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81.1 - Fall 2007
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The Effects of Our Stressful Lives
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By Alex Kazberouk

Stressing over a midterm, a job interview, or a deadline is nothing new for most of us. Neither is coping with stress by eating comfort food or enjoying ourselves with a can of beer at a party. In most cases this adaptive behavior is perfectly normal, leading to no complications and few problems besides a stomachache or a hangover.

However, the coping mechanisms we have developed to deal with stress may malfunction and in certain cases cause the loss of self control and long-term addiction problems. That stress can lead to addictive behavior is relevant to both college students pulling all-nighters with fatty and sugary snacks and to drug addicts or alcoholics attempting to fight off their addictions.

Yale scientists from multiple departments are currently working hard to elucidate this connection in hopes of developing treatment and preventing unhealthy addictive behavior.

To Stress or Not to Stress?

Stress is the body’s natural adaptive response to disruption of stability by physical, mental, or other stimuli. It was first studied in detail by Hans Selye, an endocrinologist who described stress within a framework of a General Adaptation Syndrome (GAS) in the 1930s.

Studying the reaction of animals to physical discomfort or pain, he outlined a general response of the body to stress as progressing from a fight-or-flight response, to short- and long-term coping mechanisms, and finally to complete exhaustion once the body fails to deal with stress.

More recently, stress has also come to include non-physical forms. Mental stress refers to the unpleasant feeling of befuddlement when performing a difficult cognitive task. Social stress is the stress experienced when giving a speech in front of a panel of judges or a video camera. Long-term emotional stress can be caused by emotional deregulation, trauma, and psychological disorders.

All of these can now be quantified to some extent by measuring the levels of cortisol, a corticosteroid hormone in the subject’s saliva that helps the body respond to stress by increasing blood pressure and blood sugar.

On one hand, stress is an adaptive mechanism and is not always problematic. In addition to the fight-or-flight adrenaline response helping us survive, short term mental stress promotes learning or keeps us alert. However, especially over long periods of time, stress may lead to maladaptive and compulsive behaviors.

Here, the effects of emotional stress are particularly interesting as this stress tends to last longer and is much more broadly applicable. This form of stress may be triggered by numerous psychological disorders including depression, by recent events, or even by childhood trauma. Once triggered, emotions and emotional stress may triumph over rational thought, as has been noticed by many since the days of Plato and Aristotle. This loss of rational behavior and self-control is central to understanding and treating addiction and compulsion.

What We Can Do

To study this maladaptive behavior in more detail requires a collaboration of different fields of science, medicine, public health, and social science. With tobacco smoking, alcohol consumption, and overconsumption of unhealthy comfort food being the top three preventable causes of morbidity and mortality in the United States, the National Institute of Health (NIH) is willing to provide generous funding for precisely such a collaborative study of addiction and its causes.

Since Yale already has experience with large-scale studies and a wide range of researchers interested in stress, it was a perfect fit for a $23.4 million, five-year NIH grant. The NIH distributed only a handful of such grants from a pool of over 100 applicants hoping to conduct interdisciplinary studies of complex biomedical problems such as obesity, asthma, organ regeneration, and stress.

The stress research consortium hopes to approach the problem with three steps. First, it is necessary to better understand the mechanisms behind emotional stress. The next step is to see how our mental systems are deregulated and how this leads to a loss of self-control. Finally the ultimate goal is to develop varied treatment and prevention programs in hopes of helping addicted individuals and those at risk.

Many questions are included in such a complex topic: acute versus chronic stress and its effects, the role of other psychopathological problems such as depression and anxiety, and specific biochemical pathways involved. The effects of chronic and regular use of alcohol, drugs, and large amounts of rich, unhealthy foods on our stress responses and compulsions are also a focus of study.

Dr. Rajita Sinha, the director of the consortium, hopes that by the end of five years the mechanisms that turn stress into compulsive behavior will be identified, finding new targets and solutions to both treatment and prevention.

The program brings together over 60 senior scientists from multiple Yale schools in collaboration with Florida State University and University of California at Irvine to work on ten different projects. The program also provides opportunities for numerous junior scientists and graduate students to receive valuable training and practical interdisciplinary experience.

The scope of the project covers numerous fields: biochemistry for understanding chemicals involved in stress and addiction, radiology for brain imaging, neuroscience to understand the function and inhibition of executive function during addiction, public health to provide large-scale population- based analyses of different types of stressors, and even pharmacology to develop chemical-based treatments.

According to Sinha, “experts in many fields were very interested in collaborating” and interdisciplinary collaboration was going on even before the grant. By tackling the issue of stress and compulsion from many different angles, scientists will hopefully facilitate rapid discovery.

What We Have Done

The program builds upon a solid foundation of past research that studied the interplay between stress, addiction, and psychopathology. For instance, it is well known that alcohol tolerance builds up as a person drinks more. However, the desire to drink also increases on a continuum from almost non-existent to intense as one becomes a heavier drinker.

With even a mild desire to drink, a person who is not drinking experiences mild emotional stress and copes with it through compulsive behavior that brings short-term rewards; usually the behavior involves more drinking. This cycle continues on and on and begins long before one thinks that he or she is an addict or an alcoholic.

Similar studies have been performed for drug users. The common and well-studied approach to drug abuse involves looking at reward pathways that prompt drug use and attempting to moderate those pathways.

This research has been widely successful and led to both effective therapies and preventive measures.

However, for addicts trying to stay clean, it is just as necessary to look at the stress prompted by withdrawal from the drug. For example, studies have connected higher cortisol levels to increased self-administered drug use.

The emotional stress induced by drug craving and abstinence may trigger compulsion pathways that lead to a relapse and continue the cycle of drug abuse and positive reinforcement from rewards provided by the drug. Lowering the levels of stress or channeling it into other coping mechanisms may thus make relapses less likely.

Studies have also aimed to elucidate the similarities and differences between substance addictions such as alcoholism and behavioral addictions such as gambling, overeating, sex, or even online role-playing games. Understanding the different biochemical reward pathways in each case, the specific regions of the brain involved, and the induction of these addictive behaviors by stress helps produce both results specific to each addiction and general trends.

What You Can Do

The research consortium is dependent on the public for support, feedback, data, and suggestions. They are looking for research volunteers and those who wish to receive treatment for substance abuse or addiction. Healthy volunteers are also needed for paid stress and brain imaging studies.

The program also hopes to put up an interactive website allowing individuals to track their cravings and compulsions for alcohol, tobacco, or even fatty foods over time, both for the individuals’ information and for anonymous research data.

Future conferences and seminars open to the Yale community or the general public will be held in hopes of transmitting the results of the studies to people outside the program. Finally, the consortium is looking for junior scientists, graduate students, and even undergraduates who have their own research projects and ideas.

It is also important for the general public to realize that it is natural to cope with stress through habitual behavior. If I, working under a looming deadline to complete this article, am cognizant and aware of grabbing a bar of chocolate, I am at least realizing what I am doing and thus going a long way towards controlling myself.

The notion that behaviors with immediate rewards provide relief from stress has been implanted into us through evolution. Returning to Aristotle and his dictum of “everything in moderation,” some self-control proves to be key even though emotions and stress may triumph temporarily.

Being aware, not being isolated from others, and dealing with the issue at hand may go a long way towards both preventing addiction and doing well at that job interview.

ALEX KAZBEROUK is a sophomore in Ezra Stiles College.
The author thanks Yale Research Program on Stress, Addiction and Psychopathology and specifically Dr. Rajita Sinha for information and great images.
Yale Research program on Stress, Addiction and Psychopathology “”
National Institute on Drug Abuse Stress Notes “”
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