Substance Abuse & Mental Health Services Administration

What Is Stress?

Stress is the emotional and physical strain caused by the response to pressure from the outside world. Unfortunately, there is not a universally agreed upon definition of stress, and individuals react differently to stress. What is stressful for one person may be pleasurable or have little effect on others. Stress is not necessarily bad; in small doses, it can help people perform under pressure and motivate them to do their best. But beyond a certain point, stress stops being helpful and starts causing damage to health, mood, productivity, relationships, and quality of life.

Stress is a normal physical response to events that make a person feel threatened or upset. When danger is sensed—whether it is real or imagined—the body’s defenses kick into high gear in a rapid, automatic process known as the fight-or-flight reaction, or the stress response. The brain signals the release of stress hormones. These chemical substances trigger a series of responses that gives the body extra energy: blood sugar levels rise, the heartbeat speeds up, and blood pressure increases. The muscles tense for action. The blood supply is diverted away from the core to the extremities to help the body deal with the situation at hand. The stress response is the body’s way of protecting itself.

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Are There Different Types of Stress?

Stress management can be complicated and confusing because there are different types of stress: acute stress, episodic acute stress, chronic stress, and posttraumatic stress, each with its own characteristics, symptoms, duration, and treatment approaches.

1. Acute stress is the most common form of stress. It comes from demands and pressures of the recent past and anticipated demands and pressures of the near future. Because it is short-term, acute stress does not have enough time to do the extensive damage associated with long-term stress. Acute stress can crop up in anyone’s life, and it is highly treatable and manageable.
2. Those who suffer acute stress frequently are dealing with episodic acute stress. It is common for people with episodic acute stress to be over-aroused, short-tempered, irritable, anxious, and tense. Interpersonal relationships deteriorate rapidly when people experiencing this type of stress respond to others with real hostility. Work becomes a very stressful place. Often, lifestyle and personality issues are so ingrained and habitual with these individuals that they see nothing wrong with the way they conduct their lives. They blame their woes on other people and external events. Frequently, they see their lifestyles, patterns of interacting with others, and ways of perceiving the world as part and parcel of who and what they are. Without proper coping strategies, episodic acute stress develops into chronic stress.
3. Chronic stress is the grinding stress that wears people away day after day, year after year. It destroys bodies, minds, and lives. It is the stress of unrelenting demands and pressures for seemingly interminable periods of time. The worst aspect of chronic stress is that people get used to it. They forget it is there. People are immediately aware of acute stress because it is new. Chronic stress is ignored because it is familiar and almost comfortable.
4. Posttraumatic stress disorder (PTSD) stems from traumatic experiences that become internalized and remain forever painful and present. Individuals experiencing PTSD could exhibit signs of hypervigilance (an easily triggered startle response). People with an exaggerated startle response are easily startled by any number of things (e.g., loud noises, doors slamming, shouting). They usually feel tense or on edge. Along with hypervigilance, people experiencing PTSD symptoms also could be dealing with issues including avoidance of places, events, or objects that are reminders of the experience that spurred the PTSD; feelings of emotional numbness; feelings of strong guilt, depression, or worry; loss of interest in activities that were enjoyable in the past; and difficulty with remembering the dangerous event. People experiencing PTSD symptoms wear down to breaking points because physical and mental resources are depleted through long-term attrition. The symptoms of posttraumatic stress are difficult to treat and may require the help of a doctor or mental health professional.

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What Are Some Common Myths Surrounding Stress?

Myth: Stress is the same for everyone.
Stress is different for everyone. What is stressful for one person may or may not be stressful for another. Each person may respond to stress in an entirely different way.

Myth: Stress is always bad.
According to this view, zero stress makes us happy and healthy. This is wrong—stress is a normal part of life. Stress can be the kiss of death or the spice of life. The issue is how to manage it. Managed stress makes people productive and happy. Mismanaged stress hurts and even kills.

Myth: Stress is everywhere, so nothing can be done about it.
Not so. Life can be planned so that stress does not become overwhelming.

Myth: The most popular techniques for reducing stress are the best ones.
No universally effective stress reduction techniques exist, because each individual reacts differently.

Myth: No symptoms, stress.
Absence of symptoms does not mean the absence of stress. In fact, camouflaging symptoms with medication may deprive a person of the signals needed for reducing the strain on physiological and psychological systems.

Myth: Only major symptoms of stress require attention.
This myth assumes that minor symptoms, such as headaches or stomach acid, may be safely ignored. Minor symptoms of stress are the early warnings that life is getting out of hand and stress needs to be better managed.

Adapted from American Psychological Association, 2008

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How Does Stress Affect People?

Stress is taking a toll on people—contributing to health problems, poor relationships, and lost productivity at work, according to a national survey released by the American Psychological Association (APA). Twenty-eight percent of Americans say that they are managing their stress extremely well. However, many people report experiencing physical symptoms (77 percent) and psychological symptoms (73 percent) related to stress. While Americans deal with high levels of stress on a daily basis, the health consequences are most serious when that stress is poorly managed. The body does not distinguish between physical and psychological threats. Everyone reacts differently to stress, and everyone’s body sends out a different set of red flags.

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Is Stress Experienced Differently by Genders or Generations?

The APA reported that nearly half of Americans state that their stress levels have increased since November 2007, with as many as 30 percent rating their average stress levels as extreme (8, 9, or 10 on a 10-point scale where 10 means “a great deal of stress”). At the same time, economic conditions take a physical and emotional toll on people nationwide. Compared with men, more women say they are stressed about the following issues:

• Money (83 percent vs. 78 percent)
• The economy (84 percent vs. 75 percent)
• Housing costs (66 percent vs. 58 percent)
• Health problems affecting their families (70 percent vs. 63 percent)

Across the board, women are reporting higher levels of stress, are more likely than men to cite various stressors, and report more physical and emotional symptoms as a result of stress, suggesting that stress is having a significant impact on women.

In reports released by the APA, older adults report having less stress and managing stress better than younger adults. However, the financial crisis is having a greater impact on older generations, and this impact is leading to more stress at work. Many older adults are waiting to retire or coming out of retirement and joining the workforce to make ends meet.

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Does Stress Look Different Across Cultures?

Stress is common to all people regardless of ethnicity. However, sources of stress vary among cultural groups. All cultural groups are reporting increased stress about money and work. However, as a result of cultural norms, many ethnic groups are having difficulty asking for help with coping. When it comes to managing stress, the APA reports that several cultural groups say they are doing enough to manage their stress; however, groups do not report that they are managing their stress well. It is important to maintain a sense of identity and social support when feeling overwhelmed and stressed. This includes embracing cultural background when developing a personal strategy for dealing with stress.

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What Are the Warning Signs of Stress?

It is important to learn how to recognize when stress levels are dangerously high. The most dangerous thing about stress is how easily it can get out of control. Many factors can cause it, but common triggers tend to be the pressures of work, relationships, money, or family problems, or merely the fact that life suddenly seems to be a constant tough battle. One of the important aids for combating and dealing with stress is to first recognize it. Stress affects minds, bodies, and behaviors in many ways, and everyone experiences stress differently. A body’s stress warning signs alert a person that something is not right, much like the glowing “check engine” light on a car’s dashboard.

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Can Stress Be Prevented?

Stressful situations in life cannot be prevented. However, they can be prepared for in a way that allows a positive response. This is done by building and fostering resilience in different areas of life. Resilience implies that after an event, a person or community may not only be able to cope and recover, but also change to reflect different priorities arising from the experience and prepare for the next stressful situation. Fostering resilience, or the ability to bounce back from a stressful situation, builds a proactive mechanism to manage stress. Developing a greater level of resilience will not prevent stressful conditions from happening, but it can reduce the level of disruption a stressor has and the time it takes to recover. (See the resilience section of this resource collection to learn how to build personal resilience.)

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How Can Stress Be Managed?

Stress can be dealt with proactively or reactively. It can be dealt with proactively by building personal resilience to prepare for stressful circumstances, while learning how to recognize signs and symptoms of stress. It can be dealt with reactively by utilizing coping strategies useful for the individual. The key is not to avoid stress altogether, but to manage the stress in such a way that the negative consequences of stress are avoided. There are many positive ways to manage stress.

The best defense against stress is building resilience. Resilience refers to the ability of an individual, family, organization, or community to cope with adversity and adapt to challenges or change. It is a process of drawing on beliefs, behaviors, skills, and attitudes to move beyond stress, trauma, or tragedy. While building defenses through resilience, it also is important to be ready to deal with stress if the internal resilience reservoir is not enough.

Managing stress can include simple ideas, such as recognizing signs of stress, learning breathing techniques, and engaging in spiritual communities, and more advanced interventions with professionals, such as seeking the help of a mental health professional and learning stress inoculation techniques. The goal of stress inoculation is to develop a procedure that will almost instantaneously put a person in a calm state. This is not necessarily a completely relaxed condition since many demanding situations will not allow that. The idea, however, is to be able to step back and look at problematic circumstances in a realistic light without feeling too hassled.

Uncontrolled stress can lead to many problems. Simple headaches, tight muscles, problems with sleeping, or a bad mood can be a prelude to much more severe symptoms. There are many healthy ways to manage and cope with stress, but they all require change: either changing the situation or changing reactions to the situation. If stress is affecting a person’s ability to work or find pleasure in life, help should be sought from a doctor, mental health provider, or other professional.

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References

American Psychological Association. (2008). Stress in America. Retrieved March 23, 2009, from http://www.apa.org/news/press/releases/stress/index.aspx 

American Institute of Stress. (n.d.). Effects of stress. Retrieved March 23, 2009, from http://www.stress.org/topic-effects.htm 

Mental Health America. (n.d.). Stress: Know the signs. Retrieved March 23, 2009, from
http://www.nmha.org/go/mental-health-month/stress-know-the-sign

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