For seven years, Joe Gagliardi, a programming manager for Southeast Frozen Foods, worked in what felt like a sick ward. \nEverybody was constantly ill, though Gagliardi fared better than most. "There were always colds, sneezing, temperatures and a lot of sick days," he says.The programmers worked in a separate building (no, not a freezer) so some became convinced that it must be the building making them sick. What else would explain it?A programmer called the Centers for Disease Control and Prevention, and eventually the company hired some environmental consultants to investigate.The consultants came. They sampled the air and the water, looking for poisons and pollutants. They sniffed the rugs and peered into the air-conditioning ducts, looking for viruses and bugs.They didn't find anything.Five and a half years ago, Gagliardi left that job to become CIO of Unisa, a distributor of women's shoes and accessories.And he got better.So maybe the consultants had missed something.MORE ON STRESS\u00a0\n12 Signs You're Stressed Out\nStress Not, CIO: Tips for Coping\nGood News for Type A Personalities\n\u00a0\n \nOr maybe all the coughing and sneezing and fevers had something to do with the fact that Gagliardi and his fellow programmers regularly worked long weeks and 12-hour days. Most of Gagliardi's colleagues eventually quit, until it was just him and a woman who started the same time he did. As he's talking about this, Gagliardi has an epiphany. "My God," he says. "I realize now that thats why we were sick all the time. "It was the stress."\nThe Stress EpidemicOnly in the past 20 years or so has science arrived at the same conclusion as Gagliardi. The New England Journal of Medicine in 1998 went so far as to declare that "managing the long-term effects of the physiological responses to stress is critical to survival." Stress may contribute to 85 percent of all medical problems, says Connie Tyne, executive director of the Cooper Wellness Program in Dallas, which counsels executives on stress reduction. Fifty-two percent of executives will die of diseases related to stress, according to Tyne. That's partly because stress affects nearly every major system in our bodies, creating a laundry list of health problems\u2014among them diabetes, high blood pressure, stroke, allergies, asthma and colitis.The clearest sign that there's a stress epidemic can be seen in heart disease statistics. For example, a recent study found that people who get less than five hours of sleep twice a week or more are 300 percent more susceptible to heart attacks. Their overall rate of developing heart disease doubles.Not surprising, stress has been on the rise in the past few years. With the economy gone bad, unemployment rising and the threat of terrorism, most Americans report feeling more stress today. It's even worse for executives.Constant stress does more than damage your health. It destroys your judgment and distorts your decision-making process. Constant stress has been shown to shrink the hippocampus, a region of the brain that controls memory and concentration. "We all know anecdotally that when someone is under stress they don't have the clearest vision," says Tyne. "They don't have the patience to work through a complicated decision. They will have a tendency to abdicate or jump into a decision prematurely."CIOs don't like to talk about how stress affects them. They are taught that stress is to be accepted, swallowed whole and its effects ignored. Admitting to, or worse, displaying stress is a sign of weakness, an admission of failure. Unfortunately for CIOs, this belief is widely shared, at least at work."You have to carry off the position with dignity and a show of strength in public," says Jim Quick, professor of organizational behavior at the University of Texas at Arlington. "You have to reflect the strength and power of the organization even if as an individual you're feeling somewhat vulnerable."This means that CIOs need to deal with stress on their owna lonely and difficult struggle that few executives choose to face. Denial is easier. But denial inevitably extracts its toll in health, relationships with family and friends, careers, and even lives.\nThe Science of StressThe reason that stress, and our response to it, has so much power over us has to do with evolution, which as far as stress reaction goes, stopped 30,000 years ago when modern man replaced the Neanderthal. Our earliest human ancestor, Cro-Magnon man, needed to control his environment in specific ways to avoid starving or being eaten by predators. To survive, he needed help holding off the saber-toothed tigers or bringing down a mammoth for dinner\u2014so evolution favored those who felt uncomfortable alone and sought out the company of others. Knowing the guy in the next cave increased his survival chances, as did his drive to control his environment by, say, developing a mental map of the hunting grounds nearby, or stacking a pile of clubs and rocks near the cave's entrance for protection. He learned to hate uncertainty because in his world, surprises were usually lethal.MORE ON STRESS\u00a0\n12 Signs You're Stressed Out\nStress Not, CIO: Tips for Coping\nGood News for Type A Personalities\n\u00a0\n Today, we hate uncertainty every bit as much as our ancestors did. Read the headlines about Sept. 11, the postwar in Iraq, kidnapped children or even that memo from the CEO canceling the ERP project, and you'll experience the same reactions that our caveman had when he noticed that the tigers had moved from their usual lair: sweaty palms, an elevated heart rate. No doubt the caveman's worries and stress were nearly constant, but he rarely lived long enough to develop stress-related pathologies such as heart disease.We do. And science is now linking the daily anxieties and worries that cavemen felt to a much more powerful, primitive reaction to stress, the "fight-or-flight response," as researcher Walter Cannon dubbed it in the early 1900s. This is the biological process designed to help cavemen out of serious jams such as a saber-tooth suddenly showing up at the door of the cave. The process is extremely effective for its intended purpose: fighting the tiger or running away.First, the sight of the tiger signals the brain's speed regulator, the locus coeruleus, to shock the rest of the brain into a state of hyperactivity and alertness. The brain then causes a chemical called norepinephrine to be released into the autonomic, or involuntary, nervous system\u2014turning up the dial on blood pressure and respiration.Simultaneously, cortisol, known as the "stress hormone," shoots through the bloodstream to vital systems, turning off those that don't play an immediate role in survival\u2014such as digestion and the immune system\u2014while supercharging others\u2014such as the liver\u2014to provide extra sugar to fuel the brain and muscles. Meanwhile, adrenaline turns up the heart rate and blood flow. It's like gunning the accelerator at a stoplight. The body is revving itself up for what, in the caveman days, was very likely to follow: a life-or-death struggle or a frantic escape.\nThe Wages of StressWe've come to accept stress as a normal part of our lives, but there's nothing normal about lighting up our brains with chemicals and shutting down half the systems in our bodies while flooding the bloodstream with sugar. Today, our bodies don't get much of a break from the stress response, which was designed to be an occasional event, not a constant condition of existence. "We've all come to believe that occasional headaches or muscle tension from stress is normal, but it isn't normal," says Tyne. "A normal body doesn't have headaches."Stress sends a constant flow of sugar into the bloodstream to feed fleeing muscles, but with our less active modern lives, the sugar doesn't get burned up. "Having high levels of sugar in the blood is like having rust in your gas tank," says Tyne. "It flows into every part of the engine." The body responds by releasing insulin to regulate the sugar, but over time the insulin reaction degrades and the excess sugar can cause diabetes and kidney and circulation problems.Our Apple-Shaped Leaders\nThese men became apple-shaped because the brain evolved to react to elevated cortisol levels in the blood by craving food. And not just carrots and rice crackers. Stress wants a burger with fries.Bill Clinton, 42nd PresidentLou Gerstner, Former CEO of IBMHarvey Weinstein, Miramax CochairmanAriel Sharon, Israeli Prime MinisterBill Parcells, Dallas Cowboys Coach Boris Yeltsin, Former Russian PresidentDennis Kozlowski, Ex-Tyco CEOTed Kennedy, Senator (D-Mass.)The long-term effects of cortisol aren't much better. Our metabolism slows and fat cells, particularly those around the gut, open up to receive more fat\u2014the body's most storable source of energy. In other words, stress makes us fat. Since cavemen used all that extra sugar by fighting or fleeing, the brain evolved to react to elevated cortisol levels by craving more food, according to leading stress expert Pamela Peeke. And not just a carrot and a rice cracker. Stress wants a burger with fries\u2014lots of fats and carbohydrates\u2014so that you'll have the energy stored to run next time. A trip to Mickey D's a survival response? Absolutely. Your body, after all, doesn't know the difference between a tiger on the prowl and a CFO's e-mail. Fight or flight has become "stew and chew," as Peeke calls it.Indeed, researchers found that Americans surveyed after Sept. 11 said their initial reaction was to avoid food (stress hormones initially suppress appetite so our caveman wouldn't get distracted while running from the tiger) followed by a tendency to overeat (the cortisol effect).Not that stress makes it any easier to digest the food you crave. Since eating doesn't have much to do with getting away from the tiger, stress steers blood away from the digestive tract, leading to indigestion, ulcers and more. Similarly, survival was more important than attacking a cold bug, so resources are shifted away from the immune system, increasing the body's susceptibility to everything from the trivial\u2014colds, allergies\u2014to the tragic\u2014cancer, multiple sclerosis and lupus, to name a few.But the most dramatic impact of stress is on the circulatory system. Stress runs the heart harder than a 16-year-old drives a car. The combination of stress hormones such as cortisol and adrenaline keep the heart running at a high idle. "Emergency room doctors use a shot of adrenaline to get a heart attack patient going again," says Tyne. "Imagine what that does to your heart when it's flowing constantly." But unlike a car, your heart doesn't begin to leak oil or emit the telltale odor of burning bushings as it runs down. It just stops.For 50 percent of the people who get cardiovascular disease, death is the first symptom, according to the American Heart Association.\nStress and the CIOThough the evidence is still being assembled, many scientists now believe that learning how to short-circuit the fight-or-flight response may be as important to our health as exercise and diet. For example, a recent Duke University study of about 100 heart disease patients divided them into three groups. The control group just had regular medical checkups, another had supervised aerobic exercise classes three times a week for four months, and the third group received stress reduction education once a week for 90 minutes during the same period. After five years, the first group had experienced 12 heart attacks, the second had seven, and the third had three. Results such as those are slowly convincing doctors to take a hard look at the mental state of their patients.The best antidote to stress is exercise. And viewed in the context of the chemistry of the fight-or-flight response, that makes sense. Exercise is simulated flight\u2014a chance for all the sugars and hormones in the bloodstream to be used for their intended purpose. Exercise also feeds our brains some feel-good drugs such as dopamine and beta-endorphin\u2014evolution's reward for safely escaping the tiger.Avoiding the stress response itself\u2014feeling less stress in the first place\u2014is a lot harder. To understand how to control stress, you have to think yourself back to the caves. Three major psychological factors made cavemen's stress hormones flow: lack of control, fear and isolation. All three have modern correlatives.The CIO role is tailor-made for feeling out of control. Infrastructures can crash at any moment, CEOs can change their minds and stop funding projects, businesspeople can resist using your beautiful new system for no good reason. CIOs have a vast amount of responsibility but little authority for controlling outcomes. This is what psychologists call low decision latitude."This creates a sense of chronic powerlessness," says Scott Stacy, clinical program director for the Professional Renewal Center, which counsels executives on stress. "You can't have an effect on what you need to have an effect on to generate a sense of [internal] calm." This leads directly to health problems. According to a 1997 study of about 3,000 Canadian public-service executives, those with low decision latitude saw their risk of illness increase anywhere from 30 percent to 1,700 percent.To see the theory in action, just ask a top CIO if she would like to report to the CFO instead of the CEO. "I wouldn't take a job that didn't report to the CEO," says Doreen Wright, CIO of Campbell Soup. "It would be far more stressful. Your scope of influence and your ability to execute is directly tied to your clout in the firm. If you're buried in finance, you can't exert the same influence."Put in stress terms, reporting to the CFO reduces a CIO's control over his environment because it puts someone between him and the ultimate influencer over the company, the CEO.CIOs also feel increasingly out of control as the software projects they manage get bigger and affect more people. That's more people the CIO can't control. Users don't have to do anything the CIO asks. When Gagliardi's custom manufacturing resource planning project at Unisa had its funding withdrawn earlier this year, he not only lost control over his project but also over the expectations of users."I had a bunch of half-developed applications and a bunch of half-trained developers, and I tried to deliver what I could, but it wasn't working out," he says. Disappointed departments began criticizing. So Gagliardi changed everyone's expectations, including his own. "I said we're going to stop the project and go into maintenance mode on the legacy applications until times improve," he says. "Now when my developers manage to deliver something new, it's a pleasant surprise for everybody, and they're happy to get it."Gagliardi says that since then his stress level has gone way down. Psychologically, he achieved the control over his environment that he needed to turn off his primal sense of anxiety\u2014and his physiological fight-or-flight response.It's much harder for CIOs to escape the isolation that cavemen learned to dislike so much. CIOs who show stress send it rippling through their staffs like a rock thrown into a pond. Worse, CIOs who confide in their employees about the stress they feel risk having it used against them. "You need for your staff to know that you're human; you don't need your staff to know that you're weak," says the University of Texas's Quick.MORE ON STRESS\u00a0\n12 Signs You're Stressed Out\nStress Not, CIO: Tips for Coping\nGood News for Type A Personalities\n\u00a0\n Joining a CIO networking group can help relieve the loneliness, as can a deep discussion with your spouse. But neither can change a CIO's reaction to stress or offer ways to relieve it.Indeed, CIOs who feel isolated tend to alienate those around them who could offer support. "No one understands what I'm going through, so there's no use in talking about it," is the refrain that Lee Smithson, a psychologist and executive coach for consultancy RHR International, hears a lot from the CIOs she works with.For one of Smithson's clients, who requested anonymity, stress on the job and stress at home marched in lockstep. "He was constantly having to bargain with his wife for time, and he canceled two vacations with her and their children," Smithson says. "His wife had become hardened to the whole situation." When his company merged with another, he told his wife that he wanted to apply for a higher paying but more demanding CIO position at the new company. "She hit the roof," says Smithson.This man's wife wasn't the only unhappy one. The new company told him that unless he revamped his approach to work and the way he handled stress, he wouldn't get the job. "He was functioning as the consummate problem-solver," says Smithson. But his obsession with controlling his stress by doing everything himself had alienated him from his staff, who wished he would delegate more often, and from his superiors, who could never track him down for important meetings. And when he did attend, he was so distracted that he usually sat in silence.It all came out when the new company's management asked the putative CIO to take a 360-degree review. He was stunned that far from being appreciated, the 12-hour workdays he was putting in, and the evenings he spent sifting through the e-mail that had arrived while he was off putting out fires, was viewed as a problem. "He had never gotten that kind of feedback before," says Smithson. "They said he wasn't strategic and therefore wasn't qualified for the job."Like many CIOs, this man was in denial. He had become withdrawn. Attempting to project strength, he was advertising weakness. Alone in his office cave, he was destined to become some tiger's lunch.Fortunately, spurred by the review, he and Smithson were able to create a plan for him to distribute responsibility among his staff and become more involved in business strategy. Ultimately, he got the CIO job.And last Spring, he took his wife and two kids to Disney World\u2014along with a cell phone.