Clinicians know chronic stress fuels heart disease, cancer, stroke, and depression. Yet it’s rarely measured in the exam room—meaning it’s rarely addressed. Psychologists like George Slavich at UCLA want to change that.
Slavich’s wake-up call came the night his father died unexpectedly. As a stress researcher, he knew the shock would reverberate through his body—but his doctor never assessed it. “If stress isn’t assessed, it isn’t addressed,” he says.
Short bursts of pressure can sharpen performance, but when cortisol and the sympathetic nervous system stay switched on, health risks mount: inflammation, immune suppression, unhealthy coping behaviors, and accelerated disease. And stress levels are rising—after the Great Recession, through COVID-19, and amid today’s social and economic uncertainty.
When good stress turns bad
From tight deadlines to financial strain, discrimination, and loss, stressors activate the body’s fight-or-flight response—flooding the blood with cortisol, raising heart rate, and priming the immune system. This ancient survival system wasn’t built for chronic triggers like debt, online harassment, or gridlock.
Overreacting to minor threats, anticipating danger too soon, or staying “switched on” too long shifts stress from adaptive to toxic. Yet current measurement tools—self-reports, blood pressure, cortisol, heart rate—can be skewed by coffee, exercise, or time of day.
Researchers like Slavich are expanding the view: tracking how stress alters 1,500+ genes, immune markers, hormones, microbiome balance, and more. Affordable at-home tests and new wearables now capture heart-rate variability, skin conductance, sleep patterns, and soon real-time cortisol.
From metrics to medicine
Clinicians need clear thresholds—stress “cut-off” points—to guide intervention, just as cholesterol markers guide heart care. Slavich envisions a composite stress score integrating biological and self-report data.
Effective treatments already exist: CBT to reduce rumination, breathing and mindfulness practices, social connection, exercise, and nature exposure. In some cases, beta-blockers, anti-inflammatories, or omega-3s can modulate physiological responses.
Personalizing the fix
The future is tailored stress care: matching interventions to biology, history, and environment. Men may spike cortisol for performance challenges, women for interpersonal conflict. A disrupted microbiome or early trauma can hardwire vulnerability.
Bottom line: better assessment and customized interventions could make stress a vital sign in every check-up—transforming how we protect health in a high-pressure world.
