January 2014 Newsletter Article

U-M’s Dr. Huda Akil Says Having To Respond To The Unexpected Causes Stress

[Image courtesy Association of American Medical Colleges]

Huda Akil, Ph.D., is co-director of the University of Michigan’s Molecular & Behavioral Neuroscience Institute and Gardner C. Quarton Distinguished Professor of Neurosciences in the Department of Psychiatry at the University of Michigan Medical School. She also is a member of the National Academy of Sciences.

Question: People often complain that life today is far more stressful than in the past. Is that true?

Answer: In earlier times, there were tons of physical stresses – is there going to be enough food, is it too cold, am I going to be warm? People got sick, they didn’t have treatment. So it’s definitely a myth to think that we are under more stress than our ancestors. It’s just that we are under a different kind of stress, some of it we’re not as well prepared for biologically, maybe, or psychologically. … The types of stress, how ready we are to cope with it, is really probably what has changed.

Q: What is it that makes people feel they’re under stress?

A: Typically in psychology, two features make a situation stressful. One is the inability to predict, and the other is the inability to control. So if you can predict something and you can control something, it’s not so stressful anymore. The more uncertainty there is, and the less control you have, the more stressful it is. … You can’t anticipate, you can’t plan, you can’t preprogram the behavior. You have to be ready to respond to the unexpected.

Q: We’ve just finished with the holiday season, which often bring a lot of stress. Why do people feel so much stress around the holidays?

A: There’s an image out there of the holidays being happy and cheerful and a nice time of gathering and generosity and loveliness. In real life, people get in each other’s way and there’s old relationships that don’t work out, expectations that aren’t met. So a lot of this is in our heads – the unpredictability component and the lack of control. You bring a lot of people together and they can’t necessarily all control each other very well and they can’t predict exactly how it’s going to happen. Anytime you measure something against expectations, unless you have a very strong dose of realism about you, a lot of resilience, you have trouble.

Q: Is there a way to build that resilience?

A: We’re coping all the time, both in good ways and bad ways, and if we could tweak that so that we don’t get overwhelmed by the bad stuff, that we stop and appreciate the good stuff and where our strengths come from, that eventually kind of builds resilience. It literally changes the brain biology in a stable way, so that people can do better. … A lot of that can be done from using experiences to learn new adaptive strategies, new ways of coping, taking something that was difficult or stressful and not just hiding from it, never wanting to ever confront it or think about it, (and instead saying), ‘OK, what have I learned from this and what can I do differently? Would there have been a different strategy? How do I process all this, and what is it about me that I could bring to counteract what I’m feeling?’ A lot of it is kind of mind games that we play with ourselves. Why not do it in a positive way?

Q: Are there good components to stress?

A: At a biological level, short stress is almost required. There is a whole field that shows that in fact the stress hormones are really needed to – for example – fight infection. It’s chronic and unrelenting stress that’s really bad. But a little dose of stress at just the right time is exactly what you need. So stress is not a bad thing. Some stress is absolutely required for survival. It’s only if you’re very passive and it’s very negative and it continues for a long time that the body and the mind start to pay a big price.

Q: Does stress have a role in triggering depression?

A: Stress is definitely a precipitating factor, so people who are vulnerable, they react differently to stress. The same stressor that might be seen as almost a challenge or invigorating to one person will totally crash another person. Depression is incredibly under-recognized, underdiagnosed, underestimated in its power to destroy lives. It’s really a very insidious and horrible disease. In my view, it masquerades as a lot of different things – some people become angry, some people become impatient, some people become despondent, some people can’t sleep, can’t eat. One thing can amplify others. But if it’s not caught, if it’s not labeled, if it’s not recognized either by the person, their family, their friends, then it feeds on itself. The earlier you can catch it, the better. The last thing you want is for somebody to become stuck in one of those cases where the depression is not only severe and deep, but it’s also unresponsive to treatment. The great thing about them (bouts of depression) is they are reversible, and you can retrain the brain and you can actually learn something from it, including stress management.