Chronic Stress: Examples, Symptoms, And Coping Mechanisms

Stress is an evolved trait that ensures survival by quickly preparing the body to react to an external threat or unexpected change. It occurs when the brain senses a change in your internal or external environment that threatens biological homeostasis (the balance between body systems). The human ability to survive often depends on the response system to stress, as it allows you to fight, flee, or safeguard yourself in dangerous situations. 

However, while stress is natural, chronic or unmanageable stress may have serious mental and physical consequences. For example, there is a direct link between chronic and ongoing stressful conditions and the onset of depressive episodes. If you are experiencing chronic stress and want to increase your understanding, examining the origins and symptoms of stress, treatment options, and coping strategies may be helpful.  

What is stress? 

According to the World Health Organization (WHO), stress can be defined as any change that leads to emotional, psychological, or physical strain. Stress is often divided into two categories: acute and chronic. Within these categories are unique subtypes that can be explored to understand how stress functions for you. 

What is acute stress? 

In biology, acute stress is caused by an intrusive event, whether physical, physiological, or psychological in nature. In everyday life, acute stress can be temporary stress you experience when a situation goes wrong. It is a short-term experience that can cause annoyance, anger, fear, or upset, prompting action. Acute stress can also be caused by a more serious or traumatic event that takes more time to recover from. However, in these cases, it may develop into chronic stress.  

Mental health impacts of acute stress 

Acute stress events could entail a new change in the day that causes your fight-or-flight neurological response to be activated. For example, an argument with your spouse, a near-miss car accident, or an upcoming job interview can be examples of acute stressors that might raise your blood pressure or heart rate. However, this episode is temporary, as opposed to chronic stress, and the effects can pass quickly. 

Some acute stressors may have a long-lasting impact. For example, assault, home invasion, or the sudden traumatic loss of a beloved individual in the family may be brief events of acute stress that cause long-term distress. These events may lead to the development of acute stress disorder. 

According to the medical reference Merck Manual, acute stress disorder is an unpleasant, intense, and dysfunctional reaction that follows shortly after an overwhelming traumatic event that lasts less than a month. If this stress reaction lingers for over a month, a person may be diagnosed with post-traumatic stress disorder (PTSD). 

Physiological effects of acute stress

When under acute stress, an individual may experience mood changes, digestive distress, an upset stomach, or headaches. These bodily responses may be due to the release of adrenaline and other stress hormones to counteract stressful situations. These stress hormones may give a person clarity and energy to cope with perceived (or unperceived) stressors but can also halt certain necessary physical processes. 

The adrenaline from a stress reaction may be experienced without negative side effects when one experiences acute stress of a "thrilling" nature, like riding a rollercoaster or watching a scary movie. However, in cases where stress is severe or accompanies distressing emotions, like fear, it may have side effects. 

What is episodic acute stress? 

Episodic acute stress occurs when there is a high frequency of acute stress situations in a person's daily life, causing a higher frequency of stress-related symptoms. The accumulation of stressful life events can lead to episodic acute stress. For example, some people experience stressors at multiple moments, including in relationships, at a job, or with family. 

Individuals may also experience periods where stressful life events occur in close succession, such as experiencing the loss of a job and a divorce simultaneously. A person who experiences episodic stress may tend to take on many responsibilities or overload their schedule, leading to adverse symptoms.  

Episodic acute stress symptoms can appear as they do for other types of stress, with associated cognitive difficulties and physical symptoms like a racing heart rate and high blood pressure. Cognitive symptoms accompanying an episodic acute stress event include difficulty focusing, processing, making decisions, and remembering essential details. In addition, people who experience episodic acute stress may have an increased risk of developing health problems like irritable bowel syndrome (IBS) or cardiovascular disease. 

What is chronic stress? 

Acute and episodic acute stress often subside after a temporary period of up to a few months. However, chronic stress is a persistent sense of overwhelm and pressure, often due to external or internal stressors that persist over time or are severe. This stress stems from situations like childhood trauma that can alter an individual's understanding of safety. Below are a few other situations that may prompt this stress response: 

When stress interferes with a person's ability to enjoy life, accomplish daily tasks, or perform professionally long-term, it is deemed chronic and can lead to mental and physical health conditions.

Symptoms of chronic stress

The symptoms of chronic stress can be like those of acute stress. However, consistent stress on the body can lead to more serious complications. Long-term and high levels of stress can increase a person's risk factor for the following: 

• Heart disease and heart complications
• Increased cortisol and cholesterol 
• A weakened immune system that can lead to recurrent infections and chronic diseases like lung disease
• Higher cancer risk
• Liver disease
• An increased risk of mental illness
• An increased risk of suicidal thoughts 

If you are experiencing suicidal thoughts or urges, call the National Suicide Prevention Lifeline at 988. Support is available 24/7.

You may also notice the following physical and emotional symptoms of stress:

• Headaches
• Difficulty concentrating 
• Sleep disorders 
• Changes in appetite and digestion
• Fatigue
• Irritability 
• Low self-esteem
• Sexual dysfunction
• Skin conditions like fever blisters, acne, hives, or worsened psoriasis
• Hair loss
• Mental health conditions like depression, anxiety, or PTSD 

How does chronic stress change the brain?

Doctors have investigated the effects of chronic stress on the brain and found significant results. While it is known that chronic stress and related experiences as a child can have long-term effects on the developing brain, doctors are more aware of cortisol's impacts on the brain and the permanent changes it can cause in people of all ages. 

The brain consists of white and gray matter. The white matter portion of the brain consists of multiple components, including the myelin sheath, which assists in speeding up interactions between different brain regions and the neurons within. The brain's gray matter consists of bundles of nerve cells and contributes to thought processing and making decisions. 

Cortisol affects white matter by producing excess myelin, impairing communication between the amygdala (the emotional center) and the hippocampus (the memory center). This excess myelin "hardwires" the connection to incite a constant fight-or-flight response. Constant high cortisol levels increase the production of stem cells that turn into myelin while decreasing the stem cells that become neurons, reducing one's chances of retaining information. 

Coping mechanisms for chronic stress

Though chronic stress may cause some significant problems for the person experiencing it, there are techniques and coping mechanisms they can implement to assist. 

Caring for your body, which is directly connected to the mind, is a starting point for avoiding unhealthy coping mechanisms. Try to eat a balanced diet, exercise regularly, and follow healthy sleep hygiene practices. Poor physical health can contribute to an unhealthy mind.

Relaxation can also be part of reducing stress levels. Meditation and yoga can be effective options for refocusing, calming the mind, and easing tensions. Healthy distractions can involve engaging in enjoyable activities, watching a movie, playing a game, going for a walk, reading a book, or spending time with someone you care about. 

Socializing is an effective way to reduce stress, as it is an essential factor of human wellness for everyone. Try not to isolate yourself, as doing so may cause loneliness and a low mood. If you don't have a support system, helping others through methods like volunteering may be beneficial. 

Seeking professional support for chronic stress 

When chronic stress adversely impacts your functioning in everyday responsibilities, reaching out to a professional may be valuable. Counseling, psychotherapy, and medications may be available to assist those living with constant or acute stress. A provider, like a therapist, can offer insight and clarity to help a client develop problem-solving techniques and coping skills for the future. 

While in-person therapy is one option available to you, some individuals may find it difficult to manage commuting or paying for in-person options. In these cases, online therapy through a platform like BetterHelp can be more reachable and cost-effective. People with limited psychotherapy resources, transportation challenges, a rural location, or financial limitations may benefit from this option.  

A clinical trial published in Psychotherapy and Psychosomatics examined the efficacy of internet-based cognitive-behavioral therapy (iCBT) in people living with chronic stress. ICBT, like in-person cognitive-behavioral therapy, is a form of online treatment that teaches chronic stress management strategies, helping clients identify unhelpful behavioral and thought patterns to activate positive thought and behavioral changes. 

In the study, 100 adults diagnosed with adjustment disorder and exhaustion difficulties stemming from chronic stress were randomly assigned a 12-week iCBT treatment program or a control waitlist program. The results showed that participants who completed the ICBT treatment program significantly improved their perceived stress and moderate to large improvements in associated adjustment and exhaustion. The clinical trial's authors concluded that iCBT effectively reduces stress-related symptoms and can potentially increase treatment availability.