Stress - causes, symptoms, diagnosis
Stress describes a person’s physical or emotional response to demands or pressures that they may experience from time to time. Common causes of stress include work, money, relationships and illness. Symptoms may include irritability, difficulty sleeping or relaxing, headaches and muscle tension.
Causes of modern day stress
Stress can be a positive thing - helping an individual to grow, develop, be stimulated and take action. However, if stress exceeds a person’s ability to cope it can impact on their mental and physical health in a range of ways. Some research studies estimate up to two thirds of illnesses seen by GP's are stress related.
In the days of the caveman, stress often came in the form of physical threats that required individuals to react quickly and decisively. The body helped out by automatically clicking into high gear at the first sign of trouble, releasing a surge of hormones (notably adrenaline and cortisol) to accelerate the heart rate, raise blood pressure, increase blood sugar, and enhance the brain’s use of glucose. This stress response meant the caveman was instantly ready to fight or flee.
Modern day stresses are more likely to be psychological in origin and prolonged in nature (work-related stress, financial worries, inter-personal relationships, chronic illnesses). But they can still set off the body’s alarm mechanism and the associated hormone surge. Over-exposure to those stress hormones can, in turn, have a range of impacts on the body’s systems - brain, cardiovascular, immune, digestive and so on.
People deal with stress in different ways and the capacity to deal with stress changes throughout life. Those who have developed effective strategies to deal with day to day stressors are less likely to develop physical and psychological symptoms.
Signs, symptoms and diagnosis
Stress that is not controlled and continues for a long period of time can cause a number of psychological and physical symptoms.
Psychological symptoms of stress can include:
- Sleep disturbances
- Difficulty concentrating
- Lack of confidence
- Difficulty relaxing
- Difficulty with decision making
Physical symptoms of stress can include:
- Muscle tension and pain
- Low energy
- Changes in appetite
- Decreased sexual function
- Shortness of breath or difficulty breathing.
Long term, uncontrolled stress is associated with the development of a number of different medical conditions. Primarily these occur as the result of biochemical imbalances that can weaken the immune system and over-stimulate the part of the nervous system that regulates heart rate, blood pressure and digestion.
Medical conditions that can occur as a result of long term stress include:
If it is suspected that stress is the cause for psychological or physical illness, a doctor should be consulted. The doctor will rule out any physical or mental illness that may be the cause of the symptoms. The doctor will discuss the patient's history and circumstances, including identification of any stressors that may be present in the person's life. The doctor will try to ascertain the level of stress the person is experiencing and their ability to deal with the stress.
Stress management and relief
Developing strategies to deal with stress can prevent or reduce its effects. There are many approaches to managing, relieving or coping with stress. These include exercise, dietary changes, relaxation, stress management courses, counselling and medications.
Exercise and Diet
Diet and exercise can play an important role in the relief of stress. Eat a balanced diet and avoid foods that may increase tension eg: coffee, tea, and foods high in sugar. Exercise helps to release built up tension and increases fitness (see Exercise: the health benefits). This, in turn, increases the body’s ability to deal with stress and helps to avoid the damage to our health that prolonged stress can cause. It is recommended that exercise be undertaken at least three times per week to be of most benefit. If you are not used to exercise, discuss this with a doctor prior to commencing an exercise programme.
Relaxation is an effective way to help reduce muscle tension associated with stress. There are many different relaxation techniques eg: yoga, meditation, massage. Some people find that simply taking “time out” during the day or after a stressful situation is sufficient to reduce stress levels. There are more formalised relaxation techniques available eg: Jacobson’s Progressive Relaxation Technique, The Mitchell Method and hypnosis. Consult a doctor or community resource group (eg: Citizen’s Advice Bureau) to find out what services are available. A local library may also be able to recommend suitable books on this topic.
Stress management courses
Stress management courses enable individuals to develop strategies to cope with life and stress more effectively. Most courses teach skills that enable the individual to recognise current stressors and techniques to effectively deal with these. Skills such as time management, goal setting, assertive communication, problem solving, managing change and relaxation techniques may be taught.
Discussing concerns with an impartial person may assist with recognising stressors and deciding upon strategies to deal with them. This does not necessarily need to be a professional therapist but may be a trusted family member, friend or colleague. Often the process of discussing a concern is enough to alleviate the stress it is causing. Asking for help should not be seen as a sign of weakness. Knowing when to ask for help may be one of the changes necessary in order to deal with stress more appropriately.
Some people find therapies such as acupuncture, homeopathy, herbal medicine and aromatherapy effective in both preventing and relieving stress.
In severe cases of stress, medication may be prescribed to treat some of the symptoms caused by stress. Medication should only be considered as a short-term treatment and should be strictly monitored by the prescribing doctor.
Further information and support
For further information and support about dealing with stress consult your GP or practice nurse, or contact the following agencies:
Mental Health Foundation of New Zealand
National Information Service and Resource Centre
P O Box 10051 Dominion Rd
Ph: (09) 300 7030
Nationwide Free Phone: 0800 543 354
Frey, R. J. (2006) Stress. The Gale Encyclopedia of Medicine, Third Edition. Jacqueline L. Longe, Editor. Farmington Hills, MI. Thomson Gale.
MedicineNet (2013) Stress. Foothill Ranch: MedicineNet Inc. -
Mental Health Foundation of New Zealand (2011) Stress and how to handle it. Pamphlet. Mental Health Foundation of New Zealand. Auckland.
Last Reviewed – 26 April 2013