What is chronic stress and what are its common health impacts?
Chronic stress is a prolonged, often overwhelming feeling of stress that can negatively impact a person’s daily life.
Short-lived feelings of stress are a regular part of daily life. When these feelings become chronic, or long-lasting, they can severely impact a person’s health.
In this article, we look at what chronic stress is, how to identify it, and the medical consequences it can have. We also describe ways to manage stress, including medical treatments and when to see a doctor.
What is chronic stress?
Stress is a biological response to demanding situations. It causes the body to release hormones, such as cortisol and adrenaline.
These hormones help prepare the body to take action, for example, by increasing the heart and breath rates. When this occurs, a doctor might describe a person as being in a state of heightened alertness or arousal.
Many factors can trigger a stress response, including dangerous situations and psychological pressures, such as work deadlines, exams, and sporting events.
The physical effects of stress usually do not last long. However, some people find themselves in a nearly constant state of heightened alertness. This is chronic stress.
Some potential causes of chronic stress include:
- high-pressure jobs
- financial difficulties
- challenging relationships
Chronic stress puts pressure on the body for an extended period. This can cause a range of symptoms and increase the risk of developing certain illnesses.
Signs and symptoms
Chronic stress affects the whole body. It can have several physical or psychological symptoms, which can make functioning on a daily basis more challenging.
The type and severity of symptoms vary considerably from person to person.
Signs and symptoms of chronic stress can include:
- irritability, which can be extreme
- difficulty concentrating, or an inability to do so
- rapid, disorganized thoughts
- difficulty sleeping
- digestive problems
- changes in appetite
- feeling helpless
- a perceived loss of control
- low self-esteem
- loss of sexual desire
- frequent infections or illnesses
Examples of stress
A variety of life experiences can cause stress, and these may begin in childhood. When children experience traumatic events, it can lead to the development of chronic stress that may last into adulthood.
These types of events are known as adverse childhood experiences (ACEs). In research by the Centers for Disease Control and Prevention (CDC), 61% of adults surveyed across 25 states said they had experienced at least one type of ACE, and nearly 1 in 6 had experienced four or more types.
Examples of ACEs include:
- mental illness in one or more parents
- emotional, physical, or sexual abuse
- substance misuse in the family
- parental divorce
- incarceration of a parent or close family member
In adulthood, chronic stress can happen as a result of very similar causes, as well as:
- problems in the workplace
- unemployment or financial problems
- injury that impacts a person’s daily life
- concern about problems in the country or the world
According to the Stress in America 2020 survey by the American Psychological Association (APA), 65% of people surveyed said the current uncertainty in the nation is stressful, and 60% are overwhelmed by the issues the country is facing.
In addition, 70% of parents reported family responsibilities as a source of stress, and 63% are stressed by the impact of COVID-19 on the 2019-20 school year.
Chronic stress can also affect historically marginalized groups differently than others. In 2019, surveys showed that Black and Hispanic people are three times more likely to be stressed by lack of food and safe housing, discrimination, and health inequities.
More recently, the APA also reported that nearly three-quarters of Black adults (74%), 60% of Hispanic adults, and 65% of white adults said the Capitol breach in 2020 caused them a lot of stress.
If strategies such as those listed above are not helping, it is important to see a healthcare professional for advice and support. A doctor may recommend psychological therapy, such as cognitive behavioral therapy (CBT).
One established aim of CBT is to help people deal with chronic stress. In structured sessions, a therapist works to enable a person to modify their behaviors, thoughts, and feelings concerning stressors.
CBT can also help a person develop tools and coping mechanisms to manage stress responses.
Sometimes, a doctor recommends medications to help treat some symptoms of chronic stress. For example, they may prescribe antidepressants to treat anxiety or depression. For people with trouble sleeping, doctors may prescribe sedatives.
Research has shown that chronic stress can impact the brain and the immune system. The brain’s neural networks, especially in the prefrontal cortex (PFC), can actually reduce in size. Doctors have seen this in imaging of people’s brains. When this happens, it may lead to cognitive, emotional, and behavioral dysfunctions.
When a person experiences stress, this stimulates their immune system to react. Over time, when stress is chronic, the immune system can become overstimulated. This may lead to the development of diseases and health problems.
Over long periods, chronic stress can contribute to the development of a range of physical and mental disorders, including:
- heart disease
- high blood pressure
- a weakened immune system
- sexual dysfunction
- gastrointestinal disorders
- skin irritation
- respiratory infections
- autoimmune diseases
- anxiety disorders
- post-traumatic stress disorder (PTSD)
Chronic stress vs. acute stress
Generally, acute stress is stress that a person experiences short-term. Acute stress typically manifests immediately after a person experiences a stressor as a fight-or-flight reaction.
An acute stress disorder is more serious and typically occurs in the first month after a person experiences trauma. This is similar to post-traumatic stress disorder (PTSD), but a person cannot have a diagnosis of PTSD until they have experienced symptoms for longer than a month.
Stress can also be episodic, which means a person experiences it over a long time but inconsistently. They experience stressful periods and periods with less or no stress. In comparison, chronic stress is stress that a person experiences continuously throughout their life to the point where feeling stressed becomes a normal state of being.
Chronic stress can seem overwhelming, and a person may feel unable to regain control over their life.
However, a number of strategies can help to reduce stress levels and improve well-being.
Some methods for managing stress include:
- Understanding the signs and symptoms. These indications vary, but if a person can recognize their own signals of stress, they will be better able to manage them.
- Speaking to friends and family. They can provide emotional support and the motivation to take action.
- Identifying triggers. It is not always possible to avoid triggers of stress. However, taking note of specific triggers can help a person to develop coping and management strategies, which may involve reducing exposure.
- Exercising regularly. Physical activity increases the body’s production of endorphins, which are chemicals that boost the mood and reduce stress. Exercise can involve walking, cycling, running, working out, or playing sports.
- Trying mindfulness. People who practice this form of meditation use breathing and thought techniques to create an awareness of their body and surroundings. Research suggests that mindfulness can have a positive impact on stress, anxiety, and depression.
- Improving sleep quality. Getting too little sleep or sleep of poor quality can contribute to stress. Try to get at least 7 hours every night, and set regular times for going to sleep and waking up. Avoid caffeine, eating, and intense physical activity in the hours before bed.
It can also help to unwind before sleeping by listening to music, reading a book, taking a warm bath, or meditating, for example.
When to see a doctor
Do not try to deal with chronic stress alone. If self-help strategies are not working, a doctor can provide support and advice about treatment options. They can also refer a person to a more specialized healthcare provider, such as a psychologist or psychiatrist.
Anyone feeling overwhelmed by stress should see a doctor as soon as possible, especially if they are having suicidal thoughts or using drugs or alcohol to cope.
Strategies to recover from chronic stress can include practicing mindfulness activities such as meditation and breathing exercises. People can also have a support system composed of family and friends, as well as a counselor or a psychiatrist if needed.
A psychiatrist can prescribe medication to reduce stress. A counselor can help a person explore the causes of their stress in order to recognize them and find a healthy coping mechanism. The earlier a person seeks help or treatment, the quicker their recovery may be.
Stress is a regular part of daily life. Short-lived stress is generally harmless, but when it lasts and becomes chronic, it can cause a range of symptoms. It can also contribute to the development of physical and mental disorders.
Self-help techniques include identifying triggers, developing coping and avoidance strategies, reaching out to friends and family, and practicing mindfulness.
If these techniques are not working, or if stress is becoming overwhelming, a person should speak to a healthcare professional.