By June Spence

The link between emotional and physical health is not a theory -- it’s a fact.

"We know there's a relationship between mental health and heart health," says cardiologist Christopher O’Connor, MD, director of the Duke Heart Center and co-director of the new Duke Heart-Mind Center.

Christopher O'Connor, MD"For example, people with depression are shown to have blood platelets that are stickier and therefore more likely to form a clot; it’s also associated with an increase in inflammation and heart rhythm disturbances."

And there’s a behavioral component, as well: a person under stress tends to isolate herself more, which means less social support, a key factor in healthy living. Stressed people are also less likely to take their medication responsibly or to actively participate in their health care, he says.

It all adds up to a higher likelihood of health crises, complications, and perhaps a shorter life. As study after study offers yet another compelling reason not to let stressful emotions wreak havoc on your body, perhaps it’s finally time to take the advice of teenagers everywhere to heart -- and just chill. Here’s how:

Just Sit There

Jeffrey Brantley, MDPeople who practice meditation and mindfulness have better health outcomes than those who don’t, according to Jeff Brantley, MD, director of the Mindfulness-Based Stress Reduction Program at Duke Integrative Medicine and the author of several how-to books on the subject, including Calming Your Anxious Mind.

"Research has shown that the ability to concentrate attention can promote deep relaxation in the body, and that the ability to be more mindful in each situation can help break the destructive habitual reactions to stress."

One simple exercise for deep relaxation, described in Brantley’s book Five Good Minutes, involves focusing on the sensations of the breath. Imagine that you are taking in feelings of calm and peacefulness with each inhalation, and expelling tension with each exhalation.

Simmer Down

Redford B. Williams, MDAnger management techniques have proven remarkably successful in reducing blood pressure and alleviating depression, says Redford Williams, MD, director of Duke’s Behavioral Medicine Research Center and co-founder with his wife, Virginia Williams, PhD, of LifeSkills, a psychosocial skills training program.

Williams suggests writing down specific episodes of anger to help identify your unique patterns, triggers, and responses. And when faced with enraging situations, stop to assess before taking action.

Look at the facts objectively, then ask yourself his four "I Am Worth It" questions:

I: Is this matter important to me?

A: Are my thoughts and feelings appropriate to the situation?

M: Is the situation modifiable in a positive way?

Worth It: When I balance the needs of others and myself, is taking action worth it?

Positive takes practice

Negative emotions may be bad for you, but Williams says research also shows the converse to be equally true. A recent Women’s Health Initiative study associates optimism with a reduced incidence of heart disease and total rates of death.

But can a dedicated cynic be reformed? Williams says optimism may come more naturally to some people than others, but anyone can cultivate the trait with practice.

"Simply learning to cope better increases optimism. As people improve their anger and stress management skills, they realize they are not at the mercy of the situation." In fact, they have the power to improve it.

Improving personal relationships is another path to a positive outlook. "Listening is key," Williams advises. "Keep your mouth shut until the other person is finished speaking, and try to be open to the possibility of being changed by what you hear."

One of the exercises he gives to people in LifeSkills is to "think of someone you encounter every day, list five positives you can inject into that relationship, then do them." The psychologic and physiologic benefits of such practices are measurable: participants’ satisfaction with life and social support go up, overall blood pressure goes down, and blood pressure surges during stressful times are less acute.

Don't Blow Off the Blues

"People who are depressed die at a greater rate than those who aren't, and those deaths are largely related to heart problems," says O’Connor.

Because the links are so strong and the stakes so high, he believes depression screening should be part of a routine cardiac workup.

O’Connor notes that your primary health care provider already has tools to screen for major depression -- if a patient answers "yes" to either of these questions:

• During the past month, have you often been bothered by feeling down, depressed, or hopeless?
• How about by little interest or pleasure in doing things?

"The questions can help doctors identify more than 90 percent of patients with major depression," O’Connor says -- and can make a lifesaving difference. "We think it's as important to check as blood pressure, glucose, or cholesterol."