What is stress?

Stress can be defined as the feeling of being overwhelmed or unable to cope with mental or emotional pressure. It can have mental and physical consequences (1).

At one point or another, most people deal with feelings of stress. In fact, a study from 2015 found that 59% of adults reported experiencing high levels of perceived stress.

Symptoms of stress

Decreased energy and insomnia

Prolonged stress can cause chronic fatigue and disruptions in sleep, which may result in decreased energy levels.

For example, a recent study of more than 7,000 working adults found that fatigue was “significantly associated” with work-related stress.

Stress may also disrupt sleep and cause insomnia, which can lead to low energy.

A 2018 review published in the Journal of Sleep Research found that “stress-related worry and rumination” can lead to disrupted sleep and eventually the risk of developing insomnia.

Another study of 2,316 participants showed that exposure to stress was associated with an increased risk of insomnia.

Both of these studies focus in on sleep reactivity, or the extent to which stress affects the ability to fall sleep or remain asleep.

While it’s evident that stress can disrupt sleep, not everyone who experiences stress or who is going through a stressful time will deal with insomnia or sleep disturbances.

Changes in libido

Many people experience changes in their sex drives during stressful periods.

One small study evaluated the stress levels of 30 women and then measured their sexual arousal while watching an erotic film. Those with high levels of chronic stress experienced less sexual arousal compared with those with lower stress levels.

A much more recent study published in 2021 on the impact of the COVID-19 pandemic on women’s reproductive health found that 45% of the over 1,000 women surveyed reported a reduced libido due to stress.

In addition to stress, there are many other potential causes of changes in libido, including:

• hormonal changes
• fatigue
• psychological issues

Depression

Some studies suggest that chronic stress may be associated with depression and depressive episodes.

One study of 816 women with major depression found that the onset of depression was significantly associated with both acute and chronic stress.

Another study found that high levels of stress were associated with the onset of major depression in adolescents (9).

In addition, a 2018 review highlighted the connection between depression and the experience of chronic or inescapable stress (10).

Besides stress, some potential contributors to depression include:

• family history
• age
• environmental factors
• even certain medications and illnesses

Physical effects of stress on the body

Acne

Some studies have found that higher levels of stress are associated with increased bouts of acne.

One reason for this may be because when some people feel stressed out, they tend to touch their faces more often. This can spread bacteria and contribute to the development of acne (12).

Several studies have also confirmed that acne may be associated with higher levels of stress.

One small study measured acne severity in 22 university students before and during an exam. During examination periods in which stress increased, acne became more severe.

Another study of 94 teenagers found that higher stress levels were associated with worse acne, particularly in boys.

These studies show an association, but they don’t account for other factors that may be involved. Further research is needed to look at the connection between acne and stress.

In addition to stress, other potential causes of acne include:

• inflammation
• hormonal shifts
• bacteria
• excess oil production
• clogged pores

Headaches

Many studies have found that stress can contribute to headaches, a condition characterized by pain in the head, face, or neck region.

A 2015 study showed that increased stress intensity was associated with an increase in the number of headache days experienced per month (15).

Another study surveyed 172 military service members at a headache clinic, finding that 67% reported their headaches were triggered by stress, making it the second most common headache trigger.

A smaller 2020 study also found that stress can be a driving factor in tension headaches [17].

Other common headache triggers can include lack of sleep, diet, alcohol consumption, hormonal changes, and more.

Chronic pain

Aches and pains are a common complaint that can result from increased levels of stress. Some studies have found that chronic pain may be associated with higher levels of stress as well as increased levels of cortisol, which is the body’s main stress hormone.

For example, one very small study compared people with chronic back pain to a control group. It found that those with chronic pain had higher levels of cortisol (18).

Another study showed that people with chronic pain had higher levels of cortisol in their hair, which the study described as a novel indicator of prolonged stress.

Keep in mind that these studies show an association but don’t look at other factors that may be involved.

Besides stress, there are many other factors that can contribute to chronic pain, such as:

• aging
• injuries
• chronic poor posture
• nerve damage

Frequent sickness

If you feel like you’re constantly battling a case of the sniffles or other sickness, stress may be to blame.

Stress may take a toll on your immune system. Studies show that higher stress levels are associated with increased susceptibility to infection.

In one study, 116 older adults were given the flu vaccine. Those with chronic stress were found to have a weakened immune response to the vaccine, indicating that stress may be associated with decreased immunity (20).

Similarly, one analysis looking at 27 studies showed that stress was linked to increased susceptibility of developing an upper respiratory infection (21).

A chapter in the 2019 book “The Impact of Everyday Stress on the Immune System and Health” stated that psychological stress can affect a range of bodily functions, such as inflammatory responses, wound healing, and the body’s ability to fight off infection and disease (22).

However, stress is just one piece of the puzzle when it comes to immune health. A weakened immune system can also be the result of:

• a low-nutrient diet
• substance use
• physical inactivity
• disorders of the immune system, such as AIDS

Digestive issues

Some studies have found that stress may be associated with digestive issues, like constipation, heartburn, diarrhea, as well as digestive disorders.

For example, an older study from 2010 that focused on 2,699 children found that exposure to stressful events was associated with increased rates of constipation (23).

Stress may especially affect those with digestive disorders such as irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD).

In one study, increased symptoms of digestive distress were associated with higher daily stress levels in 181 women with IBS ().

Additionally, one analysis of 18 studies that investigated the role of stress on inflammatory bowel disease noted that 72% of studies found an association between stress and negative clinical and symptom outcomes (25).

A study from 2017 also highlights the direct connection between stress and symptoms of IBS, saying stress plays “a major role” in the manifestation and worsening of digestive symptoms (26).

Keep in mind that many other factors can cause digestive issues, such as diet, bacteria, infections, certain medications, and more.

Appetite changes and weight gain

Changes in appetite are common during times of stress.

When you feel stressed out, you may find yourself with no appetite at all or overeating without noticing.

One small 2006 study of 272 female college students found that 81 percent reported that they experienced changes in appetite when they were stressed out, with 62 percent stating they had an increase in appetite (27).

Changes in appetite may also cause fluctuations in weight during stressful periods. For example, a study involving 1,355 people in the United States found that stress was associated with weight gain in adults already living with extra weight.

A third study from 2017 found that individuals with higher cortisol and insulin levels and higher levels of chronic stress were more likely to gain weight in the future. However, the study was limited in the scope of research in that participants were predominantly white females.

While these studies show an association between stress and changes in appetite or weight, more studies are needed to understand other possible factors are involved and how stress impacts different people.

Rapid heartbeat

Several studies have shown that high stress levels can cause a fast heartbeat or heart rate. Stressful events or
tasks may also increase heart rat.

In a similar study from 2001, exposing 87 students to a stressful task was found to increase heart rate and blood pressure. Interestingly enough, playing relaxing music during the task actually helped prevent these changes (31).

According to the American Heart Association, undergoing a stressful event can cause your body to release adrenaline, which is a hormone that temporarily causes your heart to beat faster and your blood pressure to rise. This is one reason why living with increased stress may create a rapid heartbeat.

Sweating

Exposure to stress may also cause excess sweating, research suggests.

One small study looked at 20 people with palmar hyperhidrosis, a condition characterized by excess sweating in the hands. The study assessed their rate of sweating throughout the day using a scale of 0–10.

Stress significantly increased the rate of sweating by two to five points in those with palmar hyperhidrosis, as well as in the control group.

Another study found that 40 teenagers exposed to stress experienced high amounts of sweating and odor.

A 2013 review on “psychological sweating” notes such sweating occurs in response to stress and anxiety, stating this type of sweat typically appears on the face, palms, soles of the feet, and underarms (35).

Treatment options

As nice as it would be to have a single pill that could completely eliminate all stress, because there are so many different factors that cause stress, there is no one-size-fits-all way to treat it.

Talking with your doctor or a therapist is a great first step, as they can help you figure out what exactly is causing your stress and suggest ways to manage and treat it. They can also help you figure out if your symptoms are indeed caused by stress or another preexisting condition.

According to the Centers for Disease Control and Prevention (CDC), there are a few lifestyle choices that can also help in managing stress. Some of these include:

• taking breaks from the news
• taking breaks from your devices (computer, phone, TV)
• getting adequate exercise and sleep
• taking breaks to allow your body to rest
• increasing nutrient-rich foods in your diet
• doing deep breathing exercises
• meditating
• avoiding excessive substance use
• talking with friends, a trusted advisor, or a therapist
• building community though faith-based organizations or activities you enjoy

If you feel overwhelmed from stress and aren’t sure what to do, or are having feelings of self-harm, it’s important to talk with someone you trust or a therapist.

You can also call the national suicide prevention lifeline at 800-273-8255, 24 hours a day.

Help is always available.

Complications of long-term stress

Chronic stress can affect your entire body, and if it’s not properly managed, can cause serious issues, such as (37):

• back pain
• muscle tension
• worsening asthma symptoms
• worsening obstructive pulmonary disease (COPD) symptoms
• increased risk of hypertension, stroke, or heart attack
• mental health conditions

The bottom line

Occasional stressful events are a part of everyone’s life.

Working through and processing these events — with a support system, if needed — is key to keeping chronic stress at bay.

Chronic stress can take a toll on your mental and physical wellness, creating a wide range of symptoms such as low energy levels, headaches, changes in mood, and decreased sex drive.

Fortunately, there are many ways to help relieve stress, such as talking with friends or a therapist, exercising, and meditating.

Originally published on Healthline December 14, 2021. Written by Rachael Ajmera, MS, RD., Medically reviewed by Cydney Ortiz, PsyD. Republished with permission.

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