You’re working long hours. You’re busier with patients than ever. It feels like you can’t catch a break. And your marriage seems to be getting worse and worse. Let’s break down Marriage Stress Points: What They Are and How to Change Them. 


At Best Friends Again, we know how to help physician marriages because we’re living in one. We work on building stronger connections between partners, even in the midst of stressful life events. 

The philosophy of stress points is a useful tool in struggling marriages. Once you see how stress points work, it’ll probably be more clear to you why your relationship is suffering. And it’ll be that much easier to be better again, together. 

What Are Stress Points?

The idea of stress points comes from research into the relationship between stress and illness. In the late 1960’s, psychiatrists Thomas Holmes and Richard Rahe wanted to investigate this link. They looked at more than 5000 medical records to investigate patients’ specific sources of stress. 

Holmes and Rahe found that 43 specific stressors carried more risk for illness. To quantify this, they ranked stressors with Life Change Units, or LCUs. Each stressor carries a different LCU score. The higher the score, the more likely a patient with that stressor is to get sick. 

Thomas and Rahe published their results as the Social Readjustment Rating Scale (SRRS). The relationship between life stressors and illness is an evolving field of study, but the SRRS scale continues to hold up to research. It’s still used to evaluate patients for stress risk.

The SRRS scale is used to predict your likelihood of developing a stress-related illness. The higher your score, the more likely you are to get sick. 

  • 300+ points: risk for stress-related illness. The chances of developing a disorder related to stress is about 80%.
  • 150-299 points: moderate risk for stress-related illness. About a 50% chance of developing a disorder related to stress. 
  • <150 points: a slight risk for illness. 

Stress points on the SRRS and their LCUs: 

Stress PointLCUStress PointLCU
Death of a Spouse100Retirement45
Divorce73Pregnancy40
Marital Separation65Changing professional fields36
Imprisonment63Trouble with in-laws29
Personal Injury or Illness53Changing living conditions25
Marriage50Vacation13

What you may find surprising about this list isn’t the link between acute stress and illness. It’s understandable how a tragedy like a spouse dying takes a toll on a person’s mental and physical health. 

What’s surprising is that many of the items on this list aren’t ones you would necessarily consider stressful. 

Events that we think of as positive, like taking a vacation (13 LCUs), lead to stress. Spending lots of money, being together 24/7, and deciding how to spend your time – makes sense, right? Outstanding personal achievements (28 LCUs) create stress. Reconciling a marriage, what we consider a positive change in life, carries 45 LCUs. 

Whether you think of them as positive or negative, major or minor, life events add stress to our minds and bodies. Even small events can increase your stress and your chances of getting sick. 

Stress Points and Resilience

We’ve learned a lot about social determinants of health since Holmes and Rahe published in 1967. On its own, the SRRS score shows a person’s average risk for developing stress-related diseases over time. But most people aren’t average. 

Since Thomas and Rahe’s research, we’re learned that resilience plays a major role in your ability to deal with stress. Just as stressful events come in life, so do factors that make them easier to bear. Factors like close relationships and a strong social network help you be more resilient when you’re faced with stress. Good thing we don’t have to face everything on our own, right?

The protective factors of resilience can keep you healthy despite SRRS stressors. But what does the SRRS scale and resilience mean for folks experiencing conflict in their marriage? Let’s talk about applying the SRRS model and resiliency to our life-long partnerships. 

Stress Points and Marriage

The same stress points that put you at risk for physical illness increase the risk for sickness in your marriage. Even in a strong relationship, a major event like the death of a family member can create pressure. You and your partner might be the best of friends. Your relationship might be strong and intimate. But a sudden death in the family can create pressure. 

Physicians have specific and tangible stressors that often impact their marriages. Working long hours and bringing stress home from the hospital puts strain on partners, and can sap your energy away from home life. The burden of supporting a busy physician-partner can leave a spouse feeling neglected. 

When marriage stressors add up over time, the pressure within the marriage rises. 

If you’re part of a marriage that is struggling, it’s probably easy to see the symptoms: 

You may notice your partner shrugging off your affection…  

You may notice yourself staying later at the hospital to avoid an uncomfortable home…  

You may think longingly about the way you felt when you got married…  

These are symptoms of deeper interpersonal stress that compounds over time. It’s this kind of unaddressed conflict that leads couples who once were happy together to drift apart. 

But now that you understand stress points, how can you lower your risk for stress-related “sickness” inside your marriage?                                            

How to Change Marriage Stress Points

The only way to change marriage stress points is to increase your marriage’s resilience. 

Here’s the kicker: stress points aren’t something you can change. As helpful as the SRRS scale is at pinpointing stressful events, it doesn’t tell us how to deal with that stress. 

You can’t get away from stressors. These aren’t events that you can avoid as individuals or partners. It’s not practical to stop seeing your inlaws (as tempting as that may be!). You also can’t just put off retiring just because it will increase our SRRS score.  

The only solution to changing the way that stress impacts your marriage is to strengthen it from the inside out. 

In struggling marriages, even small events on the SRRS can exacerbate conflict. An approaching holiday can lead to a painful fight. On a “fun” family vacation, you can start wishing you were anywhere else. 

Without the tools to deal with these stressors, dysfunction within a marriage can quickly become septic. 

In a resilient marriage, difficult events are still hard. But the difference is that you have a partner to lean on. You have a relationship that can buffer stress, rather than make it worse. 

Dealing with life’s stresses together is a huge benefit of being in a successful marriage. We can be allies in the waves of life, holding hands as we’re pulled along. Or we can fight the waves and be pulled under, alone. The events on the SRRS are stressors, but they can bring us closer if we work together.

But how can you build resilience into your marriage? Even if your marriage is struggling, it’s possible to be better together. We help couples break down marriage stressors to become best friends again. 

Key Takeaways About Marriage Stress Points

  • Stress Points come from the Social Readjustment Rating Scale, or SRRS. This scale points out 43 separate life events that increase a person’s risk for illness over the lifespan. 
  • Each life event or conflict on the stress scale carries a different risk for illness. These scores are expressed as Life Change Units, or LCUs. When combined, LCUs can show a person’s average overall risk for stress-based illnesses. 
  • Some events, like the death of a spouse, cause stress for obvious reasons. But many events on the SRRS may surprise you. Even events that are positive overall cause stress on our minds and bodies. 
  • By applying the SRRS scale to marriages, you can get a clearer picture of the events that increase our risk for conflict. Highly stressful events can put a strain even on strong marriages. In a struggling marriage, positive events can become sources of painful conflict. 
  • You can’t stop stressful things from happening in life. But you can change the way that you respond to them as a couple. Increasing resilience in your marriage can help you both respond to stressors in ways that strengthen your relationship, rather than weaken it. 

Want to learn more about healing your marriage from the inside out? 

At Best Friends Again, we’re passionate about helping couples who are struggling in their marriage. We can give you the guidance to get “back to the good ‘ole days” with your partner. 

Physicians have specific stressors that can make marriage more difficult. But that doesn’t mean you can’t have the marriage you and your spouse want. The answers are just around the corner. Download a free chapter of Dr. Jeep’s Book, What’s Forever For? A Physician’s Guide to Everlasting Love and Success in Marriage

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