top of page


Can The Most Stressful Life Changes Predict Future Illness?

When was your last significant life change? In the past 6-9 months, most of us have experienced changes at work or in our families. Can you recall that moment and how it felt to go through that particular change? Life changes affect people differently, but stress is a common factor in all our lives. Despite trying to avoid overthinking, staying distracted, or coping with tough days, are we inadvertently neglecting the impact of stress on ourselves and those around us? Perhaps it's time to learn how to effectively handle it.

Scientifically, stress has been proven to have numerous effects on the body, impacting various systems such as musculoskeletal, respiratory, cardiovascular, endocrine, gastrointestinal, nervous, and reproductive systems. (*)


In 1967, researchers Thomas Holmes and Richard Rahe went through the medical records of over 5,000 patients looking for a possible connection between illness and the most stressful life events and found that a strong correlation did exist. They ranked stressful situations on a scale, from most stressful to least stressful, which could indicate the kind of life stressors that put people at higher risk of becoming ill.

Rahe tested the reliability of this stress scale again in 1970, giving it to 2,500 U.S. military members (sailors), asking them to rank their most stressful life events, and then followed the sailors for six months, tracking their visits to the dispensary, to see if there was a correlation between their reported “life stress” and their visits to the doctor. The study proved that the more stressful the event, the higher likelihood of illness. Furthermore, these results held when looking cross-culturally (Japan and Malaysia, in addition to the United States) and among different groups in the United States (African, Hispanic, and White Americans). To this day, the Holmes and Rahe Stress Scale is often used by doctors.


In one chart, these are the ten most stressful changes that can happen to you in life, out of a total of forty-three Life Events.

Ten Most Stressful Life Changes
Source: 'The Social Readjustment Rating Scale,' Thomas H. Holmes and Richard H. Rahe, Copyright © 1967. All rights reserved.

So what are the other stressful Life Changes on the Holmes and Rahe scale, and how are they used to predict the likelihood of illness? Individuals can use it as a Stress Test (Social Readjustment Rating Scale) to improve self-awareness and assist them in mobilising for action when circumstances are too much to handle alone, and professional help is required. - Get Your Free Copy of the Stress Test at the end of this article.

Here’s how it works: each of the 43 life events has assigned one “Life Change Unit” score. Example: The Life Event Death of a Spouse has a Life Change Unit Score of 100, Divorce has a Life Change Unit Score of 73, and Dismissal from Work stress score is 47. The sum of the Life Changes Units of the applicable events over the past 12 months, or expected to occur in the near future, of an individual’s life, are used to predict the risk of illness due to stressful life changes. – continue reading and find all 43 events down in this article.

Check out the top ten most stressful life events and their “Life Change Unit” scores, for adults:

1. Death of a spouse: 100

2. Divorce: 73

3. Marital separation: 65

4. Imprisonment: 63

5. Death of a close family member: 63

6. Personal injury or illness: 53

7. Marriage: 50

8. Dismissal from work: 47

9. Marital reconciliation: 45

10. Retirement: 45

How to Calculate your Stress Score?

To calculate your stress levels, add up each Life Change Unit number for any event that has happened in the past year or is expected to happen in the future. If the event(s) is expected to occur more than once, add those additional instances into your total. According to 'The Social Readjustment Rating Scale,' by T. H. Holmes and R.H. Rahe, you have an:

  • 80% likelihood of illness for scores over 300

  • 50% likelihood of illness for scores between 150-299

  • 30% likelihood of illness for scores less than 150

Disclaimer: This tool should NOT be considered as a substitute for any professional medical service, NOR as a substitute for clinical judgement. believe-IN advises flexibility in the interpretation of your score. If you have questions, please feel free to e-mail us your questions to We'd be happy to assist.


Remember, it doesn’t have to feel catastrophic to affect or increase your stress levels. Our bodies are well equipped to handle stress in small doses, but when that stress becomes long-term or chronic, it can have serious effects on your body and mind. People undergoing these experiences benefit from a robust close social network, and professional support specialised in Life Changes and Transition Management is vital in managing stressful Life Changes.

The remaining Life Changes Units of the Social Readjustment Rating Scale are:

11. Change in health of family member: 44

12. Pregnancy: 40

13. Sex difficulties: 39

14. Gain of a new family member: 39

15. Business readjustment: 39

16. Change in financial state: 38

17. Death of a close friend: 37

18. Change to a different line of work: 36

19. Change in number of arguments with spouse: 35

20. Mortgage over $20,000 (updated for 2018 = ~$150,000): 31

21. Foreclosure of mortgage or loan: 30

22. Change in responsibilities at work: 29

23. Son or daughter leaving home: 29

24. Trouble with in-laws: 29

25. Outstanding personal achievement: 28

26. Spouse begins or stops work: 26

27. Begin or end school: 26

28. Change in living conditions: 25

29. Revisions of personal habits: 24

30. Trouble with boss: 23

31. Change in work hours or conditions: 20

32. Change in residence: 20

33. A school change: 20

34. Change in recreations: 19

35. Change in church activities: 19

36. Change in social activities: 19

37. Mortgage or loan less than $20,000 (updated for 2018 = ~$150,000): 17

38. Changes in sleeping habits: 16

39. Change in number of family get-togethers: 15

40. Change in eating habits: 15

41. Vacation: 13

42. Christmas approaching: 12

43. Minor violation of the law: 11

Again, a score of 300 or higher puts a person at risk of illness. 150-299 shows a moderate risk of illness and a score of less than 150 predicts only a slight risk of illness.

Note: If you experienced the same event more than once, then to obtain a more accurate total, add the score again for each extra occurrence of the event.

For non-adults, the scale was modified:

1. Death of a parent: 100

2. Unplanned pregnancy/abortion: 100

3. Getting married: 95

4. Divorce of parents: 90

5. Acquiring a visible deformity: 80

6. Fathering a child: 70

7. Jail sentence of a parent for over one year: 70

8. Marital separation of parents: 69

9. Death of a sibling: 68

10. Change in acceptance by peers: 67

Note: Here we present the ten most stressful from a list of 37 Life Change Units - If you have children - Get Your Free Copy at the end of this article.


Stress may be less of a mental state than we think. The human response to danger usually involves a physical response to a perceived threat, a rush of cortisol and adrenaline through our bodies meant to keep us alive. Further on, Richard S. Lazarus gave us the modern definition of stress as "a condition or feeling experienced when a person perceives that demands exceed the personal and social resources the individual is able to mobilize”. Stress, whether it is a minor event like dropping a glass or a major stressful life event such as a Divorce or Changes in Work, triggers a physical response that allows us to react quickly and decisively.

Theoretically, by removing the stressor or taking charge of the change process, our bodies would return to a neutral state. However, this perfect biological system is interrupted when we experience stressful life changes that then become chronic stress, and this state of heightened, chronic stress can lead to an increased risk of illness, many of which can be very serious. It contributes significantly as a risk factor to psychological declines and illness (read more in the post “How is Stress Working Out for You?”).


The short answer is, yes, and it is scientifically proven and widely used by healthcare professionals and the medical community. Although, here at believe-IN, we also know that some people can face it and fight back all the curve balls life throughs at them. They take charge of their situation amidst life changes and find new meanings to rebuild a new life - These People Take Control of Themselves and Their Situation.

Effective self-regulation during life changes is what enables people to reach positive mental health and use feelings to achieve the best life they can aspire to. At believe-IN, our Interventions Programmes support people to develop the set of skills and professional support to manage whatever stressful Life Changes might come.

We want to ensure you are fully functioning, capable of effective decision-making toward your full potential in the new chapter of your life, a Healthy Person.

We work with both individuals and organisations, online, in English, Portuguese and Spanish, worldwide. The first step is for you to arrange your free initial 30-min consultation appointment and find out how we can support you. Go to or email us at

Private and Confidential. We understand how sensitive it is to talk about it and experience it.


Change and Transitions Intervention Programmes, Psychometric tests and Learning Events.

Please feel free to Like Comment Share!

We'd love to hear from you

Feel free to download a free copy of "THE STRESS TEST - Adults" we have just prepared for you.

THE STRESS TEST - believe-IN. Make It Happen!®
Download PDF • 460KB

You can also get a free copy of the "STRESS TEST - non-Adults" here.

THE STRESS TEST - non-adults - believe-IN
Download PDF • 460KB

We recommend you our FREE eBook on The Healthy Person (get it here).

In this believe-IN eBook, we discuss The Healthy Person characteristics alongside three difficulties that human beings must transcend to become healthier, based on Abraham H. Maslow's research legacy and how those relate to Life Changes and Transitions.

To download your Free eBook Now, click here.

(*) Read more about it in detail on “Stress effects on the Body” by the American Psychology Association


Recent Posts

See All


bottom of page