Stress: It's Effects and How to Manage It

This week, Dr. Roderick breaks down stress: what is stress, what having stress can look and feel like, and how best to manage it.

Chronic stress, which is constant and persists over an extended period, can be hazardous and even debilitating. Our bodies are well-equipped to handle stress in small doses, but when that stress becomes chronic, it can have serious effects on the body.

Stress effects all systems, including the musculoskeletal, respiratory, cardiovascular, endocrine, gastrointestinal, nervous, and reproductive systems.

Chronic stress can lead to early death from heart disease, cancer, and other health problems! The most stressed-out people have the highest risk of premature death, according to one study that followed 1,293 men for years: “People who always perceived their daily life to be over-the-top stressful were three times more likely to die over the period of the study than people who rolled with the punches and didn’t find daily life very stressful,” says Carolyn Aldwin, who directs the Center for Healthy Aging Research at Oregon State University and led the study.

“There are a number of ways chronic stress can kill you.” Aldwin highlights the way in which increased levels of cortisol, often referred to as the stress hormone, interferes with learning and memory, lower immune function and bone density, and increased blood pressure, cholesterol, and risk of heart disease.

The American Psychological Association (APA) approaches the topic of stress so seriously that it now conducts an annual survey called Stress In America™. Poignantly, the 2023 study was subtitled, “A nation recovering from collective trauma.”

As you might imagine, it can be quite difficult to measure the precise prevalence of the occurrence of chronic stress. Regardless, for anyone suffering from chronic stress, I hope these following survey results will, at the minimum, adequately convey the basic message that you are not alone.

APA’s 2023 data showed a fascinating pattern in which respondents downplayed their personal experiences of stress; that is, around two-thirds of adults (67%) reported feeling like their problems are not “bad enough” to be stressed about because they know others have it worse. Moreover, around three in five adults (62%) said that they don’t talk about their stress because they don’t want to be a burden to others, and around three in five adults (61%) said that people expect them to just “get over” their stress.

What other important numbers came out of this 2023 study? Nearly half (47%) of adults said they wish there was someone to help them manage their stress. Many (36%) said they don’t know “where to start” in managing their stress, and 33% said that they feel “completely stressed out no matter what they do” to manage their stress levels. Another consequence of our society under chronic stress is that around three in 10 adults said they have too much stress in their daily lives to think about the future, let alone plan for the future.

What about when adults are asked to simply quantify their average level of stress on a scale of 1-10 (where 1 represents “little to no stress” and 10 a “great deal of stress”)? Strikingly, overall stress was rated as a 5, a nearly a quarter of adults (24%) rated their average stress as falling between an 8 and 10. This increase from pre-pandemic numbers is observed across all age groups except those ages 65+. Mental health was highlighted as a major concern for the 18- to 34-year-old cohort in particular.

In APA’s 2023 study, women said that they’re “stressed, misunderstood, and alone.” Women reported an overall higher average level of stress than men and were more likely to rate their stress levels between an 8 and 10 than men (27% vs. 21%).

Although people of all genders cited health and professional finances as among their top stressors, women were more likely than men to report feeling “consumed” by their worries about money (50% vs. 44%).

Women were also more likely than men to cite family responsibilities (58% vs. 52%) and relationships (49% vs. 44%) as key stressors, likely due at least in part to our society’s way of socializing women to prioritize relationships.

What’s more, women were more likely than men to say they “strongly agree” that no one understands how stressed they are (22% vs. 17%) and were less likely to report that they can quickly “get over” stress (54% vs. 65%).

It’s apparent that women’s health is an area worthy of increased attention from researchers, health care providers, and society at large.

There is a vast universe of options for navigating stress in a health manner! Cognitive Behavioral Therapy (CBT) encourages changing our thoughts and behaviors to change our emotions. Time management techniques and other tools that help us to solve concrete real-world problems that weigh us down can be powerful stress reducers in the arsenal of “weapons” that we draw upon at times of stress.

The most common behavioral tips for stress management are a great place to start, including nurturing a healthy social support network for yourself and taking care of your physical health with proper diet, sleep, and physical exercise. Some of my personal favorite tips include daily gratitude practice, spending time in nature (“forest bathing” is one such example), and artistic expression (including expressive writing).

One evidence-based CBT manual organizes coping strategies into 5 basic categories:

Thoughts of a stressful nature can be especially challenging to target! As a starting point, try to set realistic expectations for yourself, and try to introduce more positivity into your thinking. Next, it will be helpful to closely examine your negative thoughts. They often share certain characteristic features — overestimating the odds of feared outcomes and “catastrophizing” about how bad those outcomes will be. To most effectively combat stress, we can remind ourselves of the low likelihood of bad outcomes, and we can also tell ourselves, “So what?” If such outcomes occur, they are likely to be time-limited and manageable. Just be prepared that “reprogramming” your automatic thoughts like this requires a lot of practice, as we’re fighting the innate human tendency to hyperfocus on risks and danger (that is hard-wired into our brains and inherited from our ancestors who faced daily real-world dangers to survive in the wild).

Dialectical Behavioral Therapy (DBT) introduces innovative ideas above and beyond CBT tools for regulating stress. For instance, in addition to standard tips like intense physical exercise, paced breathing, and progressive muscle relaxation, DBT highlights the role of manipulating our body temperature to achieve relief from stress. Try activating the “diver’s reflex” by applying cold water to your face just below the eyes and above the cheekbones, which then triggers an immediate decrease in heart rate - wow!

These are some important things that psychologists have found from hundreds of studies on stress over the years. The below is a direct quote from the Stress In America™ 2023 report from the APA:

Below are the references used in this article and some suggestions for further reading: