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I Think I Can (Be Healthy)

来源:www.webmd.com 作者:AnneScheck 2006-8-16
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摘要: I Think I Can (Be Healthy) ByAnneScheck WebMD Feature Feb。 Medically reviewed by doctors at Beth Israel Deaconess Medical Center (BIDMC), Harvard Medical School。...


I Think I Can (Be Healthy)


Feb. 20, 2002 -- What makes Carrie Tone run? Not a healthy heart. Hers isn't.

This energetic 80-year-old had a stroke three years ago. Now her heart sometimes beats so unevenly that she jokes it'll never tick steadily again. But that doesn't seem to hold her back: She still makes the best apricot preserves this side of her native Mississippi, and with a little planning she can juggle all four grandchildren at once.

Tone, the wonder of her neighborhood, is just the kind of woman some heart researchers want to take a hard look at. They already know that reducing high cholesterol and lowering high blood pressure can lessen a person's risk of getting coronary heart disease. Now medical investigators are probing how having a positive personality -- Tone is an indomitable optimist -- might do the same thing.

It used to be that when doctors talked about personality traits and heart disease, they mainly talked about so-called "type A" personalities -- hostile, time-driven people who seemed fated to fall prey to heart attacks. But there's a new category doctors are now using to predict risk -- type D. The "D" is for "distressed" -- and Tone is about as far from being diagnosed with this heart attack risk as you can get.

From A to D

At the 2001 annual meeting of the American Heart Association, researchers pondered the implications of the type D personality on heart health. According to Lynn Doering, RN, DNSc, associate professor at the UCLA School of Nursing, we recognize type D personalities by their negative feelings: The glass is always half-empty, never half-full.

Doering says that the relationship between negative emotions and lower long-term survival of patients with heart disease is already well established. But most past studies have looked only at clinical depression. One recent example, called the Baltimore Epidemiologic Catchment Area Study, showed that people who have been diagnosed as having major depression have a significantly greater risk of developing heart disease than others, Doering says.

But what about those people who don't have symptoms of full-blown depression but still tend to think pessimistically? What about the type D personality, in other words?

A flurry of European studies has demonstrated that this type D individual -- a "negative thinker" who worries over small, everyday events -- is four times more likely to have a heart attack than others, according to Johan Denollet, PhD, a professor of health psychology at Tilburg University in the Netherlands. Denollet has authored three of the studies, involving a total of 700 heart patients.

Pessimists Among Us

Type D people "look very normal," Denollet says: Often, they don't seem either overly anxious or seriously depressed. "They may be very successful at jobs. They may not look like they are experiencing negative emotions."

Denollet and his colleagues have shown, however, that men and women who become easily worried over minor problems, and who bottle up those feelings, are far more likely to die during a heart attack than people who handle stress more easily and express their emotions.

Tone, a fruit canner and grandchild-watcher, is an example of the opposite of type D. She lets off steam frequently, but in a socially acceptable way -- airing her gripes with a trusted friend or family member -- and her laments are laced with humor. "Well, that was just clear off nutty," she'll say in her Southern drawl, when recounting a recent slight or inconvenience.

"If you open up to people, it helps," Denollet says. "On the one hand, you get some relief [from the stress] and, on the other, you help build intimacy." And, he adds, "opening up offers the possibility that a problem will get resolved, and gives a sense of some control."

Distract Yourself From Stress?

It isn't just the way you respond to stress that may affect your cardiovascular system, but also the way you recover from it, says Margaret Heitkemper, RN, PhD, professor and chair of the Department of Biobehavioral Nursing and Health Systems at the University of Washington in Seattle.

Stress can affect the immune system, says Heitcamper, whose research involves making volunteers do things like hold their hands in icy water or read words printed in eye-poppingly garish hues.

What she has found, not surprisingly, is that some people naturally feel stressed even before being put in a stressful situation. And once their hormones start jumping and blood starts pumping, some people take longer to calm down than others. A stressful situation can also cause some people's immune systems to react in a way that impairs their body's response to further stress -- a potentially unhealthy cycle.

But how stress is experienced depends on the person it is acting on. Looking after grandchildren may be an overwhelming strain for one person, but it may be only a bump on the road to happiness for another. "I can't overdo it," Tone says of her babysitting duties. "I'd go over the edge. But if I didn't do anything, that would be just as bad--probably worse."

This is what Joel Dimsdale, MD, a professor of psychiatry at the University of California at San Diego, calls a "positive distraction." It can be strong and healthy medicine, he says -- a powerful weapon against sitting at home and fretting.

Medically reviewed by doctors at Beth Israel Deaconess Medical Center (BIDMC), Harvard Medical School. BIDMC does not endorse any products or services advertised on this Web site.


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