We’ve All Been Stressed—but How Do You Know if You’re Dealing With Chronic Stress?

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A close call while driving, an upcoming presentation, childcare falling through just as you’re heading out the door—any number of everyday things can stress you out. Yep, stress is a normal—and unavoidable—part of life.

But chronic stress is different. It sticks around for weeks, months, or even years, not a brief moment in time, and it's unrelenting, according to Yale MedicineSymptoms of ongoing stress are pervasive, too, affecting both your body and mind, according to the Cleveland Clinic.

Whatever triggers stress, your body responds the same way: Your brain sends out a signal to release energy-boosting adrenaline, along with cortisol, the stress hormone, per the Mayo Clinic.

Experts In This Article
  • Alexa Mieses Malchuk, MD, MPH, a board-certified family medicine physician and District Medical Director at One Medical in North Carolina
  • Samuel Mathis, MD, a board-certified family medicine doctor and assistant professor of family medicine at the University of Texas Medical Branch
  • Divesh Goel, MD, board-certified family medicine doctor

In a single stressful moment, these hormones surge, then return to their normal levels. Think of your body’s response to a jump scare in a horror movie: There’s a quick jolt of fear, and maybe your heart rate speeds up, and then your body settles down.

But with chronic stress, there’s no natural end point: You’re not dealing with temporary stressors like a crowded train or the pop of an unexpected firework, but something that doesn't let up, like a loved one's chronic health condition or a relationship turned sour. This leads to an "always-on" state for your body’s stress-response system.

For our Real Talk Rx series, we asked readers to send us their biggest health questions and then posed the most common to a panel of doctors. Lots of you were worried about chronic stress, including how to recognize it and the best ways to get a handle on it. Here's what the experts had to say.

How can you tell if you’re chronically stressed?

Samuel Mathis, MD, headshot banner

"Stress is one of those interesting topics because it’s hard to tell if someone has acute versus chronic stress, but you can see the impact of it in someone’s life.

When we are hit with stress, it typically causes that fight-or-flight response. Chronic stress presents as that, but to a lesser degree.

Some of the signs of chronic stress that people sometimes face are appetite changes, weight gain, and difficulty sleeping, as well as muscle tension, difficulty with memory and concentration, and headaches.

Chronic stress has been shown to lead to heart disease, strokes, and high blood pressure.

That’s why it’s so important to find ways to deal with stress and also recognize when we’re not appropriately managing our stress, because it can cause a whole slew of problems.

Stress in and of itself is not a bad thing. It’s when we don’t effectively manage our stress, or when we are left with chronic stress, that it then can lead to worsening health issues."

"We think of stress as a mental thing. But in fact, when people are chronically stressed, it really tends to manifest in a physical way." —Alexa Mieses Malchuk, MD

Alexa Mieses Malchuk, MD, headshot banner

"We think of stress as a mental thing. But in fact, when people are chronically stressed, it really tends to manifest in a physical way. So people might be tired all the time despite how much sleep they’re getting. Or the opposite may be true: They may have a hard time sleeping.

You can also have mysterious aches and pains, and really just feel worn out. If someone is having physical symptoms and they can’t really pinpoint them, chronic stress could be the cause.

The harder question is: Can we quantify the impact of stress? We haven’t been able to do so yet in the medical community, but I certainly think chronic stress is a cause of premature death in people.

Classically, we know that before someone has a heart attack, sometimes they are really, really stressed out. We know stress can raise blood pressure. Stress can change the way your body metabolizes cholesterol.

I can’t emphasize enough that stress really reaches every function of your body."

Divesh Goel, MD, headshot banner

"There are two things to look at with stress. There's a psychological and a physiological component.

A good way to look at it is: Am I burnt out? To determine that, you can ask: Is my sleeping disturbed? Do I have brain fog? Am I less interested in the things I was interested in before?

A lot of the symptoms of chronic stress mimic depression. Is my irritability higher? Am I more inclined to snap at my friends and family when I wasn't before? Am I seeking solitude more often? Is my performance in work and my personal hobbies or endeavors below my average? Do I feel more tired?

Another thing is chronic pain, which can be a manifestation of chronic stress to a more severe degree. It can be joint pain, fatigue, being prone to injury and then just general pain everywhere.

You could have other physiological manifestations like irritable bowels, meaning you're constipated more, or you're having more loose stools. Dry skin, hair falling out or thinning—that can be a normal sign of aging, but it can also be due to the fact that you're chronically stressed."

The takeaway

Just about every system and function in your body can be affected by chronic stress, including your mood and emotions, appetite, sleep, sex drive, weight, and even your bowel movements. And in the long run, your overall health can suffer.

It can be tricky to "diagnose" chronic stress, but the reality is that we live in a stressful world. That's why it's so important to find healthy habits that help you manage stress—like setting boundaries and practicing other stress-reducing activities—and to stick with them.

‌Confused about your health? Get answers to more common questions in our Real Talk Rx series.

—reviewed by Jennifer Logan, MD, MPH

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