We are living in stressful times. Every day, headlines are full of economic uncertainty, political polarization, and global conflict. These are political challenges, but they are also personal. APA's 2025 Stress in America survey found that 62% of U.S. adults reported societal division as a significant source of stress in their lives, while three-quarters said they are more stressed about the country's future than they used to be. Living with this stress can pose real threats to individuals and communities' health and well-being. Today, we are going to talk about how societal stress gets under our skin to affect our health and mental health. What kinds of ripples are we seeing in communities right now? Who is most vulnerable? And what concrete steps can you take to protect your well-being in these turbulent times? Welcome to Speaking of Psychology, the flagship podcast of the American Psychological Association that examines the links between psychological science and everyday life. I'm Kim Mills. Today we are joining with our colleagues at the American Public Health Association to bring you a special episode exploring these issues. I'm pleased to welcome to this episode APA CEO Arthur C. Evans Jr. and APHA CEO George's Benjamin. Dr. Evans is CEO of the American Psychological Association and a clinical and community psychologist and healthcare innovator who has employed science, community activism, traditional clinical care and cross-system collaborations to change the status quo around behavioral health. Before joining APA in 2017, he spent 12 years as commissioner of Philadelphia's Department of Behavioral Health and Intellectual Disability Services, where he emphasized the population health approach to serving a wide range of individuals with complex needs. Dr. Evans has also held faculty appointments at Yale University and the University of Pennsylvania School of Medicine. An outspoken proponent of psychological science and mental health, he has been featured in major media outlets including The New York Times, The Wall Street Journal, The Washington Post, NBC Nightly News and ABC News. Dr. George's Benjamin has served as CEO of the American Public Health Association since 2002 and is one of the nation's most influential physician leaders. He joined APHA after serving as secretary of the Maryland Department of Health and Mental Hygiene, where he oversaw the expansion and improvement of the state's Medicaid program. Dr. Benjamin is board certified in internal medicine and is a master of the American College of Physicians, a fellow of the National Academy of Public Administration, a fellow emeritus of the American College of Emergency Physicians and an honorary fellow of the Faculty of Public Health and an honorary fellow of the Royal Society of Public Health. He started his medical career as a military physician in 1978. He is the author of more than 200 scientific articles and book chapters as well as the book Public Health Under Siege, Improving Policy in Turbulent Times. Dr. Evans, Dr. Benjamin, thank you for joining me. Welcome to Speaking of Psychology. Thanks Kim for having us here. Thank you, glad to be here. As I mentioned a moment ago, we are living through a period of intense national tension with political polarization, economic anxiety, and other stressors weighing on people's minds. Dr. Benjamin, how does this societal stress affect people's physical health and what kinds of impact can it have on our bodies as well as our minds? Well, you know, Kim, public health has long understood the fact of the social determinants of health actually impact your health. I always say that 80% of what makes you healthy occurs outside the doctor's office. We know that chronic societal stress activates the body's stress response. You get elevated cortisol levels, increased inflammation, your sleep gets disrupted, and over time that increases for cardiovascular disease, diabetes, and an ultimate immune dysfunction. If it happens for a long period of time, you get something called allostatic load. And that's what this cumulative wear and tear in your body from chronic stress is a way for us to think about what happens over time. And certainly people are carrying much more stress than it did even a decade ago. So it's not just a mental health issue. It's actually a whole body issue. And from a public health perspective, a whole community health issue. And Dr. Evans, what about the impact on people's mental health? Well, Dr. Benjamin mentioned stress can have an impact on not only our physical health, but our mental health and our social connections as well. From a mental health standpoint, we can see increased subsist use. We can see people might develop an anxiety disorder or depression or any other kind of mental health challenge that they might be susceptible to. And we can see these play out in people's relationships. We can see them play out in family relationships. We can see them play out in work relationships. And so the takeaway here is that stress not only affects us from a physical standpoint, but from a mental health standpoint and from a social standpoint. Now people experience these stressors differently. And there are other factors like housing instability, food insecurity and economic precarity that also shape how people experience and recover from stress. How do these structural conditions interact with the mental health impacts we've been discussing, Dr. Evans? Well, you know, stress, you know, when I when I was trained, we thought of stress more from an individual standpoint. I think over time we have understood the real impact that stress collectively can have on us and some of the factors that are in our environment that drive the stress that we experience. And one of the things we know is that depending on who you are in our society, you may be experiencing stress differently. We saw, for example, during the pandemic that parents of young children in particular experience more stress than other people during the pandemic. And one of the reasons is that parents of younger children have more responsibilities than other parents. We know that if you are a farmer, for example, the rate of suicide for farmers is two to three times that of the general population. And when you dig down into that, what you find is that farmers are experiencing disproportionate economic stress. And in fact, that's one of the things that drives a lot of the psychological distress that farmers experience. So depending on where you are in society, there that these stressors are not only affecting all of us, but they are affecting some of us disproportionately. And it's really important to understand what are the things that are driving stressors for us as individuals, but also what are the stressors that are driving us as a as a group. Dr. Benjamin, from your vantage point, what are these factors like housing instability and food insecurity and the economy? How are they affecting people's physical health? You know, Kim, I think the big issue here is the fact that people have never really had any rest. When people go into combat in the military, we take them out of circulation, so they can get what we call crew rest. When I used to run the EMS system here in Washington, D.C., we would put our EMS workers and our firefighters, giving them some downtime. Well, the population in our country has not had any downtime. For the last 20 years, we've had a pandemic, we've had economic disruptions, at least two of them. We've had social unrest, we have political polarization, and what's happening right now, it's on steroids. So the fact that you have these recurring events that have not resulted in any ability of the body to reduce the amount of stress, so you have prolonged stress activation that's just tearing people down. So you see more fatigue, more people that are just depressed, we're seeing more suicide, even in kids. And then when you add to that the social isolation that has occurred partially to the pandemic, but also the fact that people are now engaged in their electronic devices, so they're not interacting with people one-on-one or even groups. We're now seeing things much different in terms of what people are experiencing from a stress perspective. And that stress response is phenomenally damaging to their health. So for our listeners, what are some actions that they can take to counteract these effects? I mean, what are some practical skills or tools that people can use? Let's talk about first how to protect their mental health in these times. Dr. Evans. So I think it really starts with understanding stress, what causes stress, and what are some of the things that can mitigate and reduce stress. So we know that having social support is a big factor in how much stress and how much distress we experience as people. And social support increasing our relationships is a very important thing. But also how we think about stress. One of the things that we know happens with people is that people who catastrophize, that is, they think of the worst possible outcomes of the things that they're experiencing are going to experience more stress, more psychological distress, and then have some of the kinds of mental health and physical health outcomes that we were talking about. And when we work with people, one of the things we do is technique calls cognitive reframing or restructuring. That is thinking about our problems differently can go a long way in how we experience those problems. But then there are all these other things that we can do that have to do with our physical health. If we get enough sleep, making sure that we have a good diet, making sure that we exercise, all of those things have a profound impact on how we experience stress and how we're able to manage stress. So it really comes down to, if you kind of thought about three domains in our lives, how we think, making sure that we're not only not catastrophizing, but really trying to not only see our problems from a realistic standpoint, but also trying to see solutions and understand things from various perspectives. But then there's a domain of our social life. We know that, as I was mentioning, social support, but the opposite can also drive our stress. That is loneliness. In fact, the social general did a report a few years ago on the impact of loneliness and what a negative impact that it can have on both our physical health and our mental health. So making sure that we're doing what we can in that domain as well to ensure that we have the kind of support. And then making sure in the physical domain that we're doing the things to stay healthy. That kind of broad based strategy can really be very effective at helping us to manage our stress and mitigate the impact of stress on our lives. Dr. Benjamin, anything you would add to that? I think Arthur's points are well taken. And I would add to that community engagement. First of all, cutting off your devices. I tell people you need some me time every day. Just find some time, even if it's 15 minutes, go into a quiet place wherever you normally think when someone's getting on your last nerve. Cutting on some music just so that you can just disengage so you can think about yourself. But the other thing is you can help other people engaging in volunteering with local organizations, your faith community. Those can be some of the most protective health impacts of stress. And then know your numbers. Making sure you know who your blood pressure is. Know what your blood sugar is. Making sure that you're thinking about healthy diets in a way that's productive. Those are kinds of things you can do. And all of us really should know what triggers us, what gives us the most stress, and do everything you can to avoid those at a federal cost. There were a couple of things that Georgia said that I think are really important. One of the ways that we work with people who are experiencing psychological distress is that we ask them to intentionally do things that they enjoy that do pleasurable things. I can remember when I was working clinically so many times I would ask people that question, like, what is it that you really love to do? And then I ask the next question is, when was the last time you did it? And often it would sometimes be not months, but sometimes years. And so people don't do a lot of the things that they get a lot of pleasure from. And as a result, they're really cutting off a really important way of coping and handling stress. The other thing that I wanted to point out is that one of the things we know from the research is that the older we get, the better we're able to handle stress. And in fact, there's a really clear linear relationship that the older we get, the less stress that we have. And so that really suggests that one of the things that happens is that the more experience that we have, the better we're able to handle stress in our lives. And so talking about social support again, if you are a younger person, but for any of us reaching out to people who can help us problem solve can be a very effective way of helping to manage our stress. All good points. Now the stressors we've been talking about are also affecting the public health and the health care workforce. What does this sustained stress do to the people who are delivering care? What's the impact on communities? And what can we do to help those people who are trying to help the rest of us? I think it's important that we remember the caretakers because far too often the people that are supposed to be taking care of us, which of course, in my world, are the public health people. They're stressed. They're the ones getting up every day. And I've seen that far too often. You know, I'm doing Hurricane Katrina. People forget that you had public health people responding to that terrible flood. And yet almost all of them had lost everything as well. And so they were trying to deal with that tragedy. During our hurricane we had in Southern Maryland. I remember that just the health care providers, but also the politicians, the people that had to show the stern face and get in front of television cameras and tell us that things are going to be okay. They were under enormous stress. So we need to make sure that we're taking care of them as well because they're under enormous stress. And Dr. Evans, for the mental health practitioners. Well, I think that there are a lot of things that contribute to stress. One of them is especially for people who work in the mental health field, that area of health care is often underfunded. It's been chronically underfunded. And that means that there are often lower wages. But they're also the working conditions are much harder. When I was commissioner of behavioral health in Philadelphia, I remember we were funding some of the community mental health providers. And we were just giving them small grants to do things like to be able to paint the waiting room. I was doing this in the morning. Then later in the afternoon, I went over to University of Pennsylvania for an appointment. And I walk into this gleaming building and there's modern equipment. And that striking disparity between how we support and fund people who work in the mental health field and how we fund the rest of health care is just glaring. And that shows up not only in our ability to provide care, but it also shows up in the impact on the people who are trying to provide that care. So I really think we have to think about and understand public policy and make sure that public policy aligns with supporting all of the people in health care. And then I also think that we can do some things to make sure that people who choose to work in these areas don't have disproportionate economic stress. We need to make sure that people can pay off their student loans because most people have to get loans to do this work. It really is a comprehensive approach of making sure that we're funding, but making sure that not only the systems that people work in, but we're funding and making sure that the people are getting the kind of economic support that they need in order to do the work. Dr. Benjamin, just to close up here, what about the long-term prognosis? We're dealing with, as we've said, a lot of stressors or a lot of things happening in the world that are making things difficult for all of us. Is this the new normal or is there some light at the end of the tunnel? Well, I think that things are certainly going to be different. And in many ways, the amount of stress, the amount of activity going on, the fast moving of a society is the new normal. But we can adapt. We've learned to adapt as a society for many of these things. And so I think the things we should do is not say that these things that are an assault on our mental health or our physical health need to go unchallenged. So what can we do? We can make sure that as an employer, we're providing people with the tools that they need, the crew time, as I mentioned earlier, giving us some time to rest, helping them think about their day. If you as an individual with your family plan to have stress-free days, build, construct your day in a way that reduces your stress, how you get to work, when you get to work, how you engage your family. Getting your family some me time, both individually and as a group, are things that you can do to try to de-stress both the environment and the type of way we engage people. And then what I've noticed is that we have more and more people who frankly are having conflict. And when you start looking at how that conflict occurred far too often, it's because they're emailing one another. They're in the office and yet they're still having a social media connection instead of getting up, going to someone's office. And all the issues in the office have become even controversial and full of conflict. And so we need to figure out ways to de-stress the workplace as well. Dr. Evans, anything that you see on the horizon, any hope for us to get out from under all of this? Well, I think the larger stressors that we're experiencing, probably not. I think George has made a great comment that we've been under chronic stress for the last several decades. And if you look at our stress in America survey, for example, stress levels in the United States have not varied a lot, if anything, they've gone up over the last several years. So it's not like we have a period where we are experiencing intense stress and then that calms down and we have a break. It has been constant. And if you look at both the political environment, you look at the economic environment, you look at the social environment, those stressors have been constant. So the issue isn't how do we lean more into those break periods? We just don't have those break periods. So we have to, as people, have ways of coping and strategizing around how we deal with stress. So that means that first of all, we need to understand it. We need to understand that it can come from lots of different ways. We need to understand that it is insidious that often we're not aware that we are under stress, but our family members know, our co-workers know. And one of the things we can do is to give them permission to give us that feedback so that we're getting that feedback. And it's important for us to know our own signals for when we are experiencing stress. For me, for example, if I start to become cynical, I know that I'm stressed because I'm typically not a cynical person. But when I start to hear myself do that, that is a sign. And so I know I need to step back. But it's also not only having a literacy around what causes our stress, but it's having literacy around what reduces our stress. We gave some great examples. But understanding that stress is manageable. But there are things that we have to actively do in order to manage the stress in our lives. And that when we do that, it actually works when we are taking better physical care of ourselves that actually helps us to manage stress. When we are increasing our connections to people in our lives, that actually helps when we are doing things to rethink and to not catastrophize. That really helps us with our stress. And so doing those things consistently can help us manage through these very difficult and challenging times that we're experiencing. And I like to add there are some things you should not do. Tobacco utilization, vaping, drugs, alcohol, those are not things that we ought to do to try to de-stress. Yoga, me time, extra sleep, more exercise, good things. And maybe chocolate ice-cream, but in moderation. One of the things that I think is really important is to be able to do things that you enjoy and not feel guilty. One of the things that we've learned in giving days off for our staff to take mental health breaks is that many of them would use those days to try to catch up. And so I think we have to have this culture where we understand that taking a day off is not being lazy. Picking a day off is actually helping you to sharpen your act so you can do your work more efficiently. And I suspect that if we have that problem within the APA that other organizations have the same problem that it is not that you don't have to feel guilty to take time off, to take care of yourself, that is just a good habit that can help all of us. Thank you so much. Both of you, Dr. Arthur Evans, Dr. Georges Benjamin, thank you for joining me today. Thank you, Kim. Thank you, Tim. You can find previous episodes of Speaking of Psychology on our website at Speakingofpsychology.org or on Apple, Spotify, YouTube, or wherever you get your podcasts. And if you like what you've heard, please subscribe and leave us a review. If you have comments or ideas for future episodes, you can email us at Speakingofpsychology.org. Speaking of Psychology is produced by Lee Weinerman. Thank you for listening. For the American Psychological Association, I'm Kim Mills.
