What is Stress?

Stress is an unavoidable and—in small doses—a very important part of our lives. Without it, you’d never have been able to ask your high-school sweetheart out on that first date or pull an all-nighter before a final exam. You couldn’t beat out an infield single, your heart wouldn’t pound while watching a horror movie, and you wouldn’t feel the slightest joy at the birth of your child or buying a car. In some cases, stress can actually save your life. For example, if you’re in a dangerous situation or feeling afraid, your body gives you a jolt of adrenaline and goes into “fight or flight” mode. Your pulse races and blood rushes away from your face and body and out to your arms and legs so you can protect yourself or get away from whatever it is that’s threatening you (that’s why people who are frightened are often “white as a sheet”).

In today’s world, it’s unlikely that you’ll ever come face to face with a lion or need to get out of path of an oncoming train. But you’ll deal with lots of smaller stresses every day, like looming deadlines, some nut cutting you off in traffic, or an argument with a customer or your wife or child. Your body responds to these small stresses in pretty much the same way as it does to larger ones. Fortunately, in most cases—when the immediate excitement or danger has passed—your pulse slows down, your muscles relax, and you can get on with your day.

Sometimes, though, the pressures of daily life pile up and your “fight or flight” response never fully shuts off, causing your body to stay in stress mode longer than it should. When that happens, you may develop any number of physical or psychological symptoms, which we’ll discuss later in this chapter. For now, let’s talk about the four basic kinds of stress.

Acute stress has to do with the way you respond to individual situations or events. For example, getting a call from your child’s school telling you he’s being expelled, hitting every red light on your way to work, finding out you’re going to be audited by the IRS, or a huge project that’s due at the end of the week. With acute stress, you almost always know exactly what the cause is. And because the situation is usually resolved within a day or two, there isn’t enough time to do any long-term damage. Still, acute stress can cause headaches, irritability, anxiety, pain in the jaw, back, or neck, adult acne, and some short-term stomach problems such as irritable bowels, diarrhea, and heartburn.

Ongoing acute stress is similar to acute stress, except that the situation or event that’s causing the stress doesn’t end. What we’re talking about here is that pile of work that you’re never quite able to dig your way out from under, always being in a hurry but never managing to get anywhere on time, your inability to say “No” to people and then getting angry that you didn’t stand up for yourself, or the feeling you can’t seem to shake that something terrible is about to happen. People who have ongoing acute stress can seem nervous, and are often perceived as rude, short-tempered, tense, or abrupt. Physically, they can suffer from an increase in blood pressure and pulse, sweatiness, dizziness, headaches, chest pain, and difficulty taking a full breath.

Chronic stress is like ongoing acute stress except on an even larger scale. Chronic stress can be caused by poverty, being trapped in an unhappy marriage, a job you hate but can’t quit because your family needs the money, or a chronic illness. It’s pretty hard not to notice acute stress, but chronic stress can become so much a part of your day-to-day life that it’s easy to ignore it and resign yourself to never finding a way out of your current situation. But ignored or not, it wears you down every day of your life and may cause many serious long-term physical and emotional health problems, including heart attack, stroke, violence towards others, and even suicide.

Post-traumatic stress is the fallout from a terrifying or catastrophic event in your life, usually something where you, or someone close to you, were in danger of being seriously hurt or killed. It could be a car crash, being a witness or the victim of a violent crime, serving in combat, or living through a natural disaster such as a hurricane or earthquake.

Many people who experience traumas recover quickly and get back to their normal lives. But not everyone. Some develop Post-Traumatic Stress Disorder (PTSD). They may re-live the event over and over, in nightmares at night and scary thoughts during the day. They may go to extraordinary lengths to avoid any reminder (people, places, smells, etc.) of the event. They may also develop symptoms of any or all of the other types of stress discussed above. Those symptoms, if they occur, usually appear around three months after the event, although it could be as much as a year or longer.

Stress is so widespread that many mental health professionals consider it America’s biggest health problem. The American Institute for Stress estimates that 75-90 percent of all visits to primary care physicians are for related issues.