Dr. Grossi's Blog


Dr. Philip Grossi
Wednesday, 31 October 2012

In the last few days I have watched some of the TV coverage of hurricane Sandy and the devastation it caused.  Many public figures referred repeatedly to the resilience of the suffering citizens and that they would overcome the adversity. In the office I often ask patients to assess their progress on a scale of one to ten. Yesterday I asked such a patient and he responded that he was about at six. I asked what needed to change to get him to the nine or ten range.  He responded that he would need to feel more emotional resilience. By this he meant an increased ability to bounce back from trauma, adversity or hardship. We see this complex process played out on each fall weekend in football games we watch. Football is a game of overcoming adversity.

In humans the stress response to adversity is mediated by the sympathetic nervous system, the hypothalamic pituitary axis, neuropeptide Y, and the serotonin system. These in turn are influenced by the genes that encode variants of the components of those systems. An example I have previously blogged about (Not So Fast) is the long and short serotonin transporter resulting in differential serotonin uptake from the synapse and a differential risk of depression and response to stress. Repeated stress in childhood can result in learned helplessness and can cause exaggerated responsiveness to future stress.  On the other hand, childhood stressors that are mastered help an individual become stress-adaptive and thus more resilient than normal.

Some psychological factors related to resilience are a history of mastery of problems and challenges, i.e., a history of success; loving caretakers; robust social support; cognitive flexibility, i.e., the ability to view issues from multiple positive and negative viewpoints; physical fitness; strong commitment to developing or enhancing skills; good and constant role models; quick recovery from stressful events; careful reflection and consideration of life's experiences and drawing conclusions from them; curiosity; espousing and adhering to important values.

To summarize, resilience in humans who face stress depends on genetic, cognitive, psychological, neurobiological, developmental, and protective factors.