You’re not alone. According to the American Psychological Association’s 2018 Stress in America survey, 74 percent of U.S. adults said they’d experienced one or more signs of stress within the last month of responding to the study. The Stress in America 2020 survey revealed 67 percent of U.S. adults noticed their stress levels had increased since the coronavirus pandemic. And in 2022, the APA stress survey found that it’s no longer merely jam-packed schedules and go-go-go mentalities weighing people down: More recently, prolonged health crises, geopolitical tensions, inflation, climate anxiety, economic uncertainty, and other major global issues—many of which the majority of us have never experienced before—have taken U.S. stress levels to new heights. A little stress, on occasion, is normal and even helpful: It can sharpen focus, improve memory, and heighten emotions. But the thing about stress is that, when left unchecked (as it often is), our health takes a beating. Chronic stress weakens the immune system and increases the risk for a range of illnesses, including heart disease and depression. Stress drives people to eat more than their bodies need, sleep less than they should, sabotage their mental health, skimp on valuable exercise, and shortchange fun. In other words, sometimes good stress goes bad, and researchers have only recently started to uncover how. In an ideal world, stressors such as fire alarms and big work deadlines would simply keep you out of danger and on your toes. In the real world, however, these stressors—money stress, work demands, relationship turmoil, and more—can make you sick (literally). Here’s why.
What is stress, and how does it work?
Your “fight-or-flight” response.
In its most basic form, the stress response is known as “fight or flight,” and it swings into action whenever you’re confronted with a novel or threatening situation. “If you step off the curb in front of an oncoming bus, your body reacts automatically to protect you,” says Esther M. Sternberg, M.D., an expert on the interrelationships between mind, body, and environment, and the author of Balance Within: The Science Connecting Health and Emotions. In a matter of seconds and without even thinking, you begin pumping out brain chemicals and hormones, including adrenaline and cortisol. Your heart rate accelerates, oxygen-bearing red blood cells flood the bloodstream, the immune system gears up for the possibility of injury, and energy resources are diverted to your muscles, brain, heart, and lungs and away from functions, such as digestion and hunger, that can wait until the crisis has passed. Meanwhile, the brain releases a cascade of endorphins, the body’s natural opiates, to dull the pain of those potential injuries. You’re ready for action, whether it’s a full-out battle or a hasty retreat―in this case, fleeing back onto the sidewalk to escape the speeding bus. When the danger has passed, all these systems are restored to their normal resting state. “Your stress response makes you get out of danger,” Dr. Sternberg says. “Without it, you’d be dead.” Many of the physical changes that energize you to get out of the way of the bus are the same ones at play in positive situations. Your heart races when you’re falling in love. Your palms grow sweaty on the first day of a new job. How do you know if it’s happiness or stress? You label what you’re feeling: Your racing heart and sweaty palms happen first, and then depending on your assessment of the circumstances, you perceive yourself as either excited or happy or stressed. “Our stress isn’t a result of the event but of the view we take of it,” says Ellen J. Langer, a professor of psychology at Harvard University. “If the event is seen as negative, then we’ve set ourselves up to experience stress.”
The problem with chronic stress.
Once you escape the oncoming bus, you’re out of danger. Calm returns both physiologically and emotionally: Your pulse slows, the panic subsides, you start to become aware of things like appetite again. All good. But things go awry when stress persists and your body has no opportunity to return to this resting state (or the opposite of the fight-or-flight state). Getting back to normal is much more complicated when the source of your stress is constant and negative, or more conceptual, emotional, or psychological—and when fighting or fleeing a visible threat is not an option: when you’re constantly worrying about not having enough money to retire, stuck in a draining relationship, or trapped in a cycle of toxic productivity and burnout. The late neuroscientist Bruce S. McEwen, M.D., longtime professor of neuroendocrinology at Rockefeller University in New York City and co-author of The End of Stress as We Know It, spent his career conducting groundbreaking research that transformed our understanding of stress and the impacts of chronic stress on the brain and body systems. He identified the strong connection between our perceptions and our physiological responses, discovering that we can trigger our own stress response merely by imagining a stressful situation. Simply envisioning being in a traffic accident and/or worrying about it constantly can switch on your stress response without you actually needing to experience a car crash. Anxiety—ruminating on the past, worrying about threatening future scenarios—can activate the stress response and start a vicious loop. And emotional stressors such as frustration with a job or a relationship, which are as powerful as tangible stressors (an earthquake, a shark), are recurring and can accumulate until the fight-or-flight response is constantly ramping up. This build-up overloads us and can start to manifest as physical symptoms—fatigue, irritability, exhaustion. In the most extreme cases, an always-stressed state can lead to more serious health conditions. Unless, that is, you put the brakes on from time to time.
Can stress literally make you sick?
“There’s no doubt that the physiology that fuels a chronic stress response can make us sick,” Dr. Sternberg says. But stress doesn’t “cause” heart attacks or depression in the way a virus causes the flu. How it impacts your body depends in part on your genes. Take an autoimmune disease like rheumatoid arthritis: “There are 20 different genes on 15 different chromosomes that determine whether or not a person will get inflammatory arthritis,” Dr. Sternberg says. “If you have all 20 genes, you’ll most likely get it. If you have two, you probably won’t. If you have five, you may or may not get the disease, and the degree to which your stress response is activated could tip the balance.” Your physiological destiny isn’t completely fixed, however. Although we’re programmed to develop in a certain way and at certain times, early stressful experiences during childhood (or even before), such as the death of a parent, can alter the way our brains develop and actually change them, as well as impact the immune system and endocrine system, according to Dr. McEwen. As a result, those people tend to be more sensitive to stressors later in life and are more likely to suffer the health consequences.
Stress and Your Immune System
The dual nature of stress, both protective and destructive, is mirrored in the dual role of cortisol, a hormone central to fight-or-flight. In an emergency, a jolt of physiological chemicals, including cortisol, boosts your immune response―a good thing. Once the emergency has passed, however, it is also cortisol’s job to inform the immune system to stand down and return to normal. If too much stress keeps excess cortisol circulating for too long, your immune cells become sluggish and eventually die, leaving you open to infection. What about the flip side? If too much stress makes you more susceptible to getting sick, can minimizing stress help you heal? Maybe. A lot more research is needed to understand whether coping techniques like mindfulness actually help reverse stress damage at the physiological and biological level. But a growing number of medical facilities have been approaching this question through integrative programs that help patients control illnesses by controlling stress. One of the oldest is the Center for Mindfulness, at the University of Massachusetts Medical School, in Worcester, home of the first Stress Reduction clinic practicing Mindfulness-Based Stress Reduction (MBSR), started by Jon Kabat-Zinn, Ph.D. Here, patients learn mindfulness practices like mindful breathing, yoga, and meditation with the goal of lowering stress. At the very least, there’s no harm in looking for ways to reduce and manage stress if it helps you feel better, right? If you feel chronically overwhelmed, consider these proven ways to get out from under its grip.
How to Deal With—and Relieve—Stress
On the other hand, if you’re a passenger in the airplane cabin, you’re uncomfortable because the plane is bouncing around and you can’t do anything about it. You feel stressed. “The trick in these kinds of situations is to make yourself feel, little by little, as though you’re in control, to make an unknowable situation seem knowable,” Dr. Sternberg says. Watch the cabin crew members; they have the experience to recognize how much danger the plane is in. If they look calm (and they probably do), you’ll feel calmer. If your work schedule sets your teeth to grinding, make a list of projects you need to get done and front-load it with tasks you can accomplish quickly. As you check off accomplishments, you’ll begin to feel in control, and your stress will ease. Try scheduling daily chores so that you can tackle the most difficult ones when your energy level is highest. And delegate—not just to co-workers but also to your children, your partner, and your friends. RELATED: 6 Unexpected Health Benefits of Walking RELATED: The Best Foods for Fighting Stress, According to Doctors The basic relaxation response was first described in 1975 by cardiologist, mind-body medicine pioneer, and Harvard Medical School researcher Herbert Benson, MD. His approach involves two steps: First, close your eyes and focus on your breath (that’s the foundation). Second, choose a phrase, a word, or a prayer and repeat it to stay in the moment and be mindful. Ideally, you’d begin and end your day with a few minutes of regular relaxation exercise. But should you find your tension rising during the day, you can always take a minute to pause, take a few deep and intentional breaths. An easy place to start is with box breathing: inhale gently for four counts, hold your breath for four counts, exhale fully for four counts, hold for four counts, and repeat the cycle with another inhale. RELATED: 5 Mindfulness Breathing Exercises You Can Do Anywhere, Anytime
