‘To pity distress is but human; to relieve it is Godlike.’
(Horace Mann 1796–1859)
In this issue of Acta Neuropsychiatrica, a number of articles focus on stress in one form or another. Firstly, Pasco et al. examine ‘oxidative stress’ in an Invited Editorial and discuss its role in linking osteoporosis and depression Reference Pasco, Nicholson and Ng(1). Then, Brown et al. review the stress of immunological dysfunction and infectious disease in anorexia nervosa Reference Brown, Bartrop and Birmingham(2). Finally, Vollmer-Conna et al. report on a study of neuropsychiatric symptoms and immune activation in patients with genital herpes Reference Vollmer-Conna, Chen and Lloyd(3). Together, these three articles show how examining stress has become fundamental to our understanding of a number of disease processes. This is perhaps not surprising given that in our day-to-day lives stress is indeed a common concern and one that has gained particular prominence in our time. One reason commonly posited for this is that modern-day society is ‘far more stressful than it has ever been’. However, careful consideration of this point suggests otherwise. In fact, it is likely that our contemporary lifestyle is far less stressful than that of our predecessors.
The majority of inhabitants of the so-called western world do not routinely have to contend with the stress of starvation, extremes of temperature or sheer physical exhaustion, however, in many developing countries these stressors remain prevalent. Our modern lifestyle, much of which has been afforded through technological advancement, has at least with respect to these pressures, made our life significantly easier. However, in truth, many real worries and their associated ‘stress’ still remain and it is difficult to determine how stress has changed over time especially as expectations of life have also changed considerably.
In the context of neuropsychiatry the role of life events in the development of depression has been known for decades Reference Paykel, Meyers and Dienelt(4) and the social origins of this ‘distress’ have been examined extensively Reference Brown, Bifulco and Harris(5). However, only recently has it been possible to investigate the neurobiology of stress and its neural correlates using imaging, genetic and neurochemical tools.
Clearly, sustained unrelenting stress, and even excessive acute stress, is potentially damaging to our health and its complex effects, specifically on brain development, maturation and functioning, are gradually being unravelled. It is, therefore, interesting to note that, alongside the extant insights into the neurobiology of neuropsychiatric disorders that are expected to yield novel treatment targets and means of therapeutic intervention [see Sun et al. Reference Berk, Singh and Kapczinski(6)], there is growing emphasis on lifestyle issues that impact psychological wellbeing and that these are proving to be effective in alleviating stress (Reference Ivanovski and Malhi7–Reference Berk9).