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VOL. 37 | NO. 43 | Friday, October 25, 2013

So Nashville’s the 6th-most-stressful city in the US (really?) Deal with it!

By Joe Morris

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Nobody likes to be stressed out. And since they say misery loves company, so the 650,000 or so people who live in Metro Nashville need only to look around to find a kindred spirit or three.

Sharecare, an online health and wellness community founded by Jeff Arnold and Dr. Mehmet Oz, lists Nashville as one of the country’s top 10 most-stressful cities, checking in at No. 6 between Hartford, Conn., and Salt Lake City.

Greenville, S.C., is the most stressful.

Keeping those in-state rivalries alive, Knoxville hit the list at No. 8.

Memphis, meanwhile, is No. 9 on the list of least-stressed locales.

The rankings were compiled using data from a sample of 250,000 RealAge Test respondents, material that’s used to determining the Youngest and Oldest Cities ranking for the site, says Dr. Keith Roach, chief medical officer of Sharecare and creator of the RealAge test.

“We looked only at people who had answered the questions in the last year, which was about a million people, and then information from the 50 largest cities,” Roach says.

“People identified themselves as living in a given zip code, and so we mapped that to metro areas.

“Every year we look at factors that affect longevity, like blood pressure, smoking levels and cholesterol, but we also look at things that don’t get as much attention, such as how people feel.”

To that end, stress was scored by taking components of the test that asked about how much stress the participant was feeling at home or at work, as well as financial stress and stressful life events.

“We have some very good data showing that if people have more than one stressful event, such as a job loss, in a year, they are at higher risk for heart attacks and other problems,” Roach explains.

“In cities where there is a lot of underemployment, for example, where people aren’t working or have to take a second job to meet expenses, there was a higher level of stress.”

Given that the employment picture in Nashville isn’t significantly worse than other parts of the country, its stressors likely come from different areas. Whatever they are, they should be handled with speed and efficiency, says Dr. Tobi Fishel, director of psychological services at the Vanderbilt Center for Integrative Health.

“More than 85 percent of our illnesses and doctor visits are stress related,” Fishel says. “It’s essential for mental and physical well being to look at this issue, which is quite complex.”

Fishel specializes in body-centered psychotherapy and mindfulness, practices that help with chronic medical conditions and chronic pain, but also can do much to examine and deal with stress, once it has been properly defined.

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“Many people think that stress just means things are a little skewed; it’s highly subjective,” she explains. “What is stressful for you isn’t as much for another person: If I bump my knee, that’s not stressful. But if you have a history of knee problems and have had three operations, then that bump is going to feel completely different.”

Hans Selye coined the term “stress” in 1936, Fishel says, to define a response of the body to any demand for change. That’s important, she says, because it factors in the good as well as the bad.

“We often think of stress as something negative happening, but any demand, even a fun and positive one such as planning for a wedding, or a new baby, can be stressful,” Fishel says. “All these events have a huge impact on our physical well being.”

The trap, she adds, is that often people will tackle a project that’s not too demanding, or assume new responsibilities at work or at home, and then keep on, and on, until eventually they are overwhelmed.

“The body can only shift and accommodate for so long, and over time chronic stress can cause multiple issues,” she adds. “Sometimes people self-medicate by drinking or smoking more, which leads to other complications. But adrenal fatigue, headache, migraine, back pain, hypertension and more are all related to stress.”

What to do? The first step to solving a problem is recognizing that you have it.

“Self awareness is a very positive thing,” Fishel says. “Sometimes you end up on auto-pilot with so many demands. People who like to do a lot of things, the real go-getters, usually don’t stop and think, ‘Should I say yes to this?’

“It is very healthy to practice mindfulness – take a breath and ask yourself what your body is feeling right now. If you do that, you will get more clarity and begin to see the forest for the trees.”

Fishel also recommends meditation, as well as mind-body practices such as yoga, tai chi and chi gong, as ways of slowing down and reconnecting with your body.

In addition to lowering stress hormones and helping to build new neural pathways in the brain, they’re also good exercise. And she also says that the importance of community can’t be overlooked.

“Having a place where you can share what your stressors are, not just talking to people but actually finding people who are worthy of talking to, is an important concept,” she says.

“It is very healthy to have a group of people who are non-judgmental and let you develop connections as you share what your stresses are. And it also lets you be creative.

“I have a group where, no matter how deep and heavy the conversations have been, we always do the hokey-pokey and have some time for laughter.”

Roach agrees, noting: “The No. 1 thing to fix high stress is to have a social network. Get out and talk to friends and family in person, face to face, to let people know what’s going on.”

Lastly, keep in mind that dealing with the effects of stress will only take you so far; the root cause must be examined.

“If we are coping by staying in the same situation, whether it’s a bad job or bad relationship, then we are chronically under the same stress,” Fishel explains.

And don’t beat yourself up too much for having stress in the first place, Roach adds.

“If you have a big project due, or exams coming up, the stress you have can motivate you to do better,” he says.

“That is not a bad thing. There are optimal levels of stress that help you do the right thing.

“If someone says they never have any stress, I’d wonder about them. It’s hard to imagine living in this world, right now, with none at all.”

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