Stressed-Out Nation

Studies find financial problems top the list of causes, escalating health risks. So what can we do to ease the burden?


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Photographs by Nick Hagen

The sound of boots crunching on snow mingled with the quiet strains of conversation as a half-dozen hikers made their way along a 2-½-mile trail at Stony Creek Metropark.

The temperature: Cold. The mood: Tranquil.

Walt Whitman knew long before science told us: Nature is a balm for the soul, a refuge from the daily grind inside and outside our heads, a hedge against depression.

“On Monday, I think: ‘Oh, yeah, I have a walk on Saturday. If I can make it to Saturday, I’m good,” says Clarkston resident Andrea Jaje, 39, who is part of a Meetup walking group. “It’s the fresh air. You’re not breathing in bottled air.” 

It’s a good thing nature is free: Stress is epidemic in the U.S., and it’s taking a serious toll on our mental and physical well-being.

 

A Sober Reminder

Why are we so stressed, anyway?

According to “The Burden of Stress in America” — a landmark survey conducted in 2014 by the Harvard T.H. Chan School of Public Health, the Robert Wood Johnson Foundation, and NPR — poor health, disability, and a low income are markers for feeling really pinched.

More than a quarter of the 2,500 adults in the poll reported being under a lot of stress during the previous month, telling pollsters they felt overburdened with responsibilities and they faced financial, work, and health problems. 

Of those polled who reported household incomes under $20,000 a year, 70 percent said financial problems were a contributor to their stress — twice the level of those with incomes of $50,000 or higher.

In other words, money isn’t everything, but not having it can clearly elevate anxiety.

While the findings don’t come as much of a surprise, they subvert popular notions, says Robert Blendon, Ph.D., co-director of the survey and a professor at the Harvard T.H. Chan School of Public Health.

“In much of the popular media we think of people who are stressed as people who are in high-powered professional and business roles,” he says. “And it turns out that people living with a lot of stress are not in those roles and have other issues in their lives. Anybody who has ever surveyed Americans has found they have trouble managing responsibilities. But if they have bad health, or a dangerous job, or low income, it just exacerbates the stress.”

It’s not just adults, either. In the American Psychological Association’s annual “Stress in America” report in 2013, teenagers from 13 to 17 years old ranked their stress levels higher than adults did, citing school responsibilities, getting into a good college or deciding what to do after high school, and concerns about their family’s finances. They reported not sleeping enough, skipping meals, playing too many video games and watching too much TV, getting headaches and indigestion, and feeling irritable, angry, sad, and depressed. 

This year’s installment of “Stress in America” found, as it has since its inception in 2007, that financial problems are the top source of stress for Americans. In 2007, people who earned less than or more than $50,000 reported average stress levels, whereas in subsequent years the lower earners felt increasingly stressed as their income slipped, a finding the APA attributes to the growing wealth gap in the U.S.

And the widening income chasm may correlate with health. This year’s study found that 12 percent of Americans skipped going to the doctor because of money and 9 percent considered forgoing medical care for the same reason.

 

The Mind/Body Connection

Stress helps us to survive — as long as it’s not a constant hum in the background.

Acute stress triggers our primal “fight or flight” instinct. Perceiving danger, our nervous system reacts by speeding up the heart, slowing digestion, dilating the pupils, constricting blood vessels, and tightening muscles to prepare the body and mind for battle — or a quick getaway.

“I’m sure Tom Brady was under acute stress before the Super Bowl. That’s adaptive,” says Daniel Menkes, M.D., chair of neurology at Beaumont Health System and at the Oakland University William Beaumont Hospital School of Medicine. “We are designed to deal with acute stress. It’s the chronic stress that’s so bad.” 

If stress continues at a low level, it can become chronic, and chronic stress can lead to serious health problems, among them hypertension and heart disease. 

“The liver starts making more sugar … if you start making more and more, you become diabetic,” says Menkes. “We’re seeing more and more evidence that chronic stress leads to immune system dysfunction. [It] protects you from infection, it keeps cancer in check, and there’s increasing evidence that when your immune system goes awry, you are more prone to cancer. With chronic stress, you don’t sleep ... your body doesn’t produce enough serotonin,” a neurotransmitter that is connected to mood. 

Investigating the mind/body connection is central to the work at the Stress and Health Lab at Wayne State University.

Psychology professor Mark Lumley, Ph.D., who also serves as director of clinical training, focuses on the connection between emotional trauma, stress, and the development of chronic conditions like irritable bowel syndrome, chronic pelvic pain, and fibromyalgia. 

Lumley and his students are employing short-term therapy in clinical studies that feature relaxation and emotional expression training. They seem to improve symptoms, he says.

“We’re most interested in ongoing stress that is elevated in people with these conditions,” he adds. “They’ve had abuse experiences, trauma, they have been victimized, had a bad family life, or they’re struggling with a lot of internal conflict that probably drives their physical symptoms. We try to help people resolve their stress and see if it improves their physical symptoms.” 

 

Reacting to Adversity

If 26 percent of Americans report being really stressed out, what about the rest of us?

The Harvard study found that the majority of the 2,500 adults surveyed reported having a lot or some stress, while less than half reported having little or none.

Aside from the biggies — a dangerous job like roofing or firefighting and a meager salary — our personalities seem to dictate how much stress we can absorb.

“The leading theory of stress is that how you appraise the stuff that happens in life determines whether you experience stress — whether a threat, as a challenge, as benign, or harmless,” Lumley says. “Those appraisals tend to be big drivers of stress.”

Those perceptions may be based not just on personality but also on childhood experiences.

“If you’re raised in an environment where rules weren’t clear, where abuse was going on, people had personality disorders, you’ll be less able to adapt to stress,” Menkes adds, pointing to research showing that people who had happy childhoods and didn’t suffer from mental illness tended to survive extreme situations such as being a POW.

“To me, the ‘Burden of Stress’ study reinforced what I thought all along: Choose your parents carefully and your home environment carefully,” says Menkes, tongue sort of in cheek.

Studies have consistently shown that people react differently to adversity — even the most traumatic wartime experiences — depending on a variety of factors, among them the quality of their childhoods. The National Center for PTSD, run by the U.S. Department of Veterans Affairs, reported that soldiers who had suffered abuse as children or had a family member with a mental health disorder were likeliest to suffer from post-traumatic stress disorder.

 

Getting it Under Control

We know what we should do to get our stress levels under control: A whopping 94 percent of the greatly stressed-out subjects in the Harvard study said spending time outdoors was a top stress reducer, along with spending time on a hobby, exercising, and eating healthfully. 

So if they were being truthful, why were they still so stressed out? 

“The findings left us struggling with that question,” says Blendon. “If they’re doing stress reducers enough, they wouldn’t have had a lot of stress in the previous month. They may not be doing it on the scale that it’s relieving their levels of stress.”

Or it may be “behavioral economics,” the impulse to do things that provide immediate benefits rather than delayed reinforcement that comes with practicing stress-reducing habits. 

“The immediate demands of life (work, family, chores, eating, sleeping) usually create more powerful rewards (or potential punishments) than does the delayed benefits of setting up nature walks,” he says.

Environment and social circle will dictate how people react to stress, too. Nearby biking or walking trails make it easier to get outside and exercise. Being around people who support healthy living is another factor, as is the weather.

“We’re strongly shaped by how much the environment expects of us, makes certain actions normal or standard, facilitates them, models them, and makes them safe and feasible,” Lumley says. 

 

Managing Stress

Here are some widely known stress-busting tips: 

  • Talk with family or friends
  • Get your body in motion
  • Get outside
  • Give up unhealthy habits such as smoking or drinking too much alcohol. Cut back on caffeine intake, as well.
  • Spend time with a hobby every day
  • Practice meditation
  • Practice better nutrition
  • Get your budget in shape by cutting back on unnecessary expenses, setting up a payment plan with creditors, and eating at home more
  • Get at least 6-8 hours of sleep every night
  • Volunteer
  • Smile and laugh more
  • Try not to worry so much.

When you step out of your house or apartment, try to head for a park or a beach. 

An intriguing new study, led by a University of Michigan professor, suggests that getting into nature is a way to tame the demons of stress.

Dr. Sara Warber and her colleagues evaluated almost 2,000 people who took nature walks in groups. They found that the group walkers experienced less depression, less stress, and had a greater sense of emotional well-being. They were better able to cope with events like the death of a loved one, the loss of a job or relationship, and financial and legal problems. 

Warber says science hasn’t yet pinpointed why we feel good on a beach or in the woods. But she speculated, “We were meant to be in nature; we weren’t meant to be driving cars.”

For the Meetup group walking the trail at Stony Creek in late January, strolling in the woods is a stress buster — a blissful counterpoint to the noisy workweek. And, of course, a place to meet up with people who feel the same way. If their feelings are backed up by science, then all the better. 

“It’s definitely stress reducing for me. I get huge stress relief. It can be alone or with a group. It’s the nature that’s relaxing,” says ER nurse Kim Aman, 53, of Chesterfield Township.

“I think of it as adding another layer to your experience,” says nurse practitioner Lynne Gafford, 56, of Rochester Hills. “When you feel nature, smell nature, you feel alive.” 

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