Chronic stress

Are you ​constantly feeling tired? Having trouble concentrating and remembering things? Not sleeping well? These may be symptoms of chronic stress. I’ll often have people coming to see me because they are not sleeping well and have been focusing on fixing their sleep. But they may not have been paying attention to managing their stress. Sleep is a mirror of your day, so if your day is full of busyness and stress without a break, you should expect your night to mirror that. 

What is chronic stress?

Situations like looming work deadlines, worrying about losing a job, relationship problems, exams, or other stressful situations can trigger stress hormones that produce well-orchestrated physiological changes.

Any stressful incident can make your heart pound, breathing faster and more shallow, muscles tense and create beads of sweat. This combination of reactions to stress is also known as the “fight-or-flight” response because it evolved as a survival mechanism, enabling people to react quickly to life-threatening situations.

Over the years, researchers have learned not only how and why these reactions occur but have also gained insight into the long-term effects chronic stress has on physical and psychological health. According to experts, chronic stress contributes to high blood pressure, promotes the formation of artery-clogging deposits, and causes brain changes that may contribute to anxiety, depression, and addiction. Chronic stress may also contribute to obesity, both through direct mechanisms or indirectly.

Stress is a biological response to demanding situations. It causes the body to release hormones, such as cortisol and adrenaline. The physical effects of acute stress, such as an unexpected fright, usually do not last long. However, many people find themselves in a near constant state of heightened alertness. This results in chronic stress, which causes ongoing symptoms for weeks or months.

Chronic stress is different from front of mind worries. These can be settled quickly with a relaxation exercise or meditation to ‘clear your mind’. Chronic stress takes weeks or months to gradually build up, so it also takes weeks to gradually settle. 

Stress can be good: to a point

Not all stress is bad. We all like that feeling of nervous energy, being busy, productive, and feeling like we’re getting things done. But there’s a fine line between feeling energetic and doing too much and which then leads to a drop in performance. The stress-performance curve (below) demonstrates this nicely, with increasing performance to a point but then performance worsening as stress increases.

For a more detailed discussion of the stress performance curve and the impact on sleep check out this video.

How does chronic stress differ from anxiety?

We all experience both stress and anxiety at some point in our lives. Depending on the severity level, both stress and anxiety can detrimentally impact one’s quality of life. 

Stress: is a normal physiological response to our environment or behaviour. If we are in a situation where we are under threat, there is a physiological stress response that is triggered. But the threats don’t have to be physical threats, in fact, the threats in our modern world are more psychological:

• the threat of not getting everything done or our project complete on time
• the threat of not doing something as well as we wanted to – perfectly rather than ‘good enough’
• the threat of failing to meet high expectations we place upon ourselves

Anxiety: Think of anxiety as the excessive worries that don’t go away even in the absence of a stressful situation that lead to a nearly identical physiological response and set of symptoms as stress:

• Thinking about how we could have done a better job of something in the past
• Anticipating how we will handle a situation coming up in the future

Chronic stress and anxiety don’t just cause physical effects. They can affect your emotional or mental health, too — not just make you more prone to nervous or anxious feelings but also depressed. People under stress can also experience symptoms, such as irritability, anger, fatigue, muscle pain, digestive troubles, and difficulty sleeping.

People with a tendency to perfectionism are at higher risk of anxiety, leading to chronic stress as they tend to reflect on what they could have done better or chastise themselves for not meeting their own high expectations.

Busyness also increases chronic stress?

Stress just isn’t about the situation we find ourselves in or persistent worries. Being overly busy or constantly on the go also increases chronic stress. Think of stress as ‘nervous energy’. We will often boast about how busy we are running from one thing to the next or how we are so sharp and smashing out work or projects. These are examples of running at high levels of nervous energy, which is really increasing our chronic stress levels and walking the fine line between where we wish to be to get the most out of our days without overdoing it and feeling as if it is too much or starting to impact on our sleep. It doesn’t take much before we push too far along the stress-performance curve (see above) and our performance suffers. 

What can we do to reduce chronic stress?

Successful chronic stress management can vary from person to person. What works for you may not be for someone else. Here is a list of some things you can to reduce and help you cope with stress:

• Recognize and acknowledge that managing stress is important: Once we understand that stress impacts our lives and sleep, we can pay attention to managing our stress. Otherwise, we can be focused on the consequences of stress, such as disturbed sleep, rather than the cause. Much like dieting, we all know what we could do to manage stress, but don’t put these strategies in to place, as we may not realise that chronic stress is the underlying problem. Too often I see people very focussed on the particular symptoms such as poor sleep, not realising that sleep itself is just a consequence of their chronic stress.
• Meditation and relaxation: This doesn’t have to be too complicated. Again, just recognising that chronic stress is an issue, helps us understand that it is important to take time out and ‘smell the roses’. For some people, just giving themselves permission to take time out is the key, what they actually do during that time out is less important and very individual. However, for most people, taking time out isn’t something that comes naturally, and we do need to develop skills in this area. There are a range of strategies that have been shown to reduce chronic stress including:
  • Meditation – such as mindfulness
  • Breathing focussed relaxation exercises
  • Visualisation exercises
  • Physical activity: Exercise, such as taking a brisk walk shortly after feeling stressed, not only deepens breathing but also helps relieve muscle tension. Movement therapies such as yoga, tai chi, and qi gong combine fluid movements with deep breathing and mental focus, all of which can induce calm.

People often tell me they have tried meditation (or some of the other strategies above), but it didn’t help them sleep, so they gave it away after a few days. I wouldn’t expect meditation, or other strategies to impact chronic stress after a few days. In fact, in a research study we undertook using mindfulness meditation for insomnia, sleep took around four weeks to start changing and kept improving for many weeks after that. So, it’s important to be persistent.

If I need help, what should I do?

Whilst chronic stress can often be managed through self-help approaches, if you have tried to manage stress and feel that it is still impacting you or your sleep, talk to your doctor about it. They will look at your overall physical and mental health to look for other factors that may be an issue. They can also refer you to others, such as psychologists, for additional help.

Related links and posts:

• Good sleep: It’s not about the night
• Perfectionism and sleep
• Mindfulness and sleep
• Feeling tired? Not sleeping well?

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