Stress

Can Coping With Stress Help You Live Longer?

New research suggests how we handle stress can help prevent premature death.

Posted Dec 13, 2017

Everybody has to live with stress on a regular basis. But what about people who already suffer from chronic illness? What impact does too much stress have on them?

Whether that excess stress comes from major life crises, such as the loss of a job or a spouse, or from too many of the small daily hassles in life that seem unavoidable, it's still going to take a toll on your health. Certainly, there have been an enormous number of studies showing that people reporting more stress in their daily lives will also experience more medical problems, and even a suppressed immune system. For people who already have chronic health problems, including asthma, rheumatoid arthritis, irritable bowel syndrome, diabetes, heart disease, etc, increased daily stress often means more severe symptoms.   

But how stress affects health often depends on the way that people respond to stress. According to the transactional model of stress first proposed by Richard Lazarus and Susan Folkman, how we respond to stress depends on the nature of the stressful event itself, the kind of inner resources we have for coping, how we appraise that stressful event, and the coping responses available to us. 

This means that the emotional distress that can lead to health problems are most likely to occur when we perceive stressful events as threats rather than challenges. Not only does this threat appraisal lead to negative emotions such as depression or anxiety, but it can also have a negative impact on the cardiac, endocrine, metabolic, and immune process in the body. 

All of this is part of the body's natural "fight or flight" response which prepares us for dealing threats to survival. But repeated activation of these body systems linked to stress can eventually take a toll. People dealing with day-to-day stress on a long-term basis will experience greater problems with chronic illness and depression, lower heart rate variability, smaller antibody responding to antigen exposure, lower sleep efficiency, and quite possibly, increased mortality risk.

With this in mind, a new study published in the journal Health Psychology examines the link between daily stress and mortality using a nationwide survey of American adults. Jessica Chiang of Northwestern University and a team of fellow researchers based their study on two longitudinal surveys looking at stress and health: the Midlife Development in the United States (MIDUS) and the National Study of Daily Experiences (NSDE).  

The MIDUS study specifically focused on middle-aged adults and occurred in two waves. The first wave was conducted in 1995 to 1996 with 7,108 American adults ranging in age from 25 to 74 years and the second wave following the same adults in 2002 to 2006. 

A smaller subset of the MIDUS participants was also used in the NSDE study. For this study, 1,843 randomly selected participants were interviewed by telephone over eight consecutive evenings about stressful events they encountered and their activities, behaviors, and emotions over a 24-hour period. Daily stress was measured in terms of whether they experienced one of seven different stressors in the previous 24 hours. Stressors included whether they had an argument, avoided an argument, had a stressor at work or school, had a stressor at home, faced discrimination, had a network stressor, or experienced any other stressor.  

The total stress experienced over the eight-day period was recorded to measure cumulative stressor exposure (total stress levels) as well as the proportion of stressful days occurring during that same period. Using specialized scales measuring how the stress affected participants emotionally, the researchers also measured affect reactivity, or the difference in affect levels between stressful and non-stressful days.  

Participants were also questioned about whether they had one of 26 chronic and acute health conditions occurring over the previous year as well as demographic data such as gender, age, and educational level. Because of attrition, the final sample for the current study was 1,346 adults for whom mortality data was collected through to October 2015. For participants who had died during this period, survival time was recorded as the interval between the first MIDUS interview and date of death.

As expected based on previous research, results showed that both cumulative stressor exposure and negative affective reactivity had a significant association with mortality risk, especially for people with a history of chronic illness. While it isn't entirely clear why stress-related increases in negative emotion might affect mortality, the researchers suggest that chronic issues with negative emotion linked to stress might disrupt many of the body's natural coping mechanisms such as sleep. All of which means increased problems with hormonal, cardiac, and immune system functioning, With this in mind, it's probably not surprising that life expectancy would be affected as well.

When looking at people already dealing with chronic illness, the impact that stress and negative emotions have on life expectancy is even more apparent. This suggests that having one or more diseases that can compromise the body's ability to heal also means a reduced ability to cope with stressful situations in a positive way. 

One example provided by Jessica Chiang and her co-authors deals with heart disease and the problems that can come from stress-related overuse of the sympathetic nervous system with inadequate recovery (also known as sympathetic dominance), something that often occurs in people who overexert themselves or engage in frequent worrying. This can lead to greater risk of future cardiac events and additional cardiovascular problems. 

So what do these results mean? According to the study authors, how people respond to stressful situations can have a greater impact on health and mortality than total stress exposure on its own. Even for people dealing with multiple sources of stress in their lives as well as serious health problems, affective reactivity seems to be significantly associated with later mortality risk. 

There are limitations to this research, however. Given that this is a correlational study, there is no direct proof that a causal link exists between mortality and affective reactivity. Still, by following a large sample of American adults over a 20-year time span, this study provides the clearest evidence yet that how people respond to stress can have a dramatic impact on later health, including life expectancy. This is especially true for people who already suffer from chronic conditions that might be adversely affected by stress-related health problems. 

While much more research is needed, this study also suggests that learning good coping skills and techniques for managing negative emotions can play an essential role in helping people already at risk for premature mortality live longer, more satisfying lives.

References

Chiang, J. J., Turiano, N. A., Mroczek, D. K., & Miller, G. E. (2017, November 20). Affective Reactivity to Daily Stress and 20-Year Mortality Risk in Adults With Chronic Illness: Findings From the National Study of Daily Experiences. Health Psychology. Advance online publication. http://dx.doi.org/10.1037/hea0000567