Stress is a natural feeling of not being able to cope with specific demands and events. However, stress can become a chronic condition if a person does not take steps to manage it.
These demands can come from work, relationships, financial pressures, and other situations, but anything that poses a real or perceived challenge or threat to a person’s well-being can cause stress.
Stress can be a motivator, and it can even be essential to survival. The body’s fight-or-flight mechanism tells a person when and how to respond to danger. However, when the body becomes triggered too easily, or there are too many stressors at one time, it can undermine a person’s mental and physical health and become harmful.
What is stress?
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A person with stress may experience increased blood pressure.
Stress is the body’s natural defense against predators and danger. It causes the body to flood with hormones that prepare its systems to evade or confront danger. People commonly refer to this as the fight-or-flight mechanism.
When humans face a challenge or threat, they have a partly physical response. The body activates resources that help people either stay and confront the challenge or get to safety as fast as possible.
The body produces larger quantities of the chemicals cortisol, epinephrine, and norepinephrine. These trigger the following physical reactions:
- increased blood pressure
- heightened muscle preparedness
- sweating
- alertness
These factors all improve a person’s ability to respond to a potentially hazardous or challenging situation. Norepinephrine and epinephrine also cause a faster heart rate.
Environmental factors that trigger this reaction are called stressors. Examples include noises, aggressive behavior, a speeding car, scary moments in movies, or even going out on a first date. Feelings of stress tend to increase in tandem with the number of stressors.
According to the American Psychological Association (APA)’s annual stress survey in 2018, average stress levels in the United States were 4.9 on a scale from 1 to 10. The survey found that the most common stressors were employment and money.
To help support your mental well-being and that of your loved ones, visit our dedicated mental health hub for more research-backed information and resources.
Physical effects
Stress slows down some normal bodily functions, such as those that the digestive and immune systems perform. The body can then concentrate its resources on breathing, blood flow, alertness, and the preparation of the muscles for sudden use.
The body changes in the following ways during a stress reaction:
- blood pressure and pulse rise
- breathing speeds up
- digestive system slows down
- immune activity decreases
- muscles become more tense
- sleepiness decreases due to a heightened state of alertness
How a person reacts to a difficult situation will determine the effects of stress on overall health. Some people can experience several stressors in a row or at once without this leading a severe stress reaction. Others may have a stronger response to a single stressor.
An individual who feels as though they do not have enough resources to cope will probably have a stronger reaction that could trigger health problems. Stressors affect individuals in different ways.
Some experiences that people generally consider to be positive can lead to stress, such as having a baby, going on vacation, moving to a better home, and getting a promotion at work.
The reason for this is that they typically involve a significant change, extra effort, new responsibilities, and a need for adaptation. They also often require a person to take steps into the unknown.
A person may look forward to an increased salary following a promotion, for example, but wonder whether they can handle the extra responsibilities.
A persistently negative response to challenges can have an adverse effect on health and happiness.
For example, a 2018 review of studies found associations between work-related stress and coronary heart disease. Despite this, the authors could not confirm the exact mechanisms through which stress causes coronary heart disease.
Other literature has shown that people who perceive stress as having a negative effect on their health may be at higher risk for coronary heart disease than those who do not.
However, being more alert to the effects of stress may help a person manage it more effectively and cope better.
Types
The National Institute of Mental Health (NIMH) recognize two types of stress: acute and chronic. These require different levels of management.
The NIMH also identify three examples of types of stressor:
- routine stress, such as childcare, homework, or financial responsibilities
- sudden, disruptive changes, such as a family bereavement or finding out about a job loss
- traumatic stress, which can occur due to extreme trauma as a result of a severe accident, an assault, an environmental disaster, or war
Acute stress
This type of stress is short-term and usually the more common form of stress. Acute stress often develops when people consider the pressures of events that have recently occurred or face upcoming challenges in the near future.
For example, a person may feel stressed about a recent argument or an upcoming deadline. However, the stress will reduce or disappear once a person resolves the argument or meets the deadline.
Acute stressors are often new and tend to have a clear and immediate solution. Even with the more difficult challenges that people face, there are possible ways to get out of the situation.
Acute stress does not cause the same amount of damage as long-term, chronic stress. Short-term effects include tension headaches and an upset stomach, as well as a moderate amount of distress.
However, repeated instances of acute stress over an extended period can become chronic and harmful.
Chronic stress
This type of stress develops over a long period and is more harmful.
Ongoing poverty, a dysfunctional family, or an unhappy marriage are examples of situations that can cause chronic stress. It occurs when a person can see no way to avoid their stressors and stops seeking solutions. A traumatic experience early in life may also contribute to chronic stress.
Chronic stress makes it difficult for the body to return to a normal level of stress hormone activity, which can contribute to problems in the following systems:
- cardiovascular
- respiratory
- sleep
- immune
- reproductive
A constant state of stress can also increase a person’s risk of type 2 diabetes, high blood pressure, and heart disease. Depression, anxiety, and other mental health disorders, such as post-traumatic stress disorder (PTSD), can develop when stress becomes chronic.
Chronic stress can continue unnoticed, as people can become used to feeling agitated and hopeless. It can become part of an individual’s personality, making them constantly prone to the effects of stress regardless of the scenarios that they encounter.
People with chronic stress are at risk of having a final breakdown that can lead to suicide, violent actions, a heart attack, or stroke.
Causes
People react differently to stressful situations. What is stressful for one person may not be stressful for another, and almost any event can potentially cause stress. For some people, just thinking about a trigger or several smaller triggers can cause stress.
There is no identifiable reason why one person may feel less stressed than another when facing the same stressor. Mental health conditions, such as depression, or a building sense of frustration, injustice, and anxiety can make some people feel stressed more easily than others.
Previous experiences may affect how a person reacts to stressors.
Common major life events that can trigger stress include:
- job issues or retirement
- lack of time or money
- bereavement
- family problems
- illness
- moving home
- relationships, marriage, and divorce
Other commonly reported causes of stress are:
- abortion or pregnancy loss
- driving in heavy traffic or fear of an accident
- fear of crime or problems with neighbors
- pregnancy and becoming a parent
- excessive noise, overcrowding, and pollution
- uncertainty or waiting for an important outcome
Some people experience ongoing stress after a traumatic event, such as an accident or some kind of abuse. Doctors will diagnose this as PTSD.
Those who work in stressful jobs, such as the military or the emergency services, will have a debriefing session following a major incident, and occupational healthcare services will monitor them for PTSD.
Symptoms and complications
The physical effects of stress can include:
- sweating
- pain in the back or chest
- cramps or muscle spasms
- fainting
- headaches
- nervous twitches
- pins and needles sensations
A 2012 study found that the stressors that parents experience, such as financial troubles or managing a single-parent household, may also lead to obesity in their children.
Emotional reactions can include:
- anger
- burnout
- concentration issues
- fatigue
- a feeling of insecurity
- forgetfulness
- irritability
- nail biting
- restlessness
- sadness
Stress-associated behaviors include:
- food cravings and eating too much or too little
- sudden angry outbursts
- drug and alcohol misuse
- higher tobacco consumption
- social withdrawal
- frequent crying
- relationship problems
If stress becomes chronic, it can lead to several complications, including
- anxiety
- depression
- heart disease
- high blood pressure
- lower immunity against diseases
- muscular aches
- PTSD
- sleeping difficulties
- stomach upset
- erectile dysfunction (impotence) and loss of libido
Diagnosis
A doctor will typically diagnose stress by asking an individual about their symptoms and life events.
Diagnosing stress can be challenging because it depends on many factors. Doctors have used questionnaires, biochemical measures, and physiological techniques to identify stress. However, these may not be objective or effective.
The most direct way to diagnose stress and its effects on a person is through a comprehensive, stress-oriented, face-to-face interview.
Treatment
Treatment includes self-help and, when an underlying condition is causing stress, certain medications.
Therapies that may help a person relax include aromatherapy and reflexology.
Some insurance providers cover this type of treatment. However, it is important for people to check coverage with their provider before pursuing this treatment. Knowing the details about a potential treatment can help prevent it from adding to any ongoing stress.
Medicines
Doctors will not usually prescribe medications for coping with stress, unless they are treating an underlying illness, such as depression or an anxiety disorder.
In such cases, they may prescribe an antidepressant. However, there is a risk that the medication will only mask the stress, rather than help the person deal with it. Antidepressants can also have adverse effects, and they may worsen some complications of stress, such as low libido.
Developing coping strategies before stress becomes chronic or severe can help an individual manage new situations and maintain their physical and mental health.
People who are already experiencing overwhelming stress should seek medical assistance.
Management
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Regular exercise may help to manage stress.
People may find that the following lifestyle measures can help them manage or prevent stress-induced feelings of being overwhelmed.
- Exercise: A 2018 systematic review of animal studies found that exercise can reduce memory impairment in subjects with stress, although studies on humans are necessary to confirm this.
- Reducing the intake of alcohol, drugs, and caffeine: These substances will not help prevent stress, and they can make it worse.
- Nutrition: A healthful, balanced diet containing plenty of fruit and vegetables can help maintain the immune system at times of stress. A poor diet can lead to ill health and additional stress.
- Priority management: It may help to spend a little time organizing a daily to-do list and focusing on urgent or time sensitive tasks. People can then focus on what they have completed or accomplished for the day, rather than on the tasks they have yet to complete.
- Time: People should set aside some time to organize their schedules, relax, and pursue their own interests.
- Breathing and relaxation: Meditation, massage, and yoga can help. Breathing and relaxation techniques can slow down the heart rate and promote relaxation. Deep breathing is also a central part of mindfulness meditation.
- Talking: Sharing feelings and concerns with family, friends, and work colleagues may help a person “let off steam” and reduce feelings of isolation. Other people may be able to suggest unexpected, workable solutions to the stressor.
- Acknowledging the signs: A person can be so anxious about the problem causing the stress that they do not notice the effects on their body. It is important to be mindful of any changes.
Noticing signs and symptoms is the first step to taking action. People who experience work stress due to long hours may need to “take a step back.” It may be time for them to review their working practices or talk to a supervisor about finding ways to reduce the load.
Most people have an activity that helps them relax, such as reading a book, going for a walk, listening to music, or spending time with a friend, loved one, or pet. Joining a choir or a gym also helps some people relax.
The APA encourage people to develop networks of social support, for example, by talking to neighbors and others in the local community or joining a club, charity, or religious organization.
Those who often feel as though they do not have the time or energy for hobbies should try some enjoyable new activities that make them feel good. People can turn to their support network if they need ideas.
Being part of a group can reduce the risk of stress developing and provide support and practical help when challenging circumstances develop.
People who find that stress is affecting their daily life should seek professional help. A doctor or psychiatric specialist can often help, for example, through stress management training.
Stress management techniques
Stress management can help by:
- removing or changing the source of stress
- altering how a person views a stressful event
- lowering the effects that stress might have on the body
- learning alternative ways of coping
Stress management therapy pursues one or more of these approaches.
People can develop their stress management techniques by using self-help books or online resources. Alternatively, they can attend a stress management course.
A counselor or psychotherapist can connect an individual who has stress with personal development courses or individual and group therapy sessions.
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