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What You Should Know About Stress

What is stress?

Stress is defined as any change that you must adapt to in our ever-changing world. In particular, stress is
the body’s reaction to any demand (force, pressure, strain) placed on it. Everyone experiences some type
of stress; in fact, stress is something you cannot avoid. Stress, itself, ranges in intensity from the negative
extreme of being in physical danger to the joy of completing a desired goal. All stress is not bad. What is
important to understand is that your response to stressful events will determine the impact stress plays in
your life.

What causes stress?

The potential causes of stress are numerous and highly individual. What you consider stressful depends
on many factors, including your personality, general outlook on life, problem-solving abilities, and social
support system. Something that's stressful to you may not faze someone else, or they may even enjoy it.
For example, your morning commute may make you anxious and tense because you worry that traffic will
make you late. Others, however, may find the trip relaxing because they allow more than enough time and
enjoy listening to music while they drive.

The pressures and demands that cause stress are known as stressors. We usually think of stressors as
being negative, such as an exhausting work schedule or a rocky relationship. However, anything that
forces us to adjust can be a stressor. This includes positive events such as getting married or receiving a
promotion. Regardless of whether an event is good or bad, if the adjustment it requires strains our coping
skills and adaptive resources, the end result is stress.

• Major life changes

Major life events are stressors. Whether it be a divorce, a child leaving home, a planned pregnancy, a
move to a new town, a career change, graduating from college, or a diagnosis of cancer, the faster or
more dramatic the change, the greater the strain. Furthermore, the more major life changes you’re
dealing with at any one time, the more stress you’ll feel.

Daily hassles and demands

While major life changes are stressful, they are also relative rarities. After all, it’s not every day that
you file for divorce or have a baby. However, you may battle traffic, argue with your family
members, or worry about your finances on a daily basis. Because these small upsets occur so
regularly, they end up affecting us the most. Daily causes of stress include:

o Environmental stressors – Your physical surroundings can set off the stress response.
Examples of environmental stressors include an unsafe neighborhood, pollution, noise (sirens
keeping you up at night, a barking dog next door), and uncomfortable living conditions. For
people living in crime-ridden areas or war-torn regions, the stress may be unrelenting.
o Family and relationship stressors – Problems with friends, romantic partners, and family
members are common daily stressors. Marital disagreements, dysfunctional relationships,
rebellious teens, or caring for a chronically-ill family member or a child with special needs
can all send stress levels skyrocketing.

o Work stressors – In our career-driven society, work can be an ever-present source of stress.
Work stress can be caused by things such as job dissatisfaction, an exhausting workload,
insufficient pay, office politics and conflicts with your boss or co-workers.

o Social stressors – Your social situation can cause stress. For example, poverty, financial
pressures, racial and sexual discrimination or harassment, unemployment, isolation, and a
lack of social support all take a toll on daily quality of life.

• Internal Causes of Stress

Not all stress is caused by external pressures and demands. Your stress can also be self-generated.
Internal causes of stress include:

o Uncertainty or worries o Perfectionism

o Pessimistic attitude o Low self-esteem

o Self-criticism o Excessive or unexpressed anger

o Unrealistic expectations or beliefs o Lack of assertiveness

What are the signs of stress?

To get a handle on stress, you first need to learn how to recognize it in yourself. Stress affects the mind,
body, and behavior in many ways— all directly tied to the physiological changes of the fight-or-flight
response. The specific signs and symptoms of stress vary widely from person to person. Some people
primarily experience physical symptoms, such as low back pain, stomach problems, and skin outbreaks.
Other people experience emotional symptoms, such as crying, depression, or hypersensitivity. For still
others, stress may cause changes in the way they think or behave.

The following table lists some of the common warning signs and symptoms of stress. Use it to identify
the symptoms you typically experience when you’re under stress. If you know your red flags, you can
take early steps to deal with the stressful situation before it—or your emotions—spiral out of control.


Cognitive Symptoms Emotional Symptoms

• Confusion • Guilt
• Nightmares • Grief

• Poor judgment • Denial

• Blaming someone • Agitation

• Memory problems • Moodiness

• Constant worrying • Restlessness

• Loss of objectivity • Short temper

• Fearful anticipation • Inability to relax

• Inability to concentrate • Feeling overwhelmed

• Trouble thinking clearly • Irritability, impatience

• Seeing only the negative • Feeling tense and “on edge”

• Anxious or racing thoughts • Sense of loneliness and isolation

• Indecisiveness, poor problem solving • Inappropriate emotional response

• Increased or decreased awareness of • Depression or general unhappiness


Physical Symptoms Behavioral Symptoms

• Fatigue • Antisocial acts

• Insomnia • Eating more or less

• Elevated BP • Change in social activity

• Frequent colds • Hyper alert to environment

• Grinding of teeth • Picking fights with others

• Loss of sex drive • Isolating yourself from others

• Nausea, dizziness • Sleeping too much or too little

• Weight gain or loss • Teeth grinding or jaw clenching

• Headaches or backaches • Overreacting to unexpected problems

• Diarrhea or constipation • Nervous habits (e.g. nail biting, pacing)

• Chest pain, rapid heartbeat • Procrastination, neglecting responsibilities

• Muscle tension and stiffness • Using alcohol, cigarettes, or drugs to relax
• Overdoing activities (e.g. exercising, shopping)
• Skin breakouts (hives, eczema)

Keep in mind that the signs and symptoms of stress can also be caused by other psychological and
medical problems. If you’re experiencing any of the warning signs of stress, it’s important to see a doctor
for a full evaluation. Your doctor can help you determine whether or not your symptoms are stress-

Are some people more vulnerable to stress than others?

Personality type plays a role in reaction to stress. For example, people who drive themselves hard and
are impatient (sometimes called Type A personalities) may be more at risk for stress-related physical
problems. Certain occupations, such as law enforcement or air traffic control, are clearly more stressful
than others. In addition, people with a personal or family history of mental illness may be affected more
by stress.

How does stress or chronic stress affect a person’s health?

Chronic stress wears you down day after day and year after year, with no visible escape. Under
sustained or severe stress, even the most well-adjusted person loses the ability to adapt. When stress
overwhelms our coping resources, our bodies and minds suffer.

• Health effects

Recent research suggests that anywhere from 60 to 90 percent of illness is stress-related. The physical
wear and tear of stress includes damage to the cardiovascular system and immune system
suppression. Stress compromises your ability to fight off disease and infection, throws your digestive
system off balance, makes it difficult to conceive a baby, and can even stunt growth in children.

Many medical conditions are caused or exacerbated by stress, including:

o Chronic pain o Heart disease o Infertility

o Migraines o Diabetes o Autoimmune diseases

o Ulcers o Asthma o Irritable bowel syndrome

o Heartburn o PMS o Skin problems

o High blood pressure o Obesity

• Emotional effects
Chronic stress grinds away at your mental health, causing emotional damage in addition to physical
ailments. Long-term stress can even rewire the brain, leaving you more vulnerable to everyday
pressures and less able to cope. Over time, stress can lead to mental health problems such as:

o Anxiety

o Depression

o Eating disorders, and

o Substance abuse.

What are the costs associated with stress?

Stress has high costs for employers. Data includes:

• 60 to 80 percent of worksite accidents are the result of stress

• Costs associated with stress may reduce U.S. industry profits by 10 percent.

• 75 to 90 percent of visits to physicians are stress related.

• Cost to US industry of stress-related illness is over $200 billion a year.

• 20 percent of the total number of health care claims are stress related.

• 16 percent of health care costs are explained by stress.

What are ways to deal with stress?

• Assess your current stressors and explore ways that you respond to them.

o Generate a list of current events that produce stress in your life.

(i.e., moved to new location, work or school demands, balancing priorities, job promotion)

o Brainstorm how you cope with stressful experiences. Assess if you have a healthy or
unhealthy coping style. For example:

Healthy Coping Styles vs. Unhealthy Coping Styles

 Exercise vs. Alcohol or drug use

 Down time for self care vs. Avoidance of event

 Balancing work and play vs. Procrastination

 Time management- initiate schedule vs. Overeating

• After identifying stressors and coping styles, you can begin to modify your behavior.

o Be aware of your physiological and emotional reaction to stress.

o Recognize what you can change (your reactions to stress, internal thoughts).

o Utilize healthy coping skills.

o Incorporate good coping skills into your repertoire, increasing your options.

o Practice healthy coping skills daily even when intense stress is not present (this prepares you
for times when you may feel overwhelmed).

• Learn to relax by learn relaxation techniques

o Recognize what activities you consider relaxing.

o Be specific when exploring your options:

going for walks
meeting with friends
reading for pleasure
listening to music
taking a bath

o Be realistic about the amount of time that you can dedicate to "downtime".

o This time should be incorporated into your daily routine.

o Remember this is called BALANCE- not be used as a procrastination tactic.

o Begin practicing relaxation techniques

guided imagery
deep breathing exercises
progressive relaxation (muscle relaxation)

o Decide which relaxation technique works for you and practice daily.

o Find several techniques that work for you so you have an array of options.

• Management your stress by learning stress management techniques.


• Along with improving your ability to relax, you must assess diet and other strains on
your body.

• Aerobic exercise can reduce anxiety up to 50%.

• Good nutrition (a well balanced diet) will improve your ability to appropriately
respond to stress.

• Get an adequate amount of rest each night.

• Reducing caffeine intake will help you manage your anxiety (2 ½ cups of coffee
doubles the epinephrine level).

• Smoking cessation is important, as nicotine is also a stimulant.

• Biofeedback techniques can help up to 80% of migraine sufferers.

• Acupuncture has also shown promise.


• If you have multiple stressors (deadlines, increased responsibilities), you must

prioritize your time.

• Initiating a time management schedule remains a positive way to reduce stress and

• Break large demands into small, manageable parts. Work through one task at a time.

• Do what needs to be done first, leaving other things for tomorrow.

• Identify your goals and work toward them.

• Take direct action when stress arises- identify your needs and articulate them; be
intentional about what you can do.

• Acknowledge your thoughts and feelings concerning the stressors in your life.

• Develop a support network to rely on in times of need.

• Remember to be kind to yourself and not dwell on the "shoulds".

Stress materials adapted from the following sites: - Ellen Jaffe–Gill, Melinda Smith, M.A., Heather Larson, and Jeanne Segal, Ph.D.
contributed to this article Last modified on: 12/13/2007. A project of the Rotary Club of Santa Monica
and WISE & Healthy Aging. © 2001-2008. All rights reserved. - The University of Iowa, University Counseling Service. This handout was created by
Carolyn Mildner, M.A.