Chronic Stress: Recognise, Respond, Recover

Stress is a natural phenomenon in response to perceived challenges or threats. It is a physiological and psychological response. Stress can be a motivator but chronic and unmanaged stress is increasingly recognised as a major public health concern. Stress is, in fact, an unavoidable part of life. Pressures such as those from work, relationships, and financial uncertainty converge with additional societal factors that exacerbate stress.  However, its effect on physical, mental and spiritual health is far-reaching and often misunderstood. 

Whenever there is a need for adjustment or reaction, our body responds with stress. It is often initiated with both positive and negative circumstances. If it of short-term, acute in nature, and can be beneficial in certain situations, enhancing performance and focus. On the other hand, when stress becomes chronic, it can lead to a cascade of negative health issues. The body remains in a constant state of 'fight or flight or forget,' which elevates stress hormones such as cortisol and adrenaline, which can have damaging effects over time.

Risk of hypertension

Chronic stress not only weakens several bodily functions but also has been linked to several major health conditions. It may cause high blood pressure, increased heart rate, and inflammation. Over the period, these conditions lead to the risk of hypertension, heart attacks, and strokes. Unhealthy habits such as smoking, overeating, and physical inactivity happen to people under continuous stress, which further exacerbate the risk of heart disease. Unmanaged chronic stress suppresses the immune system, making us more susceptible to infections and slowing the healing mechanism. Chronic stress not only suppresses the immune response but also worsens autoimmune conditions like lupus or rheumatoid arthritis. 

The GIT and brain are closely linked. Stress can cause or exacerbate conditions like irritable bowel syndrome (IBS), ulcers, acid reflux, and inflammatory bowel diseases. Stress is a major contributor to insomnia, in addition to sleep disorders. Sleep disorders impair memory, emotional well-being, and physical healing, creating a vicious cycle that exacerbates stress. Elevated levels of stress hormone, i.e., cortisol, are associated with increased abdominal fat, unhealthy food longings, and insulin resistance, which raise the risk of obesity and type 2 diabetes.

The psychological consequences of stress are enormous. Chronic stress reduces levels of neurotransmitters such as serotonin and dopamine involved in mood regulation, leading to anxiety, depression, and emotional instability. This is mostly seen among professionals whose work demands heavily and are constantly exposed to stress without sufficient time for recovery. Those individuals experience symptoms such as emotional exhaustion, reduced performance, and depersonalisation. Stress also impairs concentration and the decision-making process. 

Chronic stress can lead to long-term cognitive decline and increase the risk of neurodegenerative diseases like Alzheimer’s. Hence, those individuals turn to alcohol, nicotine, or other substances to cope with stress that may provide temporary relief but ultimately harm physical and mental health. Major stressors such as academic pressures, peer relationships, and social media exposure are linked to chronic stress. The risk of mental health disorders in adulthood increases among those experiencing prolonged stress in childhood.

 Adults who are under chronic stress due to work-life imbalance, financial difficulties, and even unpaid careers suffer both in terms of physical health and productivity. Loneliness, loss of loved ones, and declining physical health contribute to stress in older adults, exacerbating conditions like heart disease and depression. In countries like Nepal, social, economic, and political stressors are ubiquitous. At the same time, several stressors such as poverty, unemployment, social discrimination, and natural disasters contribute to widespread chronic stress, especially among vulnerable and marginalized communities. 

Mental health awareness is still inadequate, and stigma prevents many from seeking support. Therefore, the healthcare system of the country must recognise stress-related illnesses and provide holistic care, including mental health services. Beyond the individual, stress carries significant economic and societal costs to the country. Loss of productivity due to stress-related illnesses, absenteeism, and increased healthcare expenditures burdens families and national health care systems. According to the World Health Organisation, stress and mental health issues are projected to be among the leading causes of disability worldwide by 2030. Therefore, investing in stress management is not just a personal responsibility but a public health priority.

Personal effort and societal support are both necessary to tackle stress. Physical activity not only boosts endorphins but also reduces cortisol levels. Similarly, a balanced diet provides the nutrients essential for ideal brain function. At the same time, adequate restful sleep is essential for emotional regulation and physical health. Therefore, it is essential to practice meditation, yoga, and deep breathing to calm the nervous system.

Emotional buffering

Another often neglected aspect of life, such as spending time in nature and engaging in hobbies, can also reduce stress levels. For emotional buffering, connecting with family and friends is important. The burden of internalised stress can be reduced by talking to someone trusted. Psychotherapy, especially cognitive behavioral therapy (CBT), is effective in helping people cope with chronic stress. In severe cases, medications such as antidepressants or anxiolytics may be prescribed.

Employers must promote mental well-being through stress-reducing strategies, flexible work hours, and access to counseling services. Stress is an inevitable part of life, but its effects on health are profound and often overlooked and underestimated. From heart disease and digestive disorders to anxiety and cognitive decline, stress can quietly erode the foundation of well-being. In a rapidly changing world, recognizing the importance of stress management is essential for both individual health and public policy. 

(Dr. Lohani is the executive director at the Health Concern. lohanis@gmail.com.)