Stress, Health & Disease - Why Zebras Don't Get Ulcers (ch18)

Chapter 18: Managing stress

Consider the physiological studies of people carrying out dangerous, stressful tasks (e.g. parachuting). The studies show the same pattern: most people have stress-responses but a subset is physiologically unflustered.

Questions of this chapter: Who makes up that subset that can cope? How do they do it? And how can we?

Successful aging

• Old rats secrete too much glucocorticoids- they have elevated levels during basal, non-stressful situations and difficulty shutting off secretion at the end of stress. This could arise from damage to the hippocampus, the part of  the brain that helps inhibit glucocorticoid secretion.
• The glucocorticoids could hasten the death of hippocampal neurons.
• The tendency of glucocorticoids to damage the hippocampus increases the over secretion of glucocorticoids, which in turn leads to more hippocampal damage, more glucocorticoids, spiraling downward.
• If a rat is handled during the first few weeks of its life, it secretes less glucocorticoids as an adult. Therefore, it will have less problems with hippocampal degeneration in  old age.
• Despite the mathematical impossibility, the average aged person feels herself to be better off than the average aged person.
• Being needed and respected in old age is related to successful aging.

Coping with illness and learned helplessness

• A study concerning the parents of children with cancer showed that some parents secreted immense quantities of glucocorticoids and others average amounts. The parents with lower levels of glucocorticoids were able to:

1. Displace their worries onto something less threatening.
2. Deny that relapse and death were likely and instead focus on the seemingly healthy moments.
3. Use religious rationalization to explain the illness (e.g.: God is testing us)

•  Feeling helpless when faced with an uncontrollable stressor, and globalizing that stressor enhances feelings of giving up on life.

Stress management lessons from baboons

• Males with low glucocorticoid personalities were likely to remain high-ranking significantly (3x) longer.
• Older baboons get harassed by younger ones. Those old baboons who don’t have a strong social network may even transfer to another group because of it, which is a stressful and hazardous journey. Those who have strong social connections stay and feel less stressed, despite the harassment.

Applying principles of dealing with psychological stress

• We can change the way we cope, both physiologically and psychologically.
• By exercising you lower your blood pressure and resting heart rate and increase ling capacity etc.
• Among type-A people, psychotherapy is useful for changing behavior. It also lowers cholesterol profiles, risk of heart attack, and risk of dying, independent of changes in diet or other physiological regulators or cholesterol.
• Repetition of certain activities can change the connection between your behavior and activation of stress-responses.
• The workings of the stress-response can change over time.

Self-medication

• When giving painkillers to patients and letting them decide when they need medication reinstitutes control and predictability to the patients. This way the pain becomes more manageable and patients actually consume less painkillers.
• If people in the nursing homes get the power of decision making and get responsibilities (e.g.: watering plants) they become more active, initiating more social interactions.
• When staff at nursing homes encourages patients, their performance improves. However, when they simply help them, their performance decreases.

Exercise

• It decreases your risk of various metabolic and cardiovascular diseases, therefore decreases the opportunity for stress to worsen those diseases.
• Exercise generally makes you feel good due to the secretion of beta-endorphins and the sense of self-efficacy and achievement.
• There’s some evidence that exercise makes for a smaller stress-response to various psychological stressors.
• Aerobic exercise (e.g. jogging) is better for your health than anaerobic exercise (e.g. sprinting).
• You need to exercise a minimum of 20 to 30 minutes at a times, a few times a week, to really get the benefits.

Meditation

• Meditation decreases glucocorticoid levels and lowers blood pressure.
• It is not clear if the benefits of meditation persist, and if so if it is because of bias.

When predictability isn’t good

• It does little good to get predictive information a few seconds before or way in advance of a bad event happening
• Predictive information can make things worse if the information tells you too little – e.g.: “go about your day as normal, but be extra careful”.
• An overabundance of  information can be stressful too.
• Too much of a sense of control can be crippling – e.g. thinking that by being stressed you are making your stress worse.

Religion and Spirituality

• A huge literature shows that religious belief, religious practice, spirituality, and being prayed for can maintain good health.
• Having an explanation for things when they are going wrong, may be able to reframe the event in a more positive light.
• Religion can be very good at reducing stressors, but is often the inventor of those stressors in the first place.

Cognitive flexibility

• Women, on average, tend toward emotion- or relationship- based coping styles, whereas men tend toward problem-solving approaches.
• Typically, problem-solving approaches work better in case of illness; emotion-and relationship-based coping works better in the case of a death.
• Different styles tend to work better in different circumstances. E.g.: It is better to cope with stress for an exam with studying than to reframe the meaning of a bad grade.
• Cognitive flexibility: Implicitly switching to the optimal strategy for the particular circumstance.
• When our coping strategy isn’t working, we tend to use that strategy even more, instead of trying something new. It is better to be able to switch between strategies easily.

Just Do It: The 80/20 Quality of Stress Management

•  80/20 rule to stress management: 80 percent of the stress reduction is accomplished with the first 20 percent of effort.
• For example, clinically depressed people feel significantly better simply by scheduling a first appointment to see a therapist.
• If you manage to do any stress reduction techniques daily, you are on the right path.

Resources: Sapolsky, R. Why zebras don’t get ulcers: The acclaimed guide to stress, stress-related diseases, and coping. New York (NY): Henry Holt and Company. 2004 3rd edition