When I walked up to the glass front door I could see the residents settling in at their tables for dinner. The Activities Director saw me standing there and came over to the locked door. She cracked the door open just enough for me to slip an envelope addressed to Mom into her fingertips.

I’m concerned that the stress associated with our response to the Coronavirus pandemic will cause more long term harm than the virus itself.

It’s hard not to be worried and fearful when all media is devoted to breathless reporting on national and worldwide infections and death rates.  I’ve noticed The Tennessean newspaper has shortened their sports coverage and added a new section called “Coping“.  In addition to the disease itself, we are feeling the financial pain of crashing markets and worry about our friends and loved ones losing their jobs.  Stress and worry increase when we don’t feel in control of our lives.

Worry increases our physical stress response. We’re all familiar with the stress response.  It’s that feeling you get when you narrowly miss a car wreck, or you see blue lights flashing in your rear view mirror.  Our adrenal glands pump out adrenalin and cortisol.  Your heart starts to race, there’s tightness in the chest, and the palms get sweaty.  It’s the same stress response that gives us the sudden surge of strength to scamper up a tree to escape a vicious animal, or to lift the wheel of a car off an injured child.

Once the immediate danger passes we gradually calm back down.  However, if the stress is sustained our adrenal glands continue producing adrenaline to the point of eventual fatigue or exhaustion.  This is when we get into trouble.

Here’s a partial list of symptoms we may feel when we’re under sustained, unhealthy stress:

• General irritability, hyper-excitement or depression
• Pounding or racing heartbeat
• Dry mouth and throat
• Inability to concentrate on the task at hand
• An overwhelming feeling of needing to cry or run away
• Easily fatigued, or loss of zest for life
• Anxiety, or a feeling of panic
• Trembling, nervous tics, a tendency to be easily startled
• Feeling “keyed up”
• Grinding your teeth while sleeping
• Insomnia, can’t fall asleep or stay asleep
• More frequent urination
• Diarrhea, indigestion, nausea or pooting
• Migraine or tension headaches
• Missed, delayed or altered menses
• Changes in appetite
• Loss of libido or ED

Over time the adrenal glands will enlarge to meet the increased demand, but eventually they fatigue and fail to respond the next time we need a healthy stress response.

With prolonged excessive stress the adrenal glands, the thymus gland and spleen begin to atrophy (shrink). All three glands are critical parts of our immune system. This leaves us with a compromised immune response and vulnerable.

Excess, prolonged stress suppresses our immune response and makes it more likely we’ll get sick.

I’m concerned the increased stress level over time will lead to an increase in many maladies including a significant increase in the prescription of anti-anxiety drugs. There will be more high blood pressure, strokes, auto-immune conditions, migraine and tension headaches, emotional instability in adults and children, poor sleep quality, PTSD, digestive issues, irritability, cancers, back and neck pain and an increase use of alcohol and recreational drugs.

I can recall a few cases over the years where the was a sudden, unexpected stressful event in the life of a seemingly healthy person, and within a year or two they were diagnosed with a life changing disease process. I’ve often suspected there was an un-researched connection between the distress and the subsequent disease process.

Persistent stress has an adverse impact on our health and longevity.

I don’t want to present a problem without a solution, so what do we do?

Focused Diversion

Hans Selye, MD, wrote in his 1956 book, The Stress of Life, “Nothing is accomplished by telling people not to worry.” Can you recall being worried about something really important to you and a friend or loved one told you “Just don”t worry about it”, or “It won’t do any good to worry about it”? Not helpful.

Dr. Selye also wrote, “Nothing erases unpleasant thoughts more effectively than conscious concentration on pleasant ones”. I think that’s the key.  He goes on to explain the concept of “focused diversion”.

In other words, find an activity, consistent with your personality, to divert your attention to something else. If you are naturally a very active person, find an active diversion. You wouldn’t be happy if you were forced to lay around and be lazy. Find an activity that is active. Mow your own yard, hand wash your car, take a hike in the woods, or start and finish a project you’ve been putting off. Likewise, if you are more naturally a calm, sedate type person you probably wouldn’t enjoy doing yard work, etc. Find something more consistent with your personality that causes you to focus on something else. Try a jig-saw puzzle, watch an old movie, fly a kite or take a leisurely stroll around the block.

The idea is to find an activity, consistent with your personality, that causes you to focus on something other than the doom and gloom that can be so overwhelming.

Rest and work must be balanced based on our individual needs.  Focused diversion is an effective tool to manage stress.

The envelope contained a letter to my 92 year old Mom who has lived in a retirement home since Dad passed away a little over three years ago. Every evening on my way home from the office I stop and see Mom. This was the first time I couldn’t get in to see her. Mom’s memory is slipping and the letter was a simple explanation of why the facility was closed to visitors and why I wouldn’t be able to see her for a while. I expect she’ll lay the letter on her dresser, and due to her fading memory, reread it often as if it were the first time.

My evening and weekend visits with Mom are typically brief, but I usually take a few extra minutes to visit with some of the other residents I’ve come to know.  Some of these older folks rarely, if ever, see family. Most are old enough to have lived through the Great Depression and WWII. They’ve raised children and supported their spouses for a lifetime. They are the parents of our current leaders. They made us who we are. They’ve paid the dues of life and have earned the right to finally take a rest, relax and enjoy the time they have left. It is our responsibility to honor, care for, and protect them. They are often referred to as “The Greatest Generation”. How will history refer to ours?

Let’s do our best to protect all the moms, dads, grandmas and grandpas out there so their remaining years are as happy and healthy as they can be. They deserve it.

Dr. David Pence