Advice // Advice 09

Invest in support that is available when stress arrives

Evidence Observational

Build and maintain a small number of relationships in which you can talk honestly about difficulties, and practise asking for specific help before a crisis. The protective effect of support depends on believing it will be there when needed.

In practice

  1. Identify two or three people you could call if something difficult happened this week.
  2. Keep regular contact with them when nothing is wrong, not only when something is.
  3. Practise asking for specific help: a conversation, practical assistance or company.
  4. When you share a difficult experience, ask for help thinking it through as well as for comfort.
  5. Offer the same support in return; reciprocity sustains relationships.

Why it matters

Stress responses protect the body in the short term and contribute to wear when they are activated too often or do not switch off (McEwen, 1998). Anything that reduces how strongly or how long stress responses are engaged has long-term value.

What the evidence shows

Cohen and Wills (1985) reviewed studies of social support and well-being. Social integration had a general positive association with health, and perceived availability of support protected people specifically against the effects of stressful events. The buffering effect was strongest when the kind of support available matched the demands of the stressor.

Rimé (2009) reviewed research showing that people share most of their emotional experiences with others. Sharing reliably strengthens social bonds and brings attention and empathy, even though, on its own, it does not reduce the emotional impact of a memory. Sharing therefore contributes to support indirectly, by maintaining the relationships that make support available.

What further research adds

The long-term stakes are large. A meta-analysis of 148 studies with 308,849 participants found that people with stronger social relationships had a 50% increased likelihood of survival (odds ratio 1.50), a result that was consistent across age, sex, initial health status, cause of death and follow-up period (Holt-Lunstad, Smith & Layton, 2010). The association was strongest for complex measures of social integration and weakest for whether a person lived alone or with others. The authors judged the influence comparable with well-established risk factors for mortality. The estimate describes an association between relationships and survival, not a controlled test of building relationships.

How support is given also matters. Bolger, Zuckerman and Kessler (2000) note that although perceived availability of support buffers the effects of stressors, research had failed to show an association between actually receiving support and adjustment. In a daily diary study of couples, many support transactions reported by the supporter were not reported by the recipient, and these invisible transactions promoted adjustment to a major stressor. A review of 100 studies of social support interventions found some support for their overall usefulness, but not enough evidence to conclude which interventions work best for which problems (Hogan, Linden & Najarian, 2002).

Relation to collective experiences

A crowd can create a strong feeling of belonging for one night. Buffering depends on relationships that persist into the following week, when a specific stressor arrives. Both are valuable. Only the second is available on demand.

Limits

  • Most evidence on social support and health is observational; it shows robust associations but cannot fully separate cause from effect.
  • Support that does not match the need, such as advice when comfort is wanted, may not buffer stress.
  • People without accessible support can still find it through community groups, peer support or professional services.
  • Receiving support has not been reliably associated with better adjustment; in a diary study of couples, it was support the recipient did not notice that promoted adjustment (Bolger et al., 2000).

Claims made on this page

Each claim is graded in the evidence ledger, with its sources and review dates. Evidence →

EmpiricalLevel DConfidence HIGH

People share most of their emotional experiences with others, and sharing has interpersonal functions such as eliciting attention, empathy and support.

Scope
Research on the social sharing of emotion across ages and cultures.
Caveat
Evidence comes mostly from one research programme and relies heavily on self-report.

Last reviewed · Review due · social-sharing-common

EmpiricalLevel DConfidence HIGH

Stress mediators such as cortisol and catecholamines are protective in the short term but contribute to allostatic load when chronically activated or poorly terminated.

Scope
Human stress physiology as summarised in a narrative review.
Caveat
Allostatic load is a construct whose measurement is still debated, and the review predates much later work.

Last reviewed · Review due · allostatic-load

EmpiricalLevel DConfidence HIGH

Perceived availability of support that matches the needs created by a stressor is associated with protection against its adverse effects, while social integration has a general association with well-being.

Scope
Adults in the observational studies reviewed.
Caveat
Most evidence is observational and cannot fully separate cause from effect.

Last reviewed · Review due · perceived-support-buffers-stress

EmpiricalLevel CConfidence HIGH

Across 148 studies with 308,849 participants, stronger social relationships were associated with a 50% increased likelihood of survival, consistently across age, sex, initial health status, cause of death and follow-up period.

Scope
Studies relating social relationships to later mortality.
Caveat
An association from non-experimental studies; it does not show that deliberately building relationships changes survival.

Last reviewed · Review due · advice-relationships-survival-association

EmpiricalLevel CConfidence MODERATE

Receiving support has not been reliably associated with adjustment to stress; in a daily diary study of couples, support transactions the recipient did not notice promoted adjustment to a major stressor, and a review of 100 support interventions found some support for their usefulness but not which work best for what.

Scope
Support between partners around a major stressor, and structured support interventions.
Caveat
One diary study and a narrative review; the kind of support that helps may differ across relationships and problems.

Last reviewed · Review due · advice-invisible-support

References

  1. Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98(2), 310–357. https://doi.org/10.1037/0033-2909.98.2.310
  2. Rimé, B. (2009). Emotion elicits the social sharing of emotion: Theory and empirical review. Emotion Review, 1(1), 60–85. https://doi.org/10.1177/1754073908097189
  3. McEwen, B. S. (1998). Protective and damaging effects of stress mediators. New England Journal of Medicine, 338(3), 171–179. https://doi.org/10.1056/NEJM199801153380307
  4. Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: A meta-analytic review. PLoS Medicine, 7(7), e1000316. https://doi.org/10.1371/journal.pmed.1000316
  5. Bolger, N., Zuckerman, A., & Kessler, R. C. (2000). Invisible support and adjustment to stress. Journal of Personality and Social Psychology, 79(6), 953–961. https://doi.org/10.1037/0022-3514.79.6.953
  6. Hogan, B. E., Linden, W., & Najarian, B. (2002). Social support interventions: Do they work?. Clinical Psychology Review, 22(3), 381–440. https://doi.org/10.1016/S0272-7358(01)00102-7