Most people suffer from stress at some point in their lives. Showing signs of stress does not mean that you are a weak person, just human like everybody else. Stress affects different people in different ways — your attitude, genetics and personality play a big part in how it affects you, and how you cope with it.
Stress is not technically a mental health condition, but it can trigger anxiety, depression and other mental health issues.
What is stress?
Stress is the description used for strain, pressure or force on a system. That system may be you. Stress can be the result of trivial annoyances like driving in heavy traffic, or a life-altering major crisis such as the death of a loved one.
Stress can be used both to refer to the event that is causing the disturbance or the effects of that event on your body. Usually, when we say we are feeling stressed we are talking about the symptoms caused by our body’s stress response.
Anything that causes a stress response is called a stressor. This includes environmental stressors such as heat or cold, poisons, toxins or emotional reactions.
What is the stress response?
The stress response is also known as the ‘fight or flight’ response. This phenomenon makes your body tense, alert, and ready for action in response to a real or perceived threat. A stress response is triggered by your brain and is a normal physiological reaction.
At the first sign of alarm or perceived threat, the hypothalamus of your brain triggers a reaction to prepare you for fight or flight and effects the release of the 2 hormones – adrenaline and cortisol.
The hypothalamus sends a signal via nerves to the adrenal glands, which then release the hormone adrenaline (also known as epinephrine) into the bloodstream. The release of adrenaline happens in seconds.
The key effects of the release of adrenaline are that your heart rate increases, blood pressure increases, breathing rate increases, digestion slows down, blood is redirected to the muscles, your pupils widen, and sweating increases. Saliva production slows down and your mouth feels dry. You feel tense, you startle easily and your attention narrows to focus on possible threats.
Cortisol and stress
Cortisol is a steroid hormone. Its release is also triggered by the stress response. The hypothalamus secretes corticotropin releasing hormone (CRH) which acts on the pituitary gland in the brain to stimulate the adrenal glands to produce cortisol.
When cortisol is released into the bloodstream it mobilises your glucose reserves for instant energy to cope with the situation, increasing sugar in the bloodstream, and releases chemicals that reduce inflammation and repair tissues.
After the reaction to the threat, your body stays on alert until you feel the danger has passed. When the stressor is gone, the brain signals an ‘all clear’, and your body gradually returns to normal. This is called the relaxation response.
When is the stress response a problem?
Some short-term stress is thought to be good for you, pushing you to make that extra effort in a sporting event or game. But long-term or chronic stress can be harmful to your health. This kind of stress is when you feel under constant, intense pressure, feel you have little or no control, or you just cannot see a way out of a terrible situation.
Chronic stress can arise from financial situations, ongoing problems with housing, relationships, illness or work.
Prolonged activation of the stress response and over-exposure to adrenaline and cortisol can disrupt and damage your body – causing physical and mental problems. Prolonged and excessive stress can result in burnout, where you feel overwhelmed and drained and feel you can’t give any more – mentally or physically. You may become cynical and disinterested and your performance at work or school may suffer.
Symptoms and complications of chronic stress
The symptoms and health problems that can be caused or exacerbated by high levels of ongoing (chronic) stress include both physical and mental issues.
Physical effects of chronic stress
- migraine or tension-induced headaches;
- shoulder, neck or back pain, caused by tensing of the muscles;
- chronic pain;
- insomnia, fitful sleeping or nightmares;
- rapid heartbeat;
- high blood pressure;
- heart disease (including atherosclerosis – build-up of plaque in your arteries and high cholesterol);
- skin eruptions and worsening of conditions such as eczema;
- Digestive problems – heartburn, nausea (feeling sick), diarrhoea or constipation;
- reduced libido (sex drive);
- Reduced fertility (lower sperm motility and fewer normal sperm in men, and reduced ability to conceive in women);
- shortness of breath;
- problems with your immune system;
- weight gain – caused by increased cortisol. Ongoing release of cortisol causes the body to deposit fat around the middle – so-called abdominal fat or belly fat.
Mental and emotional effects of chronic stress
- anxiety, anger or irritability;
- low, irritable or unstable mood;
- memory lapses and problems with concentration;
- decreased brain weight and structural changes in the brain.
Causes of chronic stress
Chronic stress can be caused by ongoing situations where you don’t feel in control, such as having a high pressure job, problems with your relationship, a serious health event or medical diagnosis, or financial or housing problems.
Risk factors for chronic stress
Some people thrive on heavy workloads, commitments and pressure and remain relaxed throughout – we may think of them as ‘laid back’. Others are challenged by small changes to their daily routine and become ‘stressed’ quite easily. How a person reacts to stressors in their life depends on their genetics and their life experiences.
Can stress be inherited?
Yes, and on top of your inherited genetic risk of stress, your upbringing and life experiences can impact how you handle stress.
Genetics can play a role in a person’s ability to handle stress. Both the genes you inherited from your parents and how those genes are affected by environmental factors such as your diet, stress and lifestyle (epigenetic changes) can affect your ability to cope with chronic stress.
Life experiences: Having been exposed to a traumatic event or life experience, such as murder, rape, sexual abuse, a road traffic accident, bush fires or floods, can predispose a person to suffer from stress. Abuse or neglect in childhood can also make people vulnerable to stress.
Reducing stress / self-care for stress
As already noted, some stress is normal, but if you are having problems with ongoing or severe stress, then you should try to make some changes to manage the stress.
Dealing with stress effectively can be complicated, but usually involves:
- general measures to improve your overall well-being; and
- specific steps to deal with particular challenging situations.
You may also reflect on any underlying coping styles that make you more vulnerable to stress.
Stress commonly results when you feel your resources — for example, time, money or skills — are insufficient to deal with your responsibilities. Doing a ‘stress audit’, where you examine your demands and resources can be a useful first step in dealing with stress.
Problem-solving techniques may help you cut some problems down to size, or you may need to work on limiting your obligations or asking for extra resources. You may need to accept that there are times in life where you simply can’t do everything that others — or more commonly you — expect.
One way to help deal with stress is to maintain a healthier mind and body. Try the following ways to reduce stress.
- Exercise regularly and work off your tensions — but check with your doctor that your chosen physical activity is right for you.
- Treat yourself to self-care and relaxation time — switch off for a while, as this will help to give you a refreshed and energetic outlook on life. Learn yoga, meditation or other relaxation exercises. Having a massage or acupuncture may help. Mindfulness techniques may help to alleviate chronic stress. There are many online resources and mindfulness apps that can teach you.
- Sleep well. Make sure you get enough sleep.
- Eat healthily. Maintain a balanced diet. It’s been shown that your diet can affect mood via your microbiome, and a poor diet has been linked to anxiety and depression.
- Learn to accept what you cannot change but also learn to be more assertive, especially if you are one of those people who always say ‘yes’. Assertiveness training, setting clear boundaries and learning to say no can be very helpful in avoiding overload.
- Do things you enjoy. Spend time doing things you like, such as seeing people whose company you enjoy, listening to music, playing sport or gardening.
- Talk about troubles: confide in a special friend or a trained professional such as a doctor, psychologist or counsellor. Another person may help you see your problem in a new light.
- Don’t self-medicate. Avoid the use of drugs or alcohol as a means of coping with stress. While they may seem to provide relaxation in the short-term, in the long term they will make things worse, leading to anxiety. The same goes for caffeine and nicotine.
- Build resilience. Resilience is the ability to adapt and cope with adversity and stress. Resilient people bounce back. It’s a skill that can be learned. There are online resources that deal with ‘mental fitness’ and resilience, or you can get help from a mental health professional, such as a psychologist.
How do I know if I need help with stress?
You may think that you can, or should, deal with your problems yourself. But you should seek professional help if:
- you constantly worry and have trouble concentrating;
- you feel a lot of guilt;
- your sleep, energy and motivation is poor;
- you can’t be bothered doing things anymore;
- you experience several of the physical symptoms associated with stress;
- you recognise that you are turning to self-destructive behaviours for temporary relief;
- everything and everybody around you is being affected by the way you feel; or
- you feel as though there’s nowhere to turn.
Where to get professional help for stress
There are treatments available that have been shown to be successful in helping people manage stress. Qualified healthcare professionals can help you access these treatments and therapies.
Your General Practitioner (GP) can help you or can refer you to a suitable professional, such as a psychologist or counsellor. They may suggest talking therapies such as CBT (cognitive behavioural therapy), coping skills training or relaxation therapy.
You may be eligible for a Medicare rebate if you’ve been referred by your GP. And depending on your situation, your GP may be able to refer you for a mental health care treatment plan – where you can get a Medicare rebate for 10 visits with a mental health professional in a calendar year.
Mental health helplines
If you are experiencing an immediate crisis, there are Australian support helplines you can ring or web chat for free.
If you or someone you know is feeling distressed and/or having suicidal thoughts, see your doctor, phone one of these helplines or click on the links below for online web chat counselling or support. Call 000 if life is in danger.
Lifeline (24 hours) 13 11 14
Kids Helpline (for young people aged 5 to 25 years) 1800 55 1800
Beyond Blue Support Service (24 hours) 1300 22 4636
MensLine Australia (24 hours) 1300 78 99 78
SANE Helpline – mental illness information, support and referral 1800 187 263
Suicide Call Back Service (24 hours) – free counselling support 1300 659 4
Last Reviewed: 01/11/2019
Your Doctor. Dr Michael Jones, Medical Editor.
1. Harvard Health Publishing. Understanding the stress response. Updated May 2018. https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response
2. McEwen BS. Physiology and neurobiology of stress and adaptation: central role of the brain. American Physiological Society. Physiological Reviews 2007. https://doi.org/10.1152/physrev.00041.2006
3. Gu HF, Tang CK, Yang YZ. Psychological stress, immune response and atherosclerosis. Atherosclerosis 2012; 223 (1): 69-77. https://www.ncbi.nlm.nih.gov/pubmed/22304794
4. Hogan C. Chronic stress: an approach to management in general practice. Australian Family Physician 2013 (August); 42 (8): 542-45. https://www.racgp.org.au/afp/2013/august/chronic-stress
5. Australian Psychological Society. Stress. https://www.psychology.org.au/for-the-public/Psychology-Topics/Stress
6. American Psychological Association. Stress effects on the body. https://www.apa.org/helpcenter/stress-body (accessed October 2019).
7. Garrie K. Epigenetics: can stress really change your genes? The Conversation. 15 March 2016. https://theconversation.com/epigenetics-can-stress-really-change-your-genes-55898
8. Garland EL, Hanley AW, Baker AK, Howard MO. Biobehavioral Mechanisms of Mindfulness as a Treatment for Chronic Stress: An RDoC Perspective. Chronic Stress 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5565157/