In this video I discuss the psychological components of stress and how we can become stressed from the anticipation of threats. Psychological stressors are especially dangerous because they have the potential to become chronic stressors which constantly plague us. Next I discuss the relationship between stress and peptic ulcers, including Barry Marshall and Robin Warren’s Nobel prize-winning research on the Helicobacter pylori bacteria and gastritis. This example demonstrates how chronic stress can cause the expression or worsening of symptoms by suppressing the immune system.
Robert Sapolsky – Why Zebras Don’t Get Ulcers: https://amzn.to/2IzRwdN (Amazon affiliate link)
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Video Transcript
Hi, I’m Michael Corayer and this is Psych Exam Review. In this video we’re going to look at some psychological components of stress and then we’re going to look at the relationship between stress and a particular illness of peptic ulcers. So in previous videos we’ve looked at the stress response and we’ve seen its effects on things like the immune system and it makes sense.
The stress response seems to be pretty well-designed for coping with physical threats to our safety. So if you’re confronted by a predator then it makes sense that you would put aside some of the long-term projects; you’d reduce things like digestion, processes related to your reproductive capacity, and even your immune function because you have to deal with this immediate threat and you want to direct as many resources as possible towards dealing with it. And if you’re being chased by a lion then you’re not concerned with eating or mating or fighting bacteria because if you don’t escape from this lion, those things don’t matter.
The problem that we have is that this stress response also occurs for psychological stressors and these are things that we can’t easily fight or flee. So if you have to make a speech in front of a large crowd, it’s not really all that helpful that now your heart is racing and your hands are shaking because of the increase in muscle tension. Or the fact that you have reductions in your digestion and your saliva production, because now your mouth is dry and you feel butterflies in your stomach and this isn’t really going to help you to make a better speech. So with psychological stressors this response isn’t always useful.
Another problem that we have is that we can have this response to these psychological factors just by anticipating threats. So we can imagine something that might be stressful in the future, we can actually have a stress response to that. So if we think about other animals, we imagine a gazelle in the savanna that’s running from a lion then that’s a very stressful experience. But once the gazelle escapes from the lion then the stress response is over and the gazelle doesn’t sit there thinking “I might have to run from a lion tomorrow. I might have to run from a lion next week. I might have to run from a lion at any time” and therefore they’re constantly experiencing this stress response. But people are able to do that. We can think about the future in complex ways that other animals aren’t doing and that means we’re anticipating threats and we can have a stress response to this anticipation.
The particularly dangerous thing here is that we can then have this stress response all the time, because we can constantly anticipate threats. The world is a dangerous place. There’s bad things that could happen to us at any time and our awareness of that means we can be chronically stressed by these psychological factors. We could imagine some terrible thing happening. We can imagine it now, we can imagine it in an hour, we can imagine it in five hours, we could have stress all the time. And what this means is if we’re constantly evoking a stress response and we’re constantly reducing things like our digestion, things like our reproductive capacity, things like our immune function, then we’re doing this long-term damage as a result of a stressor that’s actually not even physically there yet. This distinction is why Robert Sapolsky titled his outstanding book on stress and health “Zebras Don’t Get Ulcers” and I’ll post a link in the video description to that book. It’s a really great book on stress and health, I highly recommend it.
Ok, so now let’s look at a relationship between stress and an actual physical illness and this brings us to the relationship between stress and ulcers. So in the middle of the 20th century doctors were aware that gastritis, which is inflammation of the stomach lining, caused ulcers. But they didn’t know what caused gastritis. They couldn’t seem to figure it out and they knew that people who had more stress tended to have more ulcers and so they thought that stress must be causing gastritis. So the assumption was stress causes gastritis, and then gastritis causes ulcers, therefore stress basically causes ulcers. That was the view and so the treatment for somebody who had peptic ulcers would be that they will be given antacids to try to reduce some of their symptoms and they’d be told to avoid stress. This was kind of vague and the doctors didn’t really know exactly how this was going to work.
It wasn’t until 1982 that Australian researchers Barry Marshall and Robin Warren identified that there was actually a bacteria, Helicobacter pylori, that was associated with ulcers. What they found was that this Helicobacter pylori caused gastritis and that then led to ulcers as doctors already knew. And in order to prove this Barry Marshall actually drank a petri dish filled with pure Helicobacter pylori culture, and then within a few days he developed gastritis. This provided pretty clear evidence of this relationship.
Now this doesn’t mean that this is the end of the story. Just because we had a biological cause of gastritis, because Helicobacter pylori is actually very common. It’s estimated that 50% of people worldwide have Helicobacter pylori in their stomachs. And yet half the world doesn’t suffer from gastritis and ulcers. So why not? Here this brings us back to the relationship with stress. As I said doctors knew that people who are more stressed were more likely to have ulcers. We also saw that in Hans Selye’s work on General Adaptation Syndrome that rats that were chronically stressed developed peptic ulcers. So there is a relationship between stress and ulcers. So how is this working in regard to the Helicobacter pylori?
Well the role of stress in ulcers is that first of all the chronic stress reduces immune function. And what this means is that the immune system is less able to regulate levels of Helicobacter pylori in the stomach and it proliferates. So now you have more of this bacteria. In addition chronic stress reduces digestive function and one of the ways that this happens is that blood is drawn away from the stomach to the skeletal muscles. This makes sense if you’re about to fight or flee; you want to have increased blood flow and oxygen and nutrients to your skeletal muscles, and it’s not so important to have it around your stomach. But if you have this chronic stress and you’re drawing blood away from the stomach quite often this reduces the stomach’s ability to repair itself.
And so now we have this combination of more Helicobacter pylori in your stomach and less ability of the stomach to repair itself. And this leads to more damage to the stomach lining, which then results in gastritis, the inflammation of the stomach lining. And we can see similar patterns here where chronic stress can bring out symptoms of illnesses that are always there. So the Helicobacter pylori, if it’s in your stomach, it’s always there but in periods of stress it’s more likely to proliferate and you’re less able to deal with it. You’re less able to repair the damage that it does to your stomach. And we see this in other illnesses. So we see illnesses that are always in your body like herpes, shingles, or gingivitis; these potential causes are always there but the symptoms mostly express themselves when you are under chronic stress.
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