AHA names top advances in cardiovascular disease research for 2023
Can Scientists 'solve' Stress? They're Trying.
From cardiovascular disease and obesity to a weakened immune system, the side effects of stress can be life-altering. But there may be a way to prevent those outcomes.
Raising triplets Hays, Presley, and Millie is challenging for Caitlin and Chris Nichols of Lawrenceville, Georgia. Born prematurely, the children have long-term health problems. Caregivers of chronically ill children face health difficulties themselves: Telomeres—protective caps at the ends of chromosomes—are shorter than expected, a possible sign of stress-related aging.
ByYudhijit Bhattacharjee
Photographs byBrian Finke
May 14, 2024
As modern-day stress ratchets up to what feels like unbearable levels, researchers are striving to learn more about the precise mechanisms through which it affects our body and mind. The hope is that by unlocking more about how stress works physiologically, we can find ways to prevent it from permanently harming people.
Over the last five decades, scientists have established beyond doubt that persistent stress really can poison our overall health. In addition to increasing the risk of cardiovascular disease, stress plays a role in obesity and diabetes and can weaken the immune system, leaving us more vulnerable to infectious diseases. You can recover swiftly from an episode of acute stress—for example, the alarm one might feel when caught unprepared for a presentation. Chronic stress, on the other hand, is more toxic as it is an unrelenting circumstance that offers little chance for a return to normalcy. Financial strain, having a bully for a boss, and social isolation are all examples.
Inside the Computer Assisted Rehabilitation Environment Laboratory at Walter Reed National Military Medical Center in Bethesda, Maryland, Army veteran Wayne Christian walks toward an emotionally triggering photo of himself. Studies indicate that by helping patients confront traumatic memories and process the negative feelings around them, this advanced treatment reduces the symptoms of severe post-traumatic stress disorder.
Today chronic stress seems to be increasing worldwide, as people grapple with rapid socioeconomic and environmental change. A 2023 national survey by the American Psychological Association found that stress has taken a serious toll since the start of the pandemic, with the incidence of chronic illnesses and mental health problems going up significantly, especially among those ages 35 to 44.
(Do you have chronic stress? Look for these signs.)
So far, one of the major realizations among scientists is that stress harms all of us in different and powerful ways. But is there any way to avoid it—or at least recover more quickly? Some promising avenues of research offer hope for the future.
High school junior Zainab Khorakiwala undergoes a functional MRI as part of a study by Harvard's Stress and Development Lab examining how everyday stress affects teens' brain development.
Preventing chronic stress from harming you in the first placeGroundbreaking studies in orphans showed how stress in early life can leave an indelible mark on the brain.
"Chronic stress in early life has more serious and lasting effects, because that's when a lot of connections are being laid down in the brain," says Aniko Korosi, a researcher at the University of Amsterdam who has been conducting experiments on mice to elucidate that link between early-life stress and brain development.
Korosi may have found a surprising link between stress and the resulting nutrient composition in the brain. She and her colleagues noticed that mouse pups that had been exposed to stress in the first week of their lives—having been moved from their mother's care to a cage—had lower levels of certain fatty acids and amino acids in their brains compared with pups being raised in a stress-free environment.
She wondered if it was possible to normalize a stressed pup's development by feeding it a diet rich in the specific nutrients its brain would be lacking. To find out, the researchers first fed a supplemented diet to the mothers so it would pass through their milk, then continued to provide it in the pups' feed for two weeks after they were weaned. A few months later, the researchers tested the now adult mice in learning and memory. Unlike stressed mice that had never received an enriched diet, these mice did not display cognitive impairments.
(How wild animals cope with stress—from overeating to sleepless nights.)
In an Amsterdam lab, a mouse searches for the hole that allows it to escape a maze. Researchers stressed nursing females by limiting nesting material, to see the effects on their pups. Once grown, the mice were tested in the maze. In contrast to mice with easier infancies, the mice reared by stressed mothers did poorly, taking longer to remember where the escape hole was.
Early-life stress alters the way mouse brains operate. Examining thin slices of brain tissue, researchers at the University of Amsterdam observed abnormalities in microglia—cells whose job is to regulate the immune reaction in the brain and to keep the brain clean by removing dying neurons and other waste.
"I was surprised that changing the nutrition could have such a powerful effect, because it's such an easy intervention," Korosi says.
If further studies provide more evidence of the nutritional pathway, she says, there would be a strong basis for supplementing the diets of infants born to mothers living in stressful conditions.
Developing an early warning system for stressKatie McLaughlin, a psychologist at the University of Oregon, is investigating how mental health problems arise in adolescents as they're going through a particularly vulnerable time in their lives, transitioning to adulthood.
She and her colleagues are still collecting data, but a smaller, precursor study tracking 30 teenagers offers clues about what the researchers might learn—and how it might help them identify stress before it goes too far.
Monochromatic brain scan of a young girl highlights two sections in bright orange where emotional stimuli indicates signs of child maltreatment. Research into individuals who suffered abuse as children shows that their brains react strongly to emotional stimuli.
Tyler C. Hein and Christopher S. Monk, University of Michigan
In that study, McLaughlin found that the extent of stress experienced by a subject in the month before their lab visit changed how their brain responded to emotionally impactful information such as when they were shown a picture of a threatening face. The brain's prefrontal cortex, which helps regulate emotions, showed less activation when the subject had experienced higher levels of stress.
McLaughlin is optimistic that data from the ongoing study will help pinpoint changes in behavior as well as brain activity that predict the emergence of mental health problems like anxiety and depression. This could enable the development of targeted interventions delivered to teenagers at just the right time, she says. If the identified marker of stress were a sudden decrease in sleep duration or a sharp decline in social interactions, for example, it would be possible to push the intervention out to the individual on their smartphone.
"Like, here's a reminder about good sleep hygiene, or this might be a good time to check in with your counselor at school about what's been going on in your life," McLaughlin explains.
('Hysterical strength'? Fight or flight? This is how your body reacts to extreme stress.)
Learn more about stress and how to manage it Preventing inflammation caused by chronic stressGaining a deeper understanding of how stress affects the immune system may also help find a way to reverse those effects.
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Do natural adaptogens like ginseng actually combat stress?In the 1980s, psychologist Janice Kiecolt-Glaser and her virologist husband, Ronald Glaser, began exploring the physiological impact of stress on two notably stressed segments of society: medical students and older caregivers. The researchers found the students' immune systems were less robust when they were taking exams than during non-exam times—and that stress altered the body's response to vaccines.
Before her husband, Tommy, who suffers from Alzheimer's disease, moved to an assisted-living facility this year, caring for him took nearly all Ellen Ebe's time and energy. She participated in an Ohio State University study on how such caregiving affects the body's ability to fight disease, as well as the risk of depression and anxiety.
Researchers then administered the flu and pneumonia vaccines to individuals responsible for a spouse with dementia. Unlike medical students taking exams, who were likely stressed only in the short term, these people were experiencing unrelenting stress. When tested at set periods after inoculation, they had fewer antibodies compared with a control group—they couldn't maintain their protective response. "That gave us good evidence that the changes brought on by stress were biologically meaningful," says Kiecolt-Glaser, now an emeritus professor at the Ohio State University.
Around the same time, researchers led by Sheldon Cohen, now emeritus professor of psychology at Carnegie Mellon University, delivered cold-causing viruses into the nostrils of about 400 adult volunteers in the U.K. "The more stress they reported prior to our exposing them to a virus, the higher the risk was for them to develop a cold," says Cohen. The duration and type of stress mattered: Chronic economic or interpersonal stress were what really put people at high risk—and the longer it went on, the greater the susceptibility to falling sick.
Detention center officers participate in an active shooter training session at a former middle school in Texas. Law enforcement officials have a higher risk of cardiovascular disease compared with the general population. Even situations that officers know are drills have been shown to increase physiological stress markers.
Cohen and his colleagues also learned that when exposed to viruses, chronically stressed people tended to produce an excess of cytokines—proteins that serve as messengers of the immune system, traveling to sites of infection and injury and activating inflammation and other cellular processes to protect the body. Too many cytokines cause an excess of inflammation.
Researchers still don't know enough about how stress alters the immune system's ability to regulate cytokines to devise an intervention to reduce the inflammation, but in one way, these findings signal some hope: There are clear targets for more work to be done.
Understanding stress on a cellular levelThe future of understanding and combating stress may lie in our DNA.
In 2023, Ursula Beattie, then a doctoral student at Tufts University, and her colleagues found possible evidence that stress can overwhelm DNA's repair mechanisms. In their study, researchers repeatedly tapped on sparrow cages with pens, played the radio loudly, and other actions designed to cause distress but no physical harm. Blood and tissue samples from the sparrows after three weeks of this unpleasant treatment revealed damage to the DNA. "It's like if you had two pieces of string coiled up, just like DNA, and you took a pair of scissors and cut them," Beattie says.
Tufts University doctoral student Ursula Beattie holds a recently captured sparrow. For a study, she subjected similar birds to stress, such as being in a cage rolled around the lab. Blood samples reveal harm to their DNA, suggesting that repair mechanisms become overwhelmed.
In a separate study, Beattie measured sparrows' feathers for corticosterone—the stress-related hormone in birds. "We like to compare it to tree rings, which can give information about how a tree grew retrospectively," she explained. The feathers chronicle a stressful moment in time.
While these kinds of double-strand breaks in DNA occur all the time in sparrows and other species, including humans, the damage is typically reversed through self-repair mechanisms. In a chronic-stress setting, "those repair mechanisms get overwhelmed, which is how we see a buildup of DNA damage," Beattie explains. The damage in the birds appears to be the most severe in cells of the liver, she adds, suggesting that for humans, too, the extent and type of damage inflicted by stress might be different for different tissues of the body.
Separately, Kiecolt-Glaser and psychologist Lisa Christian at OSU are conducting a longitudinal study to determine whether chronic stress ages you more quickly. If results support a smaller, earlier study, it appears that chronically stressed caregivers not only are more likely to get sick and heal more slowly but they also show signs of accelerated aging.
We're still learning how deep stress goes into our bodies. But these exploratory findings mean we're getting closer to solving the puzzle that is stress, which promises a future where we can better meet the ongoing demand for change.
(20 stress-relief gifts for the frazzled friend in your life.)
Carline Raphael (at left), a public health worker in New York City, visits with new mother Marisela Bravo Berrera and her two-month-old daughter, Angel, to give advice on breastfeeding and good sleep habits for newborns. Research shows chronic stress alters the nutritional components of breast milk, so stress management for mothers of infants is key to the babies' healthy development.
Yudhijit Bhattacharjee has written more than a dozen National Geographic features, many of which delve into the science of human experience, including our cover story on stress. A contributing writer at the New York Times Magazine and author of The Spy Who Couldn't Spell, he manages stress by singing.Brian Finke has photographed multiple features for National Geographic, including the science of taste and The Carnivore's Dilemma. His work has been published in several books and featured in museum collections around the world. He manages stress by cycling around New York City.
A version of this story appears in the June 2024 issue of National Geographic magazine.
Common Causes Of Stress And How They Impact Your Health
On the broadest level, stress arises when events leave us feeling overwhelmed and out of control.
"Stress can come from any number of sources, whether it's trauma, difficult family relationships, health issues, or the dialogue in your own head," says Michelle Dossett, MD, PhD, MPH, an assistant professor of medicine at Harvard Medical School and a staff physician at the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital in Boston. "Even what we think of as a happy event, like throwing a party, can be stressful."
Feeling overwhelmed, challenged, or out of control sets off an internal process to help you confront the stressful situation. This process, known as the stress response, creates physiological changes: Your brain releases stress hormones, which make your heart pound, breathing quicken, and muscles tense.[2]
Here are the most common causes of stress.
Money Money is a constant worry for many people. Take the American Psychological Association's (APA) 2023 Stress in America survey, which found that all age groups reported money and the economy as significant stressors.[3] Moreover, people are more stressed about money and the economy than they were in 2019, the APA adds.
[4]
"Money is tied to basic survival needs like food, shelter, and healthcare. Loss of income can mean big changes to your lifestyle and quality of life, such as needing to move or losing your health insurance," says Seth J. Gillihan, PhD, a licensed psychologist in Pennsylvania and medical reviewer for Everyday Health.
Dr. Gillihan notes that finances can also stress us out because society equates wealth with self-worth and even morality, such as "assuming those who are less well-off must be 'lazy' or 'undisciplined.'" We become stressed trying to make and hold onto money because we worry what others might think of us if our finances fall apart.
Work Work is also a perennial source of agitation. According to Gallup's 2023 State of the Global Workplace report, employee engagement reached a record high of 23 percent in 2022. But workplace stress was also at a record high (44 percent).[4] U.S. Workers are among the world's most stressed employees, with 57 percent reporting stress daily — an eight-point bump from the previous year.
"With everyone connected to their digital devices, people are spending longer hours at work, even when they're home — it's harder to disconnect," says Dr. Gupta. "That means we're spending less time with family and friends, which makes things more stressful."
ParentingThe responsibilities that accompany raising kids can bring a roller coaster of emotions, including stress.
"The daily demands of parenting add to the list of what you're expected to do, regardless of what's going on with your job, your health, how much sleep you got last night, or other commitments," Gillihan says.
In addition, parents face the difficult combination of high responsibility and low control. "You want the best for your kids in every way, and society largely blames parents for how kids turn out, and yet you have limited power to direct your children's choices and the course of their life," Gillihan explains. Many parents aim for perfection, only to inevitably fall short.
Politics Politics and stress often go hand in hand. Research based on a survey of more than 1,000 Americans conducted after the 2016 U.S. Presidential election reveals that exposure to the daily political news cycle can cause chronic stress.[5]
"Our politics have gotten so tense and heated, and that conflict makes politics a really difficult space for a lot of us," Gillihan says. People worry about losing legal rights and protections, the fairness of elections, and what the other side will do if they win.
"Add the major conflicts around the world like in Ukraine and Gaza, and the role of politics in how our leaders respond to those conflicts, and it's easy to see how political issues tap into deep fears around safety and security," Gillihan says.
Health IssuesGetting — and, later, managing — a medical diagnosis such as type 2 diabetes, heart disease, and cancer can have a significant impact on your daily stress levels.
"Your health is foundational for so many of the most important parts of your life — your ability to work, do activities you enjoy, spend time with other people, and take care of your loved ones," Gillihan says.
When you don't feel well, it can create a cascade of other stressors, including loss of income, expensive medical bills, missing out on opportunities, relationship conflict, and worry over whether you'll recover, he adds.
Mental health conditions such as depression, anxiety, post-traumatic stress disorder (PTSD), and bipolar disorder are also often a major source of stress. Not only can they make stress harder to cope with, but they can add stress to your daily life.
"[Mental health conditions] often lead to a lot of impairment, meaning it's hard to take care of important things in your life such as being present at work or cooking meals for your family," Gillihan explains.
He notes that mental health conditions can also strain relationships. There may be conflict over not feeling supported or understood, disagreements about the best way to treat the condition, or if treatment is even necessary. This often adds an extra layer of stress.
Major Life ChangesSignificant life events — whether positive or negative — can cause stress. Divorce, marriage, the birth of a child, moving to a new home, the death of a loved one, and losing or gaining a job can impact your well-being.
Some life events can be more stressful than others. According to research, events that require more adaptation or change to your daily life, may be harmful or threatening, interrupt your life goals, and demand more resources than you have tend to cause the most stress.[6]
For example, while marriage and the birth of a child are often happy moments, both come with added responsibilities and disruptions to your typical routine. You may feel stressed trying to adapt to your "new normal."
Why Stress Impacts Health And Ways To Manage It
Whether at work or in our personal lives, stress impacts us all.
This Mental Health Awareness Month, National Geographic is launching its TAKE YOUR TIME campaign, inviting audiences to slow down and find time for themselves.
In the National Geographic June 2024 issue, contributor Yudhijit Bhattacharjee explores how stress impacts our daily lives and the latest science to understand and reduce chronic and acute stress.
High school junior Zainab Khorakiwala undergoes a functional MRI for Harvard's Stress and Development Lab's study examining how everyday stress affects teens' brain development.
Photo by Brian Finke/National Geographic
ADVERSE IMPACTS OF STRESSAfter largely ignoring the impacts of stress for years, scientists and experts now have a much better understanding of the science of stress and ways to cope it.
Bhattacharjee says it's crucial to deal with stress at an early age.
"Stress is so important, especially when when people are really young," Bhattacharjee said. "Chronic stress in infants can lead to deficits in attention deficits, in memory [deficits] and learning problems."
Stress can impact you at different ages. It's crucial to manage stress for babies and for young kids, but stress can impact adults in debilitating ways.
"As you get older, stress can affect your immune system, it can affect your cardiovascular health," Bhattacharjee said. "Stress is a major factor in anxiety and depression. And so unless you have tools to manage stress in your life, chances are that it will affect your health in these negative ways."
National Geographic's June 2024 issue.
National Geographic
When it comes to babies and young kids, it takes a village to support youth. In general, caregivers need to be mindful about what stress they bring into the home.
Bhattacharjee suggests making sure parents and caregivers share the responsibility and burden of taking care of babies or children.
"Parents and caregivers need to have a plan so that they themselves aren't so stressed that they're passing it on to their children," he said.
For example, if one parent is taking care of the child for several hours, the other parent or caregiver needs to step in and relieve them of duties for a little while to create a less stressful environment for the baby.
Bhattacharjee says there is a big relationship between socioeconomic status and stress.
"In families that have a hard time putting meals on the table, stress is definitely much higher," he said. "There's a need to need for the community to step up and provide help."
Bhattacharjee says to look into government programs intended to help families that are struggling and help protect children from the adverse effects of stress.
CAN SCIENTISTS 'SOLVE' STRESS?Scientists are trying to uncover the secrets of stress. So far, the only common finding is that stress harms all of us in different and powerful ways.
"Chronic stress in early life has more serious and lasting effects, because that's when a lot of connections are being laid down in the brain," says Aniko Korosi, a researcher at the University of Amsterdam.
Examining thin slices of mouse brain tissue, University of Amsterdam researchers observe abnormalities in microglia-cells whose job is to regulate the immune reaction in the brain.
Photo by Brian Finke/National Geographic
Korosi has been conducting experiments on mice to elucidate the link between early-life stress and brain development. The research offers a glimpse into understanding how stress impacts not only humans, but all beings.
HOW TO COPE WITH STRESSExperts now are highlighting meditation and other self-care activities as way to combat everyday stress.
"There are studies that show that meditation helps reduce anxiety [and] helps to reduce the risk of depression," Bhattacharjee said.
In his work, Bhattacharjee has found that those who practice meditation say they handle problems with more of a level head.
Devotees meditate at the BAPS Swaminarayan Akshardham complex in Robbinsville, New Jersey, the largest Hindu temple in the United States.
Photo by Brian Finke/National Geographic
"People who've been practicing meditation for years, they say things like they have less emotional reactivity," he said. "They're able to deal with difficult situations much better without getting hysterical, getting curious or becoming unstable."
But what if meditation isn't for you?
"Engage in the hobbies that make you happy, make an effort to carve out time for things like that," Bhattacharjee said. "I love to sing to de-stress. I sing karaoke. So music is my sort of go to activity when I'm feeling stressed."
For some people, that could be exercise, walking your dog or knitting. Any activity that makes you focus on one thing while pushing away intrusive thoughts.
The most important thing? Stay off your phone.
"All of those things involves taking your time," he said. "Find time for self-care. Engage in the hobbies that make you happy, make an effort to carve out time for things like that."
NAT GEO INVITES YOU TO 'TAKE YOUR TIME'National Geographic is urging you to "take your time" over this mental health awareness month.
Learn about the science of stress, how meditation and other self-care remedies can help alleviate stress in National Geographic's June 2024 issue.
Go to nationalgeographic.Com/magazine, where you can take the quiz to discover how stressed you really are, and if your stress level warrants a doctor's visit.
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