While these types of stressors likely feel like the overwhelming kinds, it’s important to remember that not all stress we face is bad. The National Institutes of Health (PDF) says stress is “how the body and brain responds” to demands. When the demands are more than you can cope with, you start to feel stress, according to a commentary on psychological stress and disease published in JAMA. Anxiety about a doctor’s visit or a performance review at work, for example, or even something scary, like a car heading right at you, are all examples of short-term stressors. Our body’s response to these types of stressors can sometimes be helpful — giving us a burst of energy to get away from danger or perform well under pressure, explains Michelle Dossett, MD, PhD, an internist and integrative medicine specialist at the University of California in Davis. Long-term stressors have a different effect. “Stress that lasts years or a long time is usually the worst kind of stress,” says Bert Uchino, PhD, a professor of psychology at the University of Utah in Salt Lake City, who studies stress in aging populations. If you’re in a job you hate or you’re a caregiver for a family member with Alzheimer’s disease, for instance, says Dr. Uchino, you may suffer from high levels of chronic stress. That’s where your body “never receives a clear signal to return to normal.” It’s this type of chronic stress that causes changes in the body that can do damage and contribute to disease in some cases, says Uchino. Blood tests can reveal inflammation, changes in blood pressure, and elevated levels of the stress hormone cortisol, which can all be signs of chronic stress.
9 Illnesses That Stress May Help Cause or Make Worse
Chronic stress generally doesn’t help or promote healing in pretty much any disease or health problem. Here are some of the most common illnesses that can be caused and made worse by stress:
1. Depression and Other Mental Health Conditions
The exact cause of why some people experience depression and anxiety as clinical mood disorders, and others are not as severely affected when the related emotions show up, is still unknown, according to the Centers for Disease Control and Prevention. There are a lot of things that are potentially at play including genetic, environmental, and psychological factors, as well as major stressful or traumatic events in the past. Around 20 to 25 percent of persons who experience major stressful events will go on to develop depression, according to data published in JAMA.
2. Insomnia
An informal APA survey from 2013 on stress and sleep found links in both directions. Forty-three percent of the nearly 2,000 adults surveyed reported that stress had caused them to lie awake at night at least one time in the past month. When they don’t sleep well, 21 percent reported feeling more stressed. And among adults with higher self-reported stress levels (8 or higher on a 10-point scale), 45 percent said they felt more stressed when they didn’t get enough sleep. Finally, adults with lower self-reported stress levels claimed they slept more hours a night on average than do adults with higher self-reported stress levels, to the tune of almost an hour less sleep (6.2 versus 7.1 hours a night).
3. Cardiovascular Disease
Chronic stress has long been connected to worsened heart health outcomes. While there’s limited conclusive evidence to say that stress alone can trigger heart disease, there are quite a few ways it can contribute to it, according to a JAMA review. Part of the stress response is heart rate quickening and blood vessel constriction (or vasodilation for some skeletal muscles to help the body move in a fight or flee response), thanks to the stress hormones adrenaline, noradrenaline, and cortisol signal. If the body remains in this state for a long time, like can be the case with chronic stress, the heart and cardiovascular system may be damaged, according to APA. Another means by which stress can contribute to heart disease: You might cope with your stress by eating or drinking too much, which in turn can contribute to cardiovascular disease, also according to APA. “Negative emotions and stress can contribute to a heart attack,” Dr. Dossett says. One meta-analysis published in the Scandinavian Journal of Work, Environment & Health, for example, found a 50 percent increased risk of cardiovascular disease associated with high levels of work stress.
4. Common Cold
Stress can also weaken your immune function, which can make you more susceptible to infectious diseases like colds, Uchino explains. Researchers have conducted experiments for which they exposed a group of 420 volunteers to the common cold virus and then quarantined them to see if they got sick. The data, presented in a 2004 International Congress of Behavioral Medicine keynote address and published in The New England Journal of Medicine (PDF), revealed that participants who suffered from greater overall stress (measured via surveys on stressful life events, perceived stress, and mood) were indeed more likely to become infected with a virus after exposure.
5. HIV and AIDS
Stress does not cause HIV (the virus that cause AIDS, which is sexually transmitted or passed through shared blood, which can happen when needles are shared) — it’s often sexually transmitted or passed through shared blood, but there is some evidence that stress can worsen severity of the disease. A study of 96 HIV-positive patients published in Psychological Medicine found stress increased the risk of progressing from HIV to AIDS by 50 percent and more than doubled the risk of developing an AIDS-related clinical condition. Another review, published in 2016, concluded that while the link between stress and clinical outcomes are mixed, higher stress was linked to lower disease-fighting white blood cell counts, higher viral load, and disease worsening. Studies also linked stress with worse treatment adherence, per the review.
6. Gastrointestinal Disease
“Stress can affect gastrointestinal motility,” says Dossett, which is how food moves through your digestive system, increasing your chances for experiencing [or developing] irritable bowel syndrome, inflammatory bowel conditions, gastroesophageal reflux, constipation, diarrhea, and discomfort. “All of those things can be impacted by stress,” she says. Published research (PDF) supports this as well.
7. Chronic Pain
Some chronic pain conditions like migraine and lower back pain can be caused, triggered, or worsened by body muscles tensing up. A lot of chronic low back pain is related to stress, says Dossett. “Very often it’s muscle tension and tightness that is pulling or creating strain, and then contributing to this sensation of pain.” A review published in 2017 examined the overlaps between chronic stress and chronic pain, finding that both conditions can trigger similar responses in the brain, particularly in the hippocampus and amygdala. The researchers also noted, however, that because of the wide variety of ways humans experience chronic pain and stress, these two conditions do not always overlap.
8. Cancer
What causes cancer is a particularly challenging question to answer, says Uchino. Because most patients are diagnosed only after years of cancer cell growth, it’s difficult if not impossible to pinpoint a specific cause. And it’s likely that several factors (someone’s genes, plus an environmental trigger like smoking, air pollution, or stress, for example) contribute. But there is some evidence in human studies suggesting that stress can play a role in the onset of cancer, Uchino says. (It’s also worth noting some studies find no link.) One possible reason why stress might contribute to some cancers: Stress can activate your brain and body’s inflammatory response, as well as stimulating your adrenal glands to release stress hormones called glucocorticoids, among many other downstream effects. Some research suggests too much of this type of inflammation as a result of chronic stress in the body is why stress may have a link with cancer (as well as some auto-immune diseases – see below), Dossett explains.
9. Autoimmune Conditions
“Many inflammatory conditions are exacerbated by stress, and that includes autoimmune conditions like multiple sclerosis, rheumatoid arthritis, lupus, psoriatic arthritis, and psoriasis,” says Dossett. A Swedish population-wide study published in the June 2018 issue of JAMA found patients with a stress disorder were more likely to develop an auto-immune disorder (9 per 1,000 patients per year as compared with 6 per 1,000 among those without stress disorders). The good news is there are many effective ways to manage stress, says Dossett, including yoga and mindfulness. These types of interventions don’t undo or change whatever situation is causing stress (financial woes, a family argument, or a busy schedule), but they can help retrain the body’s central nervous system’s response and help dial that response down if it’s been triggered. Some conditions like cardiovascular disease develop years before they are diagnosed, however, so more research into interventions is desperately needed, says Uchino. Overall, if you are wanting more help with your chronic stress, speak to your doctor or a trained mental health provider to help support you.
