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23 The Physiology and Pathophysiology of Unhappiness Robert M. Sapolsky Stress physiology, as applied to the average vertebrate, is the study of the defenses mobilized by the body in response to physical challenges-being chased by a predator when injured, or sprinting after a meal when starving. In contrast, humans have the cognitive sophistication to activate habitually the identical stress response for purely psychological or social reasons-worries about mortgages, relationships and the thinning ozone layer. While activation of the stress response is critical for mrviving pursuit by a lion, it is pathogenic lvhen mobilized chronically, and many Westernized diseases are caused or worsened by overactive stress responses. How do psychological and social factors-such as unhappiness-activate the stress response? Broadly, for the same physical stressor, an ollfanism is more likely to have a stress response ifit lacks outlets for frustration, social support, control, or predictability. Social status also modulates the stress response. Many studies of social primates suggest that low-ranking individuals have chronically activated stress responses and are more prone to stress-related diseases. This tendency probably reflects their being subject to higher rates of both physical and psychological stressors than are dominant individuals. HOlvever, in primates, social subordinance is not always associated with such maladaptive physiology; it is not just rank that influences physiology, but also the sort of society in which the rank occurs, and the individual's experience of rank and society. These same principles can be applied to interpreting social status and patterns of diseases in humans. Particular emphasis is placed on the extensive literature on the health risks of low socioeconomic status (SES), which are interpreted in the context of the psychological stressors associated with low SES. Personality and temperament also modulate the stress response; for example, primates with a "hot reactor') temperament hal'e an overactivated stress response, as do humans with major depression , anxiety disorders, Type A personality, or repressil'e personality. Finally, social status and personality can interact in a critical manner-specifically , an inner locus of control can be highly adaptive in one position in society but highly predictive of cardiovascular disease in another. IMAGINE THAT AN earnest young wildebeest, in the early stages of its Ph.D. program in psychobiology , has finally selected a thesis project. The ambitious ungulate plans to study the physiological correlates of social behavior of the primate Homo sapiens. Thanks to anesthetic dartings of groups of tourists that frequent the savanna, a study population is outfitted with telemetry devices , remote blood collection systems, and ambulatory EKG monitors. All is going well, and a degree seems conceivable for this scholarly wildebeest when an inexplicable set of data appears -on certain occasions, specifically in the afternoons when the humans lounge in the shade of their camp, pairs of them perform a strange behavior. Two males, for example, might begin these odd, ritualized interactions, and as they do, blood pressure quickly soars, heart rate increases dramatically, muscle tension rises, as does caloric expenditure, and androgenic steroid hormones pour into the circulation. The wildebeest knows precisely what the physiology implies, namely, an intense male-male dispute. The physiological profile is identical to when two male wildebeest contest for females in heat, as they lunge at each other. Yet the two humans do nothing more than sit in close proximity, decrease their rates of vocalization and eye contact, and, occasionally, do nothing more physically taxing than move a small piece of wood. A startling aspect of human psychobiology: people who care about such things get physiologically aroused during chess matches, and get aroused in ways that make them indistinguishable from ani mals having territorial disputes (Leedy and DuBeck 1971 ). The poor wildebeest has just discovered a startling fact about humans, one that makes no sense to virtually any other animal (particularly those com- 454 Well-Being prising its dissertation committee): humans mobilize the same physiology as any other animal, but for reasons unrelated to physical demands. This chapter is concerned with another circumstance in which humans mobilize a common set of physiological responses, but for novel reasons. For most species, this system signals either a physical insult or the imminent threat of one. For humans, in contrast, it far more frequently signals a state of unhappiness, of psychological or social unease. The stress response is a set of hormonal and neural events that are fairly stereotyped among vertebrates . This phylogenetic conservation implies a vital role in physiology, namely, saving your neck during a crisis. For most species, the...

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