“Stress is in the eye of the beholder” (Sumner, 2023, p.130)
By Dr Niamh Higgins (April 2024)
While stress is something that we all experience in our day-to-day lives, the extent to which particular circumstances or situations are perceived as stressful, varies from one individual to the next. What might be deemed as stressful by one individual, may be of little consequence to another. Psychologists commonly define psychological stress as a physical, psychological and emotional state that arises when there is a discrepancy between the demands of a situation and the resources we have, (real or perceived), to cope with that demand. This means that the experience of psychological stress can be said to be subjective in that it is dependent on our evaluations of both the potentially stressful circumstances that present and our perceived ability to cope with them. This understanding
stems from the well-known Transactional Model of Stress developed by Lazarus and Folkman (1984). The model outlines the process of primary appraisal where we consider if and then how much, threat or harm to our life goals or wellbeing we face, and secondary appraisal where we decide whether or not we possess the resources (internal or external) to cope with any threat or harm that presents. If we perceive ourselves as well positioned to meet the challenge or threat that presents, be that through personal strengths, financial or other resources, the likelihood of us feeling ‘stressed’ is greatly reduced. On the other hand, when we see ourselves falling short with respect to the resources needed to meet the demands posed, such as by not having sufficient time to study for an exam or meet a deadline, the likely outcome is a feeling of stress.
Our Body’s Response to Stress
The way in which our bodies respond to stress, referred to as our physiological stress response, is one that has evolved over millennia from a time when the types of stressful circumstances we encountered were life or death situations necessitating a ‘fight- or-flight’ response. This response, first coined as such by Walter Canon in the 1920’s, involves the activation of our sympathetic
nervous system, resulting in the release of the hormones noradrenaline and adrenaline which in turn cause our breathing to become faster and deeper and our blood pressure and heart rate to increase to carry oxygen and glucose (blood sugar) to the muscles of the body where it is needed to take action (fight) or flee. A second system that is activated more gradually than the sympathetic nervous system when we experience stress, is the hypothalamic-pituitary-adrenal or ‘HPA’ axis system. The activation of this system, in brief, involves the release of hormones one of which includes the so called ‘stress hormone’ cortisol. One of the roles of cortisol is to release energy into the bloodstream. It also plays a role in regulating inflammation in the body. Our physiological response is adaptive and healthy when it allows us to meet the metabolic demands of the present situation.
In today’s modern society, the hormonal, inflammatory and cardiovascular responses that comprise our physiological response to stress tend to be activated, not by immediate life or death situations, but either by acute or chronic stress. Acute stress is short in duration, presents typically in the form of daily hassles like waiting in line or getting delayed, or in situations like sitting an exam or doing an interview and its impact is short-lived. Chronic stress endures over prolonged periods of time. Common examples of chronic stress which are studied by researchers include caregiving for a sick or disabled family member and long-term unemployment.
The Relationship between Stress and Health
The experience or anticipation of psychological stress elicits a cardiovascular response characterized by increases in resting blood pressure and heart rate, and a gradual return to baseline levels when the stress has ended, referred to as cardiovascular reactivity. Patterns of cardiovascular reactivity to stress appear to show stability over time such that, for example, those who tend to respond with exaggerated reactivity to a stressor will do so across time or contexts. The Cardiovascular reactivity hypothesis (Obrist, 1981) proposes that prolonged or exaggerated increases in blood pressure and heart rate from resting levels in response to psychological stress can contribute to increased risk of future development of cardiovascular disease (CVD). A large number of research studies provide evidence in support of this hypothesis. More recently, research findings are showing that not only are ‘larger than normal’ cardiovascular responses implicated in greater risk of CVD, but so too are minimal or ‘blunted’ cardiovascular responses (i.e., what might be considered as lower than normal responses).
The Goldilocks Effect
If both larger and lower responses - that is, atypical responses - are associated with poorer prognosis in the context of the development of CVD, what might a normal or healthy response be? Turner and colleagues (2020) refer to the ‘Goldilocks effect’ and suggest that responses in the mid-range (where blood pressure and heart rate increase in proportion to current situational demands and return to resting levels when the stressor ends) are best in terms of positive health outcomes. Similar findings are emerging for the stress hormone cortisol. Researchers have shown higher cortisol reactivity (Hamer & Steptoe, 2012) to be associated with greater risk of hypertension (heightened blood pressure; a risk factor for cardiovascular disease), and lower than normal cortisol responses to stress to be linked to increased risk of future ill health (Lovallo, 2016).
What about prolonged or repeated exposure to stress? In the longer term, as when chronic stress presents, the repeated activation of this physiological response can result in excessive wear and tear on our bodies, a concept referred to by McEwen (1998) as ‘allostatic load’, and research findings show that it is associated with greater risk of development of chronic disease, including cardiovascular disease, which is one of the leading causes of death worldwide.
Effective Stress Management
Knowing what we know about the subjective nature of stress and the well-established links between stress reactivity and health outcomes, it’s not surprising then that many researchers have focused their efforts on establishing the ways in which we can cope better with stress. The good news is that there are a number of evidence-based approaches that we can adopt that in turn can minimize the negative effects of stress on our health.
One factor that has attracted much research attention and is well established as an important resource for managing stress is social support, which describes the perception that we are cared for and loved, esteemed, and part of a network of mutual obligations (Cobb, 1976). Social support is one important dimension of social connectedness which refers to the function, structure and quality of our social relationships. Having strong social relationships is strongly linked to better physical health outcomes, and one pathway by which this may operate is via the impact of social connectedness on our cardiovascular reactivity to stress. If you are interested in learning more about the relationship between cardiovascular reactivity to stress and social support, you can do so in the following paper I published with colleagues from University of Limerick and Baylor University Texas:
Creaven, A. M., Higgins, N. M., Ginty, A. T., & Gallagher, S. (2020). Social support, social participation, and cardiovascular reactivity to stress in the Midlife in the United States (MIDUS) study. Biological Psychology, 155.
The paper is available at this link.
- Practicing gratitude (for instance by writing about people and things we are grateful for)
- Getting regular physical activity
- Practicing mindfulness - by attending, with awareness, to one’s experience in the present moment – and meditation
- Getting regular high-quality sleep
- Reframing our thinking by becoming aware of our inner self talk and challenging our perspective of a situation.
Some effective approaches to managing stress include:
So the next time you’re feeling stressed, you may find it helpful to connect with a supportive friend or family member, engage in physical activity that you enjoy, meditate or practice mindfulness. Personally, I find a brisk walk or run most helpful in managing stress and maintaining a healthy lifestyle. And remember, it’s not all bad news when it comes to stress. When we push our personal boundaries to rise to a challenge, we broaden our skills and capabilities and the experience of psychological stress can be a very positive thing.
References
Cannon, W. B. (1929). Bodily changes in pain, hunger, fear and rage (2nd ed.). Appleton.
Cobb, S. (1976). Social support as a moderator of life stress. Psychosomatic Medicine, 38(5), 300– 314.
Hamer, M., & Steptoe, A. (2012). Cortisol responses to mental stress and incident hypertension in healthy men and women. The Journal of Clinical Endocrinology & Metabolism, 97(1), 29-34.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer Publishing Company.
Lovallo, W. R. (2016). Stress and Health: Biological and Psychological Interactions (3rd ed.). Sage Publications Ltd.
McEwen, B. S. (1998). Protective and damaging effects of stress mediators. New England Journal of Medicine, 338, 171–79.
Obrist PA. 1981. Cardiovascular Psychophysiology: A Perspective. Plenum Press.
Sumner, R. C. (2023). A Biopsychosocial approach to health: From cell to society. Sage Publications Ltd.
Turner, A. I., Smyth, N., Hall, S. J., Torres, S. J., Hussein, M. Jayasinghe, S. U., Ball, K., & Clow, A. J. (2020).Psychological stress reactivity and future health and disease outcomes: A systematic review of prospective evidence. Psychoneuroendocrinology, 114, 104559.
