33-1 What events provoke stress responses, and how do we respond and adapt to stress?

Psychologists define stress as the process of appraising and responding to a threatening or challenging event (FIGURE 33.1). But stress is a slippery concept. We sometimes use the word informally to describe threats or challenges (“Ben was under a lot of stress”), and at other times our responses (“Ben experienced acute stress”). To a psychologist, the dangerous truck ride was a stressor. Ben’s physical and emotional responses were a stress reaction. And the process by which he related to the threat was stress.

Stress arises less from events themselves than from how we appraise them (Lazarus, 1998). One person, alone in a house, ignores its creaking sounds and experiences no stress; someone else suspects an intruder and becomes alarmed. One person regards a new job as a welcome challenge; someone else appraises it as risking failure. When short-lived, or when perceived as challenges, stressors can have positive effects. A momentary stress can mobilize the immune system for fending off infections and healing wounds (Segerstrom, 2007). Stress also arouses and motivates us to conquer problems. Championship athletes, successful entertainers, and great teachers and leaders all thrive and excel when aroused by a challenge (Blascovich & Mendes, 2010). Having conquered cancer or rebounded from a lost job, some people emerge with stronger self-esteem and a deepened spirituality and sense of purpose. Indeed, experiencing some stress early in life builds resilience (Landauer & Whiting, 1979). Adversity can beget growth.

But extreme or prolonged stress can harm us. Demanding jobs that mentally exhaust workers also can damage their physical health (Huang et al., 2010). Pregnant women with overactive stress systems tend to have shorter pregnancies, which pose health risks for their infants (Entringer et al., 2011).

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So there is an interplay between our head and our health. Psychological states are physiological events that influence other parts of our physiological system. Just pausing to think about biting into an orange wedge—the sweet, tangy juice from the pulpy fruit flooding across your tongue—can trigger salivation. We’ll explore that interplay shortly, but first, let’s look more closely at stressors and stress reactions.

Stressors fall into three main types: catastrophes, significant life changes, and daily hassles. All can be toxic.

CATASTROPHES Catastrophes are unpredictable large-scale events, such as earthquakes, floods, wildfires, and storms. After such events, damage to emotional and physical health can be significant. In the four months after Hurricane Katrina, New Orleans’ suicide rate reportedly tripled (Saulny, 2006). And in surveys taken in the three weeks after the 9/11 terrorist attacks, 58 percent of Americans said they were experiencing greater-than-average arousal and anxiety (Silver et al., 2002). In the New York City area, people were especially likely to report such symptoms, and sleeping pill prescriptions rose by a reported 28 percent (HMHL, 2002; NSF, 2001). Extensively watching 9/11 television footage predicted worse health outcomes two to three years later (Silver et al., 2013).

For those who respond to catastrophes by relocating to another country, the stress may be twofold. The trauma of uprooting and family separation may combine with the challenges of adjusting to a new culture’s language, ethnicity, climate, and social norms (Pipher, 2002; Williams & Berry, 1991). In the first half-year, before their morale begins to rebound, newcomers often experience culture shock and deteriorating well-being (Markovizky & Samid, 2008). This acculturative stress declines over time, especially when people engage in meaningful activities and connect socially (Kim et al., 2012). In years to come, such relocations may become increasingly common due to climate change.

SIGNIFICANT LIFE CHANGES Life transitions—leaving home, becoming divorced, losing a job, having a loved one die—are often keenly felt. Even happy events, such as getting married or graduating from college, can be stressful life transitions. We might worry that our relationship will end or that we will not find a desirable job. Many of these changes happen during young adulthood. One survey, in which 15,000 Canadian adults were asked whether they were “trying to take on too many things at once,” found the highest stress levels among young adults (Statistics Canada, 1999). This stress effect appeared again when 650,000 Americans were asked if they had experienced a lot of stress “yesterday.” Younger adults reported higher daily stress (Newport & Pelham, 2009).

Some psychologists study the health effects of life changes by following people over time. Others compare the life changes recalled by those who have or have not suffered a specific health problem, such as a heart attack. In such studies, those recently widowed, fired, or divorced have been more vulnerable to disease (Dohrenwend et al., 1982; Strully, 2009). One Finnish study of 96,000 widowed people found that the survivor’s risk of death doubled in the week following a partner’s death (Kaprio et al., 1987). A cluster of crises—losing a job, home, and partner—puts one even more at risk.

DAILY HASSLES AND SOCIAL STRESS Events don’t have to remake our lives to cause stress. Stress also comes from daily hassles—spotty phone connections, aggravating housemates, long lines, too many things to do, e-mail and text spam, and loud talkers behind us in line (Lazarus, 1990; Pascoe & Richman, 2009; Ruffin, 1993). We might have to give a public speech or do difficult math problems (Balodis et al., 2010; Dickerson & Kemeny, 2004) (FIGURE 33.2 below). Some people shrug off such hassles. For others, the everyday annoyances add up and take a toll on health and well-being (DeLongis et al., 1982, 1988; Piazza et al., 2013; Sin et al., 2015).

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Many people face more significant daily hassles. As the Great Recession of 2008–2009 bottomed out, Americans’ most oft-cited stressors related to money (76 percent), work (70 percent), and the economy (65 percent) (APA, 2010). In impoverished areas—where many people routinely face inadequate income, unemployment, solo parenting, and overcrowding—such stressors are part of daily life.

Daily economic pressures may be compounded by prejudice against our gender identity, sexual orientation, or race, which—like other stressors—can have both psychological and physical consequences (Lick et al., 2013; Pascoe & Richman, 2009; Schetter et al., 2013). Thinking that some of the people you encounter each day will dislike you, distrust you, or doubt your abilities makes daily life stressful. When prolonged, such stress takes a toll on our health, especially our cardiovascular system. For many African-Americans, for example, stress helps drive up blood pressure levels (Mays et al., 2007; Ong et al., 2009).

Medical interest in stress dates back to Hippocrates (460–377 B.C.E.). In the 1920s, Walter Cannon (1929) confirmed that the stress response is part of a unified mind-body system. He observed that extreme cold, lack of oxygen, and emotion-arousing events all trigger an outpouring of the stress hormones epinephrine and norepinephrine from the core of the adrenal glands. When alerted by any of a number of brain pathways, the sympathetic nervous system arouses us, preparing the body for the wonderfully adaptive response that Cannon called fight or flight. It increases heart rate and respiration, diverts blood from digestion to the skeletal muscles, dulls feelings of pain, and releases sugar and fat from the body’s stores. By fighting or fleeing, we increase our chances of surviving and reproducing.

Canadian scientist Hans Selye’s (1936, 1976) 40 years of research on stress extended Cannon’s findings. His studies of animals’ reactions to various stressors, such as electric shock and surgery, helped make stress a major concept in both psychology and medicine. Selye proposed that the body’s adaptive response to stress is so general that, like a single burglar alarm, it sounds, no matter what intrudes. He named this response the general adaptation syndrome (GAS), and he saw it as a three-phase process (FIGURE 33.3). Let’s say you suffer a physical or an emotional trauma:

Selye’s basic point: Although the human body copes well with temporary stress, prolonged stress can damage it. Severe childhood stress, such as from abuse, gets under the skin, leading to greater stress responses and disease risk (Hanson et al., 2015; Miller et al., 2011). Even fearful, stressed rats have been found to die sooner, after about 600 days, than their more confident siblings, which average 700-day life spans (Cavigelli & McClintock, 2003).

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There are other ways to deal with stress. One option is a common response to a loved one’s death: Withdraw. Pull back. Conserve energy. Faced with an extreme disaster, such as a ship sinking, some people become paralyzed by fear. Another option (often found among women) is to give and seek support—what’s called the tend-and-befriend stress response (Taylor et al., 2000, 2006).

Facing stress, men more often than women tend to withdraw socially, turn to alcohol, or become aggressive. Women more often respond to stress by nurturing and banding together. This may in part be due to oxytocin, a stress-moderating hormone associated with pair bonding in animals and released by cuddling, massage, and breast feeding in humans (Campbell, 2010; Taylor, 2006).

It often pays to spend our resources in fighting or fleeing an external threat. But we do so at a cost. When stress is momentary, the cost is small. When stress persists, the cost may be much higher, in the form of lowered resistance to infections and other threats to mental and physical well-being.