Stress

Long-term or chronic stress affects the mind and can cause wear and tear on the body. This can lead to physical, emotional, and behavioral symptoms. They include:

Physical Symptoms

• Body aches
• Headaches
• Nausea
• Indigestion
• Constipation
• Diarrhea
• Chest pain
• Palpitations (feeling like the heart is racing)
• Exhaustion
• Dizziness
• High blood pressure
• Muscle tension
• Temporomandibular joint problems (due to jaw clenching)
• Weak immune system
• Involuntary twitching or shaking
• Irregular or missed periods
• Getting sick more often than normal
• Reduced libido

Emotional Symptoms

• Feeling overwhelmed
• Racing thoughts
• Difficulty concentrating
• Irritability
• Constant worry, anxiety, or fear
• Lack of self-confidence
• Troubled sleeping patterns

Behavioral Symptoms

• Being extremely emotional
• Snapping at people
• Feeling tired all the time
• Avoiding things or people
• Eating more or less than usual
• Increased drinking or smoking
• Constant agitation
• Experiencing sexual problems
• Changes in eating habits
• Nail biting
• Pacing
• Abnormal failure or delay in completing everyday responsibilities
• Significant changes in school or work performance
• Unusual desire for social isolation
• Frequent lying
• Trouble getting along with others

Stress can be caused by different factors and experienced during various stages of life. The outcomes related to stress can vary according to personal and environmental influences. Events stemming from stress significantly impact mood, sense of well-being, behavior, and health.

Stress during childhood or adolescence

The most widely studied activities that can cause stress in children and adolescents include:

• Violence: Studies have shown that many young people develop behavioral, emotional, or learning problems when mistreated by an adult, victimized by bullies, criminally assaulted, or witnessing domestic violence. The lesser-known adverse effects of experiences like violence exposure can lead to hidden physical alterations inside a child’s body, potentially affecting lifelong health negatively.
• Abuse: This can take the form of sexual, physical, or emotional abuse. In severe cases, abused children may exhibit many signs of post-traumatic stress disorder (PTSD). There is growing evidence that individuals who were abused or neglected as children may be more sensitive to stress.
• Divorce/marital conflict: According to studies, adult offspring of divorced parents report more current life stress, family conflict, and lack of friend support compared to those whose parents did not divorce.
• Exam stress: Children often feel stressed and pressured by family members and schools during exams. While this is normal, exam stress can lead to anxiety or depression, potentially affecting their sleeping or eating habits.

Note: Childhood stress is emerging as a common health concern among today’s children. With the compulsive need to excel, emphasis on competition in every aspect of life, and peer pressure, children are predisposed to varying degrees of stress. Understand childhood stress: the triggers, symptoms, and how parents can help.

Stress during adulthood

Many factors can cause stress in adults. It may arise from a significant event or situation, or it could be a build-up of numerous smaller issues. Some of the most common causes of stress in adults include:

• Personal causes: Common causes include:
  • Difficulties in personal lives and relationships
  • Unexpected life changes like moving house, having a baby, or starting to care for someone
  • Daily life minor inconveniences like misplacing keys or forgetting to bring an important item
  • Financial difficulties such as debt or struggling to afford daily essentials
  • Health issues of oneself or close family members
  • Pregnancy and children
  • Housing problems like maintenance or tenancy
  • Feeling lonely and unsupported
  • Stress while driving or being late

Note: Driving-induced stress is a serious health concern that can lead to depression, anxiety, and heart-related diseases. More people succumb to it daily due to increased time spent in vehicles. Learn about ways to de-stress while driving.

• Professional causes: Stress is often prevalent in the workplace, particularly when there is little or no help and support from supervisors and colleagues. Work-related stress can arise from the job's design and the organization's working system, including poor management and lack of support. Workplace stress includes:
  • Being unhappy in the job
  • Having a heavy workload or excessive work pressure
  • Long working hours
  • Poor work management
  • Unclear expectations of your work
  • No involvement in the decision-making process
  • Working under dangerous conditions
  • Risk of termination
  • Having to give speeches in front of colleagues
  • Discrimination or harassment at work

A stressor is an event or situation that causes stress. The reactions to stressors are highly influenced by genetics, early-life environment, and trauma, contributing to differences in stress reactivity among individuals. Risk factors for stress include:

Psychological factors

These are characteristics or facets that influence an individual psychologically and/or socially. Such factors can describe individuals in relation to their social environment and how these affect physical and mental health. Some psychological factors that increase the risk of developing stress include:

• Low self-esteem
• Decreased confidence
• Personality types
• Loneliness
• Thinking too much

Lifestyle factors

Lifestyle plays a very important role in the development of stress. A healthy lifestyle can not only help one feel better, but it can also reduce the risk of some diseases, lengthen lifespan, save money, and benefit in many other ways. Here are certain lifestyle choices that can act as risk factors for stress:

• Not exercising enough
• Eating too much junk food
• Not getting enough sleep
• Smoking
• Drinking too much alcohol

Note: While a direct link between stress and heart disease has not been determined, people who experience daily stress often engage in behaviors that increase their risk for developing heart disease.

Effects of stress

Stress symptoms can affect the body, thoughts and feelings, and behavior. The susceptibility to stress varies from person to person. Factors influencing susceptibility to stress include genetic vulnerability, coping style, personality type, and social support. Stress can affect the whole body, producing illness. Research shows that stress can alter tissue morphology and hormonal mechanisms. Effects of chronic stress on different organ systems and its relation to other diseases include:

Stress and immune response

Our immune system is susceptible to stress. There is a relationship between the brain, the nervous system, and the immune response. Several studies have shown that chronic stress exerts a general suppression of the immune system. Cytokines that play a crucial role in mediating the immune system are produced by stress-stimulated immune cells, which convey feedback to the nervous system, further modulating the release of stress hormones in the brain. During chronic stress, the neuroimmune axis can be overstimulated and break down, causing neuroendocrine/immune imbalances that can lead to chronic low-grade inflammation, acting as a precursor to various illnesses.

Stress and gastrointestinal disorders

Gastrointestinal diseases such as peptic ulcer (PU) and ulcerative colitis (UC) are greatly influenced by stress. Certain stressful life events have been associated with the onset of symptom exacerbation in other common chronic digestive disorders such as functional gastrointestinal disorders (FGD), inflammatory bowel disease (IBD), and gastroesophageal reflux disease (GERD).

Stress and cardiovascular disorders

Psychological stress is a significant risk factor for coronary heart disease (CHD) and CHD mortality. Studies have found a positive relationship between life stress and myocardial infarction (heart attack) and sudden death. Myocardial infarction has a higher prevalence of stress factors such as stress at work and home, financial stress, and major life events in the past year.

Stress and cancer

The relationship between breast cancer and stress has received particular attention. However, more research is needed to determine if there is a relationship between psychological stress and the transformation of normal cells into cancerous cells. One area currently being studied is whether psychological interventions can reduce stress in cancer patients, thus improving immune function and possibly prolonging survival.

Stress and psychiatric disorders

A lot of research has been conducted to find the relationship between recent life events and the onset of psychiatric illness. The association between stressful life events and psychiatric illness is significant. Although evidence to support this hypothesis is not conclusive, it is stronger than the association with physical or medical illness. Recent life events are believed to play a major etiological role in neuroses, the onset of neurotic depression, and act as a precipitating factor in schizophrenic episodes.

Pandemic-related stress is real! The COVID-19 pandemic has created a variety of stressors, some of which have been linked to intense stress reactions, such as posttraumatic stress (PTS)-like symptoms. Learn tips to take care of mental health during the COVID-19 pandemic.

Stress as a precursor of anxiety and depression

Stress is a common trigger for anxiety, and it's important to catch anxiety symptoms early to prevent the development of an anxiety disorder. Symptoms of anxiety usually involve an over-concern with the lack of control over one’s circumstances, either at work or in personal life. Depression is widely accepted as being linked to stress. Usual symptoms include upset sleep patterns, fatigue, increased alcohol consumption, muscle aches and pains, and poor self-esteem or lack of self-worth.

Stress and other medical conditions

• Asthma: Stress can enhance an allergic inflammatory response. In asthma, both external and internal factors are involved, with internal factors most affected by the acute effects of psychological stressors.
• Rheumatoid arthritis (RA): RA involves the body turning on itself (an autoimmune response). It has been hypothesized that a self-destructive personality may manifest itself; several investigators have found personality differences between RA sufferers and others.
• Migraine: These headaches result from the constriction and dilation of the carotid arteries on one side of the head and are believed to be triggered by stressful events.
• Diabetes: Evidence suggests that emotionally stressful experiences are associated with endocrine disorders such as diabetes mellitus. Additionally, children who experienced stressful life events stemming from actual or threatened losses within the family between ages 5 and 9 had a significantly higher risk of developing type I (juvenile) diabetes.

There is no specific test to diagnose stress. Diagnosis of stress may include:

• Personal and family health history
• Blood tests
• Urine tests
• Other assessments to rule out various medical conditions

A thorough, stress-oriented, face-to-face medical interview is currently the most practicable way to diagnose stress and its effects. It remains for future research to develop a cleaner methodology to diagnose this complex yet very common disorder.

In today’s world, stress has become a part of daily life. Preventing stress may seem like an impossible task, but trying these daily strategies can help mitigate it significantly.

• Not letting feelings or emotions hamper your mood
• Managing work and tasks efficiently to avoid build-ups
• Taking good care of your body by eating right, exercising, and getting enough sleep
• Staying positive, practicing gratitude, and acknowledging the good parts of the day or life
• Accepting that you can’t control everything
• Finding ways to let go of situations that cannot be changed
• Learning to say “no” to additional responsibilities when busy or stressed
• Staying connected with people who keep you calm, make you happy, and provide emotional support
• Balancing responsibilities with other activities you enjoy
• Knowing the triggers and avoiding them efficiently

Stress is a normal part of life, and it can be categorized as good stress or bad stress. Bad stress is associated with physical and emotional reactions to certain triggers that can cause worry and tension. Stress usually fluctuates from situation to situation, and challenging circumstances can act as stressors. More than the treatment itself, effective management is crucial. The methods for managing stress include:

• Therapy/Counseling

  Stress can affect anyone, but appropriate therapy can help manage it effectively. Several therapies aim to prevent future stress as well. Here are the most commonly used therapies for stress and related mental health conditions:

  1. Cognitive-Behavioral Therapy (CBT)

     CBT is the most common type of therapy for managing short-term stress, as it addresses thought patterns and behaviors. The goal of this therapy is to help the patient identify their stressors and develop healthier responses to mitigate the impact of their triggers. This therapy is also beneficial for patients with anxiety disorders.

  2. Acceptance and Commitment Therapy (ACT)

     ACT focuses on long-term chronic stress and aids individuals in overcoming challenges to create their own version of a quality life. It changes how people respond to stress.

  3. Psychodynamic Therapy

     This therapy is utilized on a long-term basis and aims to help individuals identify thought patterns that may dictate behavioral responses. It is particularly suited for stress caused by long-standing issues intertwined with other mental health conditions such as anxiety and depression.

  4. Positive Psychology Therapy

     Positive psychology is a scientific field that focuses on “what works” instead of “what is wrong.” This approach helps identify the patient’s character strengths and encourages planning and taking positive actions to improve their life.

  5. Behavioral Therapy

     Similar to CBT, behavioral therapy focuses on changes in behavior. However, it is more action-oriented than thought-oriented. It tends to be effective for long-term stress triggers, including traumatic events, anxiety, phobias, and attention-deficit hyperactivity disorder (ADHD).

  6. Exposure Therapy

     This therapy is traditionally used to treat phobias, PTSD, and anxiety disorders. It is beneficial for individuals who avoid certain situations, objects, people, or places due to their mental health conditions.

  7. Group Therapy

     This type of therapy addresses extremely stressful events such as natural disasters, child loss, and divorce. A trained therapist leads sessions, and the group setting fosters empowerment and reduces feelings of isolation.

• Medication

  While there is no specific medication for stress, certain medications can help alleviate or manage some signs and symptoms of stress. These include:

  • Sleeping pills or minor tranquilizers for sleep disturbances
  • Antidepressants for anxiety and stress
  • Specific medications to treat symptoms of stress such as irritable bowel syndrome (IBS) or hypertension (high blood pressure)

Worry, stress, and anxiety can trigger a host of health problems, but there are things one can do to overcome this. Mild to moderate stress levels can be managed with certain lifestyle modifications like:

• Understand what is causing stress: It’s important to know the triggers and not to ignore physical warning signs such as tense muscles, tiredness, headaches, or migraines. Think about what’s causing your stress.
• Make a plan: Doing too many things at once or doing nothing at all can cause work to build up, leading to stress. Prioritizing tasks and reorganizing your life can help manage everything.
• Give importance to supportive relationships: Find close friends or family who can offer help, practical advice, and support in managing stress.
• Reduce smoking and drinking: Smoking and drinking may seem to reduce tension, but they can make it worse. Alcohol and caffeine can increase feelings of anxiety. Planning to quit smoking? Explore our smoking cessation range. Click Here!
• Eat healthy: A healthy and well-balanced diet can improve mood and help keep other disorders at bay. Getting enough nutrients, including essential vitamins and minerals, and staying hydrated can enhance mental wellbeing.
• Exercise regularly: Physical exercise can help manage the effects of stress by producing endorphins that boost mood. Aim for a 15-20 minute walk three times a week to stay healthy and fit.
• Practice self-care: Relax and take some time out to indulge in self-care activities such as meditation, getting a foot massage, or engaging in hobbies you love. Ensure to strike a balance between your responsibilities.
• Get proper sleep: Sleep is a crucial factor that can affect stress levels. Reducing caffeine intake, making a “to-do” list for the next day, or listening to music before bed can help improve sleep quality.
• Be positive: Try to maintain a positive outlook on life, find joy in small things, and express gratitude to your loved ones. Note: It is important to take it easy and not stress about everything, whether at home or at work. Learn how to effectively handle work stress. Click Here!

Management of workplace stress:

Work stress tops the list of causes of stress, especially as the journey in the corporate sector can feel like a roller coaster ride. It can lead to losing self-control and just going with the flow, often neglecting the impact of stress levels. However, it can be managed efficiently by:

• Reducing job stress by taking care of yourself
• Getting all the support needed
• Resting properly and adequately
• Connecting with your inner self
• Organizing and prioritizing tasks
• Delegating responsibilities wherever possible

If stress becomes chronic, it can lead to various mental and physical health issues such as:

• Anxiety: It is the brain's way of reacting to stress and alerting the person of potential danger ahead.
• Depression: A mood disorder that causes a persistent feeling of sadness and loss of interest, interfering with daily activities.
• Bipolar disorder: A disorder associated with episodes of mood swings ranging from depressive lows to manic highs.
• Insomnia: A common sleep disorder that makes it hard to fall asleep and stay asleep.
• Phobias: An anxiety disorder defined by a persistent and excessive fear of an object or situation.
• Post-traumatic stress disorder (PTSD): A mental health condition triggered by a terrifying event, either experiencing it or witnessing it. PTSD is a real illness that can make you feel stressed and afraid even after the danger is over, affecting your life and those around you.
• Burnout syndrome: Not simply excessive stress, burnout is a complex physical, mental, and emotional reaction to constant high stress levels, characterized by physical and emotional exhaustion.
• Chronic fatigue syndrome: Also called myalgic encephalomyelitis (ME), it is characterized by extreme fatigue, depression, and a general disappointment with life, lasting for several months or years.
• Obsessive-compulsive disorder (OCD): Causes repeated unwanted thoughts or sensations (obsessions) or the urge to perform actions over and over again (compulsions).
• Heart disease: Stress may lead to high blood pressure, posing a risk for heart attack and stroke.
• Erectile dysfunction: Defined as difficulty getting and keeping an erection, stress and anxiety can interrupt how your brain sends messages to the penis, affecting blood flow.

Stress management is a wide spectrum of techniques and psychotherapies aimed at controlling a person's level of stress, especially chronic stress. The main purpose is to motivate and improve everyday functioning. Some of the ways to manage stress include:

• Mind-based interventions: Mindfulness-based stress reduction (MBSR) is a therapeutic technique in which an instructor guides participants in weekly activities like meditation and yoga to reduce stress levels. This technique generally uses yoga and meditation that can help those with anxiety, depression, chronic pain, addiction, immune disorders, high blood pressure, and more.
• Acupuncture: It relieves stress by promoting the movement of Qi in the body, according to Traditional Chinese medicine (TCM). According to TCM, the energy that usually flows smoothly throughout the body can become stuck or scattered due to stress or disease, leading to muscle tension. Acupuncture can help alleviate this.
• Aromatherapy: This can reduce the perception of stress, decrease levels of cortisol, and increase contentment. Lavender aromatherapy has shown promising results in promoting sleep in infants and adults. Different aromatherapy scents bring various effects on people. Here are some essential oils to calm your mind and body.
• Hypnotherapy: This is an effective method for coping with stress and anxiety. In particular, hypnosis can reduce stress and anxiety before a medical procedure, such as a breast biopsy.
• Massage: It releases feel-good hormones and relieves stress by lowering the heart rate and increasing relaxation. Receiving a massage is beneficial for enhancing feelings of contentment and well-being, as emotions such as anxiety and depression can be reduced once stress levels decrease.
• Tai Chi: Researchers found that tai chi provided the same benefits for managing stress-related anxiety as exercise, as it includes meditation and focused breathing. Some researchers noted that tai chi may be superior to other forms of exercise for reducing stress and anxiety. Meditation and relaxation techniques have not gained as much popularity as yoga recently, largely because many believe stress to be an uncontrollable part of modern life or do not give mental health its due attention.
• Virtual reality: Researchers have taken the first steps toward developing a VR application for stress management, specifically an underwater virtual world that can be used for paced breathing techniques. Additionally, viewing computer-mediated forms of nature through slideshows of images or videos affects physio-psychological processes, reducing stress levels. The VR effects that have shown results include:
  • Resting in the forest
  • Different types of forest
  • A water landscape
  • Natural environment containing some facilities

Note: The COVID-19 pandemic has disrupted everyday living, leaving many in a state of psychological distress. While nature offers solace to promote mental health, the pandemic has reduced access to it. VR offers a safe alternative to experiencing nature.

Like many other issues surrounding mental health, stress is often misunderstood or stigmatized. Here are some tips to cope with stress in a better way.

1. Do not procrastinate
   In the age of social media, it is common to spend excessive time on digital platforms, making it difficult to maintain a healthy balance between work and relaxation. This can negatively impact productivity at work and at home. Limit social media use, take on only manageable tasks, and prioritize your workload to stay on track.
2. Know the stressors
   Understanding the sources of your stress is crucial for effective management. For instance, if a busy schedule is causing anxiety, prioritize your tasks. If attending a traditional university does not fit your schedule, consider transferring to an online university that better accommodates your needs.
3. Manage academics by organizing
   Organization is vital in academic life for managing stress. Keep academic notes organized, submit assignments on time, and track deadlines to reduce stress efficiently.
4. Eat, sleep, and exercise regularly
   A nutritious diet, sufficient sleep, and daily exercise can significantly alleviate stress. Being well-rested and healthy enables the body to engage in stress-relieving activities effectively.
5. Do what you love
   Take breaks between classes, homework, work, and other obligations to engage in enjoyable activities, such as reading a favorite book or watching a movie. While it may not be possible to drop everything on your to-do list, prioritize time for activities that bring you joy.
6. Talk to your loved ones
   Surround yourself with people whose company you enjoy. Speaking with someone you trust can help relieve a significant amount of stress.
7. Get professional support
   Don’t hesitate to seek help from a professional. Trained psychologists or psychotherapists specialize in stress-related therapies. They can help you identify stress triggers and collaboratively develop a management plan. Psychotherapists are often referred to as “talk therapists.” Excessive stress can severely impact emotional health and lead to serious consequences for the immune, cardiovascular, and nervous systems. Read more about effective ways to cope with chronic stress.

Tips for parents and caregivers
It is natural for children to worry during stressful events. Monitor what children see and hear about these situations. Here are some suggestions to help children cope with stress:

• Maintain a normal routine
• Watch and listen to your children
• Be alert for any changes in your child’s behavior
• Reassure your child about their safety and well-being
• Ensure your child gets plenty of sleep, eats healthily, exercises daily, and maintains a normal routine
• Take breaks from news, internet, and discussions about disasters
• Encourage teachers and school personnel to create opportunities for students to communicate freely

Tips for employers and HR professionals
Managers and employers play a vital role in shaping the work environment for employees. HR can help create a culture that respects employees' personal lives and obligations outside of work. Here are some tips for fostering a supportive workplace:

• Improve communication with employees
• Encourage all employees to provide suggestions
• Train managers to have reasonable expectations of employees
• Promote informal communication through lunch meetings, get-togethers, or team-building activities
• Incorporate wellness programs to enhance overall employee health and reduce stress and absenteeism