Stress: When does it turn into an illness?


This is a two-part series about stress. Part One is psychoeducational, aiming to help you understand and identify how YOU stress and how it affects you. The second part – the be published in the next weeks – will address how you can stay well and balanced, so stress is not an overwhelming dominant factor in your life.

Stress can turn into illness
Photo by StockSnap on Pixabay

Combating Stress, Part One

As a clinical psychologist, I see a lot of people who struggle with feeling stressed; this is not surprising. A recent large-scale UK study found that 74% of participants “felt so stressed they have been overwhelmed or unable to cope.” Of these, 51% felt depressed and 61% experienced anxiety. That’s a lot of people struggling! So many, in fact, that it has become quite the norm to feel stressed.

We almost accept that our daily lives will be so fraught that we feel exhausted and overwhelmed. This is not OK. You can see from the statistics that it is causing widespread distress. In the long term, this will have negative consequences for our psychological and physical health, severely impairing quality of life.

I wanted to write this article now because I am aware that many of you may have recently returned from holidaying over the summer; I am hopeful you were able to re-energise during your time away.

Going back to work, and the daily routine of juggling work, social and family life, is not easy. It is typical for there to be a week or two of adjustment while you get back into the swing of things. You may feel a bit down and a bit irritable while you find your feet, which is normal – we call this the post-holiday blues – and usually things will settle. What I am keen to address is how you can identify your stress levels and keep in mind staying well and balanced off the back of returning to your routine.

It’s all too easy to fall back into habits of stretching yourselves too thin to meet others’ needs or demands, and/or to prioritise action and busyness over rest. These pressures are what cause us to feel stressed and depleted.

Firstly then, the concept of stress. Stress is familiar to everyone, and in terms of well-being topics that have been discussed and written about, it is a well-trodden path. As I said, it has become a normal feature in our daily lives. This can have the effect of obscuring our views of what stress means for us personally and minimising the impact that it has. It is a word that gets used a lot as well, sometimes in a flippant way, sometimes not; this also serves to give us a confusing message about its significance.

Let’s start by unpacking this word so you can consider what kind of stress you experience.

The American Psychological Association (APA) identifies three different types of stress: acute stress, episodic acute stress and chronic stress. Each has its own characteristics, symptoms and duration.

Acute stress is regarded as the most common, and derives from pressures related to recent past and anticipated future demands. It can feel thrilling in small doses, but in excess it can be exhausting.

An example might be doing an extreme sport such as surfing or skiing. At the start of the day, a fast run or big wave is exhilarating. By the end of the day, it is tiring, and if you push too hard, it can leave you vulnerable to injury.

That hurt.
That hurt. (Public domain photo)

In our day-to-day lives, acute stress manifests itself in events that have gone awry or are challenging now and again – for example, rushing to meet deadlines, managing a child’s problems with school or a minor car accident that resulted in a broken tail light.

With acute stress, people have a greater awareness of it because they feel different to how they normally feel, both physically and emotionally. As such, these symptoms may not seem so significant, because they do not last for a long time.

So, symptoms are TRANSIENT. They include emotional symptoms (anger, irritability, anxiety, depression), muscular symptoms (headache, back pain, jaw pain, tensions leading to pulled muscles and ligament and tendon problems), and stomach, gut and bowel problems. Symptoms of being in a heightened state of arousal can cause increased blood pressure and heartbeat, heart palpitations, dizziness, migraines, cold hands and feet, shortness of breath and chest pain.

Our bodies are designed to tolerate acute stress pretty well; it is something humans have, to varying degrees, a resilience for.

The survival of the human race is partly due to the important emotional and physiological processes associated with stress. As mammals out in the wild, when under threat we would either freeze, run away or fight in the effort to survive. We still have this useful response – the problem is, when you are stressed, your mind and body don’t distinguish between a lion attack or a project deadline; the response is the same, and it’s a big emotional and physiological effort for your body to process. Which is OK, now and again.

It is when stress becomes more frequent, the symptoms more ongoing rather than transient, that it is problematic.

Those experiencing acute stress more often seem to be reeling from one crisis to the next. This is episodic acute stress, and happens when people take on too much, over-committing to projects or activities then struggling to organise the many self-inflicted demands on their time and energy. In other words, they are in a constant state of acute stress. For this group of people, feeling short-tempered and irritable is typical. This irritability can be perceived by some as hostility, making relationships complicated when others respond with real hostility.

Episodic acute stress is also experienced by those who are “worriers” – they forecast “catastrophe” in most situations and believe that something awful is always going to happen.

Lifestyle and personality factors with individuals suffering from this more prolonged stress are so embedded and habitual that it can be difficult for them to identify that they are indeed stressed.

How they respond to the situations and environments they find themselves in – and their patterns of interacting with people – in their minds represents who they are.

A recent production of the opera Carmen, at the Salzburger Festspiele.
Opera performance – “Salzburger Festspiele 2012 – Carmen” by Luigi Caputo – Salzburger Festspiele. Licensed under CC BY 3.0 via Wikimedia Commons.

These problems become more relevant for those experiencing chronic stress. Chronic stress is the relentless stress that wears people away over many years. It’s the stress of poverty, dysfunctional families or being trapped in an unhappy marriage or despised job. It’s the stress that people cannot see a way out of it, and where people feel hopeless.

Because the situation has prevailed for so long, people get used to it, and this might also mean it has had a profound effect on their personality.

Negative beliefs about themselves, their situation, the world and other people may be so deeply ingrained that, again, it seems like being a stressed person is just part of their identity. The way they feel is familiar and normal to them, so it is difficult to notice that it is unhealthy.

Episodic-acute stress and chronic stress can have similar outcomes. Because when people are no longer able to identify that they are stressed, and consider it is part of who they are, the idea of seeking help to make changes to improve emotional and physical well-being may be not be considered.

What is important here though – and should serve as motivation for changing how to respond and behave when situations seem stressful – is that this perpetual state of being on high alert and/or feeling fearful takes its toll. Prolonged arousal and tension lead to more serious health problems.

Anxiety and depression – as well as hypertension, migraines, heart disease and chest pain – are evident in those living with episodic acute stress. The health implications for chronic stress are similar but can be more severe.

This is because prolonged stress has a significant impact on the immune system, making it much less resilient in the face of serious illness and disease, such as cancer and autoimmune conditions.

Not surprisingly, burnout is also a risk for this group. This is not new science. The evidence base for it is strong.

Do you identify with any of these types of stress? Has one always been more dominant or has one type become more dominant than the other?

It is not uncommon to oscillate between acute and episodic acute stress, but when you are moving towards chronic stress, this is problematic in many ways. It is important that you notice how you feel, give stress the attention it deserves and, in so doing, give yourself the respect you deserve. Humans are not designed to be constantly stressed. It is necessary and fair to give yourself the opportunity to feel well and to thrive, not just survive.

The first steps involve thinking and planning how to change aspects of your lifestyle and your ways of interacting with others and the world. If this seems like a daunting task, then please seek support from friends, family or a professional.

Guide to emergencies and doctors
Public domain image

If you knew a friend or family member was struggling with ongoing stress, how would you regard them? What would you say to support them? One important step in changing things and giving yourself a break, is to direct that empathy and those comforting words towards yourself.

Having compassion for your mind and body is important – look after them.

Humans are resilient and amazing and, wonderfully, you can change and heal a stressed system. It just requires the right conditions, but the process needs YOU to take steps to provide those conditions. You don’t have to do it alone; support is out there if you need it.

By Dr. Lucy Tinning

Lucy Tinning
Dr. Lucy Tinning

Dr. Lucy Tinning is a UK-trained clinical psychologist, based at The Garden Practice in Leipzig. She provides psychological therapy to adults in English. She is registered with the UK Health Care Professions Council and the European Federation of Psychologists, and is a chartered member of the British Psychological Society. She is trained in EMDR and is a member of EMDR Europe. She has a social media presence on Instagram (@drlucytinning) and on Facebook.

A Global Studies doctoral degree holder and former newspaper reporter, avid eater, pseudo-philosopher and poet, occasion-propelled singer, semi-professional socializer, movie addict, Brazilian-American nomad. In this space, she will share some of her experiences and (mis)adventures regarding various topics, with special attention to social issues.

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