Yale Stress Center clinicians have been researching stress and disease for years. Now they’re using their findings in an innovative approach to helping patients stay healthy.
Yoga/mindfulness instructor Anne Dutton assists with a Warrior One yoga pose.
(May 2012) Life can seem incredibly unfair. Jan Juris, a resident of West Haven, Conn., knows this too well. In the space of five weeks last year, she lost her 35-year-old daughter, a mother of two, to breast cancer, and her father. Years of caring for her family was taking a toll on Juris: her eating and weight had spun out of control, and she was diagnosed with pre-diabetes and soaring blood pressure.
Last year, Juris responded to an ad for a clinical trial on stress and overeating at the Yale Stress Center. The center, which opened for patients this past April, offering integrative therapies for stress and related conditions, had been helping patients in clinical trials since 2010.
Juris enrolled in a 12-week program that included counseling, nutritional coaching, yoga, meditation and group sessions with others who were also struggling with overeating. A year later, she says, “I am much more aware of what I eat, how much and how fast. I learned to stop, breathe, relax and pay attention while eating. I eat slower, chew longer and don’t gulp food down.”
Matthew Stults-Kolehmainen, PhD, assesses resting pulse rate during a fitness evaluation.
Patients at the Yale Stress Center benefit from innovative care that draws directly from research supported by a $23 million grant the Yale School of Medicine received from the National Institutes of Health in 2007. The research has already generated new treatments and improved understanding of how stress affects personal choices.
“We apply the science of stress to treat its damaging effects on the brain, mind and body,” said Rajita Sinha, PhD, the center’s director and a professor of psychiatry at the Yale School of Medicine. “We focus on how stress affects our minds and health, but also the choices we make, which can lead to addictive behaviors.”
Clinicians at the center say that until recently, doctors had precious little to offer to help patients suffering from chronic stress, despite widespread knowledge that it is detrimental to health and well-being. “The best impact of the research is that we can now offer clinical services that help people improve their lives,” says Keri Tuit, PsyD, the center’s clinical director.
Yale Stress Center staff, seated (l-r): Keri Tuit, PsyD; Ann Dutton, MA, RYT; and Ather Ali, ND, MPH. Standing (l-r) Matthew Stults-Kohehmainen, PhD; Mary Savoye, RD; Ania Jastreboff, MD; Dr. Sinha; and Rachel Hart, MS, LADC.
The Yale Stress Center integrates behavioral and physical health care with emphasis on early intervention, prevention and symptom reduction.
A patient’s first visit includes a comprehensive evaluation, typically with blood tests and other types of diagnostic screenings, and the results are used to design a treatment plan. Then clinicians customize treatment plans to a patient’s particular needs.
Typically, plans will incorporate individual and group therapy, biofeedback, weight loss (based on nutrition, exercise and fitness training), acupuncture, yoga and mindfulness meditation, in whatever combination a patient needs. If a patient already has their blood tests and an assessment, and knows the specific intervention they want (e.g., mindfulness-based stress reduction, individual therapy, yoga, medications) for their anxiety, pain or other stress-related conditions, they can also enroll directly for that service.
Doctors may prescribe medications such as selective serotonin re-uptake inhibitors (SSRIs) to improve mood and anxiety, and/or older blood pressure medications such as prazosin to decrease anxiety and improve sleep, attention and memory. They have recommended supplements such as B vitamins, vitamin D, omega 3 fatty acids and coenzyme Q10.
Dr. Sinha says the treatment plan not only helps patients to conquer their unhealthy habits, but can even reverse the damage that stress has done to their minds, bodies and spirits.
The Yale Stress Center offers treatment for people suffering from high stress levels or any stress-related medical complaint, including heart disease, diabetes, cancer, depression, anxiety and a long list of other conditions. Patients can get help if they are trying to quit smoking or abusing drugs or alcohol, looking to improve their health and well-being during or after cancer treatment, or recovering from surgery.
Physician referrals are encouraged and accepted, but not required. Many of the services at the Yale Stress Center are covered by health insurance.
Story by Nicole Wise
Photographs by Robert Lisak
2 Church Street South
New Haven, CT 06519
Dr. Sinha talks to a patient about a clinical trial.
While Rajita Sinha, PhD, and her interdisciplinary team treat patients at the Yale Stress Center, she continues to work with colleagues on research studies examining the real-time and cumulative effects of stress on the brain, hormones and metabolism, as well as the nervous and cardiovascular systems. The scientists are studying how stress promotes inflammation and cripples the immune system as well.
“We are learning, at the cellular and neuroscientific level, how our habits take over and contribute to the development of illness. This is important, because stress is a contributing factor for virtually every form of chronic disease,” Dr. Sinha says.
Dr. Sinha is internationally known for pioneering research on mechanisms linking stress to addiction and to chronic disease. Her work has shown how stress and adversity increase desire for addictive substances such as alcohol, illicit drugs, and high-fat foods, and how chronic use of these substances, along with obesity, can alter biological stress responses, promoting craving and compulsive seeking of these substances.
Most recently, she was involved in a study of more than 100 healthy subjects that showed experiencing stressful life events, such as a divorce or job loss, can reduce gray matter in critical regions of the brain that regulate emotion and important physiological functions even in healthy individuals.
Since ongoing stress is a fact of life for many people, merely advising them to reduce stress isn’t helpful, Dr. Sinha says. “Our research is designed to ask the question differently: How can we optimize functioning under stress? Our goal was to learn how it is that some people can ‘get it together’ to do what they need to do, while others cannot. What are the differences? Are they genetic? Biochemical? What helps and what gets in the way?”
The center continues to recruit people to participate in clinical studies focusing on stress. For more information, contact the center at 1-888-Y-STRESS (1-888-978-7377 or firstname.lastname@example.org.