Warning: Living in Orange County may be hazardous to your health.
So says Dr. Barbara Best North of Laguna Niguel's Healthworks Medical Group.
It's not just the often-brownish air, or the noise level, or the stresses of crowded freeways and hefty mortgage payments, she says. Even the things that make the area seem like paradise to new arrivals from back East--day after day of sunshine, 70-degree temperatures even in January, expensive cars in driveway after driveway, more leisure activities than anyone could possibly indulge in--all can cause stresses of their own.
Since she set up her practice 12 years ago, North says she has seen a steady increase in her patients' stress levels, especially in the last couple of years. Stress has become such a pervasive problem that the cases in which it isn't somehow a factor are now the rare exceptions, she says.
Stress-related illness manifests itself in many ways, says North, who was chosen one of the county's most outstanding women of 1990 by the YWCA.
Headaches, difficulty sleeping, trouble concentrating, anxiety, trouble making decisions and other problems may be signs of stress, as can headaches, high blood pressure and digestive difficulties. Even accidents, she says, can be stress-related.
Depression is one of the most common stress-related disorders, and North says she's seeing more and more of it.
"I can't give you any statistics on it, but I know what I'm seeing in my own practice," she says. "More and more people are coming in and telling me they're feeling really tired, having trouble sleeping and having trouble coping.
"People are coming in and asking for antidepressant medication. And I'm certainly prescribing it more than I used to, when we've eliminated other reasonable explanations, such as low thyroid, anemia, other illnesses or bad health habits."
New arrivals are particularly susceptible, she says. "We see a lot of folks who've moved into the area within the last year. They come in with some kind of illness, and we can usually link it very quickly to the problems they're having adjusting. They express a sense of confusion, fatigue, frustration.
"I think there's a fantasy about this area. People extrapolate inappropriately and think, 'OK, we're moving to Southern California, that's great. The weather's wonderful, we can do all the things we've been wanting to do,' and it just doesn't turn out that way. The weather's fine, but good weather is not necessarily conducive to friendship and the human contact that people need."
And with good weather year-round, North says, Southern Californians don't get the same kind of respite that comes naturally in other parts of the country. "We have no seasonal rest time," she says. "Because we have such a temperate climate, people feel obligated to push all the time. They don't have any weather breaks, no snow days."
In most other cultures with similar climates, she says, it's customary to slow down for part of the day--the Mexican siesta, for example.
"But here, it never lets up," she says.
The fast pace causes many of us to become adrenaline addicts, North says. We train our bodies to secrete adrenaline, a natural hormone that kicks the body into high gear, not only by pushing ourselves constantly, but also by worrying or being angry or anxious.
"Adrenaline is very much a part of the aggressive Southern California lifestyle," North says.
"It's a dynamite hormone," she adds. "It feels wonderful for a long time. But ultimately, it has some serious problems. If you use it all the time, you start to wear down and become susceptible to all kinds of illnesses."
(Here's an easy way to find out if you're an adrenaline addict, North says: See if you can sit quietly and do nothing for half an hour. If you can't do it without feeling distress, you probably are addicted to adrenaline rushes.)
With some patients, North can suggest lifestyle changes that may make a difference: quitting smoking, improving the diet and exercising regularly.
However, "I see more and more people where I can't just say to them, 'Listen, if you give up smoking and do this and that, you'll feel fine,' because they've already done that," she says. "They've already done all those things that anyone could ask them to do. They've given up caffeine, they have perfect diets, they're teaching aerobics, they're working on relationships, they meditate, and they're still having problems.
"And I see this often enough so that it's just living in this area. I don't care how well you treat yourself, it's still a situation that's overwhelming. If you take good care of yourself, you'll do better, but it's quite different from how you would feel if you were doing all those things for yourself and living elsewhere."
North says she's also seeing at least one frequent malady that may be attributed to the local environment.