Do Women Handle Stress Better Than Men?
As most couples are aware, men and women respond differently to stress. What hasn't been clear until now is how or why. Our understanding of the human stress response has been based on the "fight-or-flight" model, which states that when confronted with a stressful situation, humans either will respond with aggressive behavior or will withdraw.
Studies of stress response conducted prior to 1995 corroborated the "fight-or-flight" theory. These studies focused heavily on male subjects because researchers believed that a woman's monthly hormonal fluctuations created stress responses that were too varied to be statistically valid. But in 1995, the federal government mandated representation of both men and women in agency-funded studies. As a result, the percentage of female subjects participating in stress research increased.
What's the Stress Response in Women?
A study at the University of California, Los Angeles (UCLA) published in Psychological Review offers clues to the biological and behavioral differences in the ways men and women cope with stress. The study found that females of many species, including humans, respond to stressful situations by protecting and nurturing their young and by seeking social contact and support from others, particularly females. The study refers to this response as "tend-and-befriend." Researchers believe this response is a result of natural selection.
"Thousands of generations ago, fleeing or fighting in stressful situations was not a good option for a female who was pregnant or taking care of offspring, and women who developed and maintained social alliances were better able to care for multiple offspring in stressful times," says Shelley E. Taylor, the study's principal investigator .
Does Biology Favor Females?
As with the fight-or-flight response common in males, this tend-and-befriend response to stress may have a biological basis. The hormone oxytocin, which is secreted by both males and females in response to stress, is believed to play a role.
"Animals and people with high levels of oxytocin are calmer, more relaxed, more social, and less anxious," says Taylor. In males, the effects of oxytocin seem to be reduced by male hormones. But in females, oxytocin—along with other stress hormones—may play a key factor in reducing the female response to stress.
According to Taylor, men are more likely than women to respond to stressful experiences by developing certain stress-related disorders, including hypertension, aggressive behavior, or abuse of alcohol or drugs, while the tend-and-befriend response may protect women against stress.
Are Women Are at Higher Risk?
Doctors have recognized a condition that they have memorably called “broken heart syndrome.” In this probably rare condition, acute stress, such as news of a loved one’s death, leads to sudden onset of chest pain, heart failure, or even sudden death. According to Dr. Ilan Wittstein from Johns Hopkins Heart Institute, acute stress can cause severe weakness of the heart muscle that can look like a heart attack. This differs from a regular heart attack, though, because there is a potential for recovery within about two weeks. While this broken heart syndrome does occur in men, a study published by the New England Journal of Medicine reported that women were more likely to have this condition.
Broken heart syndrome reflects the important connection between our brain and our heart. In this case, the stress hormone responses work against women, making them more susceptible to serious consequences of extreme stress. Notably, two of the women reported with broken heart syndrome developed symptoms after strong pleasant surprises. It is likely that even sudden good stress can lead to bad outcomes in susceptible people. At present, we don’t really know how to predict the condition, although it has been reported most commonly in women over age 45.
What Do You Do When You're Stressed?
In a study prepared for the Assistant Secretary of Defense by the Research Triangle Institute, researchers looked into the mental health effects of stress on active-duty military personnel. The study found that more men (24.6%) than women (15.5%) reported using alcohol as a coping behavior. Women were more likely than men to talk to a friend or family member (87.1% versus 70.8%, respectively). Men were found to be more likely to light up a cigarette, while women were more likely to pray. Women were also more likely to eat in response to stress, while men were more likely to turn to illegal drugs.
The results of the UCLA study may help explain such things as why men are reluctant to ask for directions when lost, why men are more vulnerable to the adverse health effects of stress, and why women enjoy a significantly longer life expectancy than men do.
What Does This Mean for You and Your Better Half?
"For men it would suggest that reaching out is beneficial—protective, even—in times of stress," says Richard Driscoll, PhD, author of The Stronger Sex . "But for hundreds of thousands of years, men who revealed their weaknesses tended to be undesirable mates. Hiding weaknesses has been biologically advantageous, and men still tend to be less likely to reveal weaknesses."
This reluctance on the part of men to reach out, Dr. Driscoll believes, could help explain the difference in life expectancy between the genders.
"Women get more medical care; they consume two out of three healthcare dollars. They are more likely to seek help from therapists. Men don't get the healthcare; they tend not to reach out."
Is There Help for Men?
"Men have very strong tendencies to conceal stressful things," Dr. Driscoll adds. But our society is designed that way. Crying is still not acceptable in men, he points out. "We have to have a softer, gentler, more sympathetic approach to men, particularly those who aren't at the top of their game," says Dr. Driscoll. We need to acknowledge to young sons the particular difficulties that they will face being a boy and a man in an unsympathetic world, he explains.
Men need to learn to deal with stress in a healthy manner, says Dr. Driscoll. He recommends a process he developed called "mental shielding" to brush off hostility. Mental shielding involves developing the ability to disengage from hostile comments and remain in control, first by achieving a calm, relaxed state, and then creating a mental shield between yourself and your partner. This deflects the hostility and allows you to better deal with the core issues.
The American Institute of Stress
Mental Health America
Canadian Mental Health Association
Canadian Psychiatric Association
Broken heart syndrome: real, potentially deadly but recovery quick. Johns Hopkins website. Available at: http://www.hopkinsmedicine.org/press_releases/2005/02_10_05.html. Published February 2005. Accessed July 2008.
Highlights: 1998 Department of Defense survey of health related behaviors among military personnel. Tricare website. Available at: http://www.tricare.osd.mil/.
Taylor SE. Biobehavioral responses to stress in females: tend-and-befriend, not fight-or flight. Psychological Review. 2000;107:411-429.
Wittstein IS, Thiemann DR, Lima JA, et al. Neurohumoral features of myocardial stunning due to sudden emotional stress. N Engl J Med. 2005;352:539-548.
Last reviewed June 2008 by Theodor B. Rais, MD
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