Sinha warns against stress

Rajita Sinha is the director of the Yale Stress Center and Foundations’ Fund Professor of Psychiatry. She primarily examines how gender is related to stress and addiction, as well as the biological basis for the close relationship between stress, self-control and addiction. On Jan. 31, she published a paper in the American Journal of Psychiatry that describes the differences in the neurological mechanisms underlying cocaine dependence in men and women and suggests the different types of therapies that would best serve them.

Q. Your research has explored how certain aspects of stress and addiction depend on gender. Could you summarize the essential differences and their significance?

A. In every stage of the addiction cycle, alcohol and drugs affect men and women differently. For example, alcohol is metabolized differently, women approach drug dependence more quickly, and risk of relapse is also sex-based. There are also differences in stress levels, sensitivity and adaptation. Most of these differences are not dramatic, but they’re becoming clearer as the evidence grows. What this means clinically is that these key differences need to be reflected in treatment. Some medications are more effective in men rather than women, and the discrepancy can be pretty significant.

Q. What are the challenges that you and the center have faced in research or in incorporating the findings of your research into therapies?

A. It’s been difficult to get funding. Traditionally, people did not pay attention to the importance of sex differences in improving health outcomes, and health research mostly focused on men. Research is harder to do on women because of the menstrual cycle and many different hormones, so scientists have to control more variables. In the last two decades, there has been more of an effort to include women, with the establishment of the Office of Research on Women’s Health in the National Institutes of Health. So the funding situation is getting better now, but it is still not as easy as it really should be.

Q. What’s the main focus of your future research?

A. We’re going in a couple of different directions. One is developing sex-based treatments and therapies and thinking about how to incorporate [those treatments] into individual therapies. The second direction is to understand the risk factors in addiction and how [addiction] interacts with stress, which is also sex-based.

Q. For many students at Yale, having busy schedules seems to be the norm, which seems to be a common source of stress. What advice would you give to students who are stressed but feel trapped by their commitments and classes?

A. The most important thing is don’t ignore your stress. Ignoring it and pushing your body further will take a toll. Then there are some basic things people can do to reduce stress. First, social support is a key anti-stress agent. Building downtime for social interactions into one’s schedule and being able to build close relationships is number one, though it’s best that the activities are free of alcohol or drugs. The second thing is that some students work late into the night, but while working, they need to pay attention to food intake, water intake and sleep. Lastly, you need to do something that you’re passionate about. If these three broad areas don’t work, students should consider talking to somebody, and Yale has many resources for that. At the stress center, we will be starting health services, offering yoga classes and stress classes.

Q. Your research has shown the countless negative effects of stress, which often translate into large costs for society. What will it take to reduce stress across society?

A. I think pressures have increased in the post-industrial era. We’re more isolated, our parents have gotten busier, and there’s a greater availability of unhealthy things. While reducing stress throughout society may be the best goal, we believe it may not be realistic in the short run. Our approach to this is not how we can reduce stress on a large scale, but how can we optimize our ability to handle and cope with it better and improve ourselves in the process.

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