Stress Talk With Dr. Lori Mosca

CBN.com Nearly 2,500 Americans die of cardiovascular disease each day, an average of one death every 35 seconds. So why don’t we do more to prevent it?

Dr. Lori Mosca, physician and author of Heart to Heart, says you can reduce your risk of getting heart disease by losing weight and exercising. She also recommends turning off the TV, spending more time with your family, and getting involved in your church or community. By learning how to better manage daily stress, you will be on the road to a healthier heart.

Pat Robertson: Dr. Lori Mosca is here with us with more on how to beat stress. And, doctor, you certainly are a living example of a healthy life.

Dr. Lori Mosca: I try.

Pat: You look so young and vibrant. I won’t go into your age, but you sure look great.

Dr. Mosca: Thank you.

Pat: What’s the secret? What is the whole thing about stress? What does it do to you?

Dr. Mosca: Well, Pat, stress originally was a way for us to survive. It was really built to be a fight-or-flight response, and to protect us by increasing the heart rate and the blood pressure so that we could escape predators. But now, in modern days, it’s these chronic low levels of stress that are releasing these hormones that actually are damaging to our blood vessels and to our heart.

Pat: So the tiger isn’t really going to eat us. We just think they’re out there.

Dr. Mosca: Yes, a different kind of tiger.

Pat: Well, a certain amount of stress is OK, then, because you do flee the danger. But what are these people that have chronic stress? How come they’ve got it all the time?

Dr. Mosca: Well, chronic stress is really related to the fact that our body is not able to respond to the constant demands on it. And it’s that inability to meet the demands that leads to stress. This can be caused by emotional factors, environmental factors, and physical factors.

Pat: I was reading something about caregivers, women who are caregivers to an infirm, elderly parent or a child that’s handicapped or something. That kind of stress is never-ending.

Dr. Mosca: Absolutely, Pat. I mean, in today’s society, not only are we dealing with job strain, but many of us are involved in multi-tasking. We’re taking care of parents. We’re taking care of children, spouses. It seems to be a never-ending list of demands on us, and I think this has led to a lot of the chronic, stress-related illness that we’re seeing.

Pat: What are those illnesses?

Dr. Mosca: Stress really has two effects on the body. One of them is direct, and the other is indirect. So, as we talked about with the flight-or-fight response, the body actually responds by increasing the heart rate, the blood pressure. Another thing that happens is hormones are released that cause cortisol to be released, for example, adrenaline, and this can lead to an increase in the fat being deposited in the abdomen. I brought my five pounds of fat here to show you.

Pat: Wait a minute. Wait a minute.

Dr. Mosca: So stress can lead to actual fat being deposited . . . .

Pat: That sucker is—this is five pounds?

Dr. Mosca: That’s five pounds of fat.

Pat: That’s ghastly!

Dr. Mosca: And this also gets deposited in those coronary arteries that feed the heart.

Pat: Now, the cortisol does that, which in turn causes insulin to spike, which in turn causes fat to get deposited.

Dr. Mosca: Right. This fat is associated with high blood pressure, abnormal blood cholesterol, and pre-diabetes. So that’s one of the direct effects. But the other thing that we have to worry about with stress is the adverse effects that it leaves in terms of our lifestyle. It causes us to overeat. It causes us to turn to things like alcohol, being physically inactive, socially isolated. So we have these two factors, really, at play.

Pat: How many years would you lose in your lifespan with that?

Dr. Mosca: Well, that’s hard to predict, but we know that, for example, about 30 percent of the heart attacks that we’re seeing in one major international study could be ascribed to psychosocial and stress-related factors. So it’s very impressive.

Pat: Interesting. This is hard to start a personal plan of creating a heart healthy family. What do you tell people to do? You’re a preventive cardiologist.

Dr. Mosca: That’s right. I love that. But I think about it as the three P’s, because obviously, we can’t escape stress. It’s all around us. But we have to increase our coping skills. So as a preventive cardiologist, I say, number one, prevent stress through good planning. In my book Heart to Heart, I talk about families getting together on Sundays. You saw a picture of our family. That’s what we do in the afternoon. We prepare meals for the week, so that during the week when we come home from work late, we’re not stressed out and turning to fast foods. Also, P is for positive replacement therapy. Instead of reacting to stress with a negative behavior like smoking or eating, choose a positive behavior, like going for a walk, taking some time for meditation or prayer. And number three, the last thing is peace. I think it’s very important that we find peace in our lives. I talk about the inner sanctuary in Heart to Heart. We’re leading these over-stimulated, incredibly busy lives, and we need to find places where we can have some down time and relax. Also, I think it’s really important that we find peace and meaning in our lives. Pat, I’ve seen people in retirement that are more stressed out than some of the CEO’s that I treat in my practice.

Pat: Why? What’s stressing them?

Dr. Mosca: It’s a really interesting phenomenon. I think that sometimes they’re not at peace. And they don’t have the meaning that they used to have. So I like to talk to my patients about finding ways to think about the good things in their life. One of the strategies that’s used for stress management is journaling, writing down things so you can sort of vent. I like to turn this into a positive. Why not write a thank-you note? Think about how hard it would be to feel depressed and stressed at the same time you’re feeling gratitude. So I’m on a campaign for people to write thank-you notes.

Pat: And that relieves stress?

Dr. Mosca: Yes.

Pat: Thank you. Well, it really is good because the Bible says, ‘A merry heart doeth good like medicine.’ So you’re having a merry heart, and you’re saying, ‘Well, aren’t you nice?’ You write letters and that reinforces positive thought.

Dr. Mosca: It really does.

Pat: So people, they get high blood pressure. They get fat. What does it do to their minds?

Dr. Mosca: Well, I was going to say, too, in addition to the other physical things that we know about, it also depresses the immune function, so we get more infections. It’s been linked to cancer. And in terms of the mind—that’s a really good point—it’s been linked to a lot of mental disorders. Depression is closely related to stress. We found in our research that people are suffering silently with this. We doctors do not bring this up. We’re not looking for it. It’s not easy, Pat, for us to measure stress. So it’s not like cholesterol or blood pressure: I can see a number, and I can fix it. But with stress, it’s very hard. So we tend not to open that conversation up. I think that people have to be more proactive about learning. Do they have some signs of stress -- feeling irritable, having difficulty sleeping, losing or gaining weight? Loss of pleasure in activities that you normally find pleasure in is a very important sign of depression, as I mentioned, which is linked to stress.

Pat: I take Business Week magazine, and this cover was ‘Are We Moving Fast Enough to Meet the Competition?’ That’s a totally stressful cover. When I worked in business in New York years and years and years ago as a young trainee, I was working on an executive ulcer and also arthritis, because of the stress.

Dr. Mosca: Absolutely. Stress is a biological response, and it absolutely affects how our body functions. That’s why it’s so important for us to try to get a grip on it and to learn to cope with stress in a positive way because we absolutely can impact our body in positive ways if we choose to.

Pat: Well, I’m all for it. Ladies and gentlemen, this lovely lady on this cover—she’s exhibit A for a stress-free life.

Dr. Mosca: I was going to say there is one other thing that causes stress: life events, sometimes negative events like loss of a loved one. But positive events can be stressful, too, like Christmas and birthdays. I heard it was your birthday, so I brought you a little gift from New York.

Pat: Oh, isn’t she sweet? Thank you. (Holds up mug)

Dr. Mosca: It’s to remind you an apple a day can keep all the doctors away.

Pat: The Big Apple. We love New York. Doctor, thank you so much for being here.

Dr. Mosca: Thank you. My pleasure.