments to defeat stress and its effects.

Stephanie McClellan, M.D., and Beth Hamilton, M.D., both educated at USC, have founded a thriving, innovative practice specializing in gynecology and women's health based in Newport Beach, California. Dr. McClellan has served as chairman of the Obstetrics and Gynecology Department and as a consultant to Hoag Memorial Presbyterian Hospital in Newport Beach for ten years and helped found their renowned Women's Health Pavilion. Dr. Hamilton currently works for Kaiser Permanente.

Authors' Note: Standing in the Gap (Or Why We Are Writing This Book)	p. xi
Introduction: Why Are Women So Stressed?	p. xix
Identify Your Stress Type
How Stress Looks	p. 3
The Psychology of Stress	p. 13
The Anatomy of Stress	p. 41
Identify Your Type: The Four Stress-Response Patterns	p. 63
The Stress-Detox Programs
The Foundations of Stress Relief: Relaxation, Restorative Sleep, and Natural Rhythms	p. 91
Nutrition	p. 122
Exercise	p. 168
Restoration: Techniques to De-stress	p. 197
The Stress-Detox Program for Your Type	p. 237
Afterword	p. 267
Selected Bibliography	p. 269
Acknowledgments	p. 298
Index	p. 301
Table of Contents provided by Ingram. All Rights Reserved.

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INTRODUCTIONWHY ARE WOMEN
SO STRESSED?

With all that is going on in the world, it’s no wonder that we are experiencing a stress epidemic. It’s time to learn about the toll that stress takes on your well-being. Research has shown that the effects of stress are more extreme for women than for men: women release more of the chemical triggers for stress, and these hormones remain longer in a woman’s body than a man’s. Female hormones directly influence your response to stress. Women also appear to be more susceptible to the physical symptoms of stress due to gender differences in brain processing, which we will explain later. As a result of these biological differences, women tend to be more sensitive to stress, and the stress response lasts longer in the female body than in the male.

MULTITASKING YOUR WAY TO EXHAUSTION

Even though women are biologically equipped to do many things at once, we never seem to have enough time to do all that we need to do. Our brains are actually hardwired to enable us to multitask, so, because we’re good at it, we push the envelope and try to do more, thinking we can handle just one more thing. But whenever we try to do too much—and what woman doesn’t—we create a nagging sense of urgency and the feeling that we will never catch up. We race from one activity or chore to another, stretching ourselves to the limit, rarely taking time to relax. Women are also conditioned to be responsive to others’ well-being and to try to please. This nurturing tendency makes us susceptible to higher stress levels when we take on too much and find ourselves on overload.

Most women have numerous roles and are expected to assume all or some of the following:

Wife	Chauffeur
Mother	Tutor
Daughter	Mediator
Health care provider for a parent	party planner
	Life coach
Sister	Volunteer
Friend	Interior decorator
Employee	Hair stylist
Household manager	Dog walker and trainer
Cook/nutritionist	Nurse
Personal shopper	Laundress
Crisis manager	Fitness and nutrition advocate
Cheerleader	Financial manager/bill payer
Social director	Gardener
	Housekeeper

Some believe that the greatest contributor to the epidemic of stress among women now is that they are working outside the home in record numbers. At the turn of the twentieth century, only 12 percent of women were paid a salary for their work; today, we comprise 46 percent of the workforce. Seventy percent of mothers with children under the age of eighteen now work. Either raising children or working requires much more than half our attention, on top of which working women still have primary responsibility for child care and household chores. A worldwide survey of women between the ages of thirteen and sixty-five found that women who work full-time and have children under the age of thirteen report the greatest stress.

Working mothers can become stressed because they feel guilty for leaving their children. Yet women who choose to stay home to raise their children often feel isolated and stressed because they are not contributing financially. Their husbands often have to work long hours as the sole income earner, which can also become a source of friction. And married women who have not worked outside the home or who are widowed or lose their financial security after a divorce have multiple financial stresses and usually a marked decline in their quality of life.

A recent American Psychological Association Poll (2007) found that 48 percent of Americans say they are more stressed now than they were five years ago. Money and work top the list of what 75 percent of Americans worry about, a big leap from 59 percent two years earlier. And that poll was taken before the global financial crisis of fall 2008. The impact of this constant stress is staggering:

Forty-four percent of all adults suffer adverse health effects from stress.
Ninety-five percent of all office visits to physicians are for stress-related ailments.
Stress is linked to the six leading causes of death: heart disease, cancer, lung ailments, accidents, liver disease, and suicide.

Two kinds of stresses are at work on all of us every day—chronic and acute. Chronic stress is long-term, unrelenting, and seemingly inescapable; it wears down your body, mind, and spirit. Acute stresses—life’s traumatic events and most-challenging situations—can also send your stress levels off the charts.

THE TWO BASIC RESPONSES TO CHRONIC STRESS

After caring for thousands of patients at OC Gyn, we have seen that women have two basic responses to stress—hyperactive and hypoactive. With a hyperactive stress response, you’re frantically trying to wrestle with everything that’s troubling you at once; a hypoactive stress response is when you are too drained to deal with even the most-pressing problems. Of course, the line between hyperactive and hypoactive is a dynamic one, and patients’ symptoms can vary in different situations; often, they move somewhere along the scale between the two. Wherever you are on the continuum of hyperactive stress response or hypoactive stress response, you’re not feeling well.

The two basic stress responses break down into four types of stress-caused imbalance that can vary in degree from mild to extreme. Each type displays its own symptoms and each has particular tendencies to develop certain diseases. Specific diet, exercise, and relaxation techniques create physiological effects that bring the body closer to balance. The point from which you start is what matters. Different imbalances respond to type-specific relaxation techniques and diet and exercise tailored to the individual.

Today, most people expect and sometimes demand that doctors help them by prescribing a pill that will make them feel better. But at OC Gyn, we do not pull out the prescription pad quite so readily. We prefer to educate our patients about the consequences of long-term stress and then to develop individualized stress-relief programs that address their imbalance.

The four type-specific programs for diffusing stress that we’ve devised are far more powerful than any pill available, and their side effects are beneficial. By learning how to defuse stress in a way that works for you, you can take control of your health and prevent more serious diseases from developing. If you already have an illness, reducing stress will help your body deal with the illness and help you heal.

First, we tell you what stress looks like, its outward signs, and give you a sense of how it affects your behavior, emotions, and health. In chapter 2, “The Psychology of Stress,” we explore how your perceptions of stress and certain patterns of thinking often evoke the stress response. Then, in chapter 3, we describe “the anatomy of stress” and how your body is wired to respond. We help you determine which of the four types of stress response is your type and show you how to alleviate your stress using healthy, sustainable techniques.

We’ll examine the negative effects of stress, including the complaints we hear most often and the conditions we see—weight gain, fatigue, chronic pain, cardiovascular disease, and metabolic syndrome, a group of risk factors that include weight gain around the abdomen, high cholesterol, high blood pressure, and a high inflammatory response. We’ll show you how to combat these and more in part 2, “The Stress-Detox Programs,” in which we describe the anatomy of relaxation, methods for changing your psychological and physiological response to potentially stressful situations, with specific recommendations about diet, exercise, and relaxation techniques to help you avoid the negative effects of stress or to reverse any harm that has already been done. We provide you with a Stress Program Log that you can use to record your commitment and progress in these areas. We also suggest you keep a Stress Journal as you read through the book to keep track of the information that relates specifically to you. With the simple, scientifically based methods explained in “The Stress Detox Programs,” you deal effectively with the way your body responds to stress.

Once you understand what out-of-control stress does to you, we hope that you will be inspired to trust in your own power to withstand it and to make choices in your life that will promote your good health, resilience, and pleasure.