Recognising stress: symptoms and consequences

Stress is the physical and psychological response to demands that we experience as challenging or threatening. It occurs when external or internal pressures exceed our own coping resources and we simultaneously judge these resources to be insufficient, creating the feeling of not being up to a situation.

In a stress response, the brain activates two systems. First of all, the body releases the hormones adrenaline and noradrenaline within seconds. Your heartbeat speeds up, your blood pressure rises and your muscles tense up. This “fight-or-flight” response prepares you to act quickly.
The body reacts very swiftly to stress and releases the hormone cortisol. Cortisol provides a short-term energy boost, makes us more alert and helps us to perform at a higher level. This reaction is generally useful – as long as tension is followed by recovery.
If this continues without respite for an extended period of time, the body remains in a state of alertness, which can have a negative impact on our health.

Research differentiates between the different types of stress on the basis of two criteria: according to psychologist Richard Lazarus, stress arises not only from a situation itself, but from our evaluation of it.

How long the stress lasts is also important. Short-term stress often passes quickly, but if a difficult situation lasts for an extended period of time and we don’t feel as if we can deal with it, the stress persists. Both criteria influence the extent to which stress affects the body and mind.

Evaluating stress

Whether stress is perceived as challenging/motivating or stressful/threatening depends on our individual evaluation of it. The same situation can affect people differently:

• Primary evaluation of stress: first, we notice a situation and, consciously or unconsciously, ask ourselves: “Is this important, challenging, threatening or dangerous to me?” If we consider a situation to be unimportant, there is usually no stress.
  However, when we view it as a threat or a challenge, stress can arise.
• Secondary evaluation of stress: we then check whether we have sufficient resources to deal with this. For example, we consider whether we have enough time, knowledge or support. If we feel that we are well prepared, we usually experience little stress. If, on the other hand, we think “I can’t do it”, our stress levels shoot up.

People are constantly re-evaluating situations. This can lead to their stress levels increasing or decreasing at any point.

Acute vs. chronic stress

In addition to the evaluation of the situation, its duration also influences how stress affects the body. The consequences vary depending on whether the stress is short-term or long-term. There are two variants:

• Acute stress: acute stress is brief and subsides quickly. Typical triggers include exams or sudden confrontations. The body cycles through its alarm response and then recovers fully. This form is generally harmless.
• Chronic stress: chronic stress occurs when the pressure lasts for weeks or months and the recovery phases are skipped. Your cortisol levels remain permanently elevated. The body goes through three phases: an alarm response, a resistance phase and finally a phase of exhaustion. Typical symptoms of chronic stress include persistent exhaustion, irritability and an increased susceptibility to infection.

Episodic acute stress sits between the two types of stress. Even acute stress can have a negative impact on health if a person suffers regular and recurring bursts of stress at short intervals, such as an excessively busy schedule day-to-day.

The causes of stress are manifold. Certain stimuli and pressures – known as stressors – trigger a stress response in the body. The impact of a stressor depends on the interplay between the situation in question, the person’s evaluation of it and their individual resources. People who are already dealing with tension are also more sensitive to additional stimuli.

For example, a busy schedule is a stressor, i.e. it causes stress. The resulting feelings, such as being overwhelmed or nervous, are the response. Simply put, the stressor is the trigger, and the feelings are the body’s and mind’s response to it.

Stressors can be divided into two groups on the basis of their origin.

Psychological and social stressors

Psychological stressors occur when we are subject to mental challenges, like high demands, uncertainty or time pressure. The decisive factor here is how we view the situation. Stress can also be exacerbated by difficult experiences or prolonged periods of brooding.
Social stressors arise from interpersonal tensions, e.g. conflicts, criticism or lack of appreciation, and can trigger strong feelings such as fear, anger or insecurity.

Both types of stressors are closely related and often occur at the same time. How we assess a situation has a direct impact on how we feel.
The most common psychological and social stressors include:

• High demands: pressure to perform at work or in educational settings causes ongoing mental stress and impairs mental performance.
• Constant availability: 24/7 digital availability and the constant flood of information make it harder to switch off on a day-to-day basis.
• Interpersonal conflicts: disagreements at work, at home or amongst friends tie up energy and can throw our emotions out of balance.
• Loss and grief: the death of a loved one, loneliness or a separation can trigger deep-seated emotional strain.
• Financial worries: existential concerns or fear of losing your job cause persistent inner tension.

Internal factors such as negative thinking patterns or low self-confidence act as intensifiers. Perfectionism, high expectations of oneself and difficulties with setting boundaries can increase a person’s sensitivity to external pressures and their perception of stress, contributing to a situation being viewed as a threat and as unmanageable.

Physical and external stressors

 Physical and external stressors are influences that have a direct effect on the body. The body reacts quickly, usually doing so automatically – often before we can consciously evaluate what’s going on. At the same time, our nervous system instantly checks whether the situation is a threat. Even if this evaluation happens unconsciously, a corresponding response is triggered. The most common physical and external stressors include:

• Insufficient sleep: a lack of sleep or poor sleep raises your cortisol levels and reduces the body’s ability to recover.
• Persistent pain: chronic pain puts long-term strain on the body and ties up physical and mental resources.
• Noise: constant exposure to noise in the home or workplace puts the body in a state of heightened alertness.
• Extreme temperatures: extreme heat or cold put strain on the body and increase physical tension.
• Illness and overtraining: infections, injuries or excessive exercise place additional demands on the body and pave the way for a stress response.

Psychological, social, physical and external stresses rarely occur on their own: they are often interrelated and mutually reinforcing.

Stress not only affects the mind, but also the entire body. The brain activates the same stress axes, no matter whether the triggers are psychological or physical. It is normal to experience certain individual symptoms; this reflects a short-term adaptive reaction. However, if they occur in large numbers or persist for several weeks, a medical examination is recommended.

Psychological symptoms of stress

Stress influences our thoughts, emotions and behaviour in equal measure. The psychological symptoms of stress impact mental performance as well as emotional stability. The most common include:

• Inner restlessness and nervousness: sufferers feel restless and tense, even in quiet moments.
• Poor concentration: it is increasingly difficult to focus; wandering thoughts become more common.
• Problems falling asleep and staying asleep: sleep disorders are amongst the earliest signs of persistent stress.
• Irritability: even small incidents trigger disproportionately strong emotional reactions.
• Listlessness: it is progressively harder to find motivation and derive joy from everyday activities.
• Fears and brooding: sufferers ruminate on their worries and struggle to break out of these thought cycles.
• Social withdrawal: contact with family, friends or at work becomes increasingly stressful.

Symptoms often appear gradually and, as a result, can go unnoticed for a long time. Persistent stress exacerbates these complaints and can sometimes turn them into symptoms of depression. Identifying warning signs at an early stage makes it possible to take timely countermeasures.

Physical symptoms of stress

The physical signs of stress affect various organ systems and manifest themselves differently in each person. The most common include:

• Cardiovascular complaints: stress manifests itself in the heart through symptoms such as palpitations, a high heart rate or a racing heartbeat, as well as high blood pressure.
• Gastrointestinal disorders: typical symptoms of stress include abdominal complaints such as nausea, abdominal pain or changes in appetite. Diarrhoea or constipation are also common.
• Tension and pain: the stress response increases muscle tension, often resulting in neck, shoulder and back pain as well as tension headaches.
• Weakened immune system: persistently elevated cortisol levels weaken the immune system. Sufferers have more colds and other infections, and their wounds heal more slowly.
• Skin reactions: stress worsens existing skin conditions such as neurodermatitis or psoriasis and can lead to rashes or acne.
• Exhaustion: unrelenting feelings of tiredness and fatigue do not ease, even after getting enough sleep

Physical reactions to stress can easily be confused with other illnesses. If the complaints persist or are unclear, a medical examination is advisable.

Short-term stress does not usually do any lasting damage. However, if the strain persists over a long period of time, the symptoms can have serious consequences for our health. Chronic stress affects almost all areas of the body, with its consequences felt both physically and mentally:

• Cardiovascular system: persistently elevated blood pressure increases the risk of heart attacks, strokes and cardiac arrhythmias.
• Brain: constant stress leads to the ongoing release of cortisol, which impairs memory and concentration.
• Metabolism: chronically high cortisol levels promote insulin resistance and increase the risk of type 2 diabetes and weight gain.
• Mental health: the consequences of psychological stress range from depressive moods and anxiety disorders to other signs of mental illness.
• Sleep: sleep deprivation and stress are mutually reinforcing. Poor sleep increases your cortisol levels, while elevated cortisol impairs your sleep quality – a vicious circle.

Consequences of stress in children

Children, too, can experience stress – due to school pressures, family conflicts, bullying or sensory overload. According to the Pro Juventute Stress Study, one third of children in Switzerland are under high stress, with one in four children under the age of 11 even being affected. Children who are stressed are much more anxious and insecure; their personal well-being suffers.

If children have to deal with an extended period of stress, this can have long-term consequences. Stress impairs emotional development and raises the risk of mental illness in adulthood, including anxiety disorders and depression.

The first step in dealing with stress is to recognise the pressures you’re facing. If you understand what stress is and the situations that trigger it, you can respond to the warning signs sooner. Our stress test helps you to assess your personal stress factors. Build on this by making deliberate changes to your everyday life. Consciously integrate breaks into your schedule and go for walks. Even spending just a few minutes a day engaging with targeted relaxation techniques can help ease the strain. You can find further advice in our article on tips for coping with stress.

Take persistent complaints seriously. If you’re suffering from chronic stress, it’s worth seeking professional treatment from your general practitioner. The sooner you get support, the easier it will be for you to feel more balanced and more energised day to day.