Resilience by design: How nature, nurture, environment, and microbiome mitigate stress and allostatic load

Abstract

Resilience to psychological stress is defined as adaption to challenging life experiences and not the absence of adverse life events. Determinants of resilience include personality traits, genetic/epigenetic modifications of genes involved in the stress response, cognitive and behavioral flexibility, secure attachment with a caregiver, social and community support systems, nutrition and exercise, and alignment of circadian rhythm to the natural light/dark cycle. Therefore, resilience is a dynamic and flexible process that continually evolves by the intersection of different domains in human’s life; biological, social, and psychological. The objective of this minireview is to summarize the existing knowledge about the multitude factors and molecular alterations that result from resilience to stress response. Given the multiple contributing factors in building resilience, we set out a goal to identify which factors were most supportive of a causal role by the current literature. We focused on resilience-related molecular alterations resulting from mind-body homeostasis in connection with psychosocial and environmental factors. We conclude that there is no one causal factor that differentiates a resilient person from a vulnerable one. Instead, building resilience requires an intricate network of positive experiences and a healthy lifestyle that contribute to a balanced mind-body connection. Therefore, a holistic approach must be adopted in future research on stress response to address the multiple elements that promote resilience and prevent illnesses and psychopathology related to stress allostatic load.

Keywords: Resilience; Stress; Allostatic load; Epigenetics; Circadian rhythm; Attachment; Oxytocin; Diet; Microbiome; Exercise

Core Tip: There are multiple reviews in the literature that address different factors contributing to resilience, an adaptation to stress. To our knowledge, none of these reviews takes into consideration the complexity of the system that leads to allostasis or allostatic load, an indicator of physiologic “wear and tear” resulting from repeated exposure to stress and inability to cope. The purpose of this review is to shed light on the complexity of the system and discuss the molecular mechanisms that may contribute to resilience. Lastly, we conclude by emphasizing the need for a comprehensive approach to reduce stress allostatic load.