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PERSONAL HEALTH
Give More Joy to Your World: Cut Holiday Stress
By JANE E. BRODY

Few people would disagree with the observation that this is the most stressful time of the year for most people, men as well as women. Holiday preparations, planned vacations, gifts to buy and wrap and send, homes and yards to clean and decorate, bothersome relatives you "must" spend time with, kids home from school, end-of-the-year deadlines.

Let's see, have I left anything out? Oh, yes, painful reminders of lost loved ones who won't be around to share the joy ? and stress ? of the weeks ahead.

To experts in the relatively young field of medicine called psychoneuroimmunology, or P.N.I., it is no surprise that many people get sick or experience flare-ups of chronic illnesses while struggling to cope with the stress-inducing demands of the holiday season.

Integrating Mind and Body

Psychoneuroimmunology is the study of the way emotions, the nervous system (read brain) and the immune system interact. The slowly accumulating, incontrovertible evidence confirms what most people have long known but that many doctors these days seem to have forgotten: that mind and body are integrated parts of the human organism and constantly "talk" to each other through chemical and cellular signals. In other words, what affects one affects the other, positively and negatively.

Of course, doctors have long known that stress brings on an outpouring of hormones from the adrenal glands. These are the chemicals that aid survival ? the "fight-or-flight" hormones that throughout evolution enabled us, and other animals, to defeat or escape from our enemies. Only now these hormones are called into play for all kinds of reasons that have little or nothing to do with survival and may, in fact, undermine our chances of remaining healthy and energetic.

What many doctors fail to take into account is the effect of a constant or oft-repeated outpouring of these hormones on physical well-being. It is now known, for example, that undue stress inhibits the responsiveness of the immune system, especially the natural killer cells and macrophages that are the first-line warriors against infection and foreign invaders like cancer cells.

Chronic stress can also raise blood pressure and blood sugar, constrict major arteries and interfere with normal digestive processes. These effects, in turn, increase the risk of hypertension, heart disease, strokes, chronic reflux disease, diarrhea or constipation, and insulin resistance, the precursor of Type 2 diabetes.

And one of the main stress hormones, cortisol, fosters deposits of fat, especially around the abdomen, which increases the risk of heart disease. Excess cortisol may also contribute to the galloping rate of overweight and obesity.

Ways to Counterattack

But enough of the bad news. What, if anything, can you do to control your stress reactions and reduce the risk of pesky and serious illness?

There is no getting around the fact that this time of year places great demands on time and energy for many people, including me.

This year I added to the challenges of the season by scheduling a three-week bicycle trip between Thanksgiving Day and Christmas. Not only did I have to get all my work done in advance, train for the demands of daily biking and make the necessary preparations for travel, but also get holiday preparations under way to avoid a last-minute panic when I return four days before Christmas. It was no surprise to me that a minor cold I caught at the end of October developed into bronchitis.

So this column is as much a reminder to me about ways to reduce the damaging effects of stress on the body.

PLAN AHEAD This is a lesson for next year, and other demanding times ahead. Make a list of everything that has to be done well in advance, then create a timetable for doing it, leaving some unscheduled time for unexpected delays or distractions. I try to buy as many holiday and birthday gifts as possible throughout the year, label and store them until needed.

DON'T PROCRASTINATE Do what you can as soon as you can. Undone chores hanging over your head are mind-cluttering and stressful; doing them creates a sense of relief and accomplishment.

DELEGATE DUTIES Divide up household chores among all members of the family old enough to talk. Ask some of your guests to contribute part of holiday meals. Hire people to do tasks that you find unpleasant or that can easily be "farmed out." Temporarily employ an assistant who can help with demands at work. There are lots of computer-savvy, ambitious young people out there who are eager to get job experience and earn some extra money.

BE REALISTIC An overblown notion of what can reasonably be accomplished in the time available is a common source of excessive stress. Eliminate time-consuming tasks that will add relatively little to holiday enjoyment or that can be done some other time or for another occasion. Plan holiday meals that normal people can be expected to consume. No one needs ? and few want ? a Roman feast. Do most of your shopping from catalogs or online; what you may pay for shipping will be far less than the cost of getting it yourself.

GRIN AND BEAR IT For those people you have to see but would rather not, like the aunt who is always telling you what to do, the brother-in-law who brags incessantly or the cousin who regales you with details about every one of her ailments, either ignore them or try to take them less seriously. See if you can find some humor instead of annoyance in the situation.

Setting Priorities

All too often when people get very busy and short of time, care of the self comes last. But thoughtless eating and skipping meals, skimping on exercise, getting too little sleep and failing to allow for some downtime can take the biggest toll of all.

The health of your immune system depends on nutritional adequacy ? optimal amounts of nutrients like the B vitamins, vitamins C and D, beta carotene and other carotenoids, zinc and selenium. That means a diet rich in fruits and vegetables, whole grains, dried beans and peas, along with lean meats and poultry, fish and low-fat dairy products. A one-a-day type multivitamin/mineral supplement may help if you fall short in some areas, but you should not depend on supplements to provide a wholesome diet.

Regular moderate exercise also strengthens the immune system, although exhausting exercise can have the opposite effect. Physical exercise is one of the best ways known to reduce stress. Try an hour's brisk walk with one or more friends five or more days a week; your body and your mind will be ever so grateful. Yoga, lap swimming and water aerobics are especially relaxing.

Stick as closely as possible to your normal bedtime hours, and beware of caffeine or alcohol consumption late in the day. It can interfere with a good night's sleep.

Finally, factor in some relaxation. Have tea with a friend, attend a concert, knit or crochet (as long as it is not against a deadline), play solitaire, practice meditation, treat yourself to a massage ? anything that you find calming.