Life Transitions, Change, and Healthy Stress Management

man-accepting-awardThe Holmes and Rahe Social Readjustment Rating Scale (1967) is an often-used inventory that lists 30 life events and transitions, each of which is ranked and assigned a score. Mind-body therapists and other practitioners use this assessment to predict the likelihood of illness or a negative change in health, due to stress, based on the total score for the previous 12 months. While individual reactions and responses to various life events and transitions vary, the events listed on this inventory are considered to be stressful—to one degree or another—for the majority who experience them.

Upon first glance, it makes sense that No. 1 on the list, “death of a spouse,” has the highest stress score (100 points). What is less clear is why item No. 6, “marriage,” has a score of 50 points, especially when “personal injury or illness” is 53 points. Why would getting married cause nearly the same amount of stress as a car accident or pneumonia? Why would item No. 19, “trouble with the in-laws,” add 29 points to the total score, while item No. 20, “outstanding personal achievement,” adds 28 points ? How could conflict with relatives be experienced as just as stressful as winning an award? Well, the reasons lie in our physiology and the fact human beings are simply hard-wired to have difficulty coping with life transitions and change, even those they want and welcome.

When things change, even for the better, it is not the outcome which causes stress; it is the nature of change itself and, more importantly, our perception of it. Life events and transitions may be positive, negative, or neutral, according to our perception of them. An unintended pregnancy might be a crisis for one couple and a triumph for another—same event, different response—according to the perception of the event and the meaning we assign to it.

If a life transition or event is perceived to be negative, it causes distress, while if it is seen as positive, the result is eustress. These terms were coined by endocrinologist Hans Selye in 1975 in his landmark work on the effects of stress. The mind processes the information and assigns meaning to the event, but the brain and body react primarily to the fact a change has occurred and we have moved away from our internal equilibrium. Because this shift occurs whether the life event is interpreted as positive or negative, the physiological changes that occur are the same. This is why two events—one that we are excited about and the other which is a huge disappointment—can have the same or similar stress scores on the Holmes and Rahe inventory and the same mental, emotional, and physical signs and symptoms and negative effects on future health.

When stressful life events or transitions occur, our brains and bodies shift away from homeostasis, a Greek term which literally means “standing still.” Homeostasis refers to the process by which the body’s internal environment is kept stable. We experience physical, mental, and emotional changes which Selye referred to as “fight or flight.” The model has been adapted in recent years to “fight, flight, or freeze” because literally or metaphorically fighting back or running away isn’t always an option. Until the individual adjusts to the new circumstances, stress is experienced. Both distress and eustress are equally taxing on the body and have negative health consequences which are cumulative over time. In order to stay as healthy as possible, we should pay attention to and monitor the signs and symptoms of stress and adopt the behaviors that address them in body, mind, and brain.

Some of the physical signs and symptoms of stress are increased blood pressure, muscle tension, nausea, head, jaw, neck, or back pain, dizziness, sweaty palms, clumsiness, and shallow breathing. Emotional and mental signs include worry, anxiety, irritability, anger outbursts, difficulty concentrating, insomnia, depression, confusion, guilt, and memory loss. Approximately 80% of the complaints that people bring to the attention of their primary-care doctor are said to be stress-related.

Regular vigorous exercise, a balanced diet and adequate hydration, a positive mental attitude, and regular practice of meditation, stress reduction, and relaxation techniques go a long way toward dispelling the effects of stress and helping one stay healthy in spite of life’s ups and downs. While we can’t control what happens to us, we can control how we perceive it, respond to it, and cope with it. Most of these techniques can be learned and mastered on your own. Life is full of transitions and change, and you can learn to deal with them in a healthy way.

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  • cayden

    August 15th, 2013 at 10:55 AM

    Isn’t it weird how even the smallest changes in our lives can lead to some of the biggest changes in our health? I mean, who gives much thought to how this could cause negative consequences to your overall well being, but here it all is in black and white, confirming what many of us have suspected for years.

  • Diann Wingert, LCSW, BCD

    August 15th, 2013 at 7:27 PM

    Cayden, The good news is that there is so much we can do to reduce the impact of stress on our lives. Exercise, meditation, relaxation techniques, biofeedback, even eating fewer sweets and starches lowers the negative health consequences. Of course, the best thing we can do to lower our risk is to shift the way we think about events from negative to neutral, becoming less reactive and more accepting of life as it comes. Be Well, Diann

  • Blake

    August 16th, 2013 at 4:23 AM

    It is not necessarily that a certain event like getting married shouldn’t cause you stress- you think that this is only going to be something that is happy and hopefully that’s true- but think about how many changes this will bring to your life. That could be difficult for anyone to adjust to especially someone who is already prone to letting even the smallest things worry them. I don’t think that you can look at events like they “should” or “shouldn’t” cause stress, but instead think about how much of an impact they will have on your life. I think that that is going to be the true measure of just how stressful that it ends up being for you.

  • Diann Wingert, LCSW, BCD

    August 16th, 2013 at 2:05 PM

    Blake, In my experience, the word “should” and “shouldn’t” as in ” I should feel this way” or “I shouldn’t be stressed out about this” are not helpful and actually cause stress to occur. We really can’t negotiate with our emotions or reactions. Accepting what is and working with it reduces stress. I like to remind myself and my clients, “what we resist, persists.” A good thing to keep in mind, when the “s words” (should, shouldn’t) appear in our thinking. Be Well, Diann

  • Vic

    August 17th, 2013 at 1:23 AM

    This is so true!Even good things can cause stress and worry.Have experienced this more than once and it seemed funny and weird at first.But then it became common.Any change causes us to cringe and the more we go through changes the better we get at adopting new ones.Change is essential and inevitable.We may do well to learn to live and thrive with it!

  • Blake

    August 17th, 2013 at 6:53 AM

    Oh I totally agree with you Diann. I know that the times in my own life I have gotten the most bogged down have been with the “s” words as you call them. I am trying to grow past that.

  • Diann Wingert, LCSW, BCD

    August 17th, 2013 at 2:22 PM

    Vic, If we just look around us, it is obvious that change is the nature of all things. Children change rapidly, the seasons change, we grow up, grow old and eventually die. We can accept that change is inevitable and even embrace and welcome it. Of course, this takes awareness, practice, patience and maturity. I like to think that growth is another name for change. Be Well, Diann

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