It’s certainly no surprise that stress can contribute to illness, but it turns out that certain types of stress are far more likely to get you sick than others. In fact, back in 1967, psychiatrists Thomas Holmes and Richard Rahe examined the health records of 5000 medical patients and asked them if they had experienced any of 43 various life events in the previous several years.1 “Top 10 Most Stressful Life Events: The Holmes and Rahe Scale.” Pain Doctor. 30 September 2018. http://paindoctor.com/top-10-stressful-life-events-holmes-rahe-stress-scale/ Based on their findings, they devised a scale weighting each of the 43 events for its likelihood to trigger disease, assigning each event a point value, and correlating the point values to health outcomes. Holmes and Rahe repeated the research a few years later with another 2500 patients to validate their findings and derived the exact same results.
According to the resulting Holmes-Rahe Stress Scale (also known as the Social Readjustment Rating Scale, or SRRS), the most stressful of all events, by far, is the death of a spouse or child, which is assigned 100 points. The higher the point value of an event, the greater the likelihood that you’ll get sick after experiencing that event. Also, points are cumulative within a several year window, so every time you endure any stress on the scale, your score climbs. Because of the cumulative nature of the stress scale, even if you don’t undergo one of the most significant stressful events, you can still accrue a high score that puts you at added risk for disease if you endure many lesser stressful situations.
The top 10 stressors, with point values, are:
- Death of a spouse or child 100 points
- Divorce 73 points
- Marital Separation 65
- Imprisonment 63
- Death of a close family member 63
- Personal illness or injury 53
- Marriage 50
- Dismissal from work 47
- Marital reconciliation 45
- Retirement 45
It’s interesting to note that some so-called positive events—marriage, marital reconciliation, retirement— rank among the most stressful. Other positive events lower on the scale also cause significant stress. For example, outstanding personal achievement confers 28 stress points, placing it at number 25 on the stress list, while vacation adds 13 and a major holiday adds 12.
This is probably because change, in general, always adds stress. Career change contributes 36 stress points, change in frequency of arguments (either fewer or more) adds 35, moving to a new residence adds 20, change in church or recreational activities counts for 19. Some of the stress scores are bewildering: taking out a mortgage of $150,000 or more confers 32 stress points, while foreclosing on a mortgage only adds 30. Any change in financial circumstances, even if for the better, confers 38 points.
According to the research, health risk becomes significant when you experience 150 or more cumulative stress points within a two-year period. If you have fewer than 150 points, your risk of getting sick is only 30 percent.2 “The Holmes-Rahe Stress Inventory.” AIS. 3 October 2018. http://www.stress.org/holmes-rahe-stress-inventory/ But if you accumulate between 150 to 299 stress points, your risk of getting sick shoots up to 50 percent. Once you exceed 300 points, your risk of becoming ill is profound, at 80 percent. To determine your score, you can take the stress inventory here.
Holmes and Rahe reasoned that major change and stress could also make kids sick, and so they developed a separate scale for teenagers and children. The top 10 stresses on that scale are:
- Death of a parent: 100
- Unplanned pregnancy/abortion: 100
- Getting married: 95
- Divorce of parents: 90
- Acquiring a visible deformity: 80
- Fathering a child: 70
- Jail sentence of a parent for over one year: 70
- Marital separation of parents: 69
- Death of a sibling: 68
- Change in acceptance by peers: 67
Note that the stressor that ranks number 10 on the youth scale confers 67 stress points, while the stressor ranked number 10 on the adult scale only confers 45. In fact, numbers 7-10 on the adult scale all confer fewer than 50 points. Experts attribute this difference to the fact that children and teenagers are less able to cope with stress than adults, a clear indicator that young people need extra help to deal with change and life difficulties.
The evidence shows that the straight line between added stress and illness most likely will end in either chronic pain, diabetes, depression, anxiety, gastrointestinal disorders, Alzheimer’s disease, hypertension, heart disease, mental illness, or some combination of these disorders. But as other research has made clear, stress also contributes to cancer, immune disorders, and virtually every other disease. A recent study found that each of the top stressful events contributes the equivalent of four years of cognitive aging to the brain.3 “Stressful experiences can age brain by years, Alzheimer’s experts hear.” 16 July 2017. The Guardian. 5 October 2018. http://www.theguardian.com/society/2017/jul/16/stressful-experiences-can-age-brain-by-years-alzheimers-experts-hear
What can you do if you’ve had a year during which your spouse died and then your father died; then you lost your job because you took too much time off work to care for your loved ones; then you had to move, buy a new home, and take out a new mortgage? Are you doomed to illness? (And if you’re thinking nobody ever has such a year, ask around. It’s surprisingly common for people to endure times when a multitude of difficult things rain down all at once. Just ask Job.)
While the odds of becoming ill during such stressful times are high, you won’t necessarily succumb if you take steps to protect yourself and you’re extra careful with your health. Tempting as it may be to eat comforting junk foods when things are in flux and you’re dealing with grief–and yes, many people take refuge in comfort food during times of stress–this is the very time when it’s most important to eat well. And difficult as it might be to motivate yourself to exercise, this is exactly when you need to step up your exercise program as well. And this is also when you need to make a special effort to build your immune system by taking immune-enhancing products, doing a full-body detox, and pampering yourself with meditation, time with friends, plenty of rest, and massages. There’s an old saying that although you can’t control the things that happen to you in life, you can control how you deal with them.
|↑1||“Top 10 Most Stressful Life Events: The Holmes and Rahe Scale.” Pain Doctor. 30 September 2018. http://paindoctor.com/top-10-stressful-life-events-holmes-rahe-stress-scale/|
|↑2||“The Holmes-Rahe Stress Inventory.” AIS. 3 October 2018. http://www.stress.org/holmes-rahe-stress-inventory/|
|↑3||“Stressful experiences can age brain by years, Alzheimer’s experts hear.” 16 July 2017. The Guardian. 5 October 2018. http://www.theguardian.com/society/2017/jul/16/stressful-experiences-can-age-brain-by-years-alzheimers-experts-hear|