This post was written based on a conversation with Jill Zahm, program coordinator, Her Heart program, Parkview Heart Institute.
Unlike acute stress, which is tied to a certain situation that resolves and passes, chronic stress is typically defined as stress that lasts for weeks or even months. We’re really starting to understand how this prolonged stress negatively affects our physical, emotional and behavioral health.
Sources of chronic stress
Relationships
A major source of prolonged stress is relationships. Often, we see unhappiness linked to strained family connections, maybe tied to a sibling or parent-child dynamic and different views around lifestyle choices. The most relatable example might be a parent and their teenager, working to navigate personality changes and the shift toward independence.
This undercurrent of unhappiness is also seen with adult children and aging parents, as the roles tend to reverse, which can cause tension. In this dynamic, there’s also the stress of coordinating care for the parent, which can involve long hours, appointments and domestic challenges, as well as the parent feeling a loss of independence. Of course, the child also feels the anticipatory grief of knowing that the resolution will likely involve losing their parent.
Chronic stress can also show up in our romantic relationships, such as a troubled marriage. Poor communication or unresolved disagreements can generate a good deal of unhappiness.
Work
Most people can relate to the relentless strain of occupational stressors. From a constant, heavy workload and long hours to a lack of decision-making or feeling your voice isn’t heard, our jobs can certainly contribute to negative feelings.
There’s also a relationship element to our professional lives. Co-workers who don’t pull their weight or have difficult personalities can make going to work incredibly stressful.
Where acute stress would be meeting a deadline and moving on, most careers involve a constant stream of critical demands. This is very common in healthcare and sales roles. Employees experience the pressure to perform that never goes away. The only resolution is to quit that job and find another position, which might have the same exhausting workload. This is absolutely a source of chronic stress.
Other common sources of chronic stress include:
- Health challenges or setbacks
- Finances
- The news cycle and social media
Of course, some people have a natural tendency toward anxiousness or fear. Their fight-or-flight response just seems to be a bit heightened. The most important thing for these – and really all – individuals is to learn how to recognize the triggers instead of masking them and pretending we’re fine. If this generalized anxiety is left untreated, it will likely lead to feelings of chronic stress.
The sensations of chronic stress
When we talk about chronic stress, we’re referring to physical and mental symptoms akin to general anxiety. And these can show up in surprising ways, such as:
- Aches and pains
- Upset stomach or diarrhea
- Fatigue
- Trouble sleeping
- Foggy thinking
- Changes in eating patterns (lack of appetite or overeating)
- Lack of interest in hobbies or socializing
- Excessive sweating
- Depression
- Unfounded anger toward loved ones
- Negative thinking
Identifying and addressing chronic stress
It's very important to tune into your body and mind and learn how to recognize the unique ways you react to stress. If you have a backache and you haven’t done anything strenuous, like lifting weights, it could be a stress response. The same can be true for changes in bowel movements, mood and sleep.
Pause and ask yourself why you’re experiencing a physical or mental shift. If you don’t have a simple explanation, the next step is to contemplate your emotional life. Are you upset about something? Are you experiencing stress in a particular area?
If that connects for you, keep a mental or actual diary where you can document and track symptoms and stressors. This can be incredibly helpful in making connections to what you might be internalizing or holding onto that’s feeding that chronic stress. As humans, we tend to treat every ache or discomfort with something from the medicine cabinet, instead of dealing with the underlying issue. But those physical symptoms might be coming from something medication can’t cure.
Diagnosing chronic stress
From a clinical perspective, it’s common for primary care providers or care team members to ask about changes in the symptoms listed above. The actual biometrics affected by chronic stress that we can measure would be:
- Depression scale
- Blood pressure
- Heart rate
- Weight
Chronic stress and the heart
Our bodies were designed to deal with stressors. If our ancestors were out foraging and saw a bear, they knew they had to run. Adrenaline kicked in, and instinct took over. While that’s true today, our world has fewer bear encounters and more constant stressors. Everywhere we turn, there are traffic jams, work demands, travel sports and hectic routines for our kids. We have a 24-hour news cycle, and social media and notifications dinging in the palms of our hands. Most people feel overworked, overstimulated and overscheduled.
With these relentless feelings of running perpetually late and never having enough hours in the day, it’s no wonder we are such a stressed-out society. Unlike our ancestor, who encountered the bear, had an adrenaline and cortisol spike and then relaxed once the threat had been averted, we often find ourselves in a constant state of stress response, and that can take a toll on our physical health.
This consistent release of the stress hormone (cortisol), rather than just a surge, cause inflammation in the body. This causes oxidation within our blood vessels, which in turn damages them and makes them more prone to plaque development, blockages and, ultimately, heart disease or, more specifically, coronary artery disease. These complications can be a major risk factor for a heart attack, arrhythmia and heart failure.
Methods for addressing chronic stress
In today’s culture, it’s common for people to just accept the constant stream of stress as normal. But bathing in a shallow pool of unhappiness isn’t normal, and there are strategies that can help us break away from chronic stress. I love the quote, “Your comfort zone isn't always a good place for you to be.”
The next time you notice your body responding to a stressor, try one of these methods:
Mindfulness – This can apply to everything you do–eating, moving, sleeping, communicating, driving, working and interacting. (Search “mindfulness” on parkview.com for more great content.)
An added benefit of mindfulness is that it keeps you in the present. Remember, if you spend too much time worrying about yesterday, you aren’t giving today its due.
Positive self-talk – The way you talk to yourself, has a huge impact. Whether you choose to think of it as manifesting, affirmations or simply giving yourself a pep talk, healing starts with self-love. If you’re struggling, ask someone who is close to you–they can probably tell you a handful of things they like about you that you might not see in yourself. If you have nagging negative thoughts, I recommend writing them on paper to get them out of your head, wadding them up and tossing them in a fire or trash can. Get rid of what doesn’t serve you.
Breathwork and guided imagery – There are many breathing and guided imagery exercises available to promote relaxation. I like 4-7-8 breathing, which is proven to help with insomnia. But cloud breathing is my favorite. To do the exercise, picture beautiful, puffy, white clouds against a blue sky. As you breathe in for some slow counts, envision breathing in a puffy cloud. Name the cloud something that brings you comfort, such as peace or love. As you exhale, imagine you’re blowing out a dark factory smokestack. You can name the dark air something you’d like to stop worrying about, like doubt, deadlines or even stress. I find this exercise keeps me focused and I love that I can do it anywhere, for any length of time.
I also like to have people fill a small basin with sand, like one you might use for a foot bath. When stress strikes, put your toes in the sand and take a mental vacation to the beach. You’d be surprised how effective it is.
Clean up your sleep hygiene – Establish a wind-down routine that helps you transition from the day’s work to rest. Breathwork and guided imagery are great additions here. This includes creating an environment for sleep that’s cool, dark and comfortable, and also designated only for intimacy and sleep. We have so many great articles on this, including the importance of powering down.
Plan ahead – Things like meal planning, a family calendar and even scheduling apps, can help take some of the late-night worry away. This can also come in handy if your stress is tied to a project or professional challenge. Map out an action plan to make the situation feel more manageable.
Move – It’s amazing how a walk or gentle movement can boost your mood. Carve out time to move your body.
Fuel thoughtfully – Consume a healthy diet, with plenty of fruits and vegetables, and drink water to stay hydrated. Try to limit caffeine (especially close to bedtime) and sugar. This helps your body address stress and stay balanced.
Lean on the experts – It is crucial that you seek the support of a mental health professional if you are struggling to find relief from chronic stress or experience anxiety or depression. Talking to and receiving guidance from a professional can be so helpful. In addition to counseling, they can also help determine if medicinal intervention is necessary and a good fit for you.
While many still struggle with the stigma of mental health services, there’s no need to feel shame about the use of therapy or medication to manage emotional wellness. It’s not a matter of strength or willpower. The brain is an organ, just like the heart. If you were diagnosed with a cardiac condition, you probably wouldn’t hesitate to take a prescription. So, why should a mental health diagnosis be any different? These targeted, highly effective medications can help reorganize the chemicals in our brains and tame our stress response. This is certainly a safer option than substances such as alcohol and tobacco, both of which can lead to further physical stress and complications.
Intentional breaks – At least once a day, give yourself a few moments when you don’t have to be anywhere or do anything. Whether it’s three minutes or 30, it’s revitalizing to just stare at the flowers outside, take a bath, call a friend or rest your mind. Find something that speaks to you and give yourself room in the day to savor it. It’s a perfect reset button to bring you out of autopilot.
Reframe – The truth is that we can’t control a good number of the stressors we encounter. This is where reframing can be helpful. Start by naming the stressor, then ask yourself, how important will this challenge or setback be in a week, six months, in the light of eternity? Taking the stressor at that value can rob it of its power. Maybe it isn’t as important as you originally thought and you can let go a bit. Consider what you can learn from the situation and try to move forward.
Another example of reframing would be a recommendation I give around the holidays, when we tend to gather with family. Instead of focusing on differences and the past, make gatherings fun. I love to do icebreakers, where everyone writes down and takes turns answering questions like, “What three books would you read again?” and “What five people would you invite to dinner, living or dead?” It’s a healthy way to minimize relational stress and inject a little fun.
Practice gratitude – There is always something to be thankful for. Find the gifts in the grind and call them out. Write them down. Make them part of your nightly wind-down routine.
All of these approaches can help you slow down, replace those stress hormones with happy hormones, connect with the beauty around you and be in the moment. It’s in these intentional breaks and breathwork we realize that, even on the roughest days, everything is in its place. The world is still spinning.
The power of taking control
When we take action and decide to make lifestyle or mindset shifts, it’s amazing how much easier it becomes to handle stressors in a healthy way. You are worth loving, and once you realize that, you can truly see the value in positive self-talk, nourishing food, movement and moments of calm. You feel less guilty prioritizing your sleep and mental well-being. And the best news is, these changes have massive benefits for your heart!
Understanding you are worthy has a tremendous trickle-down effect. The numbers on the scale go down, cholesterol readings change and blood pressure stabilizes. Once you focus on being good to your body for the sake of loving it, rather than shedding weight or looking better, the rest tends to all into place. Self-worth is a higher motivator than being told to change.
I end every Her Heart Support Group meeting by having the attendees stand and place their hand over their hearts. I tell them to breathe in and let it out. I ask them if they can feel their capes flapping behind them, because they are superwomen. But, I remind them, it’s not because they take care of the world. It’s because they realize that they deserve to love themselves and their hearts. Pouring from a full cup is always more powerful than pouring from an empty one.
In our culture, everyone is so busy and always in a hurry. We might walk by somebody who’s crying inside and never know, because they still smile at us and say they’re fine. I say, never be afraid to speak your emotions. God gave us tear ducts for a reason. Find a person that makes you feel safe and share what you’re going through. Surround yourself with people who support you and don’t tear you down.
Resources
For those looking to make healthy shifts and reduce stress, I recommend these Parkview resources:
- Parkview Behavioral Health Institute HelpLine
- Parkview Center for Healthy Living
- Community churches and organizations such as the YMCA
- Parkview Classes and Events
- Support groups
