Medically reviewed by Kathleen Daly, MD
Stress refers to the body’s natural response to conditions or events known as stressors. Stressors may be either external, such as job loss and divorce, or internal, such as negative memories and your state of mind.
Chronic stress, or long-term stress, occurs when we are in a state of stress (physiological and psychological arousal) for a prolonged period of time. When your autonomic nervous system doesn’t often get an opportunity to activate its relaxation response, you may be at risk of various health complications, from depression and anxiety to chronic pain and heart disease.
Keep reading for the symptoms of chronic stress, as well as potential causes, risk factors, coping strategies, related conditions, and more.
Chronic Stress Symptoms
In the moment, acute stress activates our fight-or-flight response. This response floods your body with hormones, such as cortisol (the stress hormone) and adrenaline, and puts you in a state of physiological arousal, which involves an increased heart rate and faster breathing.
Symptoms of short-term stress may include:
Shortness of breath
Impending feelings of doom
Over time, chronic stress can lead to persistent health concerns. Symptoms associated with ongoing stress include:
Chronic pain, especially muscle pain and neck stiffness
Gastrointestinal problems, such as nausea, stomach pain, diarrhea, and constipation
Changes in appetite
Unwanted weight loss or gain
Erectile dysfunction (ED)
What Causes Chronic Stress?
Long-term stress can be caused by many different stressors, such as:
Major life milestones, such as marriage or retirement
Divorce and breakups
Frequent conflicts with a friend, relative, co-worker, or romantic partner
Health problems, whether your own or a loved one’s
Grief and loss
A demanding job or academic environment
Pregnancy and adoption
It’s important to note that the stressor itself no longer has to be present for you to experience ongoing stress. For example, you may continue to experience symptoms of burnout long after leaving a high-pressure job.
Anyone can experience chronic stress, but the following factors may increase your risk:
Mental health conditions: People with mental health conditions–such as personality disorders, mood disorders, or depression–tend to be more prone to long-term stress. They may also find it more difficult to cope with stressful situations.
High-pressure circumstances: Some occupational and academic environments tend to be especially stressful. For example, students in medical school often report experiencing long-term stress. People who work in certain careers, such as military service and law, also have a higher risk of chronic stress and burnout.
Certain personality traits: Low self-esteem, neuroticism, perfectionism, and lack of self-confidence have been associated with a higher chance of experiencing chronic stress.
Trauma: Any form of abuse or trauma can become a source of chronic stress. This includes interpersonal trauma–such as domestic violence, childhood abuse, and sexual assault–as well as traumatic events like natural disasters, serious illness, and injury.
Poverty: People who experienced poverty in childhood have a higher chance of developing chronic stress in adulthood. This may be due in part to the long-term effects of financial stress and debt, as well as housing and food insecurity.
Discrimination: Experiencing discrimination can lead to ongoing stress and anxiety. For example, studies suggest that disabled people often deal with chronic stress related to disability discrimination, societal stigma, and inaccessibility.
How Is Chronic Stress Diagnosed?
Chronic stress isn’t a specific diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). However, your healthcare provider may use the DSM-5 diagnostic criteria to determine whether or not you have a related condition, such as an anxiety disorder or post-traumatic stress disorder (PTSD).
A mental health provider, such as a psychologist or psychiatrist, can also help you recognize and manage the signs and symptoms of persistent stress, whether or not you meet the criteria for a mental health condition. They may ask you about your current symptoms, as well as your relationships, work and home life, and medical history.
Treatments for Chronic Stress
Professional treatment for chronic stress typically involves psychotherapy. Examples of psychotherapy that may help with long-term stress include:
Mindfulness therapy: Research suggests that mindfulness exercises, such as guided meditation and grounding techniques, may be effective in helping you stay in the moment rather than focusing on your stress. This may allow you to slow down and turn your attention to more positive thoughts.
Relaxation therapy: Your sympathetic nervous system activates your body’s stress response, including a faster heart rate, sweaty palms, and tense muscles. Meanwhile, your parasympathetic nervous system relaxes your body and mind after the stress has passed. Various kinds of relaxation therapy–such as biofeedback, deep diaphragmatic breathing, and progressive muscle relaxation–have been found to help in regulating the parasympathetic nervous system. Over time, this can reduce the effects of ongoing stress.
Cognitive-behavioral therapy (CBT): Cognitive-behavioral therapy focuses on developing problem-solving skills and identifying negative thought patterns, both of which can be effective in coping with stress.
Dialectical behavior therapy (DBT): Originally designed to treat borderline personality disorder (BPD), DBT combines some aspects of CBT with the principles of mindfulness in order to improve emotional regulation.
If you have a mental health condition related to stress, your healthcare provider may also prescribe medication, such as antidepressants or anti-anxiety medicines, to help manage your symptoms.
Finally, your healthcare provider may recommend making various lifestyle changes to reduce your stress, such as:
Spending quality time with family and friends
Making time for a relaxing hobby
Avoiding caffeine and other stimulants
How to Prevent Chronic Stress
It’s not always possible to prevent chronic stress. However, here are a few ways you can try to stop stress and burnout in their tracks before they become a pattern:
Recognize the signs: Catching the warning signs of chronic stress early can help you get help before it gets out of control. Try using a journal or mindfulness app to record your symptoms, such as anxious thoughts or problems with sleep.
Practice mindfulness: Practicing mindfulness techniques, such as meditation and yoga, on an ongoing basis can help to retrain your body to activate its natural relaxation response.
Find peer support: Finding meaningful support, whether by joining a peer support group or spending time with family and friends on a regular basis, can reduce the effects of stress.
Practice self-compassion: Practice self-acceptance and empathy by writing down three positive things about yourself and three things you’re grateful for each day.
Set attainable goals: Don’t bite off more than you can chew. Set realistic goals that won’t leave you burned out and exhausted. Set boundaries–whether at work, at home, or with friends–if you need to.
Make a change: If push comes to shove, you may need to make a major change in your life, such as leaving a toxic work environment, to cut back on severe chronic stress.
Spending a prolonged amount of time in the fight-or-flight state can affect many aspects of your health, both mental and physical. The following health conditions have been linked to chronic stress:
Infections: Stress can lower your body’s natural defenses and weaken your immune system, making you more vulnerable to viral and bacterial infections.
Respiratory conditions: The stress response prompts faster, more shallow breathing. This can worsen symptoms or even prompt an asthma attack for people with respiratory conditions, such as asthma and chronic obstructive pulmonary disease (COPD).
Gastrointestinal conditions: Stress has been found to increase inflammation and affect the digestive process. This may exacerbate symptoms for people with gastrointestinal disorders, such as irritable bowel syndrome (IBS).
Type 2 diabetes: Being in a stressed-out state can increase your blood sugar levels, which may put you more at risk of developing type 2 diabetes over time.
Heart disease: If left untreated, chronic stress can increase your blood pressure and affect the health of your heart and blood vessels. In turn, this can increase your chance of developing heart disease and related complications, such as stroke, heart attack, and heart failure.
Cancer: There is some evidence that chronic stress can promote the growth of cancer cells, possibly due to the effects of long-term inflammation and exposure to stress hormones.
Mental health conditions: Chronic stress can increase the likelihood of developing a mental health condition, such as depression or anxiety, and make existing symptoms worse. When faced with stress, some people “self-medicate” with drugs and alcohol, which may lead to the development of a substance use disorder (SUD).
A Quick Review
Stress affects everyone from time to time. However, if your stress doesn’t go away or gets worse over time, you may need help to manage it. Don’t be afraid to reach out to a healthcare provider for advice on effective coping strategies and treatment options for chronic stress.
Frequently Asked Questions
Is chronic stress a form of anxiety?
Chronic stress refers to our psychological and physical response to an ongoing stressor – whether internal or external. Anxiety refers to persistent, intense worry and fear.
Chronic stress isn’t the same as anxiety, but it can make it worse. Many people who are under long-term stress develop anxiety over time.
Does chronic stress ever go away?
Chronic stress can be difficult to alleviate, especially if it’s gone untreated for a long time. However, it can be effectively managed with healthy lifestyle changes, such as getting more sleep, exercising consistently, spending more time with loved ones, and taking time to relax. Setting boundaries in your personal and work life can also help to reduce the effects of long-term stress.
Can chronic stress permanently damage your heart?
Untreated chronic stress may put you at a higher risk for cardiovascular disease and events, such as heart attack, heart failure, and stroke. This is most likely because stress increases your blood pressure, as well as your triglyceride and cholesterol levels. These can significantly increase your risk of developing heart disease over time.
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