Stress: The Good, the Bad and the Ugly

Stress is how we react when we feel under pressure, threatened or out of control.

"Psychological stress is caused by a belief, sometimes only in the subconscious, that you may not have the resources to complete a task or resolve an awkward situation," said Terence Watts, M.C.G.I., a psychotherapist, author and founder of the BWRT Institute, based in the United Kingdom. Watts created a groundbreaking technique based in neuroscience to help manage anxiety, stress, phobias, addictions and PTSD.

Acute stress may last a few minutes or hours but can be intense over this short period. Examples of acutely stressful situations include sitting for an exam, being assaulted or witnessing an accident. Stress that prolongs over weeks, months or even years, perhaps due to being under lots of pressure a lot of the time, is known as chronic stress. Living in poverty, having a high-pressure job or being a full-time caregiver for a family member are all situations that could lead to chronic stress.

Watts explained stress might be connected to work requirements, providing support for a loved one, having to confront somebody, or anything else you fear you may not have the tools to manage well.

"It mostly affects those who are either extremely conscientious or already feeling threatened in some way or those who have failed to cope well with similar situations previously," he added.

If your expectations of yourself are too high, you probably feel stressed most of the time.

Political and world unrest always contribute to underlying stress levels. Hence, fears of a resurgence of a pandemic, money, the war in Ukraine, climate change, reported food shortages and concern about the trustworthiness of political leaders are all causing problems right now, Watts said.

According to the Stress in America 2022 report, a high percentage of adults report feelings of uncertainty and unrest regarding the government and their civil liberties. Indeed, 70 percent of adults in the United States reported they don't think people in the government care about them, and 64 percent said they feel their rights are under attack.

This is in addition to the continued high stress and anxiety levels regarding the COVID-19 pandemic, which has impacted people's mental health due to isolation, job losses, financial uncertainty, illness and grief of varying forms. Three years after the onset of COVID-19, the Kaiser Family Foundation reported that 90 percent of adults believe America is facing a mental health crisis.

In 2023, 50 percent of young adults ages 18 to 24 reported symptoms of anxiety and depression following the pandemic, making them more likely than older adults to experience mental health symptoms. There are also rising levels of concern around gun violence, crime, mass shootings, safety and feeling unprotected.

However, it's not just these national and international issues that cause problems, it's also the fear others may be coping better. It's the fear that the inability to deal with or somehow bypass the situation reveals a personal weakness, Watts added.

Everyone manages stressful situations in different ways and the level of stress some people are comfortable with may be higher or lower than others. Typically, feelings of stress start to negatively impact a person when they feel they do not have the skills or resources to manage the problem faced.

Stress itself is not considered a mental health problem. But stress can cause mental health concerns, just as mental health concerns can cause stress.

"Stress is the result of having too many 'balls in the air' to be certain that you will catch them all cleanly," Watts explained. "It's a feeling of being in some way at your limits and that you have no leeway for error or mishap."

Anxiety and depression are two different types of mental health disorders that are both extremely common.

Anxiety is a normal response to stress or danger and can be a good thing as it's your body's natural way of warning you about a threat. However, prolonged, excessive feelings of worry, panic attacks, restlessness or obsessive thoughts are a sign you might be suffering from anxiety.

The different types of anxiety include the following:

• Generalized anxiety disorder
• Obsessive-compulsive disorder (OCD)
• Panic disorder
• Phobias
• Separation anxiety
• Social anxiety disorder (SAD)

"Anxiety arises when it becomes evident that you're likely to 'drop the ball' despite your best efforts, and anxiety is a subconscious response to trigger greater effort," Watts noted. "And it is when that greater effort fails to produce the desired result that depression can set in."

Although symptoms of depression and anxiety can be similar, depression is a mood disorder that leads to a person having feelings of hopelessness, worthlessness, apathy and sadness, and these feelings interfere with their daily functioning and life.

Types of depression might include:

• Atypical depression
• Major depressive disorder
• Persistent depressive disorder
• Postnatal depression
• Prenatal depression
• Psychotic depression
• Seasonal affective disorder

It's common for anxiety and depression to occur together, so it can be tricky to know which one you have or if you have both. And you can also suffer from stress with either of these conditions or on its own. Long-term stress or severe stress can lead to physical, mental and emotional symptoms.

Watts explained that the earliest indicators of stress are often a change in sleeping patterns: nightmares, insomnia or frequent waking, sleeping more than usual or being excessively tired.

"Another early symptom is a change in appetite or diet, or craving sugary foods, for example," he added.

Smriti Joshi, the chief psychologist at Wysa, a mental health wellness platform based in India, said untreated stress can have significant long-term impacts on mental health as follows:

• Chronic stress can interfere with sleep, making it difficult to fall asleep, stay asleep or get restful sleep. This can exacerbate existing mental health conditions and make it difficult to manage stress.
• Prolonged exposure to stress can lead to feelings of anxiety, including excessive worry, nervousness and tension.
• Stress can increase the risk of substance abuse, as people may turn to drugs or alcohol as a way of coping with their stress.
• Stress can lead to burnout, which is a state of emotional, physical and mental exhaustion. Burnout can make it difficult to manage everyday tasks and lead to a loss of motivation and interest.
• Stress can lead to depression, which can cause feelings of sadness, hopelessness and a loss of interest in daily activities.

However, Watts added that there are other, less obvious indicators, such as mood changes, a feeling "something bad" is going to happen soon or a general feeling of uneasiness for which you can't pinpoint the reason.

It's time to speak to your healthcare provider if you're feeling any of these situations or symptoms:

• Feelings of stress are impacting your mental health.
• Feelings of stress are impacting your physical health.
• Techniques you're trying yourself to reduce your stress levels are not helping.
• You have been feeling stressed for a long period of time.
• You need to use alcohol or drugs to deal with stress.
• You're experiencing a lot of stress.
• You're struggling to cope with stress.

Many stress symptoms can stem from a medical issue, and Watts recommended consulting a medical professional if you notice any change in the way your body functions, even when there's a current situation that would account for stress.