MIAMI — After Silvia Clarke lost a sales executive job she had held for 18 years, the Miami Shores wife and mother of two worried about how she would support her family of four as the household's primary wage earner.

"Having been restructured out of the company was not the worst thing that could have happened — living under that stress of not knowing what was going to happen was the most stressful thing," said Clarke, 45.

Then her youngest daughter, 6-year-old Caroline, innocently asked one day, "Mom ... were you a bad worker?"

"That was the most shocking thing," she said. Clarke sat Caroline down and calmly explained that companies redirect their efforts and that even good employees can find they don't have a position in the new design.

With the daily drumbeat of slashed jobs, home foreclosures, high debt levels and skyrocketing gas and food prices, the anxiety level of the American worker is rising exponentially. Three-quarters of Americans say they are stressed about money, a jump from 60 percent two years ago, according to an April poll of 1,848 adults by the American Psychological Association.

Local therapists and mental-health experts report business is brisk, as people try to cope with the cascade of economic uncertainties.

"In my private practice, within the last year or two, the stress level of my patients has increased dramatically," says Dr. Robert Schwartz, chairman of family medicine and community health for the University of Miami medical school. "A lot of time it will come down to family stress, job issues, economic issues — people can't make ends meet; a lot of marital dysfunction, people overworked, complaining about bosses. I try and help people put these issues into perspective."

EFFECT ON THE BODY

Managing the stress is critical to containing the damage it does to your body. When a person is attacked by stress, hormones go into overdrive.

When that becomes a permanent state, it has a detrimental effect on the body's chemistry and health problems ensue.

"The endocrine system is altered," says University of Miami researcher Claudio Mastronardi, who is working with mice and rats in the lab to study how stress affects the immune, neurological and hormonal functions.

"When these systems are imbalanced, psychiatric disorders might increase," Mastronardi says. "With what we are going through now — the real estate market, people on the verge of foreclosure or losing jobs without knowing what is happening tomorrow — it can cause a chronic insult to our body. It may increase chances of depression and anxiety and lower our immune defenses and make us more susceptible to develop disease."

Studies, like a 1998 joint effort by the University of California and Sweden's Sahlgrenska University Hospital, have shown that chronic stress can throw one's cortisol levels out of sync. The result can be weight gain, diabetes, cardiovascular issues and obesity.

"It is known that chronic stress stimulates the laying down of extra fat in the abdominal area and has been associated with an increased risk of diabetes, heart disease and hypertension," says Dr. Jon Shaw, a director of psychiatry at the University of Miami.

"Acute stress mobilizes with adrenaline and then, hopefully, the body adapts," Shaw adds. "But if it's left in overdrive because of chronic stressors, then the long-term effects on biology — sleep and appetite disturbance, irritability, episodic violence control issues — can be associated with the wear and tear on our systems."

MORE PATIENTS

Schwartz, the University of Miami family medical physician, reports seeing more patients seeking help for sleep disorders, fatigue, muscle pain and anxiety — all byproducts of stress.

He and others help patients cope by recognizing the situation causing the stress and mapping out strategies to change behaviors. Feeling boxed in is a major contributor to stress.

"One way we define stress is an individual's adaptive capacity to demands placed on that individual," Shaw says. "People readily experience stress as painful while others may experience it as an opportunity."

In the case of Clark and her daughter, Caroline, her calm explanation of her company's restructuring and her resultant job loss allayed her daughter's fears.

"That made her feel more at ease," Clarke says. "Life brings these things and the way I acted was going to show them how to act when something in the future goes bad. What they thought of me and how I handled myself in front of them was important."

Clarke also began to regularly jog and started working out on an elliptical machine.

"Those runs allowed me to be by myself and to think and rethink and reposition those thoughts. It was an opportunity to work out physically but also to put myself together again," Clarke says.

The next step was to craft a winning resume.

"I hadn't done one in 18 years," she recalls. "That was a daunting experience. I couldn't remember what I've done. You have to go through a lifetime."

She ultimately composed a list, whittling a four-page resume down to a more marketable two-pager. "That made me feel good: 'I've done all of this.' I can start rebuilding. I went through a lot of personal changes and growth. The interview process helped me build confidence."

Clarke found her new job in the same field in March.