Embodying psychological thriving: physical thriving in response to stress - Thriving: Broadening the Paradigm Beyond Illness to Health

Journal of Social Issues, Summer, 1998 by Elissa S. Epel, Bruce S. McEwen, Jeannette R. Ickovics

Overexposure to stress weakens the counterregulatory systems, which leaves the body in a greater catabolic state. In addition to stress, aging can shift resting levels of hormones from a restorative to a more catabolic state. In fact, failure to thrive syndrome, including weight loss and muscle atrophy among the elderly, is thought to be in part due to a greater level of catabolic than anabolic hormones (Verdery, 1995).

The ratio of anabolic to catabolic hormonal levels may be the most sensitive indicator of one's state of anabolic functioning and potential for growth, which we refer to as the growth index. Thus, we conceptualize the growth index as a predictor of allostatic load, and allostatic load as preclinical disease processes and thus a predictor of more serious disease outcomes.

A typical profile of neuroendocrine health (a high growth index) is reflected by higher resting levels of growth-promoting hormones and sex hormones (Esler et al., 1981) accompanied by lower levels of stress hormones (cortisol and catecholamines). As shown in Figure 2, we propose that neuroendocrine health status can be measured by assessing the ratio of one's anabolic to catabolic hormones at rest. A predominance of anabolic hormones or a positive growth index (Panel A) reflects enhanced health or physical thriving and low allostatic load. This is a state of positive health in which the body is prepared to respond efficiently to stressors and in the meantime is building its defenses. When there are equivalent levels of both anabolic and catabolic processes or no growth (Panel B), there are few changes in health status but also little resilience to the wear and tear of aging. Lastly, a predominance of resting catabolic activity (Panel C) indicates a lack of growth, high allostatic load and disease processes, and eventually poor health.

When Does Physical Thriving Occur? Types and Timing of Arousal Conducive to Physical Thriving

Stress reactivity has traditionally been viewed as negative and associated with suppressed immunity, hypertension, diabetes, and coronary disease (Chrousos & Gold, 1992; Dhabhar & McEwen, 1997; McEwen, 1998; Troxler, Sprague, Albanese, Fuchs, & Thompson, 1977). The inevitable exposures to stress and occurrence of aging underscore the importance of identifying when salutary processes occur. Animal research has identified stage 2 of Selye's General Adaptation Syndrome, when the animal is adapting to chronic stress, as a time when "rejuvenating homeostatic mechanisms" can be observed, related to learning (Riga & Riga, 1996). Applying this to thriving, through facing stressors and being exposed to large amounts of stress hormones, the body may be triggered to restore greater balance in the growth-promoting counterregulatory hormones. In humans, it is important to discover under what conditions healthy adaptation takes place. We have identified three conditions that may promote physical thriving: (1) exposure to acute stressors rather than unrelenting chronic stressors; (2) toughening through repeated exposure to acute stressors; and (3) relaxation, or periods of reduced arousal below baseline.