You’re having a difficult week at work, and you notice that you’re getting stomach cramps and a backache. Or perhaps your partner is out of town for the week, you’ve been taking on a lot of household and parental duties, and you’re constantly feeling dizzy and nauseated. There doesn’t seem to be a physical cause for your pain (other than stress, that is). But how do we know whether stress is causing those symptoms? And how can stress—a feeling in your mind—result in physical illness? We often notice when we feel particularly stressed, but many people don’t realize that stress isn’t just a feeling. It’s a physiological response, and it can cause a physical reaction in your body. It can also cause a number of emotional, cognitive, and behavioral changes. According to the American Institute of Stress (AIS), 33 percent of people in the United States feel that they’re living with “extreme stress.” A whopping 77 percent of people experience physical symptoms caused by stress, and 73 percent of people experience emotional symptoms due to stress. While many people believe stress is all in your head, it affects your entire body and well-being. Stress can have a negative impact on nearly every part of your body. In fact, the AIS lists 50 symptoms related to stress: “it’s hard to think of any disease in which stress cannot play an aggravating role or any part of the body that is not affected,” their site reads. “This list will undoubtedly grow as the extensive ramifications of stress are increasingly being appreciated.” Of course, stressors—that is, the causes of stress—are unavoidable. But by paying attention to the signs, symptoms, and effects of stress, you might be able to control your response to stress. By finding healthy coping techniques for stress, you can reduce the negative impact it has on your body and mind and manage your stress-related symptoms.
Why does stress affect the body?
We know what stress feels like, but it’s often difficult to identify how it affects our bodies. After all, how can a feeling in your mind translate to an illness in your body? The short answer? Hormones. Our bodies go into a “flight-or-fight” mode when faced with stress or danger, says Lisa Herbert, MD, a family physician and life coach. Flight-or-fight mode is also known as a sympathetic response. “During this time of fight or flight, we release hormones which help us to deal with the danger,” Herbert says. She explains how the symptoms of stress develop: “Our body releases adrenaline, which causes an increased heart rate, elevated blood pressure, and boost of energy supplies. We also release cortisol, which causes increased sugar levels, alters immune system responses, and suppresses the digestive system.” A little stress is normal and healthy. Most of the time your body goes back to normal soon after the stressful trigger has disappeared. But if you’re constantly faced with stress, it can lead to chronic stress, according to Herbert. One big misconception about stress is that stress and anxiety disorders are the same thing. Indeed, stress and anxiety often feel similar. Like stress, anxiety triggers a flight-or-fight response, causing the release of certain hormones into the body. Experiencing chronic stress might lead to anxiety, but the two are not the same. Chronic stress occurs when a stressor is around for a prolonged period. If you have an anxiety disorder, you’ll feel anxious even when the stressor is gone. Chronic stress is also different from post-traumatic stress disorder (PTSD), which is one of the many kinds of anxiety disorders. PTSD occurs after someone has experienced a particularly traumatic event or series of events, such as abuse, an accident, or war. Even when there is no direct threat or stressor, people with PTSD might feel anxious. Their symptoms can be triggered by anything that reminds them of the traumatic event. A loud bang might trigger a war veteran who’s reminded of gunshots, or driving might trigger someone who survived a car crash. Other forms of anxiety can include generalized anxiety disorder, panic disorder, obsessive–compulsive disorder, phobias, and more. Much like chronic stress, anxiety can also have a negative physical effect on other parts of the body. For example, anxiety is associated with gastrointestinal issues, respiratory disorders, and heart conditions.
What causes stress?
We often associate stress with negative experience, but both positive and negative experiences can cause stress. Eustress, which is associated with positive changes and euphoria, differs from distress, which is associated with negative changes. Both eustress and distress can have a negative impact on the body if they are experienced for a prolonged period. For that reason, a number of the main causes of stress in the U.S. might not be negative in themselves. For example, getting married, starting an exciting new job, or moving to your dream home can all be stressful. Feeling excited or having butterflies in your stomach could be a result of eustress. According to 2014 statistics from the AIS and the American Psychological Association (APA), the biggest causes of stress were job pressure, money, health issues, and relationships. Other major causes of stress included poor nutrition, technology overload, and sleep deprivation. Newer causes of stress have emerged over the years. For example, 2017 statistics from the APA show that many adults in the U.S. are stressed by technology and the future of the nation.
The Signs and Symptoms of Stress
How does stress feel? Although stress feels different for everyone, there are some common physical symptoms of stress that are nearly universal. “A person can feel like there is electricity going through their body,” says Prudence Hall, MD, who is a physician, author, and practitioner of regenerative/mindful medicine. “The body feels jittery, nervous, and shaky because of the high levels of cortisol.” Those “butterflies” in your stomach are actually cortisol affecting your digestive system. “Stress can present as many physical symptoms, including sweating, constipation, abdominal pain, palpitations, insomnia, fatigue, and feeling short of breath,” says Jared Heathman, MD, a Houston-based psychiatrist. Those high levels of cortisol and adrenaline in your body can be bad news if they’re prolonged. And this can lead to a number of physical symptoms, including:
- Aches, pains, and muscle spasms
- A weaker immune system, resulting in frequent colds or flu
- Digestive issues, including diarrhea, constipation, cramps, and a change in appetite
- Dizziness, lightheadedness, and fainting spells
- Chest pain
- Hair loss
Stress can also have an impact on your cognitive abilities, which can affect your ability to work, study, read, have conversations, or run errands. Some of the cognitive effects of stress include:
- Racing thoughts
- An inability to concentrate or focus
- Memory problems
- An inability to learn new information or skills
- Constant worrying
Stress might also cause your behavior to change in the following ways:
- Using or abusing substances like alcohol, cigarettes, and drugs
- Withdrawing from social interactions and other activities
- A change in appetite
- A change in sleeping patterns
Because stress affects your body and mind on so many levels, it can also exacerbate any other conditions you might have. If you have any mental health conditions, such as depression, PTSD, or anxiety, stress might increase the intensity of your symptoms. Autoimmune conditions can also be triggered or worsened by stress. People with fibromyalgia, for example, might experience flare-ups and increased pain when they’re stressed. Issues like eczema or herpes can also flare up during times of stress. Chronic stress can increase your chances of developing certain conditions, according to Herbert, including high blood pressure, depression, anxiety, and an increased risk for heart disease and diabetes. Heathman also notes that chronic stress can cause the breakdown of proteins, muscle wasting, and decreased bone formation.
Is stress causing me to feel ill?
The above physical symptoms can be caused by a range of different issues, not just stress. So when your back hurts or you feel fatigued, how do you know whether it’s a symptom of stress? “If the symptoms do not correlate clearly with anxiety, first discuss the symptoms with a primary care physician,” Heathman says. “If no physical cause is found, consult with a psychiatrist or psychologist for diagnosis and treatment options.” Hall notes that she has patients wear a device so that she can figure out whether they are experiencing chronic stress and what their stress triggers are. Herbert also recommends keeping a journal and recording your stressors and symptoms. “Answer the following questions: What causes stress in your life? How do you react to stress?” she suggests. This can help you see whether stressful situations are causing you to feel a specific way. A therapist could also help you figure out your stressors and whether you’re experiencing chronic stress. A psychologist or psychiatrist might formally diagnose you with chronic stress or with an anxiety disorder if your symptoms correlate.
How to Cope
How does one cope with stress? Of course, there is no single, universal answer to this question. Everyone experiences stress and the symptoms of stress differently and for different reasons, which means our coping techniques will differ too. Fortunately, there are plenty of resources and tools available for stress management. The first step, Herbert says, is to notice that you’re stressed and to work on changing your mindset. “You often can’t change the stressor but you can change the way you react or better prepare for it,” Herbert explains. She suggests using certain techniques when faced with a stressful situation. This could include practicing deep breathing each day, keeping a gratitude journal, or counting to 10 before you face a difficult situation. Herbert also recommends implementing certain lifestyle changes to improve your body’s ability to cope with stress. This includes exercising at least 30 minutes a day three times a week, meditating for 10 to 15 minutes a day, and improving your eating. Herbert says you can improve your diet by “decreasing or discontinuing caffeine, eating a protein-rich breakfast every morning, and including fruits, vegetables, cereals, and nuts in the diet.” Heathman takes a two-step approach to dealing with stress: “The first way to reduce the sympathetic [flight-or-fight] response is by participating in relaxation techniques like meditation, deep breathing exercises, and visualization techniques,” he says. “The second option is to harness the benefits of the sympathetic nervous system by participating in healthy exercise. This can include jogging, yoga, weightlifting, and sexual activity.” When your body is in flight-or-fight mode, it’s the perfect opportunity to exercise. Think about it: Your body is essentially getting ready to run or attack the cause of stress, meaning it’s in a good state to try some physical activity. “After expending significant amounts of energy, the body knows to upregulate the parasympathetic branch of the autonomic nervous system to rest and promote the accumulation of more energy to handle future stressors,” Heathman says.
Do I need professional help?
You might wonder whether your symptoms are “bad enough” to warrant therapy, but seeing a therapist can help you get a handle on stress before your symptoms become unbearable. In this way, professional help can be a pre-emptive strike. Seeing a therapist of some kind can help you build skills and use techniques that will help you keep your stress in check. This can enable you to deal with stress directly, nipping it in the bud before it affects your physical and emotional health. One sure-fire sign that you definitely need help? If you feel that the stress is affecting your mental health, it’s important to seek professional help, says Herbert. This is especially true since chronic stress can cause depression and anxiety. Herbert says that the following signs suggest you should see a therapist:
- Eating too much or not having interest in food, which may cause weight gain or weight loss
- Sleeping too much or too little
- Feeling extremely fatigued
- Persistent feelings of sadness or loneliness
- Loss of interest in things that once brought you joy
- Having suicidal thoughts or attempts to hurt yourself
- Constant lack of concentration
Stress is inevitable, but with a good support network, stress-management skills, and perhaps professional help, it can be managed.