Stress and Vulnerability to Illness

LukeNotes, Spring 2020

Reactions to the COVID-19 crisis vary: sadness, fear, anger, or even despair. We are all navigating uncharted territory. Still, we have one thing in common: stress. Experience has taught us how critical stress is to survival: adrenaline and other hormones increase breathing, heart rate, and blood pressure, giving us energy to fight or flee. Our senses become keener, and we are less sensitive to pain. Our minds and bodies, in a temporary state of metabolic overdrive, are now prepared to respond to a life-threatening situation.

However, this innate response is not meant to last more than a brief period. The body needs to recuperate. People under chronic stress are vulnerable to more frequent and severe viral infections, such as the flu or common cold. Over time, continued strain from routine stress may lead to serious health problems, such as heart disease, high blood pressure, diabetes, depression, anxiety disorder, and other illnesses. The current pandemic has caused extraordinary levels of stress, the impact of which requires personal consideration.

How Does Stress Affect Me?

This is an essential, uniquely personal question. People feel stress in different ways. Some experience mainly digestive symptoms, while others may have headaches, sleeplessness, depressed mood, anger, and irritability. How does stress affect me physically, psychologically, spiritually? Knowing the answer may prompt me to seek treatment before the stress has taken too great a toll.

The Diathesis-Stress Model has been used in medicine and psychology for about 50 years. Diathesis refers to a genetic, cognitive, or social predisposition to a potential disease or disorder. That individual vulnerability is a trait that, under enough stress, can lead to illness.

According to one theory, each weakness has a liability threshold. In other words, once stress reaches a certain level, the illness will occur. Below a certain level, it will not. Other theorists employ an additive model, positing that stress adds to the potential of a vulnerability to transition into an illness.

Brief Clinical Example

A 56-year-old priest sought treatment for obsessive compulsive disorder (OCD), indicating fear that he was going to poison a member of his religious community. The interview revealed no actual desire to hurt someone and no real means to do so, but rather an obsessive thought he could not shed for over three weeks that had kept him isolated from confreres and secluded in his room except for prayer.

A clinical evaluation revealed that the priest had experienced similar OCD symptoms 30 years previously for a brief three-month period, and we explored possible causes for the symptoms returning. Everything had been going well in ministry and in fraternal life. However, he reported a recent hospitalization with pneumonia. When queried further about his medical history, he reported a similar pneumonia episode occurring when he was 26. Not a coincidence. He began a course of behavioral therapy and was free of the OCD symptoms in six weeks.

Successful treatment of OCD in six weeks is far shorter than the norm. In this specific case, a stressor (pneumonia) triggered a disorder (OCD) in a person with that vulnerability. The absence of the stressor made the treatment much easier.

Why Now?

One critical query in an initial evaluation is, “Why now?” What is different about today that leads a person to seek treatment? The stressor, like the vulnerability, may come in different forms: biological–in the form of illness, injury or surgery; social–in times of marriage, death, and transition; or environmental–mass unemployment, war, or a pandemic.

Reviewing a person’s history of symptoms, their family history of mental illness, along with their response to stressors over time, helps to determine any predisposition to a potential disease or disorder. If an individual has successfully undergone treatment before, that may point to a potential healing regimen for the current issue.

Preventative Measures

Stress is inevitable. Preparing for its effects can reduce the chance of reaching the liability threshold of a vulnerability. Each of us should take a personal inventory: What are my vulnerabilities? Is there any history of depression, anxiety, substance use, problems with sexuality, addiction, interpersonal challenges, self-destructiveness, or aggression? Have these ever been triggered by stress? How does stress affect me psychologically? How do I cope with stress?

The earlier the intervention, the better. As soon as a person notices initial symptoms of a significant vulnerability, e.g., depression, he should contact his mental health professional to check in. To wait may make treatment a longer or more difficult process.

If current methods of coping with stress are not contributing to greater emotional and physical health today, it is time to find healthier ways to manage and cope with stress. These all require change. One can either change the situation or change one’s reaction to it.

Avoiding unnecessary stressors is key. News shows and the Internet are draining experiences. Engaging in more life-giving activities will decrease stress. Examples include healthy eating, exercise, connecting with friends and family, working in the home or yard, following a schedule, and maintaining a daily rhythm.

Stress is a vulnerability factor for poor health. Instead of reacting negatively to stressors, we can choose to adapt to them or accept them. To adapt involves looking at the big picture and reframing the situation. Acceptance does not infer agreement, but it does mean moving forward: anticipating the next step, forgiving an injury, or looking towards the future.

Finally, prayer and meditation often reverse the effects of stress. Meditation is a natural form of relaxation, and all prayer reminds us of the meaning of life and our intimate connection to God and others.

Reverend David Songy, OFM Cap., S.T.D., Psy.D., is president and CEO of Saint Luke Institute.