Content Note: mention of addiction, overdose
In 1994, Robert M. Sapolsky published his famous book ‘Why Zebras Don’t Get Ulcers’, which has since become a staple text in health psychology. I know what you’re thinking: ‘why should I care about the physiology of zebras?’ – and that’s a fair point, you probably shouldn’t. But what you should care about is your physiology. Stress is one of those illusive figures in psychology and medicine; it creeps up on you in your everyday life, and somehow turns out to be connected to every sinister plot of the body, from common colds to major metabolic disease. Sapolsky managed to tackle some of the most difficult issues surrounding stress, including its causes, its effects, and how we can manage it. So, grab a cup of tea and relax. Let’s talk about stress!
Unlike zebras, human beings deal with chronic and psychological stressors which often have no immediate fix. For the average student this ranges from irritably noticing that your flatmate has forgotten to do the dishes again, to suddenly realising you have a 2,000-word essay due for tomorrow morning.
Stress doesn’t cause disease, but rather increases the chances of it and exacerbates existing issues.
Now for the technical stuff. If biology mumbo-jumbo tends to activate your stress-response, you may want to skip this bit! For those of you still here… The basic stress-response utilises the sympathetic nervous system, which involves the secretion of adrenaline from the adrenal glands. This is your ‘fight-or-flight’ response, which causes an accelerated heart rate, increased blood pressure, inhibited digestion, inhibition of reproductive organs, and the release of hormones which prevent cells from storing energy. These are all useful functions that have evolved as survival adaptations, helping humans and zebras alike to escape immediate and short-term threats. However, if this stress-response is activated frequently or for an extended period of time, this causes your body to be knocked out of physiological balance, which can eventually lead to all sorts of problems, such as cardiac disease, infertility, reduced immune function, sleep disturbance, and much more. However, it is important to note that stress doesn’t cause disease, but rather increases the chances of it and exacerbates existing issues.
It’s not all doom and gloom though! There are ways that we all can help to prevent and manage stress. Here are some of the key ideas that Sapolsky raises:
1) Predictability and Control
As an example, Sapolsky discusses a hospitalized patient with chronic pain, who frequently hits the call button, asking the nurse when their next painkiller is coming. To avoid addiction or overdose, the nurse cannot give the meds as frequently as the patient wants them, and so she has to keep explaining that it is not yet time for them. But what if the patient had the freedom to self-medicate? They’ll overdose, become addicts – you can’t let them do that, can you? When it was tried with cancer patients and postsurgical patients, researchers found that this was not the case. In fact, the number of painkillers consumed actually decreased. But why? Because as you lie there, in pain and uncertain of everything, you ask when your next painkiller is coming not only because you are in pain, but also to stop the uncertainty. If you return predictability and control, the pain becomes more manageable.
Exercise counters stress on a number of fronts. Firstly, it lowers your risk of many cardiovascular and metabolic diseases. Next, it makes you feel good. Not in all cases, granted. When you’ve spent all day listening to your lecturers drone on about X, Y and Z, sometimes the most stressful thing in the world is the thought of sweating on a treadmill. However, properly controlled studies have found that exercise consistently improves mood. It causes the release of beta-endorphins, and gives you a sense of achievement and self-efficacy. Not to mention the potential for better body positivity and confidence!
When done regularly and for a sustained period (e.g. 15-30 minutes daily), meditation appears to improve health and decrease glucocorticoid levels (a steroid hormone associated with stress-related disease).
4) Social Support
To quote Sapolsky, “this one should be a no brainer – social support makes stressors less stressful, so go get some” (p.406). Obviously not just anyone can have this effect on you; I’m sure you can think of at least one person that you would definitely not want to be around, and to be stuck with them would probably cause a stress response. At the same time, in some circumstances you might rather just be alone. Getting social support from the right people is key, but so is giving it. One of the best ways to reduce stress is to give social support to someone else; to be needed. “In a world of stressful lack of control, an amazing source of control we all have is the ability to make the world a better place, one act at a time” (p.407).
5) Religion and Spirituality
Psychology students will be familiar with the term ‘locus of control’. This is a personality trait which represents to what degree you believe the outcomes of your life are in your own control. In some circumstances, to have an internal locus of control (to believe you are the master of your own destiny) is a brilliant stress-managing trait. For example, if you have an exam looming then the best approach is probably to study, rather than check if your horoscope forecasts luck that week. However, spirituality and religion has been shown to be immensely helpful in particularly stressful times. Sapolsky discusses research conducted by Carl Thoresen of Stanford University, who finds that “regular attendance at religious services is reasonably predictive of a decreased mortality rate and of decreased risk of cardiovascular disease and depression” (p.409), but also that religiosity doesn’t seem to predict cancer progression, cancer mortality rates, medical disability, or recovery speed from illness. As with most studies, there are a range of possible confounds to these studies, and these are correlational results; they don’t prove a causal relationship, but merely show a statistical link.
Stress is a powerful force, but it is one which we have the ability to control.
Food for thought, isn’t it? Ultimately stress is a powerful force, but it is one which we have the ability to control. To finish, I’ll let Sapolsky take the mic’. “In our privileged lives, we are uniquely smart enough to have invented these stressors and uniquely foolish enough to have let them, too often, dominate our lives. Surely we have the potential to be uniquely wise enough to banish their stressful hold” (p.418).
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