A vicious cycle: Mental disorders cause the very stress that fuels them
Part of what makes depression so hard to overcome is that people with depression tend to behave in ways that lead to more stress in their lives — and stress in turn fuels mental illness.
This feedback loop was initially thought to be unique to depression, but UBC psychology researchers recently revealed in Psychological Bulletin that it is a more widespread problem. By analyzing several decades worth of studies, they showed that many mental disorders perpetuate themselves by generating stress. In a separate study published in Clinical Psychology Review, they identified factors that put people at risk of getting caught in this cycle.
We spoke with Dr. Katerina Rnic (she/her), a postdoctoral researcher in the depression, anxiety, and stress lab, about the team’s findings.
What is "stress generation theory"?
Stress is a major risk factor for physical and mental health problems, including depression. We all experience stress, but some of us are exposed to more stressors than others. Stress generation theory helps us understand why.
This theory suggests that people with depression, specifically, are more likely to behave in ways that contribute to experiencing greater stressors. For example, people with depression might be more likely to have arguments with others, or put off completing important tasks at work or home. This can lead to more stressors in their relationships, work, education, finances, health — all domains of life.
The theory was initially developed to help us understand why depression can be chronic and long-lasting. But what about other mental disorders? Although there is now 30 years of research on stress generation, there has been disagreement about whether this phenomenon is specific to depression. Does stress generation affect people with other mental disorders?
What did you find?
We conducted a meta-analysis that combined and analyzed all the research on stress generation to date and found evidence for stress generation not just in depression, but across many mental health disorders such as anxiety, personality disorders, substance use, and childhood disruptive disorders.
We did this by looking at two different kinds of stressors: dependent and independent. Dependent stressors occur at least partly as a result of a person’s actions. Independent stressors, on the other hand, are events that people couldn’t have caused themselves, such as a natural disaster or the death of a relative due to old age. We saw that people with mental disorders experienced more dependent stressors, in particular, than those without mental disorders. This provides the strongest support yet for stress generation theory, as it suggests that people with mental disorders are actively generating greater stressors. This is crucial because it also means that people suffering with mental health problems have some power and agency over the amount of stress they experience.
We also saw that these dependent stressors perpetuate mental disorders over time, creating a vicious cycle of symptoms and stress.
Does stress generation affect some people more than others?
Our main finding was that stress generation effects were strongest among children, adolescents, and young adults. Older adults also generate stress, just not to the degree that younger people do.
However, we did not find any differences in stress generation by gender, race, or geographic location. Thus, stress generation seems to be a universal phenomenon that affects people from diverse backgrounds.
What does your research suggest about potential solutions?
Our findings point to important opportunities for interventions to help break people out of this vicious cycle.
We found several risk factors that predicted dependent stressors over time, including interpersonal behaviours, negative thoughts, excessive standards for oneself, and avoidance, among others. Addressing these together in treatment may be crucial for efforts to break the cycle of stress and mental health problems.
The fact that stress generation is a universal phenomenon also suggests that developing interventions that target stress generation across diagnoses is a promising next step. Such interventions could be effective for a large number of people, regardless of their specific diagnosis.