Can you really worry yourself sick?

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A study published this week in the Journal of Research in Personality finds that personality traits that cause people to worry too much and endure chronic stress may actually increase their risk for illness and premature death. A handful of studies have shown that neuroticism—broadly, the tendency to worry too much—can actually be beneficial for your health, making you more sensitive to potential threats or more vigilant about your health, for example. Yet the vast majority of research into the health impact of neuroticism finds that excessive worry and stress are linked with a higher risk for illness, conditions such as obesity and hypertension, and an increased likelihood of turning to alcohol and tobacco to dull the anxiety and depression that frequently characterize neuroticism.

To better understand what role smoking and drinking might play in the trend of poorer health outcomes among people with an overdeveloped tendency to worry, researchers followed 1788 men with neurotic personalities from 1975 until 2005. Using data about their tobacco and alcohol consumption, they did in fact find a correlation between “self-medicating” and increased mortality, but this was only evident for tobacco. Smoking, they saw, accounted for somewhere between 25 and 40% of the association between neuroticism and increased risk of premature death.

As for what other factors can help explain why worrying too much can be bad for your health, the researchers speculate that unique biological and environmental influences may be at play for people with neurotic personalities. “[W]e presented evidence that health behaviors, especially smoking, are at least part of the puzzle,” they write.