By Joan Tupponce

There is no “can be” about it. Life is stressful. And it’s been that way since the beginning of time.

Knowing the signs, symptoms, and when to get help is crucial to not only our well-being but also those around us.

Stress can come in two forms — acute or chronic. Acute stress, which comes on quickly, can activate our brain’s ‘fight or flight’ response.

“This reaction used to come in handy when our ancestors lived in the wild, as the cortisol and adrenaline surge that accompanies this response helps the body prepare for action. These hormones speed up our breathing and heart rate and tense our muscles so they’re ready to attack or to flee,” said Melissa Bui, M.D., a psychiatrist at VCU Medical Center and an associate professor of psychiatry in the Department of Psychiatry at Virginia Commonwealth University’s School of Medicine.

The same release of the stress chemicals cortisol and adrenaline can arise today, brought on simply by reading the news or going to meet your future in-laws for the first time, for example. People usually cope with this type of acute stress until it passes and is over.

Chronic stress, on the other hand, reflects the cumulative toll of prolonged exposure to these same stress chemicals. It can detrimentally affect both your mental and physical health.

“You can start to see a lot of health problems, in particular cardiovascular problems,” said Anurag Mehta, M.D., director of preventive cardiology at VCU Health Pauley Heart Center. “If you are chronically stressed, your heart is beating faster and your blood pressure goes up. That can lead to hypertension, the most common cause of heart disease.”

Chronic stress can indirectly lead to other factors for heart disease. When people are stressed, they may grab a cigarette to help them relax or another form of nicotine or drug.

“That can cause very serious problems down the road,” Mehta said.

When people are stressed, they often make poor nutritional choices, many times grabbing sugary treats like cake or cookies.

“People who are chronically stressed eat things that are rich in carbohydrates or salt as a coping mechanism,” Mehta said. “That can lead to obesity or diabetes, which cause heart disease in the long run. Also, people who are chronically stressed don’t engage in exercise, which is perhaps the best thing people can do for their cardiovascular health.”

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The brain may undergo measurable physical changes in response to both the repeated exposure of ‘fight or flight’ reactions and underlying stressors, such as chronic health conditions or financial issues. These changes can lead to loss of brain cells, resulting in parts of the brain getting smaller over time. As a consequence, people can develop memory impairment or mental health disorders such as anxiety, depression, and insomnia.

Constant stress can also weaken the immune system, making individuals more susceptible to infections and illnesses, and slowing the body’s ability to heal and recover.

“It can also disrupt sleep patterns, leading to insomnia and other sleep disorders, which further contribute to the deterioration of mental and physical health,” Bui said. “The cumulative effects of chronic stress can create a vicious cycle, where stress leads to health problems that, in turn, cause more stress, significantly impacting overall well-being and quality of life.”

Signs and symptoms of stress

A person may not realize they are suffering from chronic stress. They may have a variety of nonspecific symptoms but don’t associate them with stress. Symptoms such as ongoing fatigue, insomnia, frequent headaches, digestive issues, recurrent infections, or diffuse aches or pain can signal that stress is affecting your physical health.

“Making the connection between nonspecific symptoms of chronic stress can be an important first step toward implementing changes in the way we experience stress, and the impact it has on our body’s health,” Bui said.

Pre-existing mental health disorders or symptoms can make stress harder to tolerate. Moreover, chronic stress can worsen the symptoms of mental health disorders.

“For example, in individuals with depression, stress can lead to increased feelings of hopelessness, fatigue and withdrawal, making it harder for them to engage in activities that might alleviate their symptoms,” Bui said. “In those with PTSD, stress can trigger flashbacks, heightened vigilance and anxiety, further impairing their daily functioning.”

Coping doesn’t have to happen alone

People can cope in a variety of ways. Regular exercise has been shown to reduce cortisol and adrenaline, prompting the release of natural mood elevators. Getting a good night of sleep is also critical for well-being.

But, if possible, taking on the storm head-on can make the biggest difference.

“Something I personally do and talk to my patients about is mindfulness and meditation,” Mehta said. “It can be any type of mindfulness technique, 15 to 30 minutes a day. It has a direct impact on chronic stress. It helps you feel grounded and able to handle day-to-day stress.”

Mehta also uses smart phone apps such as Headspace to start a mindfulness session. The meditations can have music, someone speaking to guide you through the process, or they can be done in quiet. VCU RecWell also has mindfulness courses and meditations available online.

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While most ways to manage symptoms can happen on your own time, being with others has also been shown to help. Spending time with family and friends, engaging in social groups and volunteering can optimize your psychological response to stress.

“Feeling supported by those around us and giving our support to others can have a powerful counter effect on the negative demands of our stressful lives,” Bui said.

It can be hard to admit when stress gets too big to handle on your own, but taking the step to get help is crucial for preventing long-term health problems. One key indicator is the persistence and intensity of stress symptoms.

“If you experience chronic stress that lasts for several weeks or months and does not improve with self-care strategies, it is advisable to see your primary care provider so that you can explore the problem together and identify the next steps you can take,” Bui said. “Similarly, if stress leads to persistent feelings of anxiety, panic attacks, low mood, hopelessness, or if you are having thoughts of going to sleep and not waking up or other suicidal thoughts, it is essential to consult a health care professional right away.”

Severe irritability, inability to take joy in things or mood swings that interfere with daily life and relationships are also signs that professional intervention may be necessary. Additionally, if you find yourself using alcohol, drugs, food or screens to cope with stress, it is crucial to seek help.

In medicine, we say “never worry alone and the same can be said for finding your own unique prescription for stress management,” Bui said. “Combining these strategies with other trusted members of your team can create a comprehensive approach to reduce the negative impacts of stress on your life.”