What is stress?

Stress is how we behave when we are under pressure or feel threatened. It typically occurs when we are in a vulnerable position that we don’t feel we have any control over.

We may feel stressed out because of things like

• When struggling to handle a lot of duties simultaneously, hence going through fatigue and burnout
• When the family is going through a difficult time, such as grief or financial troubles
• Being a member of a disadvantaged and marginalized religious group.
• Natural disasters or situations like the coronavirus pandemic

There are three main types of stress 

• Acute stress 
• Episodic acute stress
• Chronic stress.

This article aims to look at both acute and chronic stress. The similarities and differences between the two, treatment and management options, and how they both affect our daily lives.

What is acute stress disorder?

Acute stress disorder is a mental health condition that can occur immediately after a traumatic event. It causes a range of psychological symptoms, and without recognition or treatment, it can lead to post-traumatic stress disorder.

There is a close relationship between acute stress disorder (ASD) and post-traumatic stress disorder (PTSD). Some people develop PTSD after having ASD.

According to the United States Department of Veterans Affairs, approximately 19 percent of people will develop ASD after experiencing a traumatic event. 

Everyone responds to traumatic events differently, but it is important to be aware of the potential physical and psychological effects that can occur afterward.

Although it shares many of the same symptoms as PTSD, ASD is a distinct diagnosis.

A person with ASD experiences psychological distress immediately following a traumatic event. Unlike chronic stress, ASD is a temporary condition, and symptoms typically persist for at least 3 to 30 days after the traumatic event.

If a person experiences symptoms for longer than a month, a doctor will usually assess them for other stress disorders or stress-related disorders like PTSD.

Symptoms

People who have ASD experience symptoms similar to those of PTSD and other stress disorders.

ASD symptoms fall under five broad categories:

1. Intrusion symptoms. These occur when a person is unable to stop revisiting a traumatic event through flashbacks, memories, or dreams.
2. Negative mood. A person may experience negative thoughts, sadness, and low mood.
3. Dissociative symptoms. These can include an altered sense of reality, a lack of awareness of the surroundings, and an inability to remember parts of the traumatic event.
4. Avoidance symptoms. People with these symptoms purposefully avoid thoughts, feelings, people, or places that they associate with the traumatic event.
5. Arousal symptoms. These can include insomnia and other sleep disturbances, difficulty concentrating, and irritability or aggression, which can be either verbal or physical. The person may also feel tense or on guard and become startled very easily.

People with ASD may develop additional mental health disorders, such as anxiety and depression.

Causes

People can develop ASD after experiencing one or more traumatic events. A traumatic event can cause significant physical, emotional, or psychological harm.

Among others, possible traumatic events can include:

• the death of a loved one
• the threat of death or serious injury
• natural disasters
• motor vehicle accidents
• sexual assault, rape, or domestic abuse
• receiving a terminal diagnosis
• surviving a traumatic brain injury

Risk factors

A person can develop ASD at any point in their life. However, some people may have a higher risk of developing this condition.

Factors that can increase an individual’s risk of developing ASD include:

• previously experiencing, witnessing, or having knowledge of a traumatic event
• a history of other mental health disorders
• a history of dissociative reactions to past traumatic events
• being younger than 40 years old

Diagnosis

A doctor or mental health professional can diagnose ASD. They will ask questions about the traumatic event and the person’s symptoms.

A healthcare professional will usually diagnose ASD if a person develops nine or more ASD symptoms within 1 month of the traumatic event. Symptoms that appear after this time frame or persist longer than 1 month may indicate chronic stress.

To diagnose ASD, a healthcare professional will also rule out other possible causes, such as:

• other psychiatric disorders
• substance use
• underlying medical conditions

Treatment

A healthcare professional will work closely with a person to develop a treatment plan that meets their individual needs. Treatment for ASD focuses on reducing symptoms, improving coping mechanisms, and preventing chronic stress.

Treatment options for ASD may include:

• Cognitive behavioral therapy (CBT). Doctors usually recommend CBT as the first-line treatment for people with ASD. CBT involves working with a trained mental health professional to develop effective coping strategies.
• Mindfulness. Mindfulness-based interventions teach techniques for managing stress and anxiety. These can include meditation and breathing exercises.
• Medications. A healthcare professional may prescribe antidepressants or anticonvulsants to help treat a person’s symptoms.

Prevention

It is not always possible to avoid experiencing traumatic events. However, there are ways to reduce the risk of developing ASD afterward.

These can include:

• consulting a doctor or mental health professional following a traumatic event
• seeking support from family and friends
• getting treatment for other mental health disorders
• working with a behavioral coach to develop effective coping mechanisms
• getting preparation training if a person’s job involves a high risk of exposure to traumatic events

ASD is not an uncommon condition, and it can occur after a person experiences a traumatic event. People whose occupation exposes them to traumatic events have a higher risk of developing ASD.

ASD has a close relationship with chronic stress and shares many of the same symptoms. However, ASD is a short-term condition that typically resolves within a month. If a person has symptoms of ASD for longer than a month, a doctor may assess the person for chronic stress.

Treatment aims to reduce symptoms and help a person develop effective coping strategies. Options include CBT, mindfulness techniques, and medications.

Reaching out to friends, family, and community support groups can also help a person process their feelings and move on with their lives following a traumatic event.

What is chronic stress?

Short-lived feelings of stress are a regular part of daily life. When these feelings become chronic or long-lasting, they can severely impact a person’s health.

Stress is a biological response to demanding situations. It causes the body to release hormones, such as cortisol and adrenaline.

These hormones help prepare the body to take action, for example, by increasing the heart and breath rates. When this occurs, a doctor might describe a person as being in a state of heightened alertness or arousal.

Many factors can trigger a stress response, including dangerous situations and psychological pressures, such as work deadlines, exams, and sporting events.

The physical effects of stress usually do not last long. However, some people find themselves in a nearly constant state of heightened alertness. This is chronic stress.

Some potential causes of chronic stress include:

• high-pressure jobs
• financial difficulties
• challenging relationships

Chronic stress puts pressure on the body for an extended period. This can cause a range of symptoms and increase the risk of developing certain illnesses.

Signs and symptoms of Stress

Chronic stress affects the whole body. It can have several physical or psychological symptoms, which can make functioning on a daily basis more challenging.

The type and severity of symptoms vary considerably from person to person.

Signs and symptoms of chronic stress can include:

• irritability, which can be extreme
• fatigue
• headaches
• difficulty concentrating, or an inability to do so
• rapid, disorganized thoughts
• difficulty sleeping
• digestive problems
• changes in appetite
• feeling helpless
• a perceived loss of control
• low self-esteem
• loss of sexual desire
• nervousness
• frequent infections or illnesses

A variety of life experiences can cause stress, and these may begin in childhood. When children experience traumatic events, it can lead to the development of chronic stress that may last into adulthood.

These types of events are known as adverse childhood experiences (ACEs). In research by the Centers for Disease Control and Prevention (CDC), 61% of adults surveyed in different nations said they had experienced at least one type of ACE, and nearly 1 in 6 had experienced four or more types.

Examples of ACEs include:

• mental illness in one or more parents
• emotional, physical, or sexual abuse
• substance misuse in the family
• parental divorce
• homelessness
• incarceration of a parent or close family member

In adulthood, chronic stress can happen as a result of very similar causes, as well as:

• problems in the workplace
• unemployment or financial problems
• an injury that impacts a person’s daily life
• concern about problems in the country or the world

According to the Stress in America 2020 survey by the American Psychological Association (APA), 65% of people surveyed said the current uncertainty in the nation is stressful, and 60% are overwhelmed by the issues the country is facing.

In addition, 70% of parents in different countries globally reported family responsibilities as a source of stress, and 63% were stressed by the impact of COVID-19 and its impact on the school calendar.

Chronic stress can also affect historically marginalized groups differently than others. 

Stress treatment

It is always important to see a healthcare professional for advice and support. A doctor may recommend psychological therapy, such as cognitive behavioral therapy (CBT).

One established aim of CBT is to help people deal with chronic stress. In structured sessions, a therapist works to enable a person to modify their behaviors, thoughts, and feelings concerning stressors.

CBT can also help a person develop tools and coping mechanisms to manage stress responses.

Sometimes, a doctor recommends medications to help treat some symptoms of chronic stress. For example, they may prescribe antidepressants to treat anxiety or depression. For people with trouble sleeping, doctors may prescribe sedatives.

Health effects of stress

Research has shown that chronic stress can impact the brain and the immune system. The brain’s neural networks, especially in the prefrontal cortex (PFC), can actually reduce in size. Doctors have seen this in imaging of people’s brains. 

When this happens, it may lead to cognitive, emotional, and behavioral dysfunctions.

When a person is stressed, it stimulates their immune system to react. Over time, when it is chronic, the immune system can become overstimulated. This may lead to the development of diseases and health problems.

Over long periods, chronic stress can contribute to the development of a range of physical and mental disorders, including:

• heart disease
• high blood pressure
• diabetes
• obesity
• a weakened immune system
• sexual dysfunction
• gastrointestinal disorders
• skin irritation
• respiratory infections
• autoimmune diseases
• insomnia
• burnout
• depression
• anxiety disorders
• post-traumatic stress disorder (PTSD)
• schizophrenia

Chronic vs. acute stress

Generally, acute stress is short term. It typically manifests immediately after a person experiences a stressor as a fight-or-flight reaction.

ASD is more serious and typically occurs in the first month after a person experiences trauma. This is similar to PTSD, but a person cannot have a diagnosis of PTSD until they have experienced symptoms for longer than a month.

Stress can also be episodic, which means a person experiences it over a long time but inconsistently. They experience stressful periods and periods with less or no stress. In comparison, chronic stress is what a person experiences continuously throughout their life to the point where feeling stressed becomes a normal state of being.

Managing stress

Chronic stress can seem overwhelming, and a person may feel unable to regain control over their life.

However, a number of strategies can help to reduce its levels and improve well-being.

Some methods for managing it include

• Understanding the signs and symptoms. These indications vary, but if a person can recognize their own signals of stress, they will be better able to manage them.
• Speaking to friends and family. They can provide emotional support and the motivation to take action.
• Identifying triggers. It is not always possible to avoid triggers. However, taking note of specific triggers can help a person to develop coping and management strategies, which may involve reducing exposure.
• Exercising regularly. Physical activity increases the body’s production of endorphins, which are chemicals that boost mood and reduce stress. Exercise can involve walking, cycling, running, working out, or playing sports.
• Trying mindfulness. People who practice this form of meditation use breathing and thinking techniques to create an awareness of their bodies and surroundings. Research suggests that mindfulness can have a positive impact on stress, anxiety, and depression.
• Improving sleep quality. Getting too little sleep or sleep of poor quality can contribute to stress. Try to get at least 7 hours every night, and set regular times for going to sleep and waking up. Avoid caffeine, eating, and intense physical activity in the hours before bed.

It can also help to unwind before sleeping by listening to music, reading a book, taking a warm bath, or meditating.

When to see a doctor

Do not try to deal with chronic stress alone. If self-help strategies are not working, a doctor can provide support and advice about treatment options. They can also refer a person to a more specialized healthcare provider, such as a psychologist or psychiatrist.

Anyone feeling overwhelmed by stress should see a doctor as soon as possible, especially if they are having suicidal thoughts or using drugs or alcohol to cope.

Recovery

Strategies to recover from chronic stress can include practicing mindfulness activities such as meditation and breathing exercises. People can also have a support system composed of family and friends, as well as a counselor or a psychiatrist if needed.

A psychiatrist can prescribe medication to reduce stress. A counselor can help a person explore the causes of their stress in order to recognize them and find a healthy coping mechanism. The earlier a person seeks help or treatment, the quicker their recovery may be.

Takeaway

Stress is a regular part of daily life. Short-lived stress is generally harmless, but when it lasts and becomes chronic, it can cause a range of symptoms. It can also contribute to the development of physical and mental disorders.

Self-help techniques include identifying triggers, developing coping and avoidance strategies, reaching out to friends and family, and practicing mindfulness.

If these techniques are not working, or if stress is becoming overwhelming, a person should speak to a healthcare professional.

How we reviewed this article

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