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By the time Teresa Langford started basic training in the Army at age 18, she knew that whatever rough spots she’d faced in her life had been good for her, or at least tolerable.
The proof came with her outdoing most of her troop on conditioning drills while taking the heat from the men who resented her outperforming them. Basic training tries to take you to your limit and then break you. Not Teresa. She knew coming in she had what it takes to make it. She would later serve two tours on active duty, rising to an ammunitions ordnance corporal.
How did she know? Most of us only find out the hard way what kinds of stress break us, how much is unbearable. The line between tolerable and intolerable stress varies from person to person and across our lifespans. To add to the confusion, many of the effects of toxic stress are delayed, sometimes by months or years, making it hard to tie the stress to its effects.
When Teresa was 8, her parents separated. They were both dairy farmhands in Gurley, Alabama. Her mother took Teresa and her two sisters to Florida to look for work, leaving her brother and father in Alabama. Within months, her mother landed in prison for writing bad checks, and the girls moved back with their grandparents. When her mother got out, she spent the next four years moving with the girls from job to job and school to school. Homelessness, separations, and always being the new kid in a new school added up to Teresa learning to work hard, be scrappy, and stand up for herself.
The Good and the Tolerable
We can be glad that evolution has given us a stress response system that automatically self-regulates the basic functions that keep us alive. Imagine every day trying to figure out your breathing patterns, your heartbeats, your digestion, your sleep, and your responses to pain and pleasure. We go through most of our lives hardly thinking about this everyday miracle of self-regulation.
Good stress, the demands for which we have plenty of resources, keeps this self-regulation process working. Meals, games, sex, walking—for most of us, most of the time, the challenges of daily life tune up our stress response systems in ways that keep us fit. Even the tolerable chores we don’t enjoy—doing the laundry, fixing the toilet seat, talking with the boss about the work plan—keep our stress response systems fit.
I Can’t Handle It
Extraordinary stress, on the other hand, puts persistent demands on us that we sense may overwhelm us. Stressors that persist beyond six months begin to feel toxic for many of us. This uncertainty over many months contributes to worry, which adds to the toxicity. Living in high-crime neighborhoods can do this. COVID-19 lockdowns did this in many cases. Living with an abusive spouse or working for a harassing boss can turn unbearable. Managing multiple chronic illnesses fits this definition. And growing up with four or more adverse childhood experiences, as Teresa did, fits this definition of extraordinary stress.
We’re a resilient species. Though about one in five of us will be exposed to toxic stress at some point in our lives, many of us will endure toxic stress for years without succumbing to illness or early death. This is part of what makes it difficult to study the relationship between stress and illness. To catch this connection often takes a lifetime, or longitudinal studies of stress and illness across the lifespan.
Our Epidemic of Stress-Related Illnesses
In the 1980s, or roughly four decades ago, rates of obesity started climbing in the U.S. Rates of diabetes started climbing in the 1990s, along with rates of metabolic syndrome. Similarly, rates of depression, suicide, attention deficit hyperactivity disorder (ADHD), PTSD, and addictions have also risen, possibly reflecting decreasing stigma and increasing access to treatments. Equally puzzling has been the rise of autoimmune disorders, (multiple sclerosis, lupus, celiac disease, for example). This collection of disorders could hardly be more different from each other in their pathologies, but they all share one feature: high levels of stress increase the risk of the onset, progression, complications, or early death from these disorders.
One of our most fascinating and urgent public health mysteries: Why has this rise in the rates of so many stress-related disorders taken place at this time in our history of relative affluence and security?
At the age of 46, Teresa nearly died from hemorrhagic pancreatitis, and during her recovery, she faced the fact that she had been coping with five chronic conditions: obesity, diabetes, chronic pain, PTSD, and untreated ADHD. Here were five ways her stress response system was struggling to self-regulate. The cumulative burden of her genes, her life stressors, and aging had rattled her stress response system beyond her ability to function or heal herself.
Teresa spent several years rebuilding her resilience with the help of her loving wife, a pain program, a PTSD program, therapy, and later, her role at the VA as a peer coach helping other veterans retrain their stress response systems. She’s among the few who have experienced slowing, halting, or reversing of several chronic illnesses—a tougher challenge than Army basic training.
