Understanding chronic stress

Stress is often described as a feeling of being overwhelmed, worried or run-down. Stress can affect people of all ages, genders and circumstances and can lead to both physical and psychological health issues. By definition, stress is any uncomfortable "emotional experience accompanied by predictable biochemical, physiological and behavioral changes."¹ Some stress can be beneficial at times, producing a boost that provides the drive and energy to help people get through situations like exams or work deadlines. However, an extreme amount of stress can have health consequences and adversely affect the immune, cardiovascular, neuroendocrine and central nervous systems.²  

How stress harms your health

In addition, an extreme amount of stress can take a severe emotional toll. While people can overcome minor episodes of stress by tapping into their body's natural defenses to adapt to changing situations, excessive chronic stress, which is constant and persists over an extended period of time, can be psychologically and physically debilitating.

Unlike everyday stressors, which can be managed with healthy stress management behaviors, untreated chronic stress can result in serious health conditions including anxiety, insomnia, muscle pain, high blood pressure and a weakened immune system.³  Research shows that stress can contribute to the development of major illnesses, such as heart disease, depression and obesity.⁴  Some studies have even suggested t  hat unhealthy chronic stess management, such as overating "comfort" foods, has contributed to the growing obesity epidemic.⁵  Yet, despite its connection to illness, APA's Stress in America survey revealed that 33 percent of Americans never discuss ways to manage stress with their healthcare provider. 

Chronic stress can occur in response to everday stressors that are ignored or poorly managed, as well as to exposure to traumatic events. The consequences of chronic stress are serious, particularly as it contributes to anxiety and depression. People who suffer from depression and anxiety are at twice the risk for heart disease than people without these conditions.⁶  Additionally, research has shown that there is an association between both acute and chronic stress and a person's abuse of addictive substances.⁷  

Managing your stress

Studies have also illustrated the strong link between insomnia and chronic stress.⁸ According to APA's Stress in America survey, more than 40 percent of all adults say they lie awake at night because of stress. Experts recommend going to bed at a regular time each night, striving for at least seven to eight hours of sleep and eliminating distractions such as television and computers from the bedroom.

Many Americans who experience prolonged stress are not making the lifestyle changes necessary to reduce stress and ultimately prevent health problems. Improving lifestyle and behavioral choices are essential steps toward increasing overall health and avoiding chronic stress. The key to managing stress is recognizing and changing the behaviors that cause it, but changing your behavior can be challenging.

Taking one small step to reduce your stress and improve your emotional health, such as going on a daily walk, can have a beneficial effect. Being active is a small but powerful change you can make to manage stress. Physical activity increases your body's production of feel-good endorphins, a type of neurotransmitter in the brain, and helps in treating mild forms of depression and anxiety.⁹ In addition, eating a healthy diet and enhancing both the amount and quality of your sleep may be beneficial.

But remember, if a high stress level continues for a long period of time, or if potential problems from stress continue to interfere with activities of daily living, it is important to reach out to a licensed mental health professional, such as a psychologist. Research has shown that chronic stress can be treated with appropriate interventions such as lifestyle and behavior change, therapy, and in some situations, medication.¹⁰ A psychologist can help you ovecome the barriers that are stopping you from living a healthy life, manage stress effectively and help identify behaviors and situations that are contributing to your consistently high stress level.

Special thanks to Mary K. Alvord, PhD, Karina W. Davidson, PhD, Jennifer F. Kelly, PhD, ABPP, Kevin M. McGuiness, PhD, MS, ABPP-CH, and Steven Tovian, PhD, ABPP, who assisted with this article.

References

1) Baum, A. (1990). "Stress, Intrusive Imagery, and Chronic Distress," Health Psychology, Vol. 6, pp. 653-675. 

2) Anderson, N.B. (1998). "Levels of Analysis in Health Science: A Framework for Integrating Sociobehavioral and Biomedical Research," Annals of the New York Academy of Sciences, Vol. 840, pp. 563-576. 

3) Baum, A. & Polsusnzy, D. (1999). "Health Psychology: Mapping Biobehavioral Contributions to Health and Illness." Annual Review of Psychology, Vol. 50, pp. 137-163. 

4) Ibid. 

5) Dallman, M. et al.  (2003). "Chronic stress and obesity: A new view of 'comfort food.'" PNAS, Vol. 100, pp. 11696-11701. 

6) Anderson, N.B. & Anderson, P.E. (2003). Emotional Longevity: what really determines how long you live. New York: Viking. 

7) Sinha, R. (2008). "Chronic Stress, Drug Use, and Vulnerability to Addiction." Annals of the New York Academy of Sciences, Vol. 1141, pp. 105-130. 

8) Vgontzas, A.N. et al. (1997). "Chronic insomnia and activity of the stress system: a preliminary study." Journal of Psychosomatic Research, Vol. 45, pp. 21-31.

9) Fox, K.R. (1999). "The influence of physical activity on mental well-being." Public Health Nutrition, Vol. 2, pp. 411-418.

10) McEwen, B.S. (2004). "Protection and Damage from Acute and Chronic Stress: Allostasis and Allostatic Overload and Relevance to the Pathophysiology of Psychiatric Disorders." Annals of the New York Academy of Sciences, Vol. 1032, pp. 1-7.