What Is Stress and How Can I Recognize It?

Stress is your body's natural response to physical and psychological challenges or threats. During moments of stress, the body releases two hormones called epinephrine (adrenaline) and cortisol that trigger a chain of events to help you better cope with stressful situations.

Stress can be a positive thing, helping you overcome obstacles and push yourself to new levels of personal growth.

But when stress is persistent, it can be damaging to your health, reducing your immune response, increasing your risk of certain infections, raising your blood pressure and risk of heart disease, and sapping your concentration, energy levels, and overall sense of well-being.

The article describes the different types of stress and how they impact you physically and emotionally. It also looks at some of the complications of stress and ways to reduce stress if it is affecting your health and quality of life.

Types of Stress

Stress can be short-lasting, long-lasting, or come and go. While stress is often considered "bad" and something you need to manage, it can be beneficial in certain situations.

Stress can be broadly described as:

• Acute stress: This is stress that comes on abruptly and resolves once the perceived or actual threat is resolved. Acute stress can occur when faced with a traumatic situation but can also be something that gradually builds over time and suddenly comes to a head.
• Chronic stress: This is stress that is persistent or recurrent. It can be triggered by ongoing emotional distress or an illness or medical condition that you are managing. If left unchecked, chronic stress can have serious health consequences.
• Episodic acute stress: This is when someone experiences intense stress on a routine basis. It is common in people who face high-stress situations, such as law enforcement officers, firefighters, and soldiers on wartime duty.
• Eustress: This is the term for beneficial stress. Eustress is associated with excitement or motivation, such as riding a rollercoaster or starting a new job. Once the immediate stress eases, there is often a feeling of accomplishment.
  

Signs of Stress

Stress is regulated by the autonomic nervous system. This is a part of the nervous system that oversees involuntary functions like heart rate, respiration, blood pressure, and digestion. During moments of extreme stress, it also triggers the "fight-or-flight" response.

The fight-or-flight response is characterized by the spontaneous release of epinephrine and cortisol. These hormones trigger physiological and psychological changes to prepare you to either face or flee from the threat, whether real or perceived.

It does so by temporarily redirecting the body's resources—like blood, oxygen, and glucose (blood sugar)—away from non-essential organs (like the stomach, intestines, and bladder) to essential ones (like the muscles and eyes). These changes are responsible for the functional signs of stress.

Common signs of stress include:

• Rapid heartbeat
• Rapid breathing
• Muscle tension
• Flush or pale skin
• Dilated pupils
• Dry mouth
• Agitation or feeling on edge
• Trembling or shaking
• Sudden sweating (including sweaty palms)
• Queasy stomach
• Weak bladder or a sudden urge to pee

Once the threat is gone, the body will release other hormones, such as oxytocin, to bring epinephrine and cortisol back in check.

Symptoms of Too Much Stress

If stress is chronic, it can lead to a broader range of potentially disruptive symptoms. This is because the overload of cortisol and epinephrine can not only amplify the physiological symptoms of stress but also start to affect the brain, triggering psychological symptoms.

Symptoms of chronic stress may include:

• A pounding headache
• Heart palpitations
• Chest pains
• Muscle spasms and cramps
• Back and shoulder pain
• Nausea and vomiting
• Dizziness
• Diarrhea
• Shortness of breath
• Insomnia
• Forgetfulness
• Loss of concentration
• Daytime sleepiness
• Disorganized or racing thoughts
• Emotional outbursts
• Panicky feelings
• Ringing in the ears
• Numbness in the fingers and toes
• Changes in appetite (eating too much or not at all)
• Depression and anxiety

Many of these symptoms can also occur when acute stress is severe, such as during a panic attack. Sometimes, the symptoms come on so quickly and profoundly that it may seem like you're having a heart attack.

It is also possible to get a "stress rash" when the body is spontaneously flooded with cortisol and epinephrine. This can trigger an inflammatory reaction and the release of a chemical called histamine that instigates allergic reactions, In some people with extreme stress, this can lead to itching and hives (urticaria).

Causes of Stress

The body's stress response system is called the hypothalamic-pituitary-adrenal axis (HPA axis). When faced with a stressor (a situation that causes stress), a part of the brain called the hypothalamus sends a chemical message to the pituitary gland which, in turn, instructs the adrenal glands to start secreting cortisol and epinephrine.

There are two broad categories of stressors: physiological stressors and psychological stressors.

Physiological and psychological stressors can also overlap. For instance, a physiological stressor such as a chronic illness can cause psychological stress, further amplifying symptoms.

Examples of stressors include;

Risk Factors

We are all wired to feel stress, but certain factors can predispose you to unhealthy levels of stress, including:

• Being over 50
  
• Being a caregiver to an ill family member
• Living with depression
• Being raised in a stressful family environment
• Being a victim of crime or abuse
• Living in a high-crime neighborhood
• Living with chronic illness
• Living in poverty
• Having financial problems
• Being socially isolated
• Have an alcohol or substance abuse problem

Related Conditions and Complications

The long-term effects of uncontrolled stress can take a toll on your health. Chronic stress is characterized by sustained high blood pressure, which not only affects your heart but all other organs connected to the circulatory system.

Chronic stress can also affect your sense of well-being, which also has health consequences.

Over time, uncontrolled stress can contribute to:

• Atherosclerosis (hardening of the arteries)
• Coronary artery disease (which increases the risk of heart attack or stroke)
• Type 2 diabetes
• Obesity
• Stomach ulcers
• Major depression
• Anxiety disorders

Treatments and Ways to Cope With Stress

Managing stress is key to avoiding long-term health problems. Depending on your levels of stress and general coping skills, you may be able to manage on your own. In other instances, you may benefit from working with a healthcare provider or mental health specialist.

Lifestyle

You can’t always avoid stress, but you can manage it by making healthy lifestyle choices, including:

• Exercising regularly: Exercise not only makes you feel better but also boosts "feel-good" hormones called endorphins. Just 30 minutes of walking per day can lift your spirits and improve your cardiovascular health.
• Setting goals: Establish what you intend to achieve for your day, week, and month. Setting priorities will help you feel more in control.
• Being practical: Be realistic about what you can achieve. While stress can be beneficial within limits, overtaxing yourself can undermine your health. Focus on what is truly important to you and adjust your goals to maintain a healthy work-life balance.
• Staying positive: At the end of a stressful day, don't just drop into bed and try to forget about it. Take a moment to think about what you’ve accomplished and not what you didn’t get done.
  
• Staying connected: Keep in touch with people who can provide emotional support and practical help. Ask for help from friends, family, and community or religious organizations if you are feeling overtaxed and stressed.

Mind-Body Therapies

There are many stress management tools you can turn to if you live a hectic lifestyle. Many of these approaches are endorsed by healthcare providers who understand how the mind influences the body and your overall health.

Some effective mind-body therapies for stress include:

• Meditation
• Yoga
• Tai chi
• Deep breathing exercises
• Guided imagery
• Progressive muscle relaxation (PMR)
• Biofeedback

Psychotherapy

Psychotherapy (talk therapy) involves working with a therapist who can help you identify your sources of stress so you can better manage them. Although therapy is typically done in person, you can also have online sessions with a therapist who can see you regularly.

Different approaches may help depending on the source of your stress:

• Cognitive behavioral therapy (CBT): This involves identifying problematic behaviors or thought patterns so you can build strategies to change them.
• Dialectical behavioral therapy (DBT): This is a form of therapy intended for people who experience emotions very intensely.
• Family therapy
• Couples therapy

Prescription Medications

Sometimes medications are needed to help you through a stressful time. In such cases, you would need to get a prescription from your healthcare provider or a psychiatrist (rather than a therapist who cannot prescribe medications).

Some medications commonly prescribed for stress and anxiety include:

• Benzodiazepines: These are sedatives that include Valium (diazepam), Xanax (alprazolam), Klonopin (clonazepam), and Ativan (lorazepam).
• Selective serotonin reuptake inhibitors (SSRIs): These are antidepressants that include Paxil (paroxetine), Prozac (fluoxetine), Zoloft (sertraline), and Lexapro (escitalopram).
• Serotonin-norepinephrine reuptake inhibitors (SNRIs): These are antidepressants that include Effexor (venlafaxine), Cymbalta (duloxetine), and Pristiq (desvenlafaxine).
• Tricyclic antidepressants: These are a class of antidepressants that include Elavil (amitriptyline), Norpramin (desipramine), and Sinequan (doxepin).
  

When to Contact a Healthcare Provider

It can be easy to miss the signs of stress, particularly if you live a hectic lifestyle or are managing a heavy workload at work. Even so, it's important to notice the signs and take appropriate action if stress is interfering with your relationships, health, quality of life, and ability to function normally.

It may be time to see if a therapist or healthcare provider if:

• You find yourself having regular outbursts for little or no reason.
• You have trouble sleeping and are sleep-deprived.
• You have gained a lot of weight because you are stress eating.
• You have lost a lot of weight because you are too stressed to eat.
• You are drinking, smoking, or taking drugs to deal with stress.
• You find it hard to get out of bed and feel persistently on the verge of tears.
• You have panic attacks.
  

Summary

Stress is a natural response to physiological or psychological threats or challenges. Stress can be beneficial, helping push you to achieve more, but it can affect your health if it is extreme or chronic. Left untreated, chronic stress can contribute to heart disease, mood disorders, stomach ulcers, and diabetes.

The best way to manage stress is to live a healthy, balanced lifestyle and practice relaxation techniques like yoga, meditation, or deep breathing exercises. Psychotherapy and prescription medications (like antidepressants) can help if self-help treatments are not enough.