4: Stress the Slayer of Sanity

Reading 1: The History of Stress

Szabo, S., Tache, Y., & Somogyi, A. (September 2012) “The legacy of Hans Selye and the origins of stress research: A retrospective 75 years after his landmark brief letter to the editor of Nature.” Stress, Vol 15(5), pp 472-478.

Although Hans was not the first to use the term stress, he was the first to discover the biological stress response, which he entitled, the General Adaptation Syndrome. Decades ago, in a fervent search for a new hormone, Selye serendipitously discovered the syndrome that underpins most medical diagnostic impressions. Selye demonstrated the role of the hypophysis-adrenal cortex in the stress response, thus opening the door for our understanding of how the entire body bears the brunt of even the most basic biological storm. One prolonged cold can wreak havoc on the entire body. One malfunctioning organ can wreak havoc on the entire body. One painful memory, piercing the psyche daily, can wreak havoc on the entire body. Stress is that thing that robs us of our serenity. We must understand the biology of such an enigmatic force, to understand the means by which we must fight it.

Key Concepts: stress, stressor, general adaptation syndrome, distress, eustress, catecholamines, glucocorticoids

Key Scholar: Hans Selye

Reading 2: Symptoms of Stress

As you read through the list of stress symptoms, it is interesting to note how encompassing our biological reaction to stress can be. When you read through the list, identify those symptoms that pertain to you. Is the list long? Are there any changes that you can make in your life that might lessen the perceived stress you are experiencing?

Reading 3: Types of Stress

Not all stress is created equally. There are different types of stress and knowing which type you are experiencing can serve to ameliorate the potentially grueling symptoms. Some stress is short- lived. Some stress is episodic. Some stress pounds, and pounds, until the body surrenders. This type of chronic stress can result from struggling within the confines of poverty, not knowing if food will be available from one day to the next; from being entrapped in a controlling and abusive relationship; or from battling the perverse dysfunction that may plague your nuclear family. The prognosis from this chronic state of stress is quite grim. Our bodies cannot survive such prolonged departures from the desired state of homeostatic balance—our organ systems will fail. We must be mindful of the complacency such discomfort breeds. If we reside within the corridors of chronic stress for too long, we become comfortably numb; our new normal is the discomfort.

Key Concepts: Acute stress, Episodic stress, Chronic stress

Reading 4: The Biology of Stress

Figure \(\PageIndex{1}\): Shwartz, M. (March 2007). Robert Sapolsky discusses physiological effects of stress.” Stanford News.

Sapolsky is one of the leaders in stress research, with an interest in how cognitive sophistication and free time have tethered us to the calamitous consequences of sustained elevations of adrenaline and glucocorticoids. Sapolsky argues that humans and primates have, “…evolved to be smart enough to make ourselves sick.” Interestingly, he purports that the social hierarchy in which we live, contributes significantly to our potential for elevated stress hormones, which will wreak havoc on our health. The silver lining for humans is that we, unlike baboons, have myriad opportunities for creating experiences for ourselves where we can be at the top of the hierarchy. After decades of research, Sapolsky identified the shield that can protect us from stress-related illness in our hierarchical world: social connectedness. So, that which can kill us, can also heal and protect us.

“We are capable of social supports that no other primate can even dream of. For example, I might say, 'This job, where I'm a lowly mailroom clerk, really doesn't matter. What really matters is that I'm the captain of my softball team or deacon of my church—that sort of thing. It's not just somebody sitting here, grooming you with their own hands. We can actually feel comfort from the discovery that somebody on the other side of the planet is going through the same experience we are and feel, I'm not alone. We can even take comfort reading about a fictional character, and there's no primate out there that can feel better in life just by listening to Beethoven. So, the range of supports that we're capable of is extraordinary."—Sapolsky

Key Concepts: psychosocial stress, non-life-threatening stressors, Type A personality, hippocampus, atrophy

Key Scholar: Robert Sapolsky

Reading 5: Social Neuroscience of Stress

Social neuroscience is a new field that applies the principles of neuroscience in combination with certain theories, to understand how other people influence both mental processes and behavior. Social neuroscientists also explore how we react to social stress and which brain structures are involved in this process. In this reading, you will discover the neuroscience underlying the insidious process of social categorization. Rather than relying on self-reports, researchers evaluate the automaticity of this process using instruments such as EEG and fMRI. Social neuroscientists study how our social interactions breed stress. Neuroendocrinological findings indicate that our perception of being judged by others and categorized by others can be extremely stressful. We are stressed when we give a speech or interact with outgroup members; we are stressed when the prospect of being judged becomes palpable.

Key Concepts: amygdala, fMRI, EEG, social categorization, social neuroscience, mPFC, stereotypes, functional neuroanatomy, neuroendocrinology, outgroup, ingroup

Reading 6: The ACE Score

In this landmark study, Dr. Vincent Felitti and Dr. Robert Anda surveyed upwards of 17,000 subjects, inquiring about their childhood history of trauma and familial dysfunction. With ten simple questions, researchers could assign an ACE score to each participant. This score predicted the likelihood of these participants to battle medical problems, mental health problems and social problems as adults. “The stress of severe and chronic childhood trauma – such as being regularly hit, constantly belittled and berated, watching your father often hit your mother – releases hormones that physically damage a child’s developing brain.”

Key Concepts: ACE Score, toxic stress

Key Scholars: Dr. Robert Anda, Dr. Vincent Felitti

Reading 7: PTSD

When faced with a life-threatening experience, we may develop PTSD. For some, trauma may affect their lives for only a few weeks; for others, the effects may be felt for several months or longer. If the symptoms persist for longer than several months, a PTSD diagnosis will most likely be given. Not being able to get over a traumatic event is not a sign of weakness; we all handle trauma differently. It is of paramount importance that you seek treatment if symptoms persist. PTSD is treatable and the prognosis is quite good if you stay with the treatment.

Key Concepts: PTSD, Talk Therapy, Prolonged Exposure Therapy (PE), Cognitive Processing Therapy (CPT), Eye Movement Desensitization and Reprocessing (EMDR), Stress Inoculation Training (SIT), SSRIs

Reflections:

1. Describe what was unique about Selye’s conceptualization of the stress response relative to Cannon’s model.
2. As you read through the common signs and symptoms of stress, do you see any that pertain to you? How might understanding the biology of stress help you to ameliorate these symptoms?
3. Describe at least one personal example of each of the following: acute stress, episodic stress, chronic stress (if applicable). What are some environmental factors that might breed chronic stress? Do you feel that our culture serves as a petri dish for chronic stress? Explain.
4. Assess the social hierarchies to which you belong. Do you feel that your perceived ranking serves as a stressor in your life? How might you combat this force?
5. If social categorization is an automatic process, to which we all fall prey, why should we persist in trying to understand it?
6. How could knowing your ACE score benefit you? How could knowing your ACE score be harmful? Explain.