What is Stress?

Written By

Dr. Azhar Qureshi


Fact Checked

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Key insights

  • Stress is a normal and even useful reaction, but excessive or prolonged stress becomes harmful to physical and mental health.
  • Chronic stress leads to increased risk for conditions like heart disease, anxiety, depression, burnout, and cognitive decline via impacts on nervous, endocrine, and immune systems.
  • Stress affects people across ages and professions, but socioeconomic and cultural factors influence vulnerability versus resilience to stress.
  • Stress management requires a multidimensional approach, including lifestyle changes, social support, cognitive restructuring techniques, and professional counseling when needed.


  • 77% of people frequently have physical symptoms caused by stress, such as headaches, fatigue, muscle tension, and stomach upset.
  • Chronic stress contributes to 6 of the major causes of death – heart disease, cancer, lung ailments, accidents, cirrhosis, and suicide.
  • 80% of workers feel stress on the job, with 42% reporting that they need help in managing stress.
  • A survey found that 43% of respondents feared negative repercussions at work if they disclosed a mental health issue to their employer.

Stress is a state of mental or emotional strain or tension resulting from demanding circumstances. It is a normal reaction to life’s challenges. 

It can be beneficial in small doses by helping us perform under pressure. However, when stress becomes excessive or prolonged, it can have detrimental effects on both physical and mental health.

Historical perspective on stress

The concept of stress originated in the field of engineering, where it referred to the strain or pressure placed on a physical structure. In the 1930s, endocrinologist Hans Selye adopted the term to describe the body’s physiological response to threats or demands.

He noted that patients with different ailments often exhibited similar symptoms like fatigue, loss of appetite, and hypertension. Selye theorized these represented a non-specific "stress response" of the body.

In the 1950s, stress came to be associated with neurotic tendencies or maladaptive coping. The theory was that certain personality types were more prone to “break down” under pressure. This notion shifted in the 1960s-70s as it became evident stress could affect anyone. 

  • Researchers began looking at stress in the context of significant life changes and daily hassles. The biopsychosocial model emerged, recognizing the interplay of biological, psychological, and social factors.
  • By the 1980s, stress management was an established field with relaxation techniques, cognitive therapies, and holistic approaches.

Research today continues to uncover the complex neuroendocrine, immunological, and genetic mechanisms underlying the stress response. There is greater awareness of individual differences in stress perception and vulnerability.

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Physiology of stress

When we encounter a threat or demand, the body initiates a cascade of physiological responses and changes collectively known as the “stress response.” This involves activating the sympathetic nervous system and releasing stress hormones, including adrenaline, noradrenaline, and cortisol.

The Sympathetic Nervous System

The sympathetic nervous system controls the “fight or flight” response. When activated, it:

  • Increases heart rate and blood pressure
  • Redirects blood flow to muscles, lungs, and brain
  • Dilates pupils
  • Slows digestion
  • Triggers release of glucose for quick energy

This prepares the body for perceived threat.

Stress Hormones

The main stress hormones include:

  • Adrenaline – Released by the adrenal glands, it increases heart rate, elevates blood pressure, and boosts energy supplies.
  • Noradrenaline – Also released by the adrenal glands, it increases brain activity and alertness.
  • Cortisol – Released by the adrenal cortex, it suppresses the immune system and some other functions not needed for immediate survival.

These changes provide rapid mobilization of mental and physical resources to deal with challenging or threatening situations in the short term.

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Types of stressors

Stress can be triggered by a variety of stressors, including:

  • Life Stressors

Major life events like relationship issues, financial problems, family conflicts, divorce, death of a loved one, moving houses, etc. These tend to have a long-lasting impact on stress levels.

  • Workplace Stressors

Job concerns like high workload demands, long hours, lack of work-life balance, conflicts with boss/colleagues, lack of job security, etc. Workplace stress is one of the leading causes of stress.

Stress from social situations like giving presentations, meetings, events, tests, competitions, poor social relations, social rejection, or exclusion. Social evaluation is a common trigger.

  • Daily Hassles

Minor irritations like traffic jams, arguments, workplace politics, misplacing keys or documents, technology glitches, etc. Daily aggravations build up over time.

Any traumatic event like natural disasters, accidents, assault, abuse, violence, etc. These can have a severe impact on stress levels and last for years. Seeking counseling is recommended.

  • Health Stressors

Chronic health problems, terminal diagnoses, or pain conditions. Coping with illness is challenging physically and emotionally.

  • Environmental Stressors

Noise pollution, overcrowding, traffic, extreme temperatures, etc., create constant low-grade stress that builds up over time.

woman looking at laptop and biting a pencil looking very stressed

How stress affects the body

While acute stress can be adaptive in the short term, chronic stress can lead to:

Physical Effects

  • Headaches, muscle tension, stomach problems
  • Elevated heart rate, hypertension, high cholesterol
  • Fatigue, insomnia, lowered immunity

Psychological Effects

  • Anxiety, depression, moodiness, irritability
  • Reduced ability to focus and concentrate
  • Negative thought patterns like catastrophizing

Behavioral Effects

  • Changes in eating patterns, including overeating or undereating
  • Increased alcohol, tobacco, or drug use
  • Withdrawing from social contact and relationships
If left unchecked, chronic stress can contribute to long-term health issues like heart disease, diabetes, gastrointestinal disorders, asthma, obesity, cancer, accelerated aging, and cognitive decline.

Measuring stress levels

There are several ways to gauge your current stress levels, including:

  • Stress scales – Standardized questionnaires that measure stressors and symptoms. Examples: Perceived Stress Scale, Depression Anxiety Stress Scale.
  • Stress diaries – Recording daily stressors and your response to them.
  • Biosensors – Wearables that track heart rate variability, sleep, etc., as stress indicators.
  • Blood tests – Measuring stress hormone levels like cortisol and adrenaline.
  • Saliva testing – Analysis of salivary biomarkers like cortisol provides a non-invasive option.
  • Heart rate monitors – Fitness trackers detect heart rate patterns suggestive of high stress.
  • Mobile apps – Apps that aggregate data from smartphones and wearables to calculate personalized stress scores.

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Stress management techniques

Chronic stress requires active management using healthy coping strategies:

Relaxation Techniques

  • Deep breathing – Consciously slowing the rate of breathing activates the relaxation response.
  • Progressive muscle relaxation – Systematically tensing and releasing muscles to relieve tension.
  • Guided imagery – Visualizing peaceful scenes reduces stress hormone levels.
  • Meditation – Quieting the mind and focusing on awareness promotes calm.

Physical Activity

  • Exercise – Working out stimulates mood-enhancing endorphins and manages cortisol.
  • Yoga – Poses, breathwork, and meditation improve mind-body awareness and resilience.
  • Tai Chi – Its flowing movements and mindfulness help reduce anxiety.


  • Good sleep habits – Getting 7-9 hours of quality sleep daily to manage stress.
  • Healthy diet – Eating more fruits, vegetables, and whole grains maintains energy and mood.
  • Massage – Kneading muscles soothe the body and relieve pent-up tension.
  • Nature time – Spending time outdoors has a calming, therapeutic effect.

Social Connection

  • Talk therapy – Confiding in trusted friends/family provides emotional release.
  • Support groups – Relating with others facing similar challenges reduces isolation.
  • Volunteering – Contributing service promotes empathy, purpose, and resilience.

Time Management

  • Prioritizing – Focusing on high-value tasks avoids stress from disorganization.
  • Delegation – Appropriately handing off tasks provides workload relief.
  • Scheduling breaks – Regular short breaks help recharge mental focus and energy.

Cognitive Strategies

  • Reframing issues – Adopting a new perspective helps reevaluate stressors.
  • Practicing gratitude – Focusing on blessings lowers reactivity to triggers.
  • Acceptance – Letting go of trying to control the uncontrollable eases anxiety.

When to seek professional help

Consult a doctor or mental health specialist promptly if stress becomes unmanageable or you experience:

  • Panic attacks, anxiety requiring medication, or suicidal thoughts
  • Persistent sadness, hopelessness, uncontrolled anger
  • Alcohol or substance dependency as a coping mechanism
  • High baseline stress unresponsive to lifestyle changes
  • Stress-related chronic conditions like insomnia or ulcers
With professional guidance and commitment to healthy habits, most people can successfully manage their stress levels. The key is awareness and being proactive.

Impact of stress on physical health

Stress exerts wide-ranging effects on physical health since prolonged activation of the sympathetic nervous system and stress hormones can tax the body. Some key impacts include:

  • Hypertension – Chronic stress elevates blood pressure, which can lead to strokes or heart attacks. Stress management is an essential component of treatment.
  • Heart disease – Stress contributes to arteriosclerosis or hardening of arteries by accelerating fatty deposits. It also raises heart rate and blood pressure, which strains the cardiovascular system.
  • Diabetes – Stress worsens insulin resistance and complicates glycemic control, increasing the risk of diabetic complications. Relaxation response helps manage stress-related fluctuations in blood sugar.
  • Obesity – Stress-triggered eating and fat accumulation around the midsection are linked to metabolic disorders. Coping skills are needed to prevent stress eating.
  • Headaches – Tension headaches are exacerbated by stress-induced muscle tightening. Migraines are influenced by stress hormone changes. Relaxation techniques provide relief.
  • Sleep issues – Stress makes it hard to fall asleep and stay asleep. Lack of restorative sleep in itself becomes a stressor. Stress reduction is critical to restoring sleep quality.
  • Lowered immunity – Chronic stress suppresses immune cell functions, making us more infection-prone. Reducing stress boosts immunity and speeds healing.
  • Gastrointestinal issues – Stress aggravates symptoms of irritable bowel syndrome and ulcers by altering the gut microbiome, motility, and acid secretion. Stress management helps control flare-ups.
  • Reproductive problems – Stress interferes with reproductive hormone signaling and can inhibit fertility and sexual function. Counseling helps couples manage infertility stress.

Impact of stress on mental health

Studies clearly demonstrate that chronic stress is linked to:

  • Depression – Elevated cortisol, low serotonin, and neuroinflammation created by stress can trigger depressive episodes, especially in those with predisposition. Stress management boosts mood.
  • Anxiety – Stress induces worry, panic, and phobias by heightening activity in brain fear circuits. Relaxation techniques calm over-arousal. Cognitive behavioral therapy helps change thought patterns.
  • PTSD – Severely traumatic events lead to flashbacks, hypervigilance, and avoidance. Therapy with mindfulness training can ease PTSD.
  • Burnout – Ongoing emotional exhaustion, cynicism, and low sense of accomplishment related to chronic workplace stress. Requires changing job conditions and stress coping habits.
  • Cognitive decline – Chronic stress impairs learning, memory, and decision-making by altering brain structure. Stress reduction may help delay dementia.
  • Eating disorders – Stress coupled with distorted body image drives patterns like bingeing, overeating, purging, or excessive restriction. Counseling is needed to manage underlying emotional issues.
  • Addiction relapse – Stress lowers impulse control and triggers substance use as a coping mechanism. Boosting healthy self-care and social support systems prevents relapse due to stress.

Sociocultural dimensions of stress

The experience of stress is partly influenced by social and cultural factors like:

  • Marginalization – Minority groups and disadvantaged populations face more tremendous systemic stress from discrimination, racism, poverty, stigma, lack of opportunities, etc.
  • Gender norms – Women report higher stress from juggling multiple roles – career, family, and household duties. Expectations of self-reliance make men less likely to seek support.
  • Work cultures – High-pressure jobs like finance, medicine, etc. emphasize success at all costs. Taking time off is taboo. This promotes toxic stress levels.
  • Stoicism – In some cultures, openly communicating emotional struggles is discouraged. This can isolate people coping with high stress.
  • Access barriers – Stigma around mental health issues or lack of affordable counseling prevents stress treatment. Rural populations also have less access.
  • Awareness gaps – Many still view stress as a personal failing rather than understanding its systemic drivers. This causes people to internalize blame.

Addressing these socioeconomic and cultural barriers is key to making stress support services accessible to all.

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Stress across different age groups

The sources of and ability to handle stress vary across different life stages:

Stress in childhood

  • Stressors include school pressures, academic failure, turbulent home environment, poverty, trauma, or child abuse.
  • Excessive childhood stress negatively impacts brain development and has lifelong effects on learning, behavior, and physical and mental health.
  • Young children especially need stable caregiving to build healthy stress response capacity.

Stress in adolescence

  • Adolescents experience physical and hormonal changes, peer pressure, emerging autonomy, dating, identity issues, etc.
  • Stress management education should be part of the high school curriculum to help build coping skills.
  • Access to counseling without parental consent is crucial for teenagers in dysfunctional homes.

Stress in young adults

  • Everyday stressors are college pressures, career anxiety, financial struggles, partner conflicts, loneliness, etc.
  • Young adults need affordable mental health support services and a culture that allows them to ask for help without stigma.

Stress in middle adulthood

  • Work-life balance challenges, marital discord, parenting demands, mid-life crises, and caring for aging parents all build up.
  • Strong social connections and healthy stress relief habits in earlier life protect against burnout.

Stress in older adults

  • Stressors include health problems, grief, financial insecurity, declining social circles, and fears about mortality.
  • Remaining active, developing interests, connecting with younger people, and managing limitations are important.

Future of stress treatment

Ongoing research continues to provide greater insight into the biological pathways and health impacts of stress. Key areas being studied include:

  • Use of functional MRI scans to map stress-related changes in brain activity and structure.
  • Understanding the role of inflammation and oxidative stress in generating chronic conditions.
  • Linking dysregulation in neuroendocrine, nervous, and immune systems to disease states.
  • Mapping how maternal stress affects fetal neurodevelopment and child outcomes.
  • Linking genetics, epigenetics, and early life adversity to stress resilience or vulnerability.
  • Microbiome changes induced by stress and impact on mental health.

Exciting new interventions are also being developed, including:

  • Real-time biofeedback training using wearables to help individuals recognize and self-regulate stress arousal.
  • Virtual reality nature simulation for immersive relaxation therapy at healthcare facilities.
  • Online and app-based stress management programs to improve access and convenience.
  • Tailored cognitive behavioral therapy programs delivered through AI chatbots.
  • Biomarker-based personalized recommendations on stress reduction lifestyle habits.

With greater knowledge and innovations, the future looks hopeful for tackling the global burden of stress and related health problems.

Impact of stress on work performance

Stress affects multiple aspects of job performance and workplace well-being. Some key effects include:

  • Reduced efficiency and productivity due to poor focus, multitasking difficulties, fatigue, and forgetfulness under stress. This lowers work output.
  • Poorer work quality as highly stressed employees have less motivation for careful, thoughtful effort and creative problem-solving.
  • Increased errors and safety risks due to stress impairing concentration and judgment. This can be highly dangerous in high-risk professions.
  • Absenteeism goes up as stress-related mental health issues or physical complaints lead to increased sick leaves.
  • Higher turnover as burned-out employees constantly change jobs seeking less stressful work. This loss of experienced staff is disruptive.
  • Interpersonal friction increases when stressed individuals become irritable, impatient, and defensive, harming team dynamics.
  • Lack of engagement as stressed, cynical employees disengage from workplace initiatives and avoid risks or innovation.

Prolonged stress changes workplace behavior and thought patterns. Organizations should implement stress audits and management programs to identify and address stressors and provide support resources. Promoting work-life balance and a positive culture enables productivity.

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Stress management therapies

Many interventions are effective in managing stress:

Lifestyle changes: Adopting healthy habits provides resilience. Exercise releases endorphins that boost mood, while yoga and meditation build calmness. Relaxing leisure activities lower stress hormone levels. Getting enough sleep prevents fatigue buildup. Eating a balanced diet and avoiding excess caffeine maintains steady energy. Pacing oneself and taking breaks is vital.

Time management skills: Prioritizing important tasks, breaking them into smaller steps, and scheduling focused work blocks reduces feeling overwhelmed. Delegating when possible prevents work overload.

Cognitive techniques: Reframing thoughts from negative to positive helps change perspective on stressors. Practicing mindfulness and staying grounded in the present eases anxiety about future uncertainties. Focusing on gratitude counters negativity bias.

Assertiveness training:

  • Setting clear expectations and boundaries.
  • Saying no when needed.
  • Communicating feelings directly avoids the buildup of stress from unaddressed issues.

Support networks: Confiding in trusted friends and family provides an emotional release. Support groups connect people facing similar challenges. Support fosters resilience.

Professional counseling: Therapists can help uncover and resolve sources of excessive stress like childhood trauma, depression, or self-esteem issues through counseling techniques like CBT. Medication may be prescribed for severe anxiety or grief. Stress management workshops can also train employees in effective coping techniques.

Starting stress management early provides the best results rather than waiting for severe impacts from unrelieved stress. A multifaceted approach covering lifestyle thought patterns and addressing underlying issues helps build lasting resilience.

Stress-related occupations and protective factors

Certain professions tend to have a higher risk of work-related stress due to heavy demands and pressures:

  • Healthcare – Long hours, life and death stakes, and dealing with trauma make physicians and nurses prone to exhaustion and burnout. Rotation schedules disrupt circadian rhythms, adding fatigue.
  • Emergency responders – First responders witness tragedy firsthand. Repeated exposure to violence and human suffering can trigger PTSD. Rotating shift work is also challenging. Counseling and peer support are needed.
  • Teaching – Heavy workloads, student behavioral issues, and parental demands contribute to teacher stress. Lack of support staff and resources strain coping ability.
  • Social work – Child protection workers deal with trauma cases and high-stakes decisions with limited resources. Vicarious trauma is common. Supervision prevents isolation.
  • Law enforcement – Danger, bureaucratic pressures, and public mistrust of police create chronic stress. Younger and female officers tend to report higher stress.

However, some protective practices can help mitigate risks:

  • Clear organizational policies and standards on work hours, caseloads, and management support.
  • Peer team model to share burdens. Buddies identify signs of stress and provide respite.
  • Rotating high-stress assignments with low-stress ones. Mixing up work provides peace.
  • Mandatory stress management training for coping skills and resilience.
  • Access to counseling and mental health support without stigma.

With proper organizational safeguards and a culture that encourages self-care, fulfilling careers are possible even in high-stress fields.

Wrap up

Stress is the body and mind’s reaction to demanding situations that disrupt equilibrium. While some pressures keep us motivated, excessive or prolonged stress can be harmful mentally and physically.

Self-care practices like relaxation, exercise, social connection, and coping skills can help relieve stress. Seeking counseling for underlying issues or mental health conditions is advised when stress feels overwhelming. With proper support, stress can be managed effectively.


  1. VeryWellMind, What is Stress? https://www.verywellmind.com/stress-and-health-3145086
  2. The effects of chronic stress on health: new insights into the molecular mechanisms of brain–body communication. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5137920/
  3. Sociocultural factors, resilience, and coping: Support for a culturally sensitive measure of resilience. https://www.sciencedirect.com/science/article/abs/pii/S0193397308000063
  4. 9 Ways to Cope With Work Stress and Avoid Burnout. https://www.verywellmind.com/how-to-deal-with-stress-at-work-3145273
  5. Everything You Need To Know About Stress. https://www.mcleanhospital.org/essential/stress
  6. SLMA, The Science of STRESS. https://www.slma.cc/the-science-of-stress
  7. American Institute of Stress, Workplace Stress. https://www.stress.org/workplace-stress
  8. APA, 2023 Work in America Survey. https://www.apa.org/pubs/reports/work-in-america/2023-workplace-health-well-being
  9. NIH, Hans Selye (1907–1982): Founder of the stress theory. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5915631
  10. Stress & Health, Physiopedia. https://www.physio-pedia.com/Stress_and_Health
  11. NIH, Physiology, Stress Reaction. https://www.ncbi.nlm.nih.gov/books/NBK541120
  12. How are social stressors at work related to well-being and health? A systematic review and meta-analysis. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-10894-7
  13. Columbia University, Chronic Stress Can Hurt Your Overall Health. https://www.columbiadoctors.org/news/chronic-stress-can-hurt-your-overall-health
  14. https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037. https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037
  15. Health.gov, Manage Stress. https://health.gov/myhealthfinder/health-conditions/heart-health/manage-stress
  16. NIH, Stress and hormones. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3079864/
  17. Harvard Health, Why stress causes people to overeat. https://www.health.harvard.edu/staying-healthy/why-stress-causes-people-to-overeat
  18. Mayo Clinic, Biofeedback. https://www.mayoclinic.org/tests-procedures/biofeedback/about/pac-20384664
  19. Mayo Clinic stress definition: https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037
  20. AHA recommendations on exercise: https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults
  21. Harvard Health stress interventions: https://www.health.harvard.edu/mind-and-mood/six-relaxation-techniques-to-reduce-stress
  22. Chatbot-Delivered Cognitive Behavioral Therapy in Adolescents With Depression and Anxiety During the COVID-19 Pandemic: Feasibility and Acceptability Study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9683529/

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About the author

Dr. Azhar Qureshi

Dr. Azhar Qureshi

As a physician and cardiologist, my training encompassed a comprehensive range of invasive and noninvasive procedures, providing extensive hands-on experience in echocardiography, cardiac stress testing, diagnostic catheterization, and coronary interventions. In addition, I developed skills in psychological assessments and formulating detailed case reports. This multifaceted training has equipped me with a strong foundation across cardiology, psychological studies, and documentation to support my medical research. I am passionate about medical writing and exchanging knowledge to help the global community. Social

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