How stress can affect health and how we can fight it

As the saying goes, the mind is a powerful thing. And sometimes, that’s to our detriment.

According to doctors and researchers, prolonged mental stress can cause a host of health conditions from depression and anxiety to heart disease and gastrointestinal trouble.

“The bottom line is internal environment is a powerful risk factor for disease,” said Dr. Sanjay Rajagopalan, chief of the Division of Cardiovascular Medicine at University Hospitals Harrington Heart & Vascular Institute in Cleveland. “People with negative emotions have more risk for heart disease, hypertension and other conditions.”

Dr. Ernesto Schiffrin, physician-in-chief at Jewish General Hospital Department of Medicine in Montreal, described stress in general terms as “aggression against the body,” which could be coming from within – a disease or ailment – or your environment. When the body feels attacked, it activates the fight-or-flight reaction, releasing adrenaline and cortisol levels. Excess exposure to these hormones can affect just about every system in the body.

Extreme events can lead to acute distress disorders, like anxiety, which have been linked to several health conditions, Schiffrin said. According to a 2018 study, people were more likely to be diagnosed with autoimmune diseases than those who did not have stress disorders.

Another study from 2019 showed that during 27 years of follow-up, incidence of heart disease among those with stress disorders was higher than in those without them.

While the effects of stress can manifest slowly over time, they also can come on quickly. The sudden onset of intense stress can cause broken heart syndrome, also called stress-induced cardiomyopathy – when part of the heart enlarges and doesn’t pump as effectively, Schiffrin said. It could be brought on by the death of a loved one or even a divorce, breakup or betrayal, and its symptoms are similar to a heart attack.

Schiffrin said stress also can lead to ulcers in gastrointestinal system, can aggravate irritable bowel syndrome, and can trigger asthma attacks.

Even more minor everyday stressors can affect our bodies. A 2018 nationwide study found that lingering negative feelings caused by daily stressors were associated with more chronic conditions 10 years later. The study highlights the importance of effectively recovering from stress. 

For many people, work is a source of mental strain. Approximately 2 in 3 employees reported work as a significant source of stress, according to the report “Resilience in the Workplace” by the American Heart Association. Job stress can stem from long hours, physical strain, high demand or job insecurity.

Annual expenditures on work-related stress has been estimated at $190 billion, while the cost of poor mental health, including depression and anxiety, is approximately $211 billion annually. The estimates encompass lost productivity and work absenteeism.

There are multiple ways to manage stress, including exercising and maintaining relationships, Rajagopalan said. There also is the practice of “mindfulness” – a focus on the here and now through meditation and other cognitive training.

“Exercise has a very important role in reducing stress. It can elevate your mental state, and physiologically it helps by lowering blood pressure,” Rajagopalan said. “Mindfulness techniques like yoga can fall in both the mindfulness and exercise paradigm.”

Regular physical activity has been shown to relieve stress, tension, anxiety and depression. This can tackle stress from two angles: by releasing endorphins in the body to produce a “feel-good” effect, and by counteracting unhealthy behaviors caused by stressful feelings.

Other healthy behaviors like maintaining a proper diet and getting enough sleep have a positive effect on stress levels, Rajagopalan said. He recommends reducing coffee and alcohol consumption to prevent insomnia.

Schiffrin said adopting a glass-half-full outlook also can help reduce negative feelings. But, he said, it’s important to speak to a professional if stress doesn’t subside and interferes with daily life.

“For ongoing stress or symptoms of depression, talk with a health care provider about getting help,” he said. “Try to manage the stressors you can control.”