Does stress cause mental illness?

As a psychologist, I spend part of my time doing therapy and part of my time doing scientific research. One of my main research interests is the impact of stress and personality on health. One of the studies that my colleague D. Ivanišević and I conducted and published in the magazine “Putokazi” in 2018 – “STRESS AS A PREDICTOR OF MENTAL HEALTH” deals with this very topic. The purpose of this paper is to study the possibility of predicting mental health self-assessment based on various stressful life events.

At the heart of a large body of research over the last few decades has been stress, stressful life events, and their impact on health. Given the frequency of stressful events in all spheres of life, including work, school, family, and interpersonal relationships, and the detrimental impact of stress on both physical and mental health, the increased interest in this area is not surprising.

Stress can only be talked about when a person perceives a particular situation and estimates that this situation requires increased, extraordinary efforts to adapt. However, stressful situations do not include very long-term unfavorable living conditions, which can have different effects on the psychophysiological functioning and development of an individual. Therefore, researchers in the field of stress often study various events that can be characterized as stressful. The subject of the earliest studies is war experiences and natural disasters. Life events include important and major changes in life, such as job loss, divorce, childbirth, loss of a loved one. Psychiatrists Holmes and Rahe argued that any event that causes a change and discontinuity in people’s lives is stressful because it leads to the need to adapt. Therefore, even changes that we experience as very positive, such as marriage or the birth of the desired child, can cause stress responses such as frequent headaches, high blood pressure, or some illnesses.

Multiple studies prove that common obstacles and stressful events predict measures of negative physical and mental health indicators. The greater the number of daily issues, the greater the amount of experienced psychological symptoms. Therefore, the results of research on the effects of everyday obstacles of lower intensity on health point that they are stronger than the effects of major life changes, which is explained by the cumulative effect of daily problems. From the point of view represented by Lazarus, what is stressful for one person at a certain point in her life does not have to be stressful for another person or the same person at another time. Lazarus emphasizes the importance of subjective assessment.

Mental health is a special and very important aspect of health and according to the WHO, the definition is described as a state of well-being in which an individual realizes his potential, can cope with normal life stress, can work productively, and is able to contribute to the community. Mental health is part of general health, not just the absence of disease, and a term often referred to as the opposite of mental health is a mental disorder or illness, which refers to a health problem that significantly interferes with a person’s ability to think, feel and achieve satisfactory interpersonal relationships and fully functioning.

Recent research has shown the association of various adverse life events with the development of anxiety disorders but the greatest association with anxiety has been adverse events such as injury, illness or death of a family member or close friend. Alvarenga and Frizzo studied the impact of stressful life events on women’s mental health during pregnancy and in the postpartum period. The analysis affirmed that mental disorders during pregnancy are the only significant predictor of postpartum depression. Also, when the authors controlled the effects of postpartum depression on the perception of stressful life events, the impact of stressful life events on the variance of common mental disorders during pregnancy disappears, and income remains the only significant predictor. The results of this study indicate the stability of the symptoms of mental disorders between pregnancy and after childbirth. Kendler et al. showed that stressful life events are in a significant causal relationship with the onset of an episode of major depression. However, the authors believe that a third of this relationship is non-causal because individuals who are predisposed to major depression choose a high-risk environment for themselves. A study conducted at the University of Nigeria analyzed the impact of stressful life events on somatization propensity, and the results showed that stressful life events explain a significant proportion of results on the somatization scale.

Our research

D. Ivanišević and I (2018) analyzed how 31 different stressful life event relates to 4 aspects of mental health:

psychosomatic reactions,

anxiety, and anxiety reactions,

depression, and depressive reactions,

fear.

We concluded that there is a significant influence of different stressful life events on self-assessed mental health. One of the interesting findings is that the vacation was found to be a significant protective factor of all four aspects of mental health. This means that vacation reduces the risk of problems with self-assessed mental health in this year.
It is interesting to note that the Great Disagreements with the spouse turned out as a very significant predictor in the development of Psychosomatic Reactions, Anxiety and Anxiety Reactions, and Depression and Depressive Reactions. It is apparent that this is a very important and very stressful life event, and it is clear that it is not a stressor that is temporary or one-time. It is assumed that large disagreements are more prolonged, ie they last over a longer period. Of course, a spouse is one of the most important people in every person’s life, especially since a spouse plays numerous roles in our lives, so it’s no surprise that Large Disagreements with a partner have proven to be a significant predictor of self-assessed mental health. The situation is comparable with the predictors Severe illness or injury of a partner, as well as Severe illness or injury of a family member or Death of a partner. With such stressful life events, there is a need for an remarkably large adjustment to the changes that have occurred, as well as taking on the roles played by a partner or other family member. It is often grief that is disguised as anxiety or psychosomatic illness, and is seldom manifested through depression and depressive reactions. It is also intriguing to note that Job Loss is a predictor of Anxiety and Anxiety Reactions, and Depression and Depressive Reactions, but not Psychosomatic Reactions or Fear. Also, a major change in finances is a significant predictor of only Anxiety and Anxiety Reactions. Furthermore, Child Death is a predictor exclusively of Depression and Depressive Reactions, in contrast to Partner Death, which is a significant predictor of Psychosomatic Reactions. The latter is very appealing because Holmes and Rahe (1967) found that these two life events were rated by the respondents as the most stressful of all, as events that require the most sweeping adjustment. But, as we see from the results of our research, these two life events are statistically significant predictors of different reactions. We can explain this in several ways, but perhaps the most acceptable is that after the death of a partner, the surviving partner mourns, but expresses grief through psychosomatic distress, which is in some way “more acceptable” because they act as somatic distress, which “could not be influenced”. while they expect themselves, as others do, to continue to live and suppress grief for the sake of children, sick family members, all those “who find it harder,” etc. On the other hand, parents are expected to grieve for their children, moreover they are expected to grieve for a long time and to show this grief, and perhaps precisely because they do not suppress feelings, psychosomatic reactions and anxiety reactions do not occur, but depression and depressive reactions do occur. This finding needs to be further examined on different samples and with different research designs and instruments.

From the above, it is easy to assume that the connection between stressful life events and specific aspects of mental health is indisputable, and the presence of certain “more difficult and demanding” life events lead to mental health disorders, and then to the necessity for treatment, decreased productivity and psychological and existential demands of the person. However, mental health disorders also lead to a vital economic and social burden.
It is more than self-evident that there is a sweeping need to invest in mental health, through numerous programs of personality empowerment, learning to adequately deal with stress, or minimizing its consequences through the application of relaxation methods, with the aim of enhancing health, quality of life and well-being.