Hepatitis C and Stress

It’s natural for everyone to feel stress, but people with hepatitis C have additional concerns. There’s the prospect of medical tests and procedures, worry over medical bills, and the fear of infecting others to name a few. Some people feel angry either at themselves or at someone else — or simply at the rotten blow that life has handed them. That anger can lead to depression, which only adds to the burden of emotional stress.

Being diagnosed with hepatitis C can be especially stressful because of the uncertainty associated with its course. Uncertainty creates a feeling of helplessness, which, researchers have learned, is one of the key factors in stress. Having a lot of demands on you isn’t inherently stressful, after all. Not having control over those demands is.

Taking stress seriously

Stress can erode the quality of life, taking the pleasure out of work and relationships. It can also compromise overall health. There is no direct evidence that chronic stress worsens hepatitis C infection or injures the liver, but there is good evidence that chronic stress can impair the immune system. Easing stress, on the other hand, can boost immunity.

The most startling evidence comes from experiments involving AIDS patients. In research conducted by Michael Antoni, PhD, a psychologist at the University of Florida at Coral Gables, volunteers who took part in group sessions on stress reduction lowered their levels of cortisol and noradrenaline — two hormones associated with stress that are known to impair immunity. One year after learning and practicing stress-reduction techniques, the volunteers had significantly more new T cells, the immune cells that are generated to fight infections. So by learning to handle stress, the volunteers were actually able to restore some of their immune function.

Reducing stress has also been shown to alleviate symptoms of other conditions, such as heart disease and asthma. Learning to cope with stress is obviously important for your emotional well-being, but it’s also important for your overall physical health.

Know the danger signs

The first step is recognizing the symptoms of too much stress. Remember: Not all stress is negative. Pressures at work and occasional tensions within your family are a normal part of life. Sometimes stress pushes you to do your best. However, stress becomes negative when you feel as if you can’t escape it, or when you feel as if the pressures in your life are out of control.

The immediate physical reaction to stress can include high blood pressure, perspiration, a racing pulse, and a fluttering feeling in your chest. Adrenaline, the biochemical that readies the body for fight or flight, surges into the bloodstream. Other typical signs of stress include:

  • Headaches
  • Insomnia
  • Neck, shoulder, or back pain
  • Fatigue
  • Irritability
  • Loss of concentration
  • Loss of appetite
  • Increase in cigarette smoking or alcohol consumption
  • Stomach pain, cramps, and diarrhea

Unfortunately, there is no objective test for stress. But if you feel as if the pressures of dealing with hepatitis C are a problem for you, it’s time to make some changes.

Different ways of reducing stress work for different people. Most people try a few approaches before finding the ones that work best for them. The good news is that you won’t have to turn your life upside down to tame stress, says psychologist Frederic Luskin, PhD, a researcher at the Stanford University Center for Research in Disease Prevention. “A few simple techniques, things you can do anywhere and that don’t have to take more than a few minutes, can stop the stress response before it goes out of control.”

Here are eight strategies for beating stress:

1. Clear your head

At least once every day, find a quiet corner and take five or 10 minutes to sit quietly and do nothing. Sitting quietly slows heart rate and reduces blood pressure, countering two of the most obvious effects of stress. A quiet break can also increase your sense of control over events. At the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts, patients are encouraged to sit and become aware of their feelings and the sounds around them. Taking a quiet break like this can help you get past the fatigue that is a common symptom of hepatitis C infection.

2. Refocus your thoughts

Shifting the focus of your thoughts from things that worry you to things that bring you happiness can change your mood for the better — and ease stress. Psychologists call this technique “positive emotion refocusing.” Thinking pleasant, calming thoughts can actually counteract the physiological changes that occur during stress by slowing your heart rate and lowering your blood pressure, for example.

3. Take a deep breath

Deep breathing exercises have been part of meditation techniques for centuries — with good reason. Concentrating on the simple act of inhaling and exhaling almost inevitably calms mind and body. Some people get even more benefit from repeating a mantra-like word or phrase each time they breathe in. Another technique is to picture each inhaled breath filling your body with soothing light. Imagine each exhaled breath blowing away tension and stress.

4. Have a laugh

Laughter really is the best medicine, according to studies at Loma Linda University in Loma Linda, California. Researchers there have shown that laughter lowers levels of the stress hormones cortisol and epinephrine. A good belly-laugh also boosts immunity and these physiological effects can last up to 24 hours. Amazingly, the team at Loma Linda found that just looking forward to something funny helps. Telling volunteers that they would participate in an experiment that involved watching a humorous video lowered their stress levels and created a more positive mood.

5. Do what you love

Managing a health problem like hepatitis C isn’t easy. The best solution is to make time in your day for at least one thing you really love to do, whether that’s listening to music, dancing, gardening, playing with the kids or the dog, painting, or reading. Listening to music may be especially soothing. At Monash University in Victoria, Australia, two groups of students were told to prepare an oral presentation. One group worked in silence. The other listened to the gentle strains of Pachelbel’s Canon in D Major. Blood pressure and heart rate were more likely to climb among the silent workers, while those who listened to music reported feeling much less stress. Another study, this one at the Medical College of Ohio in Toledo, found that patients who listened to music while undergoing uncomfortable medical procedures required less sedation.

6. Take a hike

Exercise of any sort can help ease stress. Walking is an especially good choice because you can do it almost anywhere. Even if you’re feeling tired as a result of your condition, you probably have the energy for at least a leisurely walk around the block. And walking has proven benefits. In an investigation at Stanford University School of Medicine, researchers studied people who were taking care of relatives with Alzheimer’s Disease. Volunteers who began walking for 30 to 40 minutes four times a week reported feeling less distressed and sleeping better. Also, tests showed that their blood pressure was more likely to hold steady when they were under pressure.

7. Change what you can

If you notice yourself getting stressed out again and again in the same situations or because of the same problem, think about what you can change. Overwhelmed by chores at home? Create a chore-sharing plan with the other members of your household. Does your blood pressure climb every time you find yourself searching for your glasses or the car keys? Decide on a place to put them and get into the habit of placing them there. Having trouble with your boss at work? Consider sitting down to talk about the situation and offer constructive ways to make things better.

8. Accept the rest

Of course, some of life’s frustrations and worries can’t be eliminated. If you or someone close to you has been diagnosed with hepatitis C, this is a reality you have to live with. It’s important to recognize what you can’t change and move on. The process is very much like forgiving someone who has hurt you, according to psychologist Luskin. Accepting what you can’t change allows you to let go of hurt and anger and focus on more constructive thoughts.


Benson, H. The Relaxation Response. Harper Collins

King, AC. et al. Effects of moderate-intensity exercise on psychological, behavioral, and emotional responses to family caregiving: a randomized controlled trial, Journal of Gerontology, Jan 2002, pp M26-36

Smolen, D. et al. The effect of self-selected music during colonsocopy on anxiety, heart rate, and blood pressure, Applied Nursing Research, Aug 2002, pp 126-36

Knight, WE et al. Relaxing music prevents stress-induced increases in subjective anxiety, systolic blood pressure, and heart rate in healthy males and females, Journal of Music Therapy, Winter 2001, pp 254-72

Berk, LS. et al. Modulation of neuroimmune parameters during the eustress of humor-associated mirthful laughter, Alternative Therapies in Health and Medicine, Mar 2001, pp 62-76

Antoni, MH. Stress management effects on psychological, endocrinological, and immune functioning in men with HIV infection, Stress, Sep 2003, pp 173-88

Antoni, et al. Cognitive-behavioral stress management reduces distress and 24-hour urinary free cortisol output among symptomatic HIV-infected gay men, Annals of Behavioral Medicine, Winter 2000, pp 29-37

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