Marry Me

By Lori Oliwenstein

Miriam Kamin is feeling a lot better now, thank you very much.

It was rough there for a while--infertility, a crippling case of endometriosis, the collapse of her nine-year marriage, and four years of single parenting while building a career as a corporate blogger. Then, last May, she married Mark, a longtime friend. And that, she says, has made all the difference.

"I've struggled with depression for most of my life," she explains. "Yet, despite the fact that I've moved, relocated my kids and am working harder than I have in a very long time, I'm not on medication right now. I had no idea marriage was supposed to be this much fun."

Never mind the popular palaver about a good marriage as a source of bliss for the couple, security for the kids and stability for society. Plenty of spouses--at least after the first wedded year--just come to see it as a whole lot of work. And why shouldn't they? Pair up any two people with often clashing needs, add the pressure-cooker variables of kids, doctor bills, career, housework, car repairs and the fact that someone--he knows who he is--can't pull himself away from the TV during college-basketball season, and there are bound to be problems. Marriage is criticized as a source of stress (and it is), conflict (that too) and endless crises that need to be resolved (guilty there as well).

But it's also something more. Decades of data collection have shown that marriage--for all its challenges--is like a health-insurance policy. A 2006 paper that tracked mortality over an eight-year period found that people who never married were 58% likelier to die during that time than married folks were. And no wonder. Marriage means no more drinking at singles' bars until closing, no more eating uncooked ramen noodles out of the bag and calling it a meal. According to a 2004 report from the Centers for Disease Control and Prevention (CDC), married people are less likely to smoke or drink heavily than people who are single, divorced or widowed. These sorts of lifestyle changes are known to lower rates of cardiovascular disease, cancer and respiratory diseases. And while you might sometimes gripe that your spouse drives you nuts, just the opposite is true. Married people have lower rates of all types of mental illnesses and suicide. And none of that touches the reduced likelihood of contracting sexually transmitted diseases that comes simply from climbing out of the dating pool.

"I clearly recall my then boyfriend and myself watching TV in the early '80s and hearing about AIDS," says psychologist and sex therapist Stephanie Buehler. "We looked at each other wide-eyed. I don't know that we chose to marry because of this, but it was a factor that pushed us to stay together and remain monogamous."

All the health benefits of marriage are consistent across age, race, education and income groups, and while researchers have not conducted equally exhaustive studies of gay couples, the benefits probably flow to them too. Some of the reasons for this are obvious. Smoking and drinking naturally decline if you've got a spouse at your side flashing you a don't-you-dare look when you reach for a cigarette or a third glass of wine. Depression and other emotional ills are less likely to go undiagnosed if there's someone at home who's mindful of your moods and notices if they darken. But there are other, less self-evident things at work too--things that you didn't realize when you decided to get married and that scientists and doctors are only now beginning to appreciate fully.

Marriage on the Brain

For all the watch-your-cholesterol lifestyle safeguards spouses erect around each other, much of what makes marriage so healthy for us takes place within our own bodies, entirely without our knowledge. A lot of those benefits come down to stress--or, specifically, the management of it. Stress puts into motion a biological cascade involving hormones, glands and neural circuits, all activating one another in a complex feedback loop. When you are stuck in traffic or overwhelmed at work or worn down by the kids, the hypothalamus--a structure buried deep in the midbrain--tells your adrenal gland to pump out a supply of the stress hormone cortisol. Cortisol, in turn, tells your body to stop worrying about its basic metabolic needs and instead to "do the things you need to do to save yourself from whatever created the stress," says University of Virginia neuroscientist James Coan.

That's great if you're fleeing an attacking bear, since the things you need to do to save yourself require boosting your heart rate and respiration, tensing your muscles and generally cranking up your body's alert level. But such an energy-intensive system is designed to be used only in brief bursts; you either escape the bear or you get eaten by it, but either way the crisis ends. The daily stresses of the modern world can throw our bodies into emergency mode and keep us there. That takes a toll through high blood pressure, tension headaches and a lot of gnawed pencils. "If you're chronically releasing stress hormones, your body starts to fall apart," says Coan. "Ultimately, you're going to live less long--and you're going to be miserable."

Being married somehow helps the body circumvent this mess, either by hushing the hypothalamus or reducing cortisol production. Coan and his colleagues conducted an experiment in which married women underwent brain scans using functional magnetic resonance imaging (fMRI). During the scans, the women were told they were going to receive a painful electric shock. The researchers then watched to see how the subjects' brains responded to the threat and found that among happily married women, hypothalamus activity declined sharply if husbands held their wives' hands during the experiment. Women who reported being less satisfied with their marriage--and women whose hands were held by strangers--got little such relief. "The effect was pretty profound," says Coan. "It was much stronger than we thought it would be."

He also found that spousal hand-holding had an effect in an entirely different part of the brain: the right anterior insula, which responds to the threat of pain by calling your attention to the part of your body that's in danger, increasing the amount of discomfort you ultimately feel. In Coan's study, the right anterior insula of happily married women stayed relatively quiet. "This suggests," he says, "that your spouse may function as an analgesic."

All of this is especially good news for men. A study published in the January 2008 issue of the journal Health Psychology showed that while married men get relief from their workday barrage of stress hormones when they come home after a particularly busy day at work--perhaps benefiting from the same marital proximity the women in the fMRI study enjoyed--working women are able to de-stress similarly only if they describe their marriage as a happy one.

There may be a simple explanation for this. "I'm speculating," says Rena Repetti, a professor of psychology at the University of California, Los Angeles, and one of the authors of the study, "but it may just be that some of these women are coming home and facing dinner prep and assisting the kids with homework, and they're not getting the help that the more maritally satisfied women are getting."

The full explanation for this gender gap, however, is undoubtedly more complicated than that. Long-term data from an Israeli study, for example, indicate that the life-lengthening powers of marriage have increased over time--but again, mostly for men. Over nearly two decades, the study found, married men widened the already significant difference in cancer-death incidence between themselves and unmarried men by 25%; married women gained absolutely zero ground over their unmarried peers. Why this subtle somatic sexism? "This is a gross generalization, but women are really the mental- and physical-health housekeepers for a marriage," says psychologist Janice Kiecolt-Glaser of the Ohio State University College of Medicine. "They are often the ones who prod men to go to a doctor or to eat more healthily."

Miriam Kamin's husband Mark agrees. "As a man, I'm more concerned with making sure the oil has been changed in the last 3,000 miles than with whether I had a physical lately," he says. "Miriam's much more likely to notice something is wrong with me than I am."

When Things Turn Bad

For all its benefits, marriage is not a gift certificate for good health. For one thing, it's fattening. According to a CDC study of health and marriage, married people, while least likely to be physically inactive, are most likely to be overweight or obese. Married men, in particular, seem to pack on the pounds after they say their vows: they are nearly 20% more likely to be overweight or obese than are men who have never married--perhaps because they simply have someone to sit down to dinner with each night or perhaps because the often empty refrigerator of a onetime bachelor fills up fast when someone is making sure to do the shopping.

Data also show that the stress of a bad marriage can undo much of the good that comes with a happy one. In a series of studies, Kiecolt-Glaser and her husband, immunologist Ronald Glaser, also of the Ohio State University College of Medicine, found that "negative marital interactions," such as arguments, name-calling and nonverbal cues like eye-rolling lead to increases in cortisol and decreases in immune function and even wound-healing. The effects were observed in both sexes, but particularly strongly in women. The eye-rolling studies go even deeper than that, with related research conducted by marital expert John Gottman of the Gottman Institute in Seattle revealing just how sensitive spouses are to such nonverbal signs of disdain or dismissal. Coan, who has collaborated with Gottman, says: "How often someone rolls their eyes at you can predict how often you need to go to the doctor."

And when the protective bonds of marriage break, watch out. Those supposedly apocryphal tales of spouses who die within days of each other have more than a little truth to them. A 2007 British study found that at any given moment, a bereaved spouse has a greater risk of death from just about any cause (except, oddly, lung cancer) than a still married person. "Over time," says Coan, "your brain becomes used to the other person as part of your emotional-regulation strategy. You take that person away, and you become what we dryly call dysregulated--weepy, mournful, stay up half the night. This can come from death, divorce, even a long business trip. When those bonds break, it can cause a lot of pain and emotional suffering."

Certainly not all suddenly single spouses are fated to languish this way--no more than all people who never pair off are destined for a shortened life filled with illness and stress. Humans are socially resourceful creatures who build and rebuild networks of relationships, getting the attention, hand-holding and even scolding they need in a lot of different ways. Still, it's hard to argue with an institution that keeps a companion and caretaker constantly nearby, even if now and again--when a wet towel has once again been dropped on the floor or a tube of toothpaste has been squeezed all wrong--we may lose sight of that happy fact.