How stress affects our mental health

With evidence to suggest that stress contributes to physical and mental illness, we need to work hard to avoid overwhelm and burnout - but how?

Achieving balance and optimal wellbeing has been said to be dependent upon our ability to keep our internal balance or ‘homeostasis’ in the face of a changing environment.* Whilst it is practically impossible to avoid stress completely, finding ways in which to cope can help to alleviate the effects on our physical and emotional health. The Mini SKINday Times talks to Dr Justine Jordan about the ways in which to do this...

What is stress?

Stressful situations can be defined as ones in which the demands of the situations threaten to exceed the resources of the individual.** When it perceives a stressor (an actual or perceived threat), the brain signals the release of serotonin and adrenaline. Stress hormones then follow which are said to impact areas of the brain that are vital for memory and regulating emotions.

In general, stress responses in healthy individuals do not cause any harm, however prolonged proinflammatory cytokine production may negatively affect mental health in more vulnerable individuals and during times of illness, and can produce symptoms of fatigue, loss of appetite, and listlessness, all of which are symptoms also associated with depression.

How chronic stress is different

In situations in which the stressor is overwhelming and continuous, stress becomes chronic. ‘Short term stress is normal emotion to experience,’ explains Dr Justine Jordan, ‘Short term stress is what we all experience at times in our lives. This includes exams, job interviews, and meeting new people. This can increase our energy, improve our performance, and can help focus you on the job at hand. The problem arises when this short-term, moderate level stress escalates, and people can experience panic attacks which are distressing and at times terrifying for people.’ Studies have reported that chronic stress is linked to changes in certain brain areas, such as the prefrontal cortex and limbic system, which can cause cognitive, emotional, and behavioral changes. ‘Nature's way of improving our performance by increasing our heart race, visual acuity, blood pressure and concentration is over exaggerated and proves to be maladaptive.’

Impact on mental health

Experiencing long-term stressful situations without effective stress management techniques can lead to sleeping issues, burnout and emotional overwhelm. Research has also found that mental health conditions such as anxiety and depression can also be linked to stress. ‘On a daily basis, I see people suffering with chronic stress suffering with either anxiety or depressive type symptoms,’ says Justine. ‘In states of long-term stress your cortisol raises, increasing blood pressure, heart rate, causing poor sleep, being unable to enjoy usual activities, it can cause poor concentration. All these have a cumulative effect, and we can easily end up in a vicious circle leading to low mood and even panic attacks.’

How effectively a person can cope with stress has been suggested to be influenced by a person's perception of its predictability and controllability. This means that stress-related outcomes vary according to personal and environmental factors, but we can all make an effort to boost our resilience to stress, ‘Stress management is not something we are born knowing how to do, explains Justine. ‘Yes, some are us are more relaxed in general that others and let things “roll off their backs” so to speak but we all should be learning stress management skill from a very early age.’

‘We can all do things to help build our resilience to stress. There is no avoiding stress in our lives and so learning to deal with this head on is essential to avoiding chronic stress and the long-term consequences of this. We can begin by looking after our physical health, finding time to relax, explore hobbies, build support networks, spend time in nature, organise our time and importantly, we can try to identify our triggers.’

And what shouldn’t we do? ‘We should avoid drinking or taking illicit drugs. This never helps and only causes bigger issues down the road. We need to find time daily to unwind and pursue a hobby. Guided meditations that are free to access, simple to perform and incorporate deep breathing can help. Finally limit phone and social media time and get out in nature. We know this boosts our mood and can decrease our blood pressure and increase our endorphins (happy hormones). We need to take time daily to do something that brings us joy,’ Justine summarises. ‘I often see patients eager to start medications and yes, they are very helpful and even lifechanging in certain circumstances, but they never work alone, they need to be used in conjunction with talk therapy, self-care and social interaction to have the best effects.’

How to recognise burnout

‘Burnout is best described as physical and emotional burnout,’ Justine informs us. ‘Symptoms can be very subtle and present gradually so are often missed or not recognised at the time. People often reflect on periods of their lives and recognize burnout after the fact. Chronic exhaustion is a major symptom, cynicism, decline in performance at work, irritability affecting relationships and people describe a lack of interest or motivation.’

*Bernard, 1961 and Cannon, 1956.
**Lazarus & Folkman 1984
**Schneiderman N, Ironson G, Siegel SD. Stress and health: psychological, behavioral, and biological determinants. Annu Rev Clin Psychol.

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