Stress Management: Let Go and Live a Little

Like so many others, I think that I have had a love hate relationship with stress all my life. In one respect, it can feel like stress is important and essential to my survival in school and a career- how else would I meet deadlines and make meetings on time? In another way, stress leads me to constantly think about what I could and should be doing, and leaves me exhausted at the end of the semester. Stress can minimize the enjoyment I believe we’re intended to experience on a daily basis. Through the years, I have tried all sorts of methods to cope with stress, some that stick around, and some that have fallen by the wayside.

My initial efforts were in high school and early college. I never had really thought about how stress was impacting me, until I joined a dancing team and realized that I simply was not as stressed when I was dancing. I had less time for homework as a result of practices, but was always confident the homework would get done in a timely manner. Because I knew time was limited, my habits became more efficient, and in turn, I was able to spend more time with my family and friends. After practices, I was tired, and yet I felt focused and calm. The differences between my stress levels during exam periods when I was on and off the dance team were remarkably different. Exercise and the variety of dance combinations explored in practice created a sense of peace and centeredness that I had never experienced. And yes, of course there were times (like exam periods) when I would become extremely stressed, but I knew the solution was often to ‘dance it out.’

Scientifically, as Sapolsky (2004) points out, exercise can be a great source of stress relief. Particular aerobic exercise, like dancing, has been shown to improve mood and blunt stress-response for a few hours after exercising. In a 20-week aerobic exercise intervention study, von Haaren and colleagues (2015) found that students had lower emotional stress reactivity during an exam than inactive students. However, it is important to consider that the type or style of exercise that a person gravitates toward should not be forced. Sapolsky discusses a study that demonstrates that health can actually worsen in rats that are forced to exercise. Therefore, while dancing is a great stress reliever for me, it’s possible that memorizing all of those combinations of steps would be stressful to another person, and not their preferred type of exercise. And as for me, well, no rock climbing please.

As I got a bit older and moved on to later college years, I became more involved in the community and eventually attended a week-long retreat where 20 minutes of guided meditation was a part of every morning. Talking with another person about what we were grateful for that day was a practice each night. Interestingly, even though I did not have my typical outlet of dancing that week, I found that I was still experiencing a sense of stillness, and framing the world differently in my mind. Because I knew that I would have to tell someone several things that I was grateful for each day, I was searching for reasons to be grateful all day long. Small things, like how the color of the leaves change in New England in the fall, came to my attention in a way that typically do not when I’m bustling around campus. Going into breakfast after a 20 minute meditation, I was contemplating where my food came from, and actually thinking about how it tasted instead of scarfing it down.

Sapolsky (2004) also highlights meditation as a form of stress management. Studies have shown that individuals can experience positive health outcomes from meditation (i.e. lowered blood pressure), but it is unclear how long after meditation the effects last. Despite this, I was experiencing positive effects all day, so what’s going on here? I think the key is mindfulness. Mindfulness-based cognitive therapy and mindfulness-based stress reduction has been shown to lead to better psychological outcomes (Alsubaie et al., 2017). Although it is possible to experience meditation for a short time, it is possible to experience mindfulness all day everyday (likely after many years of practice). Because I was actively searching for reasons to be grateful, I was mindful of the present moment, and thinking without judgment, but rather with curiosity throughout the retreat. It seems that this is the key to practically bring the psychological and health benefits of meditation into everyday life.

We live in a highly stressful world.  Stress can certainly serve us during times of fight or flight, but we need to remember that on a daily basis, we probably don’t need to be as stressed as we are.  For me, dancing and mindfulness do the trick, and for you it might be something different.  However, the key is to find what works for each of us to truly manage the stress, so that the stress does not manage us.  As a result, we can all hope to live longer, happier, and healthier lives.

Substance Abuse and Stress

As Sapolsky (2014) points out, we live a fast-paced world with addictive qualities at every turn. As a society, we are constantly scrolling through social media, eating sugary and high fat processed foods, and even Netflix wants us to binge watch our favorite shows by continuously playing them back to back and making it that much harder to walk away. Although we can begin to understand addictive qualities through our daily experiences, for some individuals alcohol and drugs bring the quality of addiction to a whole different level. Sapolsky does a great job of detailing the neurological components that can lead to addiction, including the role of dopamine. He also highlights the role of environmental triggers that lead to addictive behaviors. However, what was most interesting to me was the consideration of how stress is tied to addictive behaviors, and considering ways in which we might be able to intervene.

It is no secret that substance abuse often results from coping with stress. As Sapolsky puts it, “Drugs of abuse make you feel less stressed.” However, in a recent study by Hoffman (2016), there were mixed results in whether high levels of cumulative stress led to increases in substance abuse from early adolescence into emerging adulthood. For some groups, cumulative stress was a risk factor for increased substance use, while in others the strongest predictor was peer use. Interestingly, the comparisons made were across a sample of individuals from low socioeconomic status. Therefore, conclusions were not entirely convincing, as it would seem this is a particularly stressed set of individuals to make comparisons between.

Another study examined the impact of stress management via mindfulness training intervention on substance abuse outcomes (Bowen, De Boer, & Bergman, 2016). The particular population of interest in this study was individuals with PTSD, in part due to the high rate of comorbidity with substance abuse. The authors highlighted that mindfulness is typically inversely related to addictive behaviors, and positively related to approach-based coping and positive PTSD outcomes. Therefore, the objective of this study was to better understand the relationships between PTSD, substance abuse, and mindfulness as an intervention. Results demonstrated that higher mindfulness was related to lower severity of dependence in substance abuse. Additionally, higher levels of PTSD symptoms were associated with lower levels of mindfulness, and in turn more severe substance abuse. Within the mindfulness practices, awareness and nonjudgment were significant mediating factors between PTSD symptoms and substance abuse.

So what does all of this actually mean? Well, for starters, we can be doing more to support individuals who depend on substances. If we have the knowledge that the awareness and nonjudgment aspects of mindfulness training are particularly helpful, then we should be thinking of ways to integrate mindfulness training into relapse prevention and rehabilitation programs. I often feel that more holistic treatments can be threatening to pharmaceutical companies that provide the medications, or even to the on-site therapists that go through cognitive behavioral practices with addicted individuals. After all, restructuring a rehabilitation system can take a lot of work, and can mean that some of the parties who were previously making money may lose some of their profits. However, if we can view mindfulness as another part of the balancing act of treatment, rather than as a replacement, then it seems that it could be integrated in a more seamless way. Eventually, this could mean a lesser need for pharmaceuticals, but it seems unlikely that pharmaceuticals would be replaced altogether. It seems that what pharmaceuticals currently offer is a biological way of rebalancing and reconfiguring neurological chemicals. And yet, it also seems possible that pharmaceuticals could be a starting point in the most severe stages of substance abuse and slowly be replaced with mindfulness strategies that can take on a longer-term role as a coping strategy.

Bowen, S., De Boer, D., & Bergman, A. L. (2017). The role of mindfulness as approach-based coping in the PTSD-substance abuse cycle. Addictive Behaviors, 64, 212-216. doi:10.1016/j.addbeh.2016.08.043

Hoffmann, J. P. (2016). Cumulative stress and substance use from early adolescence to emerging adulthood. Journal of Drug Issues, 46(3), 267-288. doi:10.1177/0022042616638492

Sapolsky, R. M. (1994). Why zebras don’t get ulcers. New York: WH Freeman.

Election Stress

In the United States this past year, we have all individually experienced the ups and downs of the nightmarish political campaign that was Hillary Clinton vs. Donald Trump. Some felt strongly about one candidate, and some felt that neither candidate was a good option leaving them as a swing vote. However, no matter what you believe, there was no escaping the bombardment of negativity and division on a daily basis. We can all sense that elections and particularly Election Day is a stressful event, but what is it actually doing to us? How is it affecting our psychological and medical health?

Trawalter and colleagues (2011) investigated changes in cortisol and testosterone during the 2008 election, and the role that social dominance orientation played in understanding changes in diurnal rhythms. Social dominance orientation refers to how strongly an individual believes in a social hierarchical system (i.e. highest in the hierarchy could be a white male with a powerful position in the top 1% of earners). As you might recall, 2008 was a historic election in that Barack Obama became the first Black individual to ever become a United States president. For individuals that were high in SDO (who were more often Republicans), this could raise serious concern, and not conform to their typical learned ideas of hierarchy (Trawalter et al., 2011). Interestingly, regardless of whether individuals were high or low in SDO, everyone experienced stunted cortisol and testosterone rhythms. These stunted rhythms have been a result of anticipating the election, and could be the body’s way of not providing a cortisol or testosterone response until it is known what is needed (Trawalter et al., 2011). Additionally, the day after the election and President Barack Obama’s win, individuals with high SDO experienced a boost in cortisol, perhaps as a physiological response to the defeat of the election.

A question I had when reading this article was related to the authors’ inclusion of the fact that it is very possible that those who reported high SDO were also Democratic supporters. The authors highlight that many of the Democratic party’s ideals fall in line for those low in SDO, but why would an individual with high SDO be a Democrat? Possible ideas that came to mind were that an individual with high SDO could feel particularly strong about a specific issue, and happen to have a liberal view for that one issue. Perhaps that would lead to a Democratic vote. Or perhaps, an individual with high SDO could be surrounded by other Democratic individuals who influence their thinking or are not open minded to the individual’s perspectives. Therefore, the high SDO individual could also declare that they are voting for the Democratic candidate. This is certainly conceivable in a highly liberal environment like Boston.

Majumder and colleagues (2017) examined stress and anxiety levels pre- and post-2016 elections. Of course, the 2016 election was one like never before. Issues were not only of a political nature, but also quite personal. Donald Trump made several degrading and disturbing comments relating to women, non-white individuals and communities, and even individuals with disabilities. Majumder et al. found that women experienced higher stress levels than men before and after the election. If this were another election cycle, the result might be somewhat surprising, and would warrant further exploration. However, it seems quite evident that in this particular election, we would expect women to experience more stress. After all, it was not only that Donald Trump made degrading comments and got away with it to hold the highest office in the world, but that he defeated a woman who had much higher qualifications than he did.  Although I cannot speak for all women, to this woman, it was the greatest collective symbol of gender inequality that this nation has seen.

Technology: Personal Life and Productivity

It’s hard to think of a white-collar job, or even a friendship, that does not require 24/7 connection and communication with others through technology. The expectation is that emails will always be answered promptly, and friends will always be texted immediately. However, we should be taking the time to stop and ask why we’re doing this. What are we actually getting out of this on the individual level and as a society? Are we actually being more productive and are we happier?

Looking to personal use of technology, the answer seems to be that we are unfortunately becoming more depressed, anxious, and dissatisfied with ourselves.  As it turns out, passively using Facebook without intention of making social connection can lead to increased depressive and anxiety symptoms (Frost & Rickwood, 2017). Particularly in females, viewing images of others and their life events can lead to social comparison that can result in body dissatisfaction. Considering the high accessibility and potential for social comparison on social media sites, these findings are unsurprising. It is well established that when women view thin models in magazines and advertisements, there is an increased drive for thinness and lowered body satisfaction. Now, imagine the spring season on Facebook; everyone is hitting the beach for the first time, taking pictures with their beaming smiles, flat stomachs, and filtered tans. Is it any wonder that their Facebook “friends” may experience heightened depressive and anxiety symptoms? Shouldn’t we expect that a woman would experience heightened body image concerns when the ability to access these images are virtually endless, and always novel as they flip through their feed? Certainly, Facebook does give us access to all kinds of people that we may or may not have interacted with in our lives, but how we interact with the material makes all the difference. How we interact as a society to Facebook really suggests that we should not be using Facebook nearly as much as we do.

Ok, so you get it, I’m not a fan of Facebook. What about technology in the workplace? Is there something to be said for technology making us more productive when we can access documents, emails, shared folders, and basically our entire office and staff 24/7? Unfortunately, the evidence suggests that we are not more productive, and may just be making more sacrifices in our work-life balance (Ayyagari, Grover, & Purvis, 2011). As a time management consultant, being smart about using technology is something that I preach to the students I work with. Technology often provides more of an obstacle than assistance with productivity. Students working on their computers can receive text notifications, email notifications, or simply be tempted to check what’s new in social media, or BuzzFeed. In order to actually make technology work toward your advantage, it takes an incredible amount of self-control, knowing your weaknesses, and planning; all of which the marketing companies are working against. Without taking the proper precautions, you might think that technology is helping you to address various different aspects throughout your day (ie responding to an email quickly in the middle of writing a report), but really, you are losing time to orient to the email and then back to the report. Multitasking is something we all think we can do and are actually terrible at doing. Before you know it, an entire day spent multitasking due to the “benefits” of technology can actually lead to doing more work later on, and work overload. There might also be the perception that because you can do the work any time of day, that you will spread it out or procrastinate, and instead of getting the work done, stress and worry of doing the work takes over the day. Creating helpful strategies can make all the difference, but don’t be fooled by the lure of technology seemingly making the day more productive.

References

Ayyagari, R., Grover, V., & Purvis, R. (2011). Technostress: technological antecedents and implications. MIS quarterly35(4), 831-858.

Frost, R. L., & Rickwood, D. J. (2017). A systematic review of the mental health outcomes associated with Facebook use. Computers in Human Behavior76, 576-600.

Social Stigma and Stress

A variety of studies have shown that engaging in interracial interactions, or having a social disadvantage can lead to stress (Major, Mendes, & Dovidio, 2013;Sapolsky, 2004; Trawalter et al., 2011). As a result of the stress caused by social disadvantages, there can be a combination of negative psychological and physical outcomes. Although the authors highlight poverty and interracial interactions as the predominant forms of social stress, I focus mainly on the impact of obesity stigma in my research.

Obesity stigma researchers indicate that individuals with obesity are not immune to the effects of social stress. Social stress can take many forms for an individual with obesity. This can range from a situation where all chairs in the room have arm handles, and there is not a viable option for seating for the individual, to reporting their weight on medical forms. In addition, unlike race, stigmatizing obesity is sometimes considered the last acceptable form of social stigma. Many individuals believe that telling someone to lose weight is a form of social service, and that it will encourage weight loss (Puhl & Heuer, 2009). In fact, the result of stigmatizing comments toward obese individuals is further psychological and medical consequences. Obese individuals who experience higher frequency of stigmatizing comments also face more negative outcomes, including risk for depression, diabetes, cardiovascular disease and weight gain (Puhl & Heuer, 2009).

Major and colleagues (2013) discuss the negative consequences of interracial interactions in a medical setting, but it is possible that the consequences are perhaps just as, if not more, severe for obese individuals. Medical doctors and medical students have identified that they find obese patients to be “annoying” and “helpless”, as well as spending less time with obese patients (Puhl & Heuer, 2009). Furthermore, obese patients are already experiencing a heightened level of stress in a medical encounter compared to their normal weight counterparts, so if they receive negative feedback from their doctor, it impacts their stress levels more severely. Other studies have shown that when obese individuals are trying to make a positive change by losing weight, they are still critically evaluated, and often discouraged by fitness professionals from continuing a healthy lifestyle. This is particularly concerning due to the rising obesity epidemic, with over 66% of Americans being either overweight or obese. Similar medical biases were also found internationally in Europe, India, and Australia- all areas where the average waistline continues to expand (Puhl & Heuer, 2009).

Even though Sapolsky (2004) highlights that the common factor among social stress research in people is the feeling of being in poverty, I can’t help but wonder how many of these individuals also share maladaptive eating. He does point out that some of the complications individuals in poverty may experience are lack of access to nutritious foods, and education. However, I share the same question of whether individuals who are exposed to nutritious foods to begin in their childhood (regardless of their SES) have a lesser chance of being in poverty. Obese individuals do tend to fall into lower SES categories, but previous research has suggested this is due to hiring and promotion biases. Rather, I think it would be interesting to consider how someone who comes from a low SES background, but has access to healthy foods throughout their childhood into adulthood, either changes or does not change their SES status over time. This of course would be difficult to examine, as most individuals in poverty cannot maintain access to healthy foods that are generally more expensive. Additionally, this would require a prospective study that follows children from birth through adulthood- a difficult feat in any area of study.

PTSD and Physical Symptoms

The link between trauma in the mind and effects on the body is an interesting one. Perhaps the most widely studied mental disorder related to trauma is PTSD (posttraumatic stress disorder). PTSD can be comorbid with a variety of other psychological disorders and physical health risks, such as depression, obesity, and chronic pain.

In particular, I am most interested in the connection between PTSD and weight gain. Often times, individuals who binge eat are said to be “eating away the pain” or “trying to fill the emptiness inside”. Binge eating can of course lead to obesity, which then puts the individual at greater risk for other psychological and physical health risks, and creates somewhat of a vicious cycle in their health outcomes. It seems to be similar for individuals who experience PTSD in that their traumatic experiences may lead to binge eating as a coping mechanism, and this maladaptive coping pattern can result in further issues. Hall and colleagues (2014) describe that PTSD-diagnosed individuals are much more likely than non-diagnosed individuals to become obese over time. This is both because of binge eating and because there may be an avoidance of physical activity. The avoidance of physical activity makes sense as sensations such as sweating and faster heartbeat could be feared by an individual who has experienced these same bodily arousal sensations during a traumatic experience. Hall and colleagues also highlight that individuals who were overweight and obese prior to the onset of PTSD are more likely to gain weight faster. Although they do not provide a potential explanation for this pattern, this makes sense as individuals who already have an established coping mechanism for dealing with life’s issues may continue to use what they have already established. However, for individuals who have just been diagnosed, they may be a bit slower to find binge eating as a way of working through their trauma.

After reading through Hall et al.’s (2014) review, I wondered what would happen if we were able to treat the PTSD effectively. After all, it seems like the core of the issue is PTSD, and it is leading to all of the other possible physical symptoms. Therefore, one would think that by treating the main issue, the other problems would simply go away. However, Schnurr (2015) addressed this problem in a review of examining pathways between trauma and physical health. As it turns out, even when PTSD is treated through cognitive behavioral therapy and medication, it does not necessarily mean that the physical symptoms will be mitigated. There are a few exceptions that have been cited, such as chronic whiplash disorder (Schnurr, 2015). For more chronic diseases, such as cardiovascular disease, diabetes, or obesity, there is a lack of research and the effectiveness of treating such disorders during or after PTSD treatment seems to be largely unknown. However, from previous readings (see previous blog posts), it would seem that the development of long term diseases cannot simply be reversed, even if PTSD is treated. Because the initial steps that lead to cardiovascular disease are a process that occurs over time, and could even be triggered by other comorbid factors (such as life event stress, or depression), it seems unlikely that cardiovascular disease would be reversed. Even with obesity and weight gain, it would not be enough to simply treat PTSD, but rather all of the physical activity and binge eating patterns that had developed over time. Behaviors that had been established over time after the onset of PTSD would need to be reversed. Therefore, it seems unlikely that just because someone may learn to work through the trauma they experienced, and learn how to avoid responding to potential triggers for traumatic responses, that their other physical risks would simply dissipate.

 

Stress and Cancer

I don’t know about you, but most of the time when I get stressed out, one of my first thoughts is, “Oh no- snap out of it or you’re going to get sick!” Throughout my life, I’ve always heard of the negative impacts of stress on health. During exam season, I get particularly paranoid about keeping up a healthy diet and physical regimen that will combat stress, in hopes of not getting sick. Although my efforts are often to no avail (it turns out that if you’re stressed out about not getting stressed, then you’re still stressed), the connection between stress and sickness stays solid in my mind.

As it turns out, research supports that stress can increase risk of the common cold (Cohen et al., 2012; Sapolsky, 2004). Cohen and colleagues (2012) examined the role of chronic stress in glucocorticoid resistance, and in turn, the immune response that can lead to illness. In this study, participants were quarantined after exposure to rhinoviruses and taking measures of their stress level. Those who had high levels of stress or chronic stress were found to be more vulnerable to the virus. What does this research teach us? Well, for starters, we really need to consider how to combat stress- not just because it feels good to release tension, but also because stress can lead to a lack of response and functioning in our immune response. Second, don’t sign up to be a participant in a study that makes you sick!

Although researchers examining the impact of stress on the common cold have found an association, it makes you wonder whether more stress over a longer period of time leads to a worse diagnosis. In particular, can stress get so intense and chronic that it actually leads to cancer? Shoemaker and colleagues (2016) ran a prospective study that followed the lives of 106,000 women occasionally checking in about medical and psychological information every 2.5-3 years. Women were also asked about stressors in the previous 5 years to the study. The researchers found, somewhat surprisingly, that there was no link between stress and breast cancer diagnosis. Sapolsky (2004) also discusses a bit about the role of stress in cancer, and concludes that there is no link. His reasons follow from analysis of studies that have included retrospective studies. Sapolsky makes the case that when asked about whether you experienced stress prior to a diagnosis, but already know that you have cancer, it is likely this can be an outlet for an explanation for why cancer occurred to the patient. However, as we can see in a prospective study, there is no link.

Sapolsky (2004) continues discussing previous studies that indicate group therapy is an effective intervention leading to greater longevity for cancer patients. However, he boils these findings down to individuals likely having better compliance with treatment as a result of discussions in group therapy. As an individual trained in clinical psychology, I can imagine that some of Sapolsky’s claim may be true, but as he does not have substantial evidence to support his claim, I think there may be a larger component to this finding of an effective therapeutic intervention. Across findings, those who are widowed or who have lost a very close loved one are at greater risk for diagnosis. Although it is unclear whether the group therapy intervention targeted individuals who lost loved ones directly, it is certainly possible that group therapy was serving another purpose of connection, and perhaps even lifting individuals out of depression. It seems as though this is an open opportunity for further research.

Cohen, Janicki-Deverts, Doyle, Miller, Frank, Rabin, & Turner. (2012). Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. Proceedings of the National Academy of Sciences, 109(16), 5995.

Sapolsky, R. M. (2004). Why zebras don’t get ulcers: A guide to stress, stress related diseases, and coping. New York: W.H. Freeman.

Schoemaker, M., Jones, M., Wright, L., Griffin, J., Mcfadden, E., Ashworth, A., & Swerdlow, A. (2016). Psychological stress, adverse life events and breast cancer incidence: A cohort investigation in 106,000 women in the United Kingdom. Breast Cancer Research : BCR, 18(1), 72.

Obesity: Treating the Symptom as the Diagnosis

Now that obesity has become a worldwide epidemic, it is more important than ever that we understand the underlying causes for obesity, and how we can further prevention and intervention efforts.  Research demonstrates that most people think the obesity epidemic is due to laziness, lack of effort, and high fat foods.  These stereotypes of obese individuals are harmful, and can lead to hurtful perceptions and further weight gain. To look at causes of obesity only from the strictly physical perspective is to deny the role of the mind entirely.

As Kiecolt-Glaser et al. (2015) highlight, pathologies such as depression and underlying stress can alter the way in which our bodies metabolize food, and thus, can lead to significant weight gain over time. Depression and obesity are highly comorbid, and often fuel the existence of the other. For instance, individuals with depression may feel like engaging in less physical activity, slow their metabolism, and may begin to have erratic eating behaviors (either overeating or lack of appetite). In turn, this may lead to weight gain, and a common reason for low esteem and mood in individuals with obesity is due to their appearance and concern for how others perceive them, which leads back to depressive patterns of thinking.

In order to intervene, it is clear that we cannot simply play the blame game and call out individuals with obesity by saying that they are not trying hard enough. Sometimes their minds, and by extension their bodies, are working against efforts that are made (as in the case of depressed individuals). And yet, media tells the public that it’s all about calories in versus calories out, and that obese individuals need to move more, and go on restrictive diets. Nobody seems to be talking about the mind-body connection, and yet it seems to be an essential component to intervening with the obesity epidemic.

Some research has begun to investigate the role of the mind in commitment to health-related lifestyle changes, and the framing of goals related to physical activity and weight loss. Magnan et al. (2017) discusses previous research that found participants’ self-reported exercise was greater after messages about affective benefits of exercise (reducing anxiety) than cognitive benefits (reducing heart disease). This finding is in direct contrast to the messages we receive from the media. The benefits we hear about in relation to exercise rarely relates to making our mental quality of life better, but rather focuses on the physical aspects. We know that we can reduce heart disease, or that our legs will look better if we run, but do we all know about the research that highlights the mental clarity and work productivity that can come from running on a regular basis?

It seems that it is time to change our tune as a nation, and perhaps worldwide. Americans in particular are known for their intense work ethic and long work hours, but perhaps we can consider what stress, and the pathologies that result in large part from stressors, are doing to our bodies and in particular our waistlines. Is it possible that providing more mental health services, including mental maintenance (such as yoga, meditation, and therapy) could go beyond altering stress levels, but also lead to healthier weight? Furthermore, teaching mental health strategies may even allow for longer-lasting results of weight loss and weight maintenance if we consider making services available for all Americans, regardless of their weight. I feel that this is a potential avenue for research, and that given the connections we already know exist, it is a promising one.

Kiecolt-Glaser, J. K., Habash, D. L., Fagundes, C. P., Andridge, R., Peng, J., Malarkey, W. B., & Belury, M. A. (2015). Daily Stressors, Past Depression, and Metabolic Responses to High-Fat Meals: A Novel Path to Obesity. Biological Psychiatry77(7), 653–660. http://doi.org/10.1016/j.biopsych.2014.05.018

Magnan REShorey Fennell BRBrady JMHealth decision making and behavior: The role of affect-laden constructsSoc Personal Psychol Compass2017;11:e12333. https://doi.org/10.1111/spc3.12333

 

Cardiovascular Health and Social Hierarchy

Newman and colleagues (2011) found that younger individuals were more likely to have ischemic heart disease (IHD) within 10 years of follow-up from their baseline interview where trained nurses made observations for hostility. Although no explanation is provided in the article, as a millennial who is approaching the age range of participants in the study (~30-70 years), it seems a bit concerning that being younger could be indicative of increased risk for IHD. It also seems very confusing to think that a young adult would be at greater risk for a health issue at all. Aren’t we supposed to be the healthy ones that worry about the health of vulnerable populations like children and the elderly?

Sapolsky (1994) provides a potential explanation with his discussion of previous studies that found atherosclerosis (plaque that develops from platelets and “crud” in the circulatory system) in monkeys who were at the bottom of the social dominance hierarchy. Although Sapolsky does not address young adults specifically, it seems very feasible that young adults would experience cardiovascular and circulatory issues due to lack of social dominance. After all, young adults are typically at the bottom of the totem pole in their workplace, and therefore may be working toward objectives that a boss or supervisor has set forth. Young adults are also coming into a world and society where the pervasive culture has been created by generations before us. Additionally, it can be understandable in this day and age to consider whether young adults simply feel down on their luck. Most young adults have concerns that their parents and grandparents did not have- everything from massive student loans and fear of never being able to afford a home, to trying to solve the impending environmental crises for our generation and others to come.

Although Sapolsky provides a possible legitimate reason for the findings in the Newman and colleagues study, there’s still a gap that is missing. Is the fact that there is a difference in rates of IHD in age groups indicative that younger adults are always at higher risk, but then learn health tactics as they become older that prevent further damage? Or is it that younger people are becoming more hostile throughout generations, and therefore more likely to have IHD?

The study does not account for some of the confounding factors that could lead to cardiovascular disease, as was mentioned in Whooley and Wong’s (2011) editorial comment. One of these potential confounding factors is particularly noteworthy in consideration of incidents of IHD over generations- obesity. Two-thirds of Americans are now overweight or obese, and this rate has increased three-fold since the 1970s. This means that it is possible that the impact of obesity at a younger age may have impacted risk for IHD in the younger sample of this study in a way that it did not impact the older generations when they were younger. Because of this confound, it is actually possible that both generations may have experienced negative cardiovascular effects of being low on the totem pole in society as a young adult. However, because the younger group may have a higher rate of obesity than the older group, the effect of obesity and hostility on cardiovascular disease accumulated in such a way that was more detrimental than for older participants. If this is truly the case, it would be very concerning indeed, and possibly mean that the younger group of participants would likely suffer fatalities or excessive cardiovascular damage when they reach the age of the older participants at a higher rate than we currently see in the older participants in this study.

References

Newman, J. D., Davidson, K. W., Shaffer, J. A., Schwartz, J. E., Chaplin, W., Kirkland, S., & Shimbo, D. (2011). Observed hostility and the risk of incident ischemic heart disease: A prospective population study from the 1995 canadian nova scotia health survey. Journal of the American College of Cardiology, 58(12), 1222. doi:10.1016/j.jacc.2011.04.044

Sapolsky, R. M. (1994). Why zebras don’t get ulcers: A guide to stress, stress related diseases, and coping. New York: W.H. Freeman.

Whooley, M. A., & Wong, J. (2011). Hostility and cardiovascular disease. Journal of the American College of Cardiology, 58(12), 1229. doi:10.1016/j.jacc.2011.06.018

 

 

 

Stress in Society

One of the most interesting aspects of stress is how we as a society interpret stress. After reading through the scientific community’s models of stress, it struck me how logical and practical it all sounded. Each part of stress fits neatly into its little box, with explanations for the hormonal changes in our bodies, and how our body is constantly attempting to bring us back to homeostasis with these internal changes.

However, when you’re a graduate student, or any professional really -perhaps aside from a stress researcher- no one is thinking about stress this way. Instead, we all seem to have a tiny devil that sits on our shoulder yelling at us that we don’t have time to relax because we have seven deadlines, thirteen errands, and a laundry basket filled with dirty clothes that all need to be addressed and completed by Friday. Having lived my entire life in the Northeast, all of these tasks are just that- life. The hustle and bustle are part of what comes with the territory of creating a successful life, and one that builds what my parents liked to call ‘character’. In most circles that I’ve been a part of, being stressed is actually a positive thing. It indicates that I’m working hard, and staying focused on the tasks at hand. I have been thanked for sending an email response within five minutes when I was strung out on coffee and had been awake for 20 hours, but have been criticized for not responding for 24 hours when I took a long weekend vacation (when I was getting my full 8-10 hours of sleep, thank you very much). A supervisor once told me, “You’re smiling too much, you must need more work.” And this is where things get confusing. Being chipper at work might mean that I have enough time to think about other things in life aside from work and that I don’t have my game face on. What if I was a grouch at work? Well, that would be no good either. My stress and emotions are often not allowed to match as a matter of how society sees them fitting together, and given the context of what it means to be a professional.

Then, there is the other side of the coin. It seems that the self-care movement and the idea of work-life balance is everywhere. The idea is that yes, you have to put on a face for work for the sake of professionalism, but then on your own time, you should do the things that make you happy. It sounds easy, right? Just find the things that make you happy and do them- until you consider additional responsibilities. You should exercise too even if you don’t think that makes you happy. You should probably make sure that you make time to clean your home too, and definitely make sure that you’re cooking at home or else you’re not healthy. You should probably volunteer too, to make sure you’re a good person and then maybe pick up a hobby, so you’re interesting. Of course, these are all societal expectations and no one needs to do all of these things, but there are a significant amount of responsibilities that will cut into the ‘life’ portion of the work-life balance equation. Most weekdays, you’ll probably run out of time in the day to find time to do something that helps you to be free of negative stress unless you strictly plan for it or, more unrealistically, don’t experience stress at your job.

Experienced stress unfortunately does not fit into the nice little boxes that scientific explanations of stress do. Experienced stress feels abstract and often out of our own grasp. It’s hard to know when your body is rising to help you meet a challenge, and when it’s holding you back from an opportunity that would be best for you. With our perceptions and negativity toward stress as a society, thinking of stress in a more concrete way might actually make the topic more tangible and help us to understand it has a positive side too.