Depression Treatment

Depression and Anxiety Stress Scale



How to measure the level of stress with the Social Readjustment Rating Scale?

Stress is usually thought of as something that happens to us – considered as a factor from outside. But it is not as simple as that. Stress is actually generated by our response to things that happen, not by the events themselves as what we have perceived them to be. Hence, something like moving house or relocating¬† a new environment can be hugely worrying and unpleasant for someone who does not particularly welcome the change, while for a person who has been longing for a move may find it exciting and joyous. Both people without a doubt are actually experiencing stress, but in the former’s case it is debilitating and in the latter’s, it is energizing. How our body responds to potentially stressful events varies too, according to our past experiences and genetic make-up. Some people crave constant change and novelty, and will become stressed whenever there is too little going on around them. Basically, these people are looking for changes all the time. Others are easily unsettled by changing circumstances, and become anxious when something big happens even when the occasion is supposedly ” good”.

How do a person adjust to the inevitable chain of events which change the direction of your life? The “Social Readjustment Rating Scale” was designed to show the relationship between social readjustment, stress and susceptibility to illness. It lists the things which may trigger stress-related anxiety, depression or other illness, in the general population.’ So-called “life events” such as getting a new job, going on holiday or getting married are each given a score. For example, divorce scores 73 points and taking out a large loan for a house, 31 points. The higher your total score, the higher your risk factor.

However the scale is a guide, not a “stand-alone” measure of stress. Divorce, for example, may not be especially stressful if the partners have been separated for a long time, and some people are more genetically susceptible to stress-related disease. Moreover, it can take years for stress to contribute to illness.

But tests did seem to confirm the validity of the calculations used in the scale. For example, of 2500 men aboard three Navy cruisers, the 30 per cent with the highest life-change scores developed almost 90 per cent more first attacks of depression during the first month of the trip than the 30 per cent with the lowest scores. During the rest of the mission, the high scoring 30 per cent consistently developed more illnesses than the lowest 30 per cent.

Nonetheless life events such as those on the rating scale are still only part of the story. “Minor” or “everyday” stressors – a late train or an irritating colleague – can also have profound repercussions. It is important here to recognize the imperfections within our brains which can contribute to depression and anxiety disorders. There has been, in effect, a head-on collision between evolution and what we know as progress. The body’s stress response evolved to deal with short term “tooth and claw” emergencies in which our ancestors chased prey or ran from predators. This “flight or fight” response is not so good for the many people (most of us) who have to face the same situations, the same family, the same pressures, the same stresses, week in, week out. There is nowhere to run to; no effective way to fight off the threat and no dispersal of the adrenaline and feelings associated with preparation for fight. In short, our lifestyle may have changed, but our bodies remain much the same as they were thousands of years ago.