What is chronic stress?
Chronic stress is a state in which the body functions in a mode of “continuous mobilization” for weeks or months. It is not about a single difficult situation, but about a long-lasting sense of overload from duties, responsibilities or relationships – without real space for regeneration.
The nervous system, which is supposed to switch on an “alarm mode” briefly, begins to act as if the threat were present all the time. Over time this state stops being perceived as “something exceptional” and becomes for many people a new “norm” – until clear symptoms in the body and mind appear.
Chronic stress – symptoms in the body
Chronic stress has very concrete effects on the body, although it is not always immediately associated with the psyche. Common symptoms include:
chronic muscle tension (especially neck, shoulders, back, jaw),
recurrent headaches or migraines,
gastrointestinal complaints (diarrhea, constipation, abdominal pain, “tight stomach”),
palpitations, shortness of breath, pressure in the chest,
sleep problems – difficulty falling asleep, waking up, early awakening,
greater susceptibility to infections, a sense of “constant cold”, slower recovery.
Long-term elevated stress hormone levels can also contribute to the development of hypertension, metabolic disorders, worsened glycemic control or increased inflammatory states. From the perspective of holistic psychiatry somatic symptoms are an integral part of the clinical picture, not an “addition”.
Chronic stress and the psyche
The connection between stress and the psyche is especially visible when tension persists for months.
Symptoms may include:
increasing anxiety, difficulty “switching off thoughts”, excessive worrying,
irritability, explosiveness, reduced tolerance for frustration,
concentration problems, “brain fog”, losing the train of thought,
low mood, a sense of being overwhelmed, helplessness,
gradual loss of joy in things that previously brought satisfaction.
Chronic stress is one of the risk factors for developing depression, anxiety disorders, adjustment disorders or occupational burnout. In some people it leads to maladaptive regulation strategies – excessive alcohol, compulsive eating, workaholism, or addictions to digital stimuli.
How does chronic stress affect the nervous system?
Chronic stress changes how the nervous system works. It increases the excitability of structures responsible for fear responses and vigilance while reducing the brain’s capacity for regeneration, learning and emotion regulation.
In practice this means that even small stimuli (an email, a phone call, a minor conflict) can trigger a response similar to a major threat. The nervous system “learns” to be in alarm. Over time this can lead to:
a chronic sense of tension or “freeze”,
difficulty resting even during free time,
increased sensitivity to noise, light, social stimuli,
difficulty changing habits and maintaining new coping strategies.
Regulating the nervous system is therefore a key element in working with chronic stress – alongside pharmacotherapy or psychotherapy, if indicated.
Chronic stress, lifestyle and burnout
Lifestyle can both alleviate and exacerbate the effects of stress. Overworking, lack of time boundaries, constant online availability, irregular sleep and lack of real rest create the ground for occupational and emotional burnout.
Occupational burnout often begins innocently: with “overfatigue” and the sense that one must “hold on a little longer”. Over time the following appear:
chronic fatigue that does not subside after a weekend or vacation,
reduced engagement, indifference, cynicism,
a sense that “I have nothing left to give”.
In a holistic approach one analyzes not only symptoms but also context: pace of work, responsibility, way of resting, beliefs about effectiveness and “being strong”.
Where does a psychiatrist fit in?
In the stream of holistic and integrative psychiatry chronic stress is an important starting point for diagnosis and treatment. During a psychiatric consultation in-person, online, psychiatric teleconsultation or e-visit with a psychiatrist one can:
discuss somatic and psychological symptoms related to chronic stress,
assess whether an episode of depression, anxiety disorders or burnout has already occurred,
plan pharmacological treatment (if indicated) and further therapeutic steps,
organize priorities in lifestyle and nervous system regulation.
Online psychiatry can combine a medical approach with work on habits, psychoeducation and support for the nervous system.
Selected sources
McEwen B.S., Protective and damaging effects of stress mediators, The New England Journal of Medicine.
Juster R.P., McEwen B.S., Lupien S.J., Allostatic load biomarkers of chronic stress and impact on health and cognition, Neuroscience & Biobehavioral Reviews.
Slavich G.M., Psychoneuroimmunology of stress and mental health, Current Opinion in Psychology.
Maslach C., Leiter M.P., Understanding the burnout experience: recent research and its implications for psychiatry, World Psychiatry.
Harvey A.G., Sleep and circadian functioning: critical mechanisms in the mood disorders?, Annual Review of Clinical Psychology.
The information in this article is general and educational in nature.
They do not constitute medical advice or an individualized diagnostic or therapeutic recommendation.
Decisions regarding initiation, continuation or change of treatment, including modification of doses of antidepressant medications, should be made only after consultation with a physician, taking into account the patient’s full clinical picture.
