Your Relationship Is Affecting Your Health (More Than You Think)

Is your relationship affecting your health?

In this episode of Health Recoded, we explore how romantic relationships can directly influence your stress levels, hormones, heart health, sleep, and long-term physical and mental wellbeing.

Most people don’t realize that the quality of your relationship is not just emotional—it is also physiological. Chronic relationship stress or emotional instability can affect the body through changes in cortisol, autonomic nervous system activity, and overall stress regulation.

At the same time, supportive and secure relationships can have measurable benefits for both mental and physical health.

We cover:

- The science of how relationships affect the body (stress, hormones, and physiology)
- What happens in unhealthy or high-conflict relationships over time
- How relationship stress impacts heart health, sleep, and mental wellbeing
- Differences in how men and women may experience relationship stress
- How emotional regulation and communication influence long-term relationship health

If you’re looking to improve your relationships and long-term health, this episode gives you a clear place to start.

Subscribe for more conversations that help you better understand your body. New episodes weekly.

Chapters:

00:00 Intro – Are relationships a health factor?
00:54 Why relationships impact physical health more than people realize
02:10 How relationships affect the body: Relationship stress, cortisol, and the nervous system
09:53 Unhealthy relationship patterns in the body
10:45 Men vs women: differences in relationship stress responses
13:29 Practical ways to improve relationship health
22:00 Key takeaways

This content is for educational and informational purposes only and is not a substitute for guidance provided by your own medical professional.

Resources:

https://pmc.ncbi.nlm.nih.gov/articles/PMC12668558/

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

Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality. *Perspectives on Psychological Science, 10*(2), 227–237. https://doi.org/10.1177/1745691614568352

Kiecolt-Glaser, J. K., Gouin, J. P., & Hantsoo, L. (2010). Close relationships, inflammation, and health. *Neuroscience & Biobehavioral Reviews, 35*(1), 33–38. https://doi.org/10.1016/j.neubiorev.2009.09.003

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

Robles, T. F., Slatcher, R. B., Trombello, J. M., & McGinn, M. M. (2014). Marital quality and health: A meta-analytic review. *Psychological Bulletin, 140*(1), 140–187. https://doi.org/10.1037/a0031859

https://www.artsci.utoronto.ca/news/new-study-finds-single-women-are-happier-single-men

Transcript

SPEAKER_00 0:00

As a nurse, I can tell you something most people underestimate. Your romantic relationship might be more powerful for your health than your diet, your workouts, or even your sleep. Hi, I'm Alex. I'm your nurse, and today we're talking about one of the best health decisions and most important decisions that you can make who your romantic partner is. Research shows that loneliness and unstable relationships increase mortality risk by up to 30 to 50%, and that's on par with smoking and obesity. Strong social relationships increase survival odds by roughly 50%, and loneliness increases risk of early death by 25 to 30% at least. All of that being said, let's dig in deeper to how your closest personal relationship, your romantic relationship, affects your body, your physiology, and therefore your health. So some statistics on partnership. When researchers look at predictors of mortality, they consistently find something surprising. Social connection is not a soft psychological variable. It behaves like a biological one. So marriage and mortality, married individuals have lower all-cause mortality risk compared to unmarried individuals. A large meta-analysis found marriage is associated with 10 to 15% lower mortality risk, but poor quality marriages are associated with worse health outcomes than just being single. What this means clinically is that relationships are not just quality of life, they function as a long-term physiological exposure, shaping health trajectories and outcomes over decades. So some stats on divorce as well. Divorce and separation is associated with increased cardiovascular disease, higher inflammation markers, higher depression and anxiety rates, and recently divorced individuals show higher mortality risk in the years following separation, particularly with men. So, all of that being said, let's talk about this in a more physiological standpoint. How do relationships actually affect your body and your physiology? Starting with the brain, the person you love most can either regulate your nervous system or slowly dysregulate your entire body. Romantic bonding activates multiple systems, particularly your dopamine, which is the reward pathway, oxytocin, which is bonding, attachment, and trust, and then endogenous opioids, so calm and safety. This is back to love being addictive, like we've talked about previously. This down rate down regulates stress physiology. So chronic relationship stress does the opposite. It increases your amygdala activation, which is your threat response, and reduced prefrontal cortex regulation, which is your emotional control. So, in essence, you're in a higher threat monitoring state when you're in chronic relationship stress. And so, therefore, that affects your body. Moving into the heart, we talk about heart disease like it comes from cholesterol, but one of the strongest predictors of heart health might actually be who you're sleeping next to at night. Conflict in relationships can predict higher blood pressure because of increased catecholamines in your system and endothelial dysfunction. So, again, that's the vascular lining in your blood vessels, and it can increase the risk of coronary artery disease because that endothelial lining is not operating as effectively. So even short conflict discussions can increase your blood pressure for hours afterwards. In long-term studies, though, people in high conflict relationships show higher rates of coronary heart disease compared to those in low conflict or supportive relationships, even when controlling for traditional risk factors such as smoking or high cholesterol. So essentially, you're placing more work on your heart and you're increasing the amount of stress in your system, which then increases the amount of stress on the heart, and it's having to work more, and therefore you're at an increased risk of disease. Hormones are also affected by your relationships. The HPA access, the hypothalamic, pituitary, adrenal axis, this governs your cortisol release. And so in healthy relationships, cortisol spikes are short-lived and often quickly recovered from, which is really important nuance to note. But in chronic relational stress, cortisol can remain elevated or dysregulated. So again, short-term cortisol can be really effective. It is to help you get away from the bear, essentially. But if that state remains activated chronically, it can actually start to really wear down on your body. So this contributes to what researchers called allostatic load. And this is the cumulative wear and tear on the body from repeated stress activation. So unhealthy relationships or chronic stress increases the activation of this axis or this response. So you'll have higher cortisol, higher adrenaline, and therefore decreased sex hormones such as testosterone or estrogen. And these help to balance all of this regulation and disruption over time. So over time, high allostatic load or this high stress and pressure is associated with insulin resistance, abdominal fat accumulation, immune suppression, and accelerated biological aging. This is one of the key mechanisms linking emotional environments to long-term disease risk. So your surroundings and your environment directly influence the state of your health. And your mental health is obviously going to be affected if your romantic relationships or any of your relationships are not that healthy or safe. Relationships act as a primary driver of mental health, serving either as a protective buffer against stress or a major catalyst for it. Stress reduction, this supportive bonding, lowers cortisol levels, while physical affection triggers oxytocin or the love hormone. That fosters emotional trust and relaxation. It also fosters a sense of belonging. So regular social connection builds your self-esteem and it creates a sense of purpose and reduces long-term isolation risks. Because if you have a group to rely on, you don't feel as isolated, and therefore you feel more resilient and like you can actually handle things. And therefore, your body is, again, not in that stress response. And then from there, crisis buffering, having a reliable network provides the emotional backing and healthier coping mechanisms during traumatic life events, or honestly, just life in general. High conflict relationships strongly correlate with increased levels of depression, anxiety, emotional dysregulation overall, and even substance use risk. But the key insight is that this is a feedback loop. Stress worsens mental health, and worsening mental health can therefore strain relationships, creating and reinforcing this cycle of physiological stress. So something similarly related to that would be your immune system. Your relationships do affect your immune system because it affects your stress levels. So chronic relationship stress decreases your immune function and increases the inflammation cytokines that are going on in your body, and this can result in recurring infections or slower wound healing. One study has actually shown that wounds healed roughly 40% slower in couples that are in a higher conflict state. One of the most important findings in immunology is that relationship stress increases systemic inflammation. So again, if your body is in that high stress response or if it's got higher cortisol pumping throughout your body, your body's in a more stressed state. So its baseline of functioning is going to be lower. And anything that is above that is just stressing it out even further. And then therefore you can become more sick more frequently or have a harder time recovering from illnesses should you incur them. Couples experiencing chronic conflict show elevated levels of inflammatory markers such as IL6 and CRP. This matters because chronic inflammation is not just about illness, it is a central driver of cardiovascular disease, neurodegeneration, metabolic disease, and autoimmune disorders. So relational stress literally shifts your immune system toward a more inflammatory baseline. And then also your gut will be affected by this. Higher levels of increased stress are going to affect your gut and again your mentation, and that is a feedback loop in of itself. So although this is less widely discussed, the gut is highly sensitive to autonomic nervous system tone. Chronic stress shifts the body towards sympathetic dominance, which is your fight or flight response. And this affects your gut motility, IBS symptoms, severity, and microbiome composition. So this is why many people notice digestive symptoms worsening during periods of stress or emotional instability. And again, it's a feedback loop. Your gut will feel bad, and so maybe your mind does, or your mind will feel bad, and then maybe your gut does, and then both of them feeds back into the other, and it doesn't help it feel any better. So the effects of an unhealthy relationship. Even unhealthy relationships function physiologically like chronic stress exposure. As we just discussed, elevated cortisol, increased systemic inflammation, disrupted sleep, higher resting heart rate, slower healing and immune response, chronic exposure to toxicity not only breaks down your self-esteem and your happiness and your mental state, but it can also trigger lasting physiological response. The key point to note here is that the body does not distinguish between emotional threat and physical threat. It responds through the same pathways for both. So I do want to talk about some differences between men and women because there are some differences in the research and in the statistics. Men often have worse health outcomes when they're not in a pair-bonded relationship. And single women tend to have better outcomes as compared to single men when they're single. On average, though, unpartnered men show higher all-cause mortality risk, higher rates of substance use, and poorer health behaviors overall. One interpretation in the literature is that men often derive a larger proportion of their emotional regulation and support, and then therefore health behavior structure from their romantic partner, meaning that loss or absence of that relationship has a more immediate health impact. And then for women, women generally maintain broader social support networks even outside of their romantic relationship. So there's greater likelihood of exiting high conflict relationships and then a strong buffering as a result from friendships and family systems. So making a case for being single or being partnered here, being single, higher autonomy, single women experience fewer of the domestic and emotional compromises often found in traditional partnerships, and they have stronger social ties, as we just discussed. So they invest more in friendships, in community, and have more robust social systems. And then there's the avoidance of unequal labor. Many women actively choose singlehood to avoid uneven division of household labor and emotional support, often required in relationships. But the case for being partnered, health and longevity benefits, statistically, women in healthy, stable marriages often experience better long-term health and emotional support. And then also shared financial burden. The economy, in an economy with high cost of living, pooling resources like housing and bills can provide significant economic stability and therefore improved health access and outcomes. Importantly, I'm not making a case that you should stay single or that you should be in a relationship. It's just to highlight the differences between the two. Women do not have universally better outcomes outside of relationships. Rather, outcomes are more strongly determined by the relationship quality than relationship status. So it is not relationship status that predicts health, being single or being partnered. It is relational safety, conflict level, and emotional support within that relationship. And relationship quality matters more than relationship status for both sexes. So, my nursing tips for a healthy relationship. Early relational discernment matters. Early stress patterns predict long-term physiological burden. So again, I'm not advocating to just go get into a relationship or avoid one altogether, ladies or men. But we need to make sure that we're discerning that the person that we're choosing that we're partnering with is going to affect us. It's more than just that you love them or that you enjoy their company. How your partner lives will be your life. And this is something to consider that I don't think a lot of people really realize. How they spend a random Tuesday, Wednesday night is going to directly affect you in your life. Do they sit there and scroll their phone for an hour before bed? Do they have to watch TV in order to fall asleep? Do they consume copious amounts of caffeine or smoke or do things that really affect you and your own habits and therefore your own health? Our partners influence our sleep, our diet, our exercise, substance use patterns, our social life, everything. This is somebody that you're partnering with and living with. So you're choosing a lifestyle and a partner, a person to share it with, not just someone to love or have sex with. So from there, nervous system safety is greater than chemistry. And this is something that I didn't really realize either when I got into my last relationship. I think, particularly when we're younger, we want the spark and we hear so much about chemistry and finding that spark, that person, that connection. And that's important. I'm not saying that we shouldn't go find that. But calm regulation predicts long-term health outcomes better than intensity. And I can speak to this. When you're in that highly activated, intense relationship, it can feel so good in the beginning, but you have to really question how sustainable is that over time? Is this person going to support me? Are they going to listen to my feelings and emotions? Or are they going to offload everything onto me, blame me, and not take care of theirs? And this goes for both sides. I'm not saying that women should stay single or that men absolutely have to be partnered in order to be healthy. I think both of these aspects are important for both sides. So pay attention to how you feel around somebody. Chemistry can be important, but so is compatibility. So what are we going to do once we're actually in that relationship to help support healthy relational functioning for healthy health outcomes? Communicate honestly and authentically. This isn't to say to be super blunt and honest all the time to the point that you're hurting somebody. It's to say don't make your partner guess what you need or what you're thinking. Communicate honestly and effectively of what your needs and desires are between each other so that you can then understand the other person and also on your own end not sit in resentment. We want to be able to communicate with each other so that we can then support each other, so that we're then supporting ourselves. We also want to prioritize quality time with one another. This is the person you're choosing to spend your life with, right? It's the person you're going to talk to the most, the person that you're going to sleep next to every night. That's a lot of hours already. Carve out time for face-to-face connection free from distraction. We've talked about phones, we've talked about all different kinds of stress and distracting measures. Method that I found is a 777 rule. Go on one day every seven days, take a weekend getaway every seven weeks, and plan a vacation away every seven months. That sounds a lot on paper, but I think it's actually a pretty good baseline to follow because it's really easy for life to get away from us, even when we're single. And so just planning those things ahead of time and making that commitment can actually help to support your health overall. Just like you would plan your doctor's visit. Go and plan your date with your partner so that you can support your health and your enjoyment in that relationship overall. This is not to say that you will avoid conflict in every relationship. There will be conflict in the best relationships, and there should be. We're all individual people. We all have our own thoughts and opinions. It's how we express it that matters. So just because you get into conflict doesn't mean that it's a bad thing. It's how it's handled after the fact that can really discern whether this person is going to be helpful and healthy or not. So relationship repair reduces physiological stress responses. And this is not just an apology. This is the behavior that follows the apology. Do they actually change the behavior that they said they would? Do they actually follow through on their word? Do they actually act upon the apology that they've given you? Or was it just words and it's going to happen again next time? And this is something that I wanted to talk about. It's a little bit personal to me. Toxic cycle of good and bad. It's so easy to get the apology and think that things are okay, but with no behavioral adjustment, that doesn't mean that anything's actually changed. It's just a cycle that's likely going to happen again. So then the behavior is going to repeat itself. You'll have your conflict. They'll come back and apologize, and then you'll think you're okay. And it's just a cycle. It's just going to continue. And maybe you're going to think, well, it's going to get better and it's going to be great and then it's going to go bad again. And that's actually a harder cycle to break than if it was just bad all the time. Because I think this is where a lot of people get stuck. You'll say, Well, it's so great when they do this. If we can just stay in the good all the time, then everything will be fine. And you actually wind up staying stuck because maybe the good is 20 or 30% of the time, and that's what you're fighting for to be 100% of the time. But that other 70% or what have you is really where you're operating from. But ultimately, it doesn't matter if it's good or bad. What matters is that the inconsistency is the pattern. And the fact that you're not able to stay consistently in one way. And it's not to say that it has to be all good or all bad in order to stay or leave, but I just want to highlight that this particular pattern can be particularly toxic and very hard to leave. So again, all healthy relationships are going to have conflict. I am fully advocating for the fact that you will have arguments and that's perfectly okay. And yes, you'll feel the stress response and XYZ, but it's not to be scared of having the conflict. It is how the conflict is handled that I really want to stress is the important part. So off of that, something that I feel like personally is still a little bit taboo is therapy, particularly couples therapy. This is actually preventative care. And I feel like a lot of people start couples therapy when it's a little bit too far gone. So let's talk about that. Couple therapy improves relational functioning and reduces psychological distress. Couple therapy, couples therapy is highly effective, with 70 to 80% of participants seeing improved relationship satisfaction and emotional well-being. But most couples wait an average of six years to seek help after issues begin. And the median couple starts therapy four years into the relationship. So from that, when do therapy sessions struggle? Or when does therapy struggle in general? Mixed agendas. About 30% of couples enter therapy with a mixed agenda, meaning one partner wants to save the relationship and the other one is already leaning out, or maybe late intervention. Most common reason for failure is delaying treatment until the resentment is too deep or one partner is already mentally checked out. And so then at that point, there's not really anything to save. You're kind of just already on the way out. And so that's why I say that couples therapy is preventative. You don't need to go just because something is wrong. You need to go to help manage and maintain things so that something doesn't go wrong. So my key takeaways for you healthy love is the most powerful longevity hack of all. Our romantic relationships determine not just our mental health and psychological well-being, but our physiology and our health overall. The person you are partnered with can affect your weight, your immunity, your mentation, your heart health, and your sleep. Their habits and their lifestyle will become a part of yours. Choosing a romantic partner is one of the biggest preventative health measures that you can make. So choose wisely. I hope this helps shed some light on just how impactful your romantic relationships are. If you found this interesting, you can share it with someone else who might enjoy. Please like and subscribe for weekly health conversations. If you ever have any questions, you can always reach out to me, comments, email. I'm also on Instagram. And I'll see you guys next week for our next topic. And thank you for listening.