Reduce the Symptoms of Chronic Stress

The pressures of modern life, with its information overload, rapid change, and loss of social connections, add to the normal strains of everyday living, and exact a mounting physical, psychological, and emotional toll. When stresses last for a short time and are quickly resolved, the symptoms they cause disappear, and the mind and body return to normal. But when stress becomes chronic and tension and worry are prolonged, individuals pay a price. Fortunately, it’s possible to recognize the symptoms of chronic stress and find ways to overcome them.

“Normally, the brain does you a favor by readying you for challenges through the fight-or-flight response, and then turning off this acute response when the emergency is over,” explains Gregory L. Fricchione, MD, Associate Chief of Psychiatry and Director of the Benson-Henry Institute for Mind Body Medicine at MGH. “But some of us have a hard time turning off the stress response, and it becomes chronic.

“An individual’s health is strongly influenced by the balance of ‘energy in’ and ‘energy out,’ and stress uses up a tremendous amount of energy. People who are faced with a constantly vigilant response to the environment become more vulnerable to a variety of physical and emotional illnesses.”

Warning Signs

Stress attacks us on all levels. It affects the health and functioning of our minds and bodies, and impacts our behavior and our emotions,. The longer it lasts, the more damage it may do.

If you have been experiencing the following warning signs of serious stress for several weeks or more, or your symptoms are especially upsetting, consider making an appointment with your healthcare provider for an assessment and discussion of treatment options.

• Behavioral symptoms: Nervous habits such as nail biting or fidgeting, difficulty communicating, decreased social contacts, social withdrawal, increased difficulties at work, loss of interest in appearance or punctuality, loss of interest in sex.
• Physical symptoms: Stress may disrupt virtually any of our bodily systems. Examples of some of the more common physical indications of stress include:
  • Gastro­intestinal system
    • Symptoms: Changes in appetite, heartburn, acid reflux, excess belching or flatulence, nausea, pain, vomiting, diarrhea, or constipation.
  • Cardio­vascular system
    • Symptoms: More rapid heart rate, elevated blood pressure, chest pain or palpitations, dilation of blood vessels that supply the large muscles, or inflammation of the coronary arteries.
  • Musculo­skeletal system
    • Symptoms: Increased muscle tension, twitching, tremors, muscle spasms, neck and back pain, clenched jaw and grinding of teeth, headaches, migraines, or various musculoskeletal disorders.
  • Respira­tory system
    • Symptoms: More rapid or shallower breathing, difficulty breathing, frequent sighing, hyperventilation, or sudden panic attacks.
  • Endocrine system
    • Symptoms: Increased production of stress hormones such as cortisol, adrenaline, and noradrenaline lead to light-headedness, dizziness, ringing in the ears, cold or sweaty hands and feet, dry mouth, difficulty swallowing, and more.
  • Repro­ductive system
    • Symptoms: In men, lowered levels of testosterone and increased incidence of impotence, or erectile dysfunction. In women, irregular menstrual cycles, painful periods, or reduced sexual desire.
• Mental symptoms: Racing thoughts, confusion, mental slowness, negative thinking, nervousness, forgetfulness, difficulty concentrating and/or making decisions, trouble learning new information.
• Emotional symptoms: Feelings of helplessness, worthlessness, anxiety, or depression, feeling overwhelmed, frustration, apathy, irritability, jumpiness, over-excitability, lack of a sense of humor, crying jags, suicidal thoughts, insomnia, feeling lonely, increased anger or hostility.

Toll on Heart

A team of researchers led by Ahmed Tawakol, MD, co-director of the Cardiac MR PET CT Program at MGH, has linked, for the first time, stress-associated brain activity in humans with increased cardiovascular risk conveyed by vascular inflammation. The research involved 293 healthy participants who underwent brain and body scans that recorded activity in their brains, bone marrow, and spleen, as well as inflammation within their arteries.

Participants were tracked for about four years, during which time 22 subjects experienced a major cardiovascular event, such as stroke, angina, heart attack, heart failure, or peripheral arterial disease. The researchers reported in the Jan. 11, 2017 issue of The Lancet that participants whose scans indicated the highest levels of activity in the amygdala, a brain region linked to stress, were most likely to develop cardiovascular disease, and to develop it more rapidly than those with lower levels. The researchers suggested that amygdalar activity might prompt the bone marrow to produce white blood cells that, in turn, lead to arterial inflammation and heart disease.

Tackling Your Tensions

“If you are feeling the effects of stress, you can protect your health by making self-care a priority,” Dr. Fricchione says. “First, address the major lifestyle issues that affect your ability to deal with stress. Resolve to get at least seven hours of good-quality sleep each night; stay physically fit with regular exercise (at least 30 minutes per day, five days per week); and consume a nourishing, low-fat diet rich in fruits, vegetables, legumes, fish, and healthy fats.”

With a healthy lifestyle as a basis, Dr. Fricchione suggests the following four strategies for conquering stress:

1. Use a relaxation technique: Try to spend at least 10 to 20 minutes a day engaging in exercises that elicit the relaxation response, the physiological opposite of the stress response. Examples of these techniques include relaxation breathing, yoga, tai chi, mindfulness meditation, deep breathing—even listening to music—while purposely emptying your mind of everyday thinking. Mindfulness meditation starts with relaxation breathing and then allows you to focus on thoughts and sensations that may emerge with a non-judgmental awareness.
2. Connect with others: Maintain and strengthen ties to friends and family, and engage in pro-social activities, such as volunteering to help others.
3. Change the way you think: Replace negative thinking with flexibility, acceptance, humor and an optimistic attitude. Put your problems in perspective. Practice forgiveness and gratitude. Strive to live a life of purpose.
4. Seek spiritual connection: Whether you embrace a special relationship with God, nature, or a meaningful social movement, find something greater than yourself to believe in.

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