Let’s Talk About Stress Baby
When most of us hear the word “stress”, we get an unpleasant feeling in our bodies and think of terrible things like divorce, death, and any kind of badness. In fact, “stress” has become the term to use with any kind of negative emotion or discomfort. “I have so much to do and don’t know where to begin. I’m stressed.” Overwhelm = stress. “I am worried about finances and whether we can afford some things.” Anxiety = stress. “Everyone at work is so obnoxious. I can’t stand them and they have me stressed.” Annoyance/anger = stress. Any of this sound familiar?
The truth is that stress is not enemy number one. Stress can be quite beneficial, in fact. Think of all the times in your life you felt “stressed” and then grew from the experience. I can think of at least eight extremely anxiety-producing events where I felt stress and am better for the experience. So how do we develop a better relationship with stress? Well, let’s explore how we got here and what the evidence really tells us.
In the early 1930s, a researcher by the name of Hans Selye conducted experiments on rats to discover new female hormones. He injected rats with various mixtures of pureed cow ovary and placenta and saw the rats weren’t doing so hot and died. He then performed the same experiments but injected half of the other rats with saline as a control group. He soon figured out regardless of what he injected, the rats experienced similar negative physiologic consequences. Selye attributed these changes to the stress he induced with the experiments.1 He found similar responses in other animals and called the physiologic state in which an organism was responding as “stress”.2 Between 1911-1915, another scientist, Walter Cannon, conducted experiments on animals to measure the adrenal response to stimulants. The things he did to the animals were kind of horrific so I won’t detail them, but bottom line is he put them through near-death experiences and then measured their heart rates, respiratory rates, and cortisol levels.3-5 The animals had high heart rates, high respiratory rates, and high cortisol levels. Some of them fought and some ran for fear. His experiments gave rise to the fight-or-flight response of today.6 The assumptions acquired from these animal studies were applied directly to human beings. Even though other early research demonstrated positive health outcomes from stress,7-10 the negative narrative regarding stress dominated. Newer research states otherwise.
First of all, humans have more than just the fight-or-flight response. The tend-and-befriend response11 is an oxytocin-mediated response that comes from the parasympathetic nervous system (our more chilled out nervous system). Heart rates decrease, individuals feel less fear, circulating cortisol levels decrease, and this response can lead to a faster recovery from a stressful event.11 Rather than prepare for battle or flight, this stress response is characterized by seeking out others for increased affiliation and coming together in groups during times of stress. It is present in both sexes but appears to occur more often in women.11-13 Humans also have a dehydroepiandrosterone (DHEA)-mediated challenge stress response.14 DHEA may serve as a buffer against the negative physiological effects of cortisol-mediated stress responses.15
The physiological outcomes of stress are in the eye of the beholder. The original Framingham study suggested high-stress individuals had a higher incidence of cardiovascular events. However, when the data was revisited, we learned that was not the case for everyone. Individuals who felt they had high levels of stress AND thought that stress was bad for them had a higher incidence of cardiovascular events. The individuals who rated themselves as having high levels of stress but did not feel stress was bad and debilitating, did not have higher episodes of cardiovascular disease.16,17 In another study, researchers followed individuals for 8 years and demonstrated those who stated they experience high levels of stress and feel that stress has negative health consequences had an increased risk of premature death.18
Do you think you have high stress and think it will kill you? Don’t worry if yes. You can change your mind. An individual’s perspective on stress and levels of perceived stress can be altered through mindset interventions.19,20 This is something I like to work on with patients. Another thing I like to work on with patients is helping them choose their stress response. Remember the challenge response I mentioned? You can choose to respond that way. A challenge response is more likely to occur when individuals have resources available to address situations that threatens an important goal or personally relevant matter.37,38 If you are having a hard time seeing those resources yourself, you can tend-and-befriend for help.
The fact is that stress is not an evil demon trying to kill us. It can be quite beneficial and help us problem solve and learn. We just need to learn how to choose that path. Stress happens when something we care about is threatened. It is during those times that we must pause and think clearly. I made some changes in my life that have helped me with this tremendously. The greatest lesson has been learning what my body does when I am “stressed”, taking a deep breath during those moments so that I can think more clearly, and then looking for resources to help me address the trigger. If I can do it, you can do it. For more on the good we experience with stress, I highly recommend Kelly McGonigal’s book “The Upside of Stress.” If you found this post interesting, you will LOVE her book.
References
1. Selye H. A syndrome produced by diverse nocuous agents. 1936. Journal of Neuropsychiatry and Clinical Neurosciences. Spring 1998;10(2):230-1. doi:10.1176/jnp.10.2.230a
2. Selye H. Stress without distress. Psychopathology of human adaptation. Springer; 1976:137-146.
3. Cannon WB, de la Paz D. Emotional stimulation of adrenal secretion. American Journal of Physiology-Legacy Content. 1911;28(1):64-70.
4. Cannon WB, Hoskins RG. The effects of asphyxia, hyperpnœa, and sensory stimulation on adrenal secretion. American Journal of Physiology-Legacy Content. 1911;29(2):274-279.
5. Cannon WB. The emergency function of the adrenal medulla in pain and the major emotions. American Journal of Physiology-Legacy Content. 1914;33(2):356-372.
6. Cannon WB. Stress and strains of homeostasis. American Journal of Medical Science. 1935;189:1-14.
7. Caplan G. Principles of preventive psychiatry. Basic Books; 1964.
8. Park CL. Stress‐related growth and thriving through coping: The roles of personality and cognitive processes. Journal of social issues. 1998;54(2):267-277.
9. O’Leary VE, Ickovics JR. Resilience and thriving in response to challenge: an opportunity for a paradigm shift in women’s health. Women’s health (Hillsdale, NJ). 1995;1(2):121-142.
10. Tedeschi RG, Calhoun LG. The Posttraumatic Growth Inventory: Measuring the positive legacy of trauma. Journal of traumatic stress. 1996;9(3):455-471.
11. Taylor SE, Klein LC, Lewis BP, Gruenewald TL, Gurung RA, Updegraff JA. Biobehavioral responses to stress in females: tend-and-befriend, not fight-or-flight. Psychological review. 2000;107(3):411.
12. Taylor SE. Tend and befriend: Biobehavioral bases of affiliation under stress. Current directions in psychological science. 2006;15(6):273-277.
13. Turton S, Campbell C. Tend and Befriend Versus Fight or Flight/ Gender Differences in Behavioral Response to Stress Among University Students. Journal of Applied Biobehavioral Research. 2005;10(4):209-232.
14. Izawa S, Sugaya N, Shirotsuki K, et al. Salivary dehydroepiandrosterone secretion in response to acute psychosocial stress and its correlations with biological and psychological changes. Biological psychology. 2008;79(3):294-298.
15. Morgan CA, 3rd, Southwick S, Hazlett G, et al. Relationships among plasma dehydroepiandrosterone sulfate and cortisol levels, symptoms of dissociation, and objective performance in humans exposed to acute stress. Arch Gen Psychiatry. Aug 2004;61(8):819-25. doi:10.1001/archpsyc.61.8.819
16. Haynes SG, Feinleib M, Levine S, Scotch N, Kannel WB. The relationship of psychosocial factors to coronary heart disease in the Framingham study: II. Prevalence of coronary heart disease. American Journal of Epidemiology. 1978;107(5):384-402.
17. Haynes SG, Levine S, Scotch N, Feinleib M, Kannel WB. The relationship of psychosocial factors to coronary heart disease in the Framingham study: I. Methods and risk factors. American journal of Epidemiology. 1978;107(5):362-383.
18. Keller A, Litzelman K, Wisk LE, et al. Does the perception that stress affects health matter? The association with health and mortality. Health Psychol. Sep 2012;31(5):677-84. doi:10.1037/a0026743
19. Crum AJ, Salovey P, Achor S. Rethinking stress: the role of mindsets in determining the stress response. Journal of Personality and Social Psychology. Apr 2013;104(4):716-33. doi:10.1037/a0031201
20. Crum AJ, Akinola M, Martin A, Fath S. The role of stress mindset in shaping cognitive, emotional, and physiological responses to challenging and threatening stress. Anxiety Stress Coping. Jul 2017;30(4):379-395. doi:10.1080/10615806.2016.1275585
21. Harvey A, Nathens AB, Bandiera G, Leblanc VR. Threat and challenge: cognitive appraisal and stress responses in simulated trauma resuscitations. Med Educ. Jun 2010;44(6):587-94. doi:10.1111/j.1365-2923.2010.03634.x