Many of us stress about the holiday season. Some of us worry what that stress may do to us. With MS, it is thought stress can precipitate a flare, though all the evidence I have seen for this is anecdotal. It’s simply not ethical to cause stress on a group of people to see if they suffer an exacerbation which may have long term negative health consequences. So as I go through a fairly stressful time period, I started wondering what research is available outside of MS on the impacts of stress, and I came across two theories.
The first theory is based around the idea stressful events have major health impacts. In 1968, two psychiatrists came up with a stress inventory called the Holmes-Rahe Stress Inventory after asking more than 5,000 subjects to track their major life events. They then looked at how the events correlated with major health incidents over the following two years. Using this data, they scored each event and created the Holmes-Rahe Stress Inventory of the top 43. The cumulative score from the events present over the course of a year was used to categorize the risk of future subjects by putting them into one of three categories. http://www.stress.org/holmes-rahe-stress-inventory/
0-150 had little correlation with increased risk.
150-299 indicated a fifty percent chance for a major health incident in the following two years.
300+ represented an eighty percent chance for a major health incident in the following two years.
As I read through the index, my score was between 215 and 272 depending on how strictly I interpreted the categories. So in my effort to minimize my concern, I started looking for reasons this test does not apply to me. I started with the date the list was created, more than 45 years ago. I thought I was in the clear until I found articles indicating it had been studied more recently with updated versions for the changing times. The only new item was death of a pet…which I recently had. This means I score even worse with the update… The biggest draw back on the following study done in 1970 to validate the original findings was the sample was only men, but this does nothing to invalidate its findings for me.
This got me thinking about just what being in the second category meant. It meant I had an increased risk, but how strong is the correlation between the risk category and the health events. It turns out the correlation is only 0.18. So while there is a statistically significant increase in likelihood of health events, it is not quite as dire as the fifty percent in the category would make one believe.
The first approach deals with the impact of stressful events, and I do not score very well on it, but given the low correlation studies have found between events and health, maybe the better prediction can be made looking at day to day living.
It seems there is a general consensus the daily look at stressors is a more accurate way to look at stress and its impact on our body. The best study I have seen described is from Ohio University in 1992, so again dated material is an issue. Still for the sake of understanding, the write-up at http://www.ohioupsychology.com/files/images/holroyd_lab/Holm%20&%20Holroyd%20The%20Daily%20Hassles%20Scale%20Revised%201992.pdf
is excellent. On pages 8 and 9, it lists seven major categories of daily hassles and components within the categories. The major categories are Inner concerns, Financial concerns, Time pressures, Work Hassles, Environmental hassles , Family hassles, and Health hassles. This report looks also looks at the hassles as possibly being just two categories, inner and external, before coming back to the seven mentioned above with all their elements.
As I look at the measures listed for this approach it quickly became apparent, I would do no better on the daily hassles than the stressful events, and I decided I was better served to look at what I can see stress is actually doing to me. After all, I really do not need various scientific studies to tell me I belong in the “stressed” category. I knew this going into the reading. So I am back to noting far more MS symptoms which is right in line with the original theory about stress causing MS flares. However, I do not have the symptoms constantly. As a result, they do not rise to the level of a flare I need to report. Instead, I just note more times when my vision blurs to the snow channel with quick head movements up and down and more incidents of pain and spasticity.
I guess I should just be thankful and employ all the stress relief techniques I know while praying the rest of my family and friends will do likewise. For now, I will just go back to my inner Karaoke song of choice, good for any season: