County Health
A Doctor for a Stressed-Out Nation
Dr. Paul Rosch has argued for decades about the ill health effects of undue stress. Are people finally getting the message?
By Karen Pallarito
In late October, national media organizations flooded Paul J. Rosch, MD, with requests for interviews. The American Psychological Association had just released survey results suggesting that one in three Americans is extremely stressed. At least half of us, the survey found, believe that stress is impairing our health, relationships, and productivity at work.
Dr. Rosch, a clinical professor of medicine and psychiatry at New York Medical College and arguably one of the world’s leading authorities on stress, doesn’t seem the teensiest bit agitated by the demands on his time. In fact, he revels in it. “This is not work for me,” the Yonkers native declares. “I can’t wait to get to work in the morning.”
At 80, Dr. Rosch still clocks seven-hour days in his Park Avenue office in Yonkers, where he presides as president of the American Institute of Stress, a nonprofit clearinghouse for stress-
related information, which he runs with the aid of one assistant. (The organization’s website, www.stress.org, is the number one stress-related destination on the web, as ranked by Google.) The Institute is purely a labor of love: Dr. Rosch says he’s never taken a dime in salary and has, in fact, absorbed 95 percent of its expenses over the past three decades at a cost of well over $1 million.
While he retains the title of “senior consultant in medicine” at St. John’s Riverside Hospital down the street, Dr. Rosch essentially is retired from active practice. These days, much of his time is devoted to writing and teaching. And when he’s not working, you might catch him on the golf course or at his home overlooking the ninth green at St. Andrews Golf Club in Hastings-on-Hudson. Despite a frustrating rise in his golf score (Dr. Rosch attributes this to growing older), his health is otherwise good, thanks to good genes. His parents lived well into their 90s, and his brother is still going strong at 91.
Entering the American Institute of Stress is a bit like peeking into the back room of a museum. The musty smell of old books permeates the air and the calming piano of Brahms’s “Opus 119” chimes over the radio. The walls of Dr. Rosch’s office and lobby are spread thick with awards and photographs of famous friends and patients. There’s one of comedian and actor Bob Hope, cited among a list of founding members of the Institute. There are images of distinguished physicians and scientists as well, including Dr. Hans Selye, a Canadian endocrinologist born in Vienna in 1907 who coined the term “stress” as it is currently used. (Before the 1930s, the term “stress” as a description of the mental strain that people experience in their lives was largely absent from our lexicon.)
Dr. Selye’s animal studies at McGill University in Montreal decades ago exposed rats to stressful conditions (torture, by today’s standards), in which, for example, their eyelids were sewed back and bright lights were beamed into their eyes. While scientists used to believe that all diseases had a specific cause, his experiments showed just the opposite: that many different things could cause the same damage to the body. In other words, no matter what type of stress they endured, the animals had some common health effects, like ulcerations in the lining of the stomach. Those early studies laid the foundation for our understanding of stress and its effects on the body.
Having earned his stripes as a physician and scientist, Dr. Rosch seamlessly carries on that work through various avenues, including the Institute’s monthly newsletter, Health and Stress, which examines the latest research on stress and disease. “He has the respect of people not only in the stress field but in general medicine,” says Yonkers native Dr. John H. Laragh, director of the Cardiovascular Center at NewYork-Presbyterian Hospital/Weill Cornell Medical Center in New York City.
When people are under extreme stress, the body reacts in a couple of ways. Acute stress triggers an outpouring of adrenaline, prompting the classic “fight or flight” response that’s protected man from predator since ancient times. Stress also causes the release of a hormone called cortisol. In large doses, cortisol can boost blood sugar, depress the immune system, and cause other damage to the body.
But what causes stress? Is free-falling from a bungee cord stressful? Not to a thrill-seeker! And how much is too much? That breaking point differs for everyone. Likewise, the signs and symptoms of stress run the gamut, affecting our emotions and behaviors in a multitude of ways, from headaches and hives to increased smoking and excessive gambling. What we do know, Dr. Rosch says, is that stress has grown more prevalent in the past three decades, thanks primarily to job stress, and it is exacting a sinister toll on our health.
Wasn’t there always job stress? Sure, but our forefathers, often farmers and craftsmen, labored under a more controlled and predictable pace than workers today, Dr. Rosch reasons, and there was more cooperation than competition, and workers were more likely to see how the fruits of their labors benefited others. “Pride of accomplishment is a powerful stress buster,” he says.
Dr. Rosch argues that stress—not cholesterol—is a major culprit in coronary heart disease. For many years, orthodox medicine did not buy into this view. Many thought Dr. Rosch was crazy, a heretic even, for making such a statement. “No question about it,” he agrees. Lately, though, the Johns Hopkins-trained internist is gratified to see some of his assertions coming to fruition. A recent commentary in JAMA: The Journal of the American Medical Association cites evidence supporting an association between psychological stress and cardiovascular disease. And many traditionally trained physicians now agree that stress plays some role in heart disease, if not a major one. “Stress is a factor,” says Dr. Robert O. Bonow, a professor at Northwestern University Feinberg School of Medicine and chief of the Division of Cardiology at Northwestern Memorial Hospital in Chicago, “but a minor factor.”
Thus, people continue to view
cholesterol as enemy No. 1, and doctors increasingly prescribe cholesterol-
lowering statin drugs, like Lipitor and Zocor, to ward off heart problems, something of which Dr. Rosch is skeptical. “You’ll never get it across to the public because they’re brainwashed,” says Dr. Rosch, who stops short of advising statin users to toss their pills away. He believes that statins are widely overprescribed “because their benefits have been hyped and serious safety concerns have been suppressed.”
Statins do lower cholesterol, Dr. Laragh notes. However, he says: “Despite doing that, nobody’s being saved.” He claims the death rate from heart attack today versus 20 years ago is essentially unchanged. Dr. Bonow offers a sharply different interpretation: “You can’t prove nationwide that the reduction in heart attacks and heart attack mortality is related to statins. You can’t prove that. What you can prove is that statins reduce the risk of heart attacks and that nationwide there’s been a steady decline in the number of people having heart attacks and dying from them over the last twenty years.”
Few quibble about the role of stress in depression and anxiety. One study found that up to 80 percent of people who are depressed have experienced a stressful event in their lives in the three to six months prior to the onset of depression. And stress, some research shows, can set us up for colds and infections, too. In one well-known study, healthy people took surveys assessing their psychological stress, and then each was given nose drops containing either one of five respiratory viruses or saline drops. The upshot? The risk of respiratory infection and colds increased with rising levels of psychological stress. And stress may also aggravate autoimmune diseases, such as rheumatoid arthritis, lupus, and multiple sclerosis.
Could stress be making us fat, too? It’s “a powerful contributor to obesity and overweight,” Dr. Rosch says. When people are stressed, they crave sweets and fatty foods, he says. Plus, studies show that stress increases deep abdominal fat, the most deadly kind; it boosts the risk for heart disease and diabetes.
By reducing the stress in our lives, Dr. Rosch insists, we’ll see not only a significant reduction in disease but a marked improvement in quality of life. One way to do that, Dr. Rosch believes, is to harness the body’s own healing powers. The ancient Chinese called it qi or chi, and in India, it’s known as Ayurvedic medicine. Whatever you call it, suffice it to say that the body and mind impact each other. “For example, there’s no denying the power of a placebo—mind over body—but we’re paying lip service to that,” Dr. Rosch says. “A good scientist says, ‘Well, how does it work?’”
As surprising as it may seem for a traditionally trained physician, Dr. Rosch even endorses a couple of newfangled devices for stress relief, the emWave Personal Stress Reliever and StressEraser. By giving users feedback on their “heart-rate variability,” as he describes it, these handheld gadgets teach people to modify their breathing and, in turn, relieve their stress. The technology is supported by solid, double-blind clinical trials and other scientific studies, Dr. Rosch claims. On Amazon.com, the emWave retails for $179; StressEraser will set you back for $299.
“I have recommended them to a lot of patients, as well as members of my family, and got rave results with both of them,” he reports. They’re calmer, sleeping better, and coping better with stressful situations, according to Dr. Rosch. Yet he doesn’t use the technology himself. “I don’t need it,” he says.
(Of course, there are less expensive ways to cope with stress. “You can go into any discount store where a blood pressure/heart-rate cuff can be purchased to do the same job for a fraction of the cost,” notes Dr. Kathleen Hall, founder and CEO of The Stress Institute, an Atlanta-based center. “They are not as glamorous as the pricier machines, but they get the job done,” says Dr. Hall, author of the book, A Life in Balance: Nourishing the Four Roots of True Happiness.)
What Dr. Rosch recognizes is that some stresses can be quelled while others are out of our control; the trick is to learn the difference. “If a loved one dies, that’s the most stressful thing that can happen to you and it would be abnormal not to grieve,” he says. But some stresses we create, like the fury that mounts within when motorists face a mile-long backup at the Tappan Zee Bridge. Instead of honking the horn and giving people the finger, use the commute to learn a foreign language or listen to a book you haven’t had time to read, he suggests.
Dr. Rosch used to ask his patients what they would like to be doing, say two, three, or 30 years from now. Frequently, the response was a blank stare. “No wind favors a vessel that does not have a port of destination,” he says, paraphrasing the French philosopher Michel de Montaigne. “Too many of us in life are just buffeted about on the seas because we don’t have a port of destination.” Rather, people should set meaningful and appropriate goals, both immediate and long-term, he says, because striving for something and taking pride in one’s accomplishments can do wonders to beat back stress.
The even-keeled stress doctor, of course, knows exactly where he’s headed. His goal is to continue on with his life’s work—and take pride in it. “The most stress-relieving and health-rewarding emotion of all is doing something you enjoy that benefits others,” he says.
Karen Pallarito is a freelance writer in Port Chester who specializes in health. When she’s not stressing over a deadline, she enjoys unwinding with her husband and two boys.
