Rethinking Stress: What the Latest Research is Telling Us

Patient Expert

We need to rethink how we look at stress. Do I have your attention?

For more then a decade, I have written extensively about the devastating effects of chronic stress on our mental and physical health, both here at HealthCentral and elsewhere. So linked is stress to depression and mania that it pays to conceptualize bipolar as a downstream effect of stress. In effect, managing bipolar is a nonstarter without managing stress.

So far, so good. Here comes the rethinking part:

We see stress as a pathology. Yes, we recognize stress as an adaptive tool that primes us for fight or flight, but this is viewed as overkill in today's world. Basically, our ancient biology sets us up for tomorrow's heart attack, nervous breakdown, auto-immune disease, you name it.

Not so fast, says Stanford psychologist Kelly McGonigal. In an eye-opening TED talk, she confesses that for ten years she has taught people that stress is the enemy. But she has changed her mind.

Her epiphany came with a study (Keller et al, 2012) that tracked 30,000 adults over eight years. The researchers asked, "How much stress have you experienced in the past year?" They also asked, "Do you believe that stress is harmful for your health?" Then they waited to see who died. No surprise: Those who had experienced a lot of stress in the past year had a 43 percent increased risk of dying.

Big surprise: This finding was only true for the people who also believed that stress is harmful for your health. Not only that, people who experienced a lot of stress but did not think it was harmful had the lowest risk of dying, even lower than those who had very little stress.

According to Dr McGonigal, this translates to more than 20,000 Americans a year dying not from stress, but from the belief that stress is bad for you.

Dr McGonigal asks us to imagine ourselves under stress, heart pounding, breathing faster, breaking into a sweat. Normally we interpret these physical changes as anxiety or signs that we are not coping very well under pressure. "But what if you viewed them instead as your body was energized, preparing for you to meet this challenge?"

A Harvard study she cited (Jamieson et al, 2012) validates this view. In the study, participants were taught to rethink their stress response as helpful (breathing faster, for instance, gets more oxygen to the brain) before they were exposed to a standard stress test (such as doing a math test in public). The participants sailed through the test. Get ready for the significant finding:

Ordinarily, when stressed, your heart rate goes up and your blood vessels constrict. Those in the study experienced pounding hearts, but their blood vessels stayed relaxed. According to Dr McGonigal, the response "actually looks a lot like what happens in moments of joy and courage."

We're just getting started. You may have heard of the neuro-hormone oxytocin, which has received a lot of attention as the "love hormone" or "the cuddle hormone," but it also induces us to strengthen close relationships. Get ready: Oxytocin is actually a stress hormone. The pituitary gland pumps this stuff out as part of the stress response. It's as much a part of the stress response as adrenalin.

According to Dr McGonigal, when oxytocin is released as part of the stress response, our biology is nudging us to seek support instead of bottling everything up. The hormone also benefits the heart (which has oxytocin receptors). Accordingly, when you reach out to others (either to seek help or give support) your stress response becomes healthier and you recover faster. Thus, our stress response has its own secret weapon for resilience, which is human connection.

One more study: This one (Poulin et al, 20013) tracked a thousand people over five years. Predictably, the ones who experienced recent major stressful events (such as financial difficulties) incurred a 30 percent increased risk of dying. But - surprise, surprise - those who spent time caring for others showed absolutely no increase in dying. Thus, says Dr McGonigal:

The harmful effects of stress on your health are not inevitable. How you think and how you act can transform your experience of stress. When you choose to view your stress response as helpful, you create the biology of courage. And when you choose to connect with others under stress, you can create resilience.

In essence: "You're saying that you can trust yourself to answer life's challenges, and you're remembering that you don't have to face them alone."

Now for the cherry on top: At the end of her talk, the TED moderator asked Dr McGonigal about someone making a lifestyle choice between a stressful job and a non-stressful job. Dr McGonigal noted: "One thing we know for certain is that chasing meaning is better for your health than trying to avoid discomfort." Thus: "Go after what creates meaning in your life, and then trust yourself to handle the stress that follows."

Dr McGonigal did not discuss the stress-mental illness connection, but it is clear that we can use her talk as the basis for this conversation. I look forward to more posts on this topic, and - it goes without saying - I can use your help. Please check out her TED talk below, then gives us your thoughts in the comments section ...