What is stress?

Stress is a physiological or emotional response to change or threat. Some have defined stress as any uncomfortable “emotional experience accompanied by predictable biochemical, physiological and behavioural changes.”

There are many different forms of stress. A perceived threat (stress) could be emotional, psychological, physical, chemical or nutritional. The body’s response is the same in every situation but ongoing stress depletes the health reserve capacity of an individual, consequently increasing their vulnerability to health concerns, complications and problems.

Common causes of stress

Everyone experiences stress – in our busy modern world, stress is unavoidable; the deleterious health effects of stress, however, are avoidable. Common causes of stress include:

  • Major life events – e.g. births, deaths, marriage, divorce, moving house, changing jobs, trauma
  • Personal relationships – e.g. conflict, deception, bullying
  • Work/study – e.g. exams, deadlines, responsibilities, unemployment, bullying, peer pressure
  • Health issues – e.g. pain, chronic illness, ill-health of a loved one
  • Dietary and lifestyle issues – e.g. lack of sleep, poor diet, smoking, excessive intake of alcohol
  • Financial – e.g. mortgage, income, stability
  • Environmental
  • Family history of mental health
  • Personality type
  • Substance abuse

Misconceptions about stress

Some of the biggest misconceptions about stress include:

  1. Stress is the same for everyone – This is simply not true. Stress is different for each of us. What is stressful for one person may or may not be stressful for another; each of us perceives and responds to stress in an entirely different way.
  2. All stress is bad – There’s a relationship between stress and performance and a certain amount of stress is critical for peak performance. If you are engaged in tasks that are below your skill level, boring, easy and underwhelming, you are likely to experience very little to no stress at all. This can be detrimental to your performance as you become disinterested and disengaged. However, when faced with a situation which is challenging, but not overwhelming, and where you feel reasonably confident that you have the skills, energy and other resources to achieve positive results in the face of the situation, being able to optimise your functioning in this area is one of the keys to high performance. If a task is more complex and extremely overwhelming, we worry and become too stressed and fall into a state of distress, which can lead to exhaustion, fatigue, ill health and burn out.
  3. No symptoms = No stress – The absence of symptoms does not mean the absence of stress. In fact, camouflaging symptoms with medication may deprive you of the signs you need for reducing the strain on your physiological and psychological body systems.
  4. Only act on stress when the symptoms are chronic – By this stage it can be too late. The physiological and psychological damage of building stress can impact heavily on the body leading to ill health, which could have been prevented if the early signs of stress were managed appropriately.

The impact of stress on our health and body

Stress causes many physiological responses in the body with some lasting a short time under acute (short-term) stress, but others lasting a lot longer under times of chronic (long-term) stress. It is usually the chronic state of stress that has an adverse effect on the body.

Some of the major body systems affected include:

Musculoskeletal system

When the body is stressed, muscles tense up. Muscle tension is almost a reflex reaction to stress, which is the body’s way of defending against injury and pain.

With acute stress, the muscles tense up all at once, and then when the stress passes they release their tension. Chronic stress causes the muscles in the body to be in a more constant state of defence. When muscles are taut and tense for long periods of time, this may trigger other reactions of the body and even promote stress-related disorders. For example, tension headaches and migraines can be a result of chronic muscle tension in the shoulders, neck and head.

Millions of Australian’s suffer from chronic painful conditions secondary to musculoskeletal disorders. Often, but not always, there may be an injury that sets off the chronic painful state. Muscle tension, and eventually, muscle atrophy (loss of muscle) due to disuse of the body, all promote chronic, stress-related musculoskeletal conditions.

Respiratory system

The stress response causes your respiration rate to increase, which can make you breathe harder. This is not a problem for most people, but for those with asthma or a lung disease such as emphysema, getting the oxygen you need to breathe easier can be difficult.

Additionally, stress can cause rapid breathing — or hyperventilation — that can trigger a panic attack in someone who is prone to them.

Cardiovascular system

Acute stress causes an increase in heart rate and stronger contractions of the heart muscle due to a sudden increase in the stress hormones — adrenaline, noradrenaline and cortisol. In addition, the blood vessels that transport blood to the large muscles and the heart dilate, which increases the amount of blood pumped to these parts of the body and elevates your blood pressure. This is also known as the “fight or flight response”. Once the acute stress episode has passed, the body returns to its normal state.

Chronic stress, however, can contribute to more long-term problems for the heart and blood vessels. The consistent and ongoing increase in heart rate, the elevated levels of stress hormones and elevated blood pressure, provides a lot of wear and tear on the body. This long-term ongoing stress can increase the risk for hypertension, heart attack or stroke.

Repeated acute stress and persistent chronic stress causes inflammation in the circulatory system, particularly in the coronary arteries, which in turn can lead to increased risk of atherosclerosis and heart attack.

Endocrine system

During the fight or flight response, many hormones are produced due to a trigger response from the brain. One of the major hormones produced during this response is cortisol, our main stress hormone. While in the short-term this can be healthy as it increases alertness, productivity and physical performance, in the long-term it’s an entirely different story.

Cortisol is produced in the adrenal glands and while it is needed to maintain normal physiological processes during times of stress, prolonged elevated cortisol levels can lead to hypertension, glucose intolerance, diabetes, fatigue, muscle loss and increased infections. Furthermore, excessively prolonged or severe stress (i.e. trauma, infection) and poor nutrition can lead to abnormal messages from the brain causing dysfunction of the adrenal glands.

The next step is ‘burnout’, which is a result of a decrease in the brain’s ability to stimulate cortisol secretion at rest and in response to a stressor. This state is also known as adrenal fatigue.

Furthermore, long-term stress has been associated with biological aging, oxidative stress and inflammation, suppression or abnormal regulation of immune function, impairment of brain structure and function, increased susceptibility to some types of infection and worsening of conditions like depression, heart disease and some types of cancer.

Gastrointestinal system

Stress disrupts digestive function by impairing gastrointestinal barrier function and altering intestinal microflora i.e. decreases the good bacteria in the gut needed to fight infection and optimise immunity. Additionally, when you’re stressed, you are more likely to crave or eat different foods that are high in fat, sugar and/or salt. If you choose to eat these foods or eat larger portions, or increase your use of alcohol or tobacco, you are more likely to experience heartburn or acid reflux. Stress can increase the severity of heartburn pain.

During times of stress, your brain becomes more alert to sensations in your stomach. As a result, you may experience symptoms such as “butterflies”, nausea, cramping, gas, pain, bloating, diarrhoea or even constipation. Furthermore, if the stress becomes chronic, you may be more susceptible to developing ulcers.

Stress can affect your digestion and how well your intestines absorb nutrients from the food you consume. If you experience a lot of the above gastrointestinal symptoms, it is a good chance your body is not absorbing nutrients well, placing you at risk of malnutrition and nutrient deficiencies.

Reproductive system

In males, the fight or flight response, produces testosterone and activates the sympathetic nervous system which creates arousal.

As we know, stress causes the body to release the hormone cortisol, which is important for male reproduction. Excess amounts of cortisol can decrease libido and sexual desire, and more importantly, can affect the normal biochemical functioning of the male reproductive system. Chronic stress can affect testosterone production, sperm production and maturation, and even cause erectile dysfunction or impotence.

For women, stress can affect menstruation and may cause absent or irregular menstrual cycles, more painful periods and changes in the length of cycles. Stress may also make premenstrual symptoms worse or more difficult to cope with for some women. These symptoms include cramping, fluid retention and bloating, negative mood (feeling irritable and “blue”) and mood swings.

As menopause approaches, many hormonal changes are occurring in the body. These changes may induce feelings of anxiety and distress, and cause mood swings. Thus, menopause can be a stressor in itself. The emotional distress associated with menopause may cause the physical symptoms to be worse. For example, women who are more anxious may experience an increased number of hot flashes and/or more severe or intense hot flashes.

The hormonal imbalances, which occur as a result of chronic stress may also alter the libido of women, decreasing their desire for sex and/or intimacy.

Can stress cause disease?

Yes. Stress wreaks havoc on the mind and body as we know it. Over time, researchers have defined how stress influences disease and health. The main findings are that chronic psychological stress is associated with the body losing its ability to regulate the inflammatory response and in turn can promote the development and progression of disease.

Inflammation is partly regulated by the stress hormone cortisol and when cortisol is not allowed to serve this function, inflammation can get out of control. The reason for this is because stress alters the effectiveness of cortisol to regulate the inflammatory response due to decreasing tissue sensitivity to the hormone.

When the body is in a constant state of inflammation, the immune system is compromised making us more susceptible to the common cold and flu, as well as many diseases.

Long-term chronic inflammation damages blood vessels and brain cells, leads to insulin resistance (a precursor to diabetes) and promotes painful joint diseases. In addition to this, many people who are stressed are more likely to eat, drink and smoke more, and sleep and exercise less — tendencies that have obvious negative consequences for our health.

The link between mental health and stress

Stress is a process, not a diagnosis. We experience stress when there is an imbalance between the demands being made on us and our resources to cope with those demands. The level and extent of stress a person may feel depends a great deal on their attitude to a particular situation.

However, when the term ‘stress’ is used in a clinical sense, it refers to a situation that causes discomfort and distress for a person and can lead to other mental health problems, such as anxiety and depression. If stress is not addressed or untreated, it can turn into a mental illness such as an anxiety disorder or depression.

Common anxiety disorders include:

  • Panic disorder
  • Specific phobias – such as fear of flying or of spiders
  • Agoraphobia – fear of public places or of being away from home
  • Social anxiety disorder – fear of the scrutiny and judgement of others
  • Post-traumatic stress disorder (PTSD) – following a real and very distressing event such as a disaster, accident, war, torture, violent death or assault.

Other, less common, anxiety disorders include:

  • Obsessive compulsive disorder (OCD)
  • Acute stress disorder
  • Generalised anxiety disorder – the person is constantly worried, often about irrational things, and cannot be reassured.

Finally, it’s important to note that untreated anxiety disorders can lead to serious depression.

The impact of stress on relationships, work and your personal life

Depending on how you manage or cope with stress, will determine the effect it has on relationships, work and personal life. We’ve explored how stress affects the mind, body, and behaviour in many ways, and everyone experiences stress differently. Not only can overwhelming stress lead to serious mental and physical health problems, it can also take a toll on your relationships at home and work and can seriously affect your performance at work.

As mentioned previously, stress can cause a decrease in libido for both men and women as well as a sex hormone imbalance causing a decrease in sexual desire. This can cause a lot of friction and frustration in relationships and with the addition of mood swings and irritability, it can exacerbate arguments and a breakdown in the relationship.

At work, a build-up of stress may cause you to become more short, frustrated or irritable with your colleagues, which makes for a toxic environment setting yourself up for isolation. Your level of enjoyment and participation may suffer as a consequence and you may find yourself being excluded from social engagements.

A build-up of stress over time may cause you to become more isolated and you may find yourself avoiding social situations as they may make you feel more anxious. This can cause a breakdown of friendships and support networks, which are important during these times.

Coping with stress

To avoid the negative impact of stress on your central nervous, immune, musculoskeletal, digestive, endocrine, respiratory and cardiovascular system, it is important to implement some stress management strategies. What technique works for one person may not necessarily work for another. In order to find the best strategy for you, try a few different things to see what you are enjoy and are able to master. Some examples of stress management strategies that have been shown to work, include:

  • Yoga
  • Meditation
  • Tai chi
  • Keeping a stress diary – to identify symptoms and causes
  • Deep breathing relaxation exercises
  • Guided visualisation techniques
  • Progressive muscle relaxation – tensing different muscle groups and releasing them one by one.
  • Massage
  • Hypnosis
  • Exercise
  • Listen to music
  • Surround yourself with a support network e.g. friends, family, colleagues, mentors
  • Seek psychological help if you become overwhelmed
  • Have a good laugh
  • Take a nap
  • Take a walk
  • Play with your pet
  • Plan a holiday

Stress management

Diet – Diet plays a major role in stress management. A diet consisting of unprocessed foods, healthy fats, vegetable or fish protein, 7+ brightly coloured vegetables and fruits per day, whole grains, nuts, and pure water will help boost antioxidant, vitamin and mineral intake, and reduce inflammation and free radical damage caused by stress. manage a hormone imbalance. It’s important to minimise refined carbohydrates/sugars, animal fats, and eliminate trans fatty acids (hydrogenated or partially hydrogenated fats, shortening) as these all contribute to inflammation.

Nutriceuticals/supplements – There are several supplements on the market that are designed to assist with various hormone imbalances. These supplements contain natural nutrients and herbs that have been clinically proven to assist your body to cope with unwanted stress and the negative side effects associated with stress such as disturbed sleep patterns, increased cortisol response, restlessness etc.

Work with a Dietitian or Nutritionist to get a nutritional and herbal supplement program best for you. This will help to assist in brain and adrenal gland repair.

Quit smoking – If you are a smoker, stop immediately. Sadly, this behaviour is heightened under times of stress, but not only does smoking increase your risk of certain cancers, it also increases inflammation, which exacerbates the stress-response. If you need quitting, contact your GP or the QuitLine to find out how. Also, avoid caffeine, alcohol and recreational drugs as they will heighten your stress and inflammation response.

Exercise – depending how chronically stressed you are, rest and recovery is very important, so if you plan on exercise, aim for a low intensity session as exercise increases cortisol levels. Otherwise aim for 30 minutes of exercise on most days with as much incidental activity as possible e.g. taking the stairs instead of the lift, walking to the bus stop, getting out at lunch for a walk.

Sleep – It’s important that you sleep during regular hours. Aim to be in bed between 9-10pm and sleep for approximately 7-8 hours. Ensure that you don’t eat, drink alcohol or caffeine, or exercise for approximately 2 hours before your bedtime. Sleep in a dark, quiet, cool room and use ear plugs or an eye mask if necessary (if you live in a noisy and bright environment). Also, refrain from watching TV or checking your phone/email in bed as the bright lights increase cortisol production, which also reduces our sleepy hormone production, melatonin.

How can you tell if you are stressed?

Firstly, it’s important to look for the signs and symptoms associated with stress as mentioned previously. If you are ticking a lot of the boxes, it’s important to intervene early. If you are struggling to acknowledge these, ask a friend, loved one or colleague to see if they have noticed any changes in your personality or behaviour. A simple check list for signs and symptoms include:

  • You feel tired for no reason
  • You have trouble getting up in the morning, even when you go to bed at a reasonable hour
  • You are feeling rundown or overwhelmed
  • You have difficulty bouncing back from stress or illness.
  • You crave salty and sweet snacks
  • You rely on coffee (caffeine) and other “energy” drinks for a pick me up
  • You experience an afternoon low between 2pm and 5 pm
  • You feel tired at 9-10pm but may resist going to bed
  • You get a second wind at 11pm
  • Anxiety/nervousness, irritable
  • Decreased libido
  • Light headed when rising quickly from sitting or lying
  • You suffer from food sensitivities and/or allergies
  • Increased muscular weakness
  • Mental “fog” and poor memory
  • Mild constipation or diarrhoea that increases under stress
  • Chronic fatigue and/or infections
  • Increased susceptibility and duration of colds and flu