Stress: its surprising implications for health

Stress: its surprising implications for health

Whether it is down to work pressure, money worries or relationship troubles, most of us experience stress at some point in our lives. In fact, around 75% of us report experiencing moderate to high levels of stress over the past month. It is well known that stress can cause sleep problems, headache and raise the risk of depression. But in this Spotlight, we look at some of the more surprising ways in which stress may harm our health.

Over the past month, around 75% of us have experienced moderate to high levels of stress.

The National Institute of Mental Health (NIMH) define stress as the "brain's response to any demand." In other words, it is how the brain reacts to certain situations or events.

It is important to note that not all stress is negative. Many of us who have been in a pressurized situation may have found that stress has pushed us to perform better. This is down to a "fight-or-flight" response, whereby the brain identifies a real threat and quickly releases hormones that encourage us to protect ourselves from perceived harm.

It is when this fight-or-flight response overreacts that problems arise, and this usually happens when we find ourselves exposed to constant threats.

"Stress is caused by the loss or threat of loss of the personal, social and material resources that are primary to us. So, threat to self, threat to self-esteem, threat to income, threat to employment and threat to our family or our health," Stevan Hobfoll, PhD, the Judd and Marjorie Weinberg presidential professor and chair at Rush University Medical Center in Chicago, IL, and member of the American Psychological Association (APA), told

Stress levels 'too high' in Americans

In February last year, the APA released their annual "Stress in America" Survey, which assesses the attitudes and perceptions of stress and identifies its primary causes among the general public.

The survey, completed by 3,068 adults in the US during August 2014, revealed that the primary cause of stress among Americans is money, with 72% of respondents reporting feeling stressed about finances at some point over the past month. Of these, 22% said they had felt "extreme stress" in the past month as a result of money worries.

The second most common cause of stress among Americans was found to be work, followed by the economy, family responsibilities and personal health concerns.

On a positive note, average stress levels among Americans have decreased since 2007. On a 10-point scale, respondents rated their stress levels as 4.9, compared with 6.2 in 2007. However, the APA say such levels remain significantly higher than the 3.7 stress rating we consider to be healthy.

"[Last] year's survey continues to reinforce the idea that we are living with a level of stress that we consider too high," says Norman B. Anderson, CEO and executive vice president of the APA, adding:

All Americans, and particularly those groups that are most affected by stress - which include women, younger adults and those with lower incomes - need to address this issue sooner than later in order to better their health and well-being."

The surprising health implications of stress

"Stress is significantly associated with virtually all the major areas of disease," Prof. Hobfoll told "Stress is seldom the root cause of disease, but rather interacts with our genetics and our state of our bodies in ways that accelerate disease."

Some of the more well-known implications of stress that many of you may have experienced include sleep deprivation, headache, anxiety and depression. But increasingly, researchers are uncovering more and more ways in which stress can harm our health.

Heart health

According to the American Heart Association (AHA), stress can influence behaviors that have negative implications for heart health.

One study found stress could increase heart attack risk by 23%.

Have you ever arrived home after a stressful day at work and reached for that bottle of wine? Many of us have.

In January 2015, reported on a study that found working long hours was associated with risky alcohol use, which the study researchers say is partly down to the belief that "alcohol use alleviates stress that is caused by work pressure and working conditions."

Some of us may smoke in response to stress, while others may "comfort eat," which can lead to obesity. All of these are factors that can contribute to poor heart health by raising blood pressure and causing damage to the walls of the arteries.

According to a study reported by in November 2014, stress may also reduce blood flow to the heart - particularly for women. The study researchers found that in patients with coronary heart disease, stressed women had a three times greater reduction in blood flow than stressed men.

Stress has also been associated with increased risk of heart attack. In 2012, a study published in The Lancet found that work stress may raise the risk of heart attack by 23%. And in February last year, reported on a study by researchers from the University of Sydney in Australia, which found periods of intense anger or anxiety may raise heart attack risk by more than nine times.

Even after a heart attack, stress may continue to affect health. A study published in the journal Circulation in February 2015 found women were more likely to experience higher levels of mental stress following a heart attack, which results in poorer recovery.


You may be surprised to learn that stress has been associated with increased risk of diabetes. In January last year, a study published in JAMA Psychiatry found that women with symptoms of post-traumatic stress disorder (PTSD) - a condition triggered by very distressing events - were more likely to develop the condition than those without PTSD.

Periods of stress increase production of the hormone cortisol, which can increase the amount of glucose in the blood - a potential explanation for why stress has been linked to higher risk of diabetes.

For people who already have diabetes, stress can lead to poorer management of the condition. As well as interfering with stress hormones and increasing blood glucose levels, the American Diabetes Association note that stressed patients with diabetes may be less likely to take care of themselves.

"They may drink more alcohol or exercise less. They may forget, or not have time, to check their glucose levels or plan good meals," states the organization.

On the next page, we look at more health problems associated with stress and look at how you can protect against stress-related health problems.

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Section Issues On Medicine: Psychiatry