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Stress, Coping, and Health

Stress and Disease


Quick Review

Chronic stress is linked to the development of many psychological problems, such as depression, anxiety, and schizophrenia. A large body of research also indicates that stress is linked to a variety of physical problems, including cancer, heart disease, rheumatoid arthritis, genital herpes, periodontal disease, yeast infections, and the common cold, to name just a few.

Stress and Immune Function

Stress affects the functioning of the immune system, as do age, nutrition, and genetic factors. The immune system is the body’s defense against harmful agents such as bacteria, viruses, and other foreign substances. It communicates constantly with the brain and the endocrine system. The immune system has many different kinds of disease-fighting cells, including B lymphocytes, T lymphocytes, and macrophages:

  • B lymphocytes are formed in the bone marrow and release antibodies. Antibodies are protein molecules that travel through the blood and lymph and defend the body against bacteria and cancer cells.
  • T lymphocytes are formed in the thymus gland and defend the body against cancer cells, viruses, and other foreign substances.
  • Macrophages destroy foreign substances by absorbing them.

Stress affects the immune system in many ways. For instance, hormones that are released in response to stress can inhibit the activity of lymphocytes.

The Link Between Emotions and Illness

Researchers have linked negative emotional states to disease.


Recent research suggests that depression makes people more vulnerable to heart disease.

Type A Behavior and Hostility

Researchers have identified a type of personality, called the type A personality, that is associated with a higher risk of coronary heart disease. People with type A personalities tend to be competitive, impatient, easily angered, and hostile. People with type B personalities, on the other hand, are relaxed, patient, easygoing, and amiable.

Type A personalities may be more prone to heart disease for several reasons:

  • Type A people tend to be more physiologically reactive than type B people. In challenging situations, type A people have higher pulse rates, blood pressure, and hormone levels. This physiological reactivity can impair health in the long term. For instance, frequent release of stress hormones increases the likelihood of atherosclerosis, or hardening of the arteries because of cholesterol deposits.
  • Type A people may encounter more stressors. For example, because of their behavior, they may be more likely to have marital stress and work-related problems.
  • Type A people may have less social support because of their characteristic ways of relating to people.
  • Type A people may pay less attention to health-promoting behaviors such as getting exercise and resting when tired. They also smoke more and consume more caffeine.

Hostility, a key type A personality feature, relates most to increased risk of heart disease. A tendency to get angry easily is associated not only with heart disease but also impaired immune function and high blood pressure.

Emotional Inhibition

People who have a tendency to suppress emotions such as fear, anxiety, and anger have a higher risk of becoming ill than people who can acknowledge and express their feelings.

Lifestyles That Endanger Health

People’s lifestyles can endanger their health. Three features of problematic lifestyles include smoking, not exercising, and eating poorly.


Smoking increases the risk of many cardiovascular and lung diseases, including heart disease, hypertension, stroke, bronchitis, and emphysema. Smoking also increases the risk of cancers of the lung, mouth, bladder, kidney, larynx, esophagus, and pancreas. Although formal smoking cessation programs don’t help most people quit, many people eventually do stop smoking. Research shows that many people quit only after several unsuccessful attempts.

Lack of Exercise

Lack of exercise can also have strong negative effects. Regular exercise leads to longer life expectancy, promotes cardiovascular health, decreases obesity-related problems such as diabetes and respiratory problems, and decreases the risk of colon, breast, and reproductive system cancers.

Poor Nutrition

Research shows that bad eating habits contribute to health problems:

  • Chronic overeating increases the risk of heart disease, hypertension, stroke, respiratory problems, arthritis, and back problems.
  • Low-fiber diets and diets that increase serum cholesterol levels are linked to heart disease.
  • Eating too much salt may contribute to high blood pressure.
  • High-fat, low-fiber diets are linked to cancers of the colon, prostate, and breast.
  • A low-calcium diet may contribute to osteoporosis.

Getting Medical Treatment

Once people develop symptoms of illness, their behavior influences whether their health will improve or worsen. People’s behavior can have an impact at three different stages.

Seeking Medical Help

People who are highly anxious, who score high on the personality trait of neuroticism, who are very health-conscious, and who are very aware of bodily sensations tend to report more physical symptoms than other people.

Delaying seeking medical help can have serious consequences, as early diagnosis can improve the treatment of many health problems. Despite this, people often delay seeking medical help for several reasons:

  • Fear of appearing ridiculous if their symptoms turn out to be benign
  • Reluctance to bother their physicians
  • The tendency to minimize symptoms
  • Unwillingness to have a medical appointment interfere with other plans.
Communicating Effectively

People often have trouble communicating effectively with health care providers. Communication difficulties frequently happen for the following reasons:

  • Medical providers often use jargon and unclear explanations when talking to patients.
  • Patients sometimes forget to ask questions they should have asked.
  • People sometimes forget to mention symptoms they have or avoid mentioning the extent of their problems for fear of a serious diagnosis.
  • People are sometimes passive in their interactions with health care providers because they feel intimidated by health care providers’ authority.
Adhering to Treatment Regimens

People’s chances of recovery decrease if they don’t adhere to the treatment regimens that their health care providers prescribe. People don’t adhere to medical advice for three main reasons:

  • Not understanding the instructions they are given
  • Not following treatment regimens that are unpleasant or interfere significantly with daily routines
  • Not following advice if they are displeased about their interactions with their health care provider

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