As it turns out 60-90% of visits to health care providers are stress-related. Recent studies of human well-being have shown that the US population is “mildly happy” only 54% of the time. Psychosocial stress takes a significant toll on human happiness and well-being.
In a "holistic" approach, mental and physical health requires the proper balance of multiple factors with the dual goals of prevention of emotional and cognitive disorders (e.g., panic and anxiety attacks or inability to concentrate or pay attention) and the promotion of individual well-being.
What is psychoneuroimmunology, that is, how does psychosocial stress affect the brain and body? Click here
Personality places a significant role in mental and physical health. That's because the big five (5) personality dimensions are deeply rooted in human biology and culture and, as a result, play a significant role in psychosocial stress as well as in mental and physical health. The good news is that they can be generally managed with various forms of psychotherapy, medication, and other forms of treatment.
(1) Neuroticism connotes the preponderance of negative affect in one's personality as in someone who is frequently anxious or depressed.
(2) Extraversion indicates the preponderance of positive affect in one's personality as well as the propensity to be outgoing as opposed to being introverted with others.
(3) Openness reflects the extent to which someone is open to novel experiences as opposed to someone who is closed to new people, places, events, and things.
(4) Agreeableness is the ability of an individual to get along with as opposed to being antagonistic with others.
(5) Conscientiousness is the ability in an individual to do the right thing with oneself and others as opposed to lacking direction in one's life and with others.
But, there are also other stress-related factors that impact on mental and physical health. What might some of these be?
- Age is important as early in life the level of responsiveness of the autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal axis are set and both are implicated in the human response to psychosocial stress
- Belief systems (e.g., having a positive attitude)
- Diet and nutrition
- Use and abuse of licit and illicit drugs including alcohol and cigarettes
- Education for its protective effects on mental and physical health
- Emotional style (e.g., an impatient versus calm individual)
- Physical exercise
- Relaxation, including touch, which facilitates the enhancement of the immune system
- Sexual activity
- Quality of sleep since 50% of Americans suffer from some form of insomnia (either initiating or maintaining restful sleep)
- Social support or one's social network of family and friends as well as colleagues at work
Psychological factors including psychosocial stress, therefore, have a significant effect on central nervous system functioning as well as on heathy functioning of the cardiovascular, endocrine, immune, and metabolic systems.
What is "psychosocial stress"? Click here
Psychosocial stress is a change in one's social environment (home, work) that requires psychological action (thought, emotion or movement). Psychosocial stress is affected by the following factors:
(1) Frequency and multiplicity of sources of stress → Examples of the results of multiple stressors: Cardiovascular disease, hypertension, and diabetes. Treatment: Stress reduction and education.
(2) Inability to adapt to stress → Treatment: Positive psychology: Relieve the states that make life miserable through facilitation of the positive emotions, strengths, and virtues.
(3) Belief systems influence one's expectations that affect health. These include placebo, nocebo, and iatrogenic effects. For instance, often fake substitutes of a medication are as effective as the real medication (placebo effect) or the so-called "white coat syndrome" that affects blood pressure readings in the physician's office. Treatment: Health education, stress reduction, and cognitive-behavioral therapy.
(4) Inability to shut down the stress response → Examples: Elevated serum cortisol and decreased bone density in women. Treatment: Various forms of the psychotherapies, stress reduction, and education.
(5) Inadequate stress response → Example: Autoimmune diseases. Treatment: Health maintenance and prevention and healthy lifestyle choices.
What are the health conditions that appear to result from stress?
(1) Stress causes the deposition of abdominal fat leading to cardiovascular disease and diabetes, which is also affected by chronic hostility towards others. Two-thirds of the US population are overweight; one-third are obese often leading to a condition called, "diabesity".
(2) Lack of control at work leads to hypertension and cardiovascular disease and these two conditions are also related to living and financial conditions.
(3) Stress-related disorders: Anxiety and depression; autoimmune and allergic disorders; fibromyalgia (chronic fatigue syndrome); headaches; hypochondriasis/malingering; neck, muscle, and back pain; interstitial cystitis and endometriosis; neuralgia; post-traumatic stress syndrome; and rheumatoid arthritis.
(4) Depression and chronic pain are closely associated. For instance, depression is commonly associated with lower back pain. 50% of Americans regularly complain of back pain.
(5) Preparation for surgery and infertility are psychosocial stress-related.
(6) Psychosocial stress is significantly implicated in most common autoimmune disorders: autoimmune hepatitis and cirrhosis, glomerulonephritis, Graves’ disease (thyroid), Hashimoto’s thyroiditis, hemolytic amnemia, insulin-dependent diabetes, multiple sclerosis, rheumatoid arthritis, scleroderma, Sjogren’s syndrome, and uveitis.
(7) Psychosocial stress is implicated in some early childhood disorders including asthma, attentional and hyperactivity disorders, influenza, and food allergies.
(8) Irritable bowel syndrome (IBD) may have an autoimmune component and dysthymia (mild depression) and depression are common. Premenstrual syndrome (PMS) may also have a psychosocial stress-related component.
(9) Major psychiatric disorders including bipolar mood disorders (mania and depression), obsessive-compulsive disorders (OCD), psychosis, and Tourette’s disorder may have significant autoimmune-related and psychosocial stress-related components.
(10) Children and in-laws, separation and divorce, living and financial conditions, marriage, pregnancy, sexual problems, work issues, and career changes are all psychosocial stress-related.
(11) Family constellation such as excessively enmeshed or distant families as well as dysfunctional family relationships are psychosocial stress-related.
Some suggested reading:
Sapolsky, R. M. (2004). Why zebras don’t get ulcers (3rd ed.). NY: Holt, Henry, & Company.