Moving From Chronic Stress to Wellbeing & Resilience

Stress.

It can be as minute as daily hassles, car trouble, or an angry boss or as massive as financial strain, a death, or terminal illness.

The ongoing stressors that are psychologically taxing and persist over time lead to what we know as chronic stress.

While most people know that chronic stress can lead to negative physical, mental, and emotional health, the good news is that it can also be a catalyst to build resilience and improve wellbeing.

To understand how that could be possible, we investigate chronic stress, its causes and symptoms, protective factors, and great ways to reduce stress and move toward wellbeing.

Before you continue, we thought you might like to download our three Stress & Burnout Prevention Exercises (PDF) for free. These science-based exercises will equip you and your clients with tools to better manage stress and find a healthier balance in your life.

Breaking Down Chronic Stress: An Explanation

Any demand placed on an individual that they perceive is greater than the resources they have to meet that demand is considered a stressor (Lazarus & Folkman, 1984).

Stress is a normal physical and psychological response to changes or challenges in the environment (Aldwin, 2007).

The autonomic nervous system is activated when individuals encounter a perceived threat. The autonomic nervous system releases hormones that increase heart rate and breathing, create changes in vision and hearing, and slow digestion so that blood flow can be redirected to muscles — fight or flight (Aldwin, 2007).

Stress response

The first stage of the stress response is fight or flight. This is the physiological stress response that has kept humans alive for thousands of years. In order to survive, humans need to be aware of physical dangers and have the strength, focus, and endurance to escape.

This stress response begins when an individual perceives a threat, and the emotional interpreter of the brain, the amygdala, sends a distress signal to the hypothalamus. The hypothalamus activates the autonomic nervous system (McEwen, 2013).

The autonomic nervous system controls involuntary bodily functions like blood pressure, heart rate, pupil dilation, and constriction of blood vessels and airways. These changes occur so quickly and subconsciously that most people are not even aware they are happening.

Once this initial stage (fight or flight) of the stress response occurs, the hypothalamus activates a second component of the system: the hypothalamus, pituitary, and adrenal gland axis (McEwen, 2013). These glands, known collectively as the HPA axis, release another flood of hormones to the central nervous system, telling the body to stay revved up and alert.

The stress response can then become acute, dissipating after the initial response, or chronic.

Acute vs. chronic stress

Both acute and chronic stress are designed to keep the body in homeostasis (Musazzi et al., 2017).

Acute stress is short-term stress, such as an issue at work or a fight with your spouse. Typically, when the fight-or-flight response kicks in, the body responds and can recover from this type of stress quickly through activation of the parasympathetic nervous system (Musazzi et al., 2017).

On the other hand, chronic stress is long-term stress, which includes working in a toxic environment over long periods of time or having ongoing issues in a relationship with a partner. Chronic stress can last for weeks, months, or years and is correlated with physical, mental, and emotional health problems (Musazzi et al., 2017).

Stress hormones

Adrenal glands are activated in both acute and chronic stress. These glands are responsible for releasing hormones that stimulate the sympathetic and parasympathetic nervous systems in an effort to shift into fight or flight and then into rest and digest (Chrousos & Gold, 1992).

The main hormones involved in this process include:

• Cortisol
  Famously known as the stress hormone, cortisol is responsible for increasing blood sugar levels in the body and shifting glucose to the brain. Cortisol speeds up tissue repair and slows down the digestive system, allowing energy that was used in this state to move to the muscles and body (Chrousos & Gold, 1992).
• Adrenaline
  Adrenaline is also known as epinephrine, and it increases heart rate, elevates blood pressure, and causes energy levels to rise (Chrousos & Gold, 1992). This is known as the performance hormone and is what helps athletes, musicians, actors, and politicians perform at their best.
• Catecholamines
  This group includes dopamine, norepinephrine, and epinephrine, which elevate blood pressure and activate areas of the brain (Chrousos & Gold, 1992).

While these stress hormones serve a purpose in survival and can improve performance, they may also have a negative effect on the body. For example, excessive cortisol production can cause insulin resistance, leading to diabetes (Chrousos & Gold, 1992).

The combined effects of these stress hormones over time can also suppress the immune system as they limit the production of cells that produce antibodies (Chrousos & Gold, 1992).

Chronic inflammation caused by stress hormones can damage the tissues of the internal organs, increase the risk of muscle failure, and lead to chronic health diseases (Chrousos & Gold, 1992).

The positive side of stress

While most people have been taught and believe that stress is negative, some evidence suggests that there are many positive aspects of stress. It is not necessarily the level or amount of stress that we experience, but our perception of it that matters (McGonigal, 2015).

McGonigal (2015) discusses research that has shown how the stress response can help focus our attention, heighten our senses, and increase motivation in work and academic environments if it is perceived as something positive rather than something harmful to health.

Stress also helps us connect with others by activating our natural prosocial instinct, which encourages social cognition and connection (McGonigal, 2015).

Additionally, stress can make individuals more resilient when it is viewed as positive stress. The stress response actually restores the nervous system and helps the brain process and integrate experiences, learn new information, and grow (McGonigal, 2015).

If clients can learn to identify the physiological aspects of the stress response and know that the acute effects of stress can be positive, they may be able to avoid the negative impact of chronic stress.

Examples

There are ample examples of how the stress response can influence us in daily life and also in major life events.

An athlete preparing for an event

An Olympic swimmer steps up onto the starting blocks. Her heart is racing, stomach in knots, respiration increasing, and all she can see is the lane in front of her because her eyesight has narrowed its focus. The adrenaline will help her swim faster, feel stronger, and move smoothly through the water if she can see it as a necessary part of competition rather than an uncomfortable deterrent.

A father looking for his lost child in a grocery store

The immediate instinct of social connection with others helps him seek support and do anything to find his child. The child is found and reunited with the father.

A college student feeling overwhelmed

Mounting assignments, tests, deadlines, and roommate conflict activate a flow of stress hormones as the body perceives danger. The increase in cortisol, a lack of healthy coping skills, and certainty that “stress is bad” cause the student to retreat. The struggle to stay focused on work causes them to give up on classwork. The stress becomes chronic, is seen as negative, and leads to anxiety, depression, and physical illness.

Causes & Symptoms of Chronic Stress

Chronic stress can be caused by many factors and manifests differently for everyone.

Chronic stress is something that continuously drains psychological, physical, and emotional resources, which can lead to a variety of health conditions (Cohen et al., 2016).

Environmental factors such as ongoing relationship conflict, poverty, a dissatisfying job, toxic living conditions, and domestic violence can all be sources of chronic stress. Continuous stress, where an individual feels incapable of changing the situation, is especially harmful. Over time, these stressors and the perception of the stressful situation take a toll on health.

The negative health effects and symptoms of chronic stress include (Cohen et al., 2016):

• Physical aches and pains
• Changes in sleep patterns, such as inability to sleep or sleeping too much
• Inability to focus or concentrate
• Changes in social behavior, such as emotional withdrawal or avoiding others
• Changes in appetite
• Lack of energy or motivation
• Problems with work productivity and increased tension in close relationships

When an individual has three to five of these symptoms lasting several weeks or reports feeling “stuck” with their stressors, they are most likely experiencing chronic stress (Cohen et al., 2016).

If left untreated, chronic stress can lead to hypertension, addiction, depression, and anxiety (Cohen et al., 2016).

5 Risk & Protective Factors

There are factors that make individuals more prone to stress and others that make us more capable of being resilient to it. Various studies have found risk factors for stress and mental health issues can fall into five categories (Mofatteh, 2021).

1. Psychological

Psychological factors include levels of self-esteem, personality, and self-confidence. Individuals with higher levels of self-esteem and confidence are less likely to experience the negative effects of stress (Mofatteh, 2021).

2. Biological

Biological factors involve physical health, such as underlying chronic conditions, physical pain, and even sex. Female participants report higher levels of stress and suffer more negative consequences from chronic stress (Mofatteh, 2021).

3. Lifestyle

Lifestyle choices play a large role in determining who is at risk versus who is protected from stress and the effects of stressful events (Mofatteh, 2021). Getting adequate sleep, moderate physical activity, and a healthy diet, and limiting drugs, alcohol, and nicotine are all protective factors for stress.

4. Social

Social support, a feeling of connection and belonging, and having close relationships are protective factors against stress. On the other hand, loneliness is linked with higher levels of perceived stress and more severe health consequences from stress (Mofatteh, 2021).

5. Financial

Economic and financial factors play a role in levels of stress. Individuals who come from or experience poverty are more likely to feel and experience chronic stress (Mofatteh, 2021).

Reducing Stress: The Parasympathetic Nervous System

In addition to these risk and protective factors, there are aspects of the nervous system that play a role in our experience of stress.

The parasympathetic nervous system (PNS) is one of two active parts of the autonomic nervous system. While the sympathetic nervous system (SNS) is responsible for fight or flight, the PNS drives the rest-and-digest response of the body (McCorry, 2007).

Acting in opposition to the SNS, the PNS functions to conserve energy and regulate bodily functions such as digestion, urination, and bowel movement in a rested, stress-free state.

The PNS causes smooth muscle relaxation and vasodilation, and maintains the function of internal organs, decreases heart rate, constricts pupils, and is responsible for tear production (McCorry, 2007).

There are practical ways that clients can promote or activate the PNS in order to reduce stress and create relaxation in the body and the mind.

Breathing exercises

Breathwork is a powerful tool. It is the only conscious way to activate the parasympathetic nervous system. The sympathetic nervous system is activated on the inhale, and the PNS is activated on the exhale (McEwen, 2007).

Clients can practice lengthening the exhale. Slowing down the breath will automatically decrease the resting heart rate and create a relaxation response.

Spending time in nature

Spending time in nature, whether it is an outdoor hike or gardening in the backyard, can help clients connect with their physical senses. This is a natural way to induce mindfulness, and creates a calming effect on the nervous system. Research consistently demonstrates the calming effect of nature, and theories point to the idea that this is due to how humans evolved in the natural environment (Jo et al., 2019).

Massage

Massage or any form of deep pressure can regulate the sensory system and downregulate the fight-or-flight response to stress and anxiety (McEwen, 2007).

Physical activity

Physical activity helps the body release hormones that signal that the body is not in physical danger (McEwen, 2007). The parasympathetic nervous system is activated to regulate how high the heart rate goes and can jumpstart a relaxation response once the activity session ends.

Mindfulness practices

Research on the practice of mindfulness consistently demonstrates that it decreases anxiety and stress and helps the body shift from the sympathetic to the parasympathetic nervous system (Kabat-Zinn, 2003).

Mindfulness teaches clients to be present without judgment or expectation. Mindful practices teach users to become aware of physical, emotional, or mental sensations with openness.

Cultivating Wellbeing & Resilience Against Stressors

Resilience is the ability to prosper in the face of adversity and bounce back from negative experiences (Southwick & Charney, 2013).

Researchers have been able to identify specific strategies to improve wellbeing and increase resilience while experiencing stress (Southwick & Charney, 2013).

Change your mind

One of the most powerful tools we have is our mind. While many stressors are not in our control, changing our perception of them is. Instead of seeing an event as a crisis, it can be seen as a challenge that will make us stronger.

Looking beyond present circumstances and visualizing growth can help clients feel better about what they are facing. One of the benefits of cognitive behavioral therapy is that it can help clients learn some of the skills to reframe setbacks as temporary experiences that can have positive outcomes.

Set goals, take action

Setting goals can provide clients with direction, and taking small steps toward larger goals gives a sense of accomplishment. Setting goals can also help overcome challenges and create positive changes that provide a sense of empowerment and strength.

Make connections

Social connections are a critical component of resilience. Strong social ties, including relationships with family, friends, and members of the community, have been linked to lower levels of stress, better physical health outcomes, and longevity (Mofatteh, 2021).

Social support can further strengthen resilience by providing physical assistance, encouragement, and hope.

Practice flexibility and acceptance

Change is an unavoidable part of life. When clients can be flexible and adaptable to unexpected change and life events, they will develop a “muscle of resilience” to navigate life with ease.

Clients can also work to accept things they cannot change and take steps in areas that are within their control, thereby embracing change with greater acceptance.

Engage in self-care

Physical health is directly correlated with levels of stress and resilience (McEwen, 2007).

Individuals who engage in physical activity, take care of their bodies, get out in nature, get adequate rest, and practice gratitude have lower levels of stress, and a stronger ability to cope with negative events (McEwen, 2007).

There are a variety of daily habits, lifestyle changes, and shifts that can protect clients from stress and improve resilience, and some of them are discussed in this video.

3 Worksheets to Help Clients Manage Chronic Stress

With the prevalence of chronic stress, it can greatly benefit your clients to provide them with resources and guidance to identify, manage, and cope with it in daily life. These worksheets offer practical ideas for implementing stress management inside and outside of sessions.

1. Action plan

Creating goals and taking actionable steps toward them can be a good way to tackle stress. Uncertainty and overwhelm are frequently the root causes of chronic stress. Setting goals and seeing the progress made in reaching them can decrease these feelings and provide clients with a sense of control and confidence. Use this goals and action plan worksheet to help your clients with the process.

2. Mindfulness right now

Mindfulness is something that anyone can learn to do and put into practice. When clients engage in each of their senses, it will help bring them into the moment and out of a stressful situation or thought. Mindfulness and here-and-now experiences are a healthy way to cope with chronic stress and anxiety.

3. Stress worksheet

This free stress worksheet from Western Carolina University discusses the difference between positive and negative stressors and invites clients to explore healthy coping mechanisms to manage stress.

Helpful Resources From PositivePsychology.com

PositivePsychology.com emphasizes a move from stress to resilience and offers a variety of helpful resources for clinicians and clients to put into practice.

In group settings, Do The Hula can inspire movement, help clients cope with stress, and transform it into a healthy form of connection with others. Laughter, social support, and movement are all healthy ways to release stress, and working with others can create a sense of accomplishment, leading to motivation and resilience.

Hope is a critical part of resilience. Exploring moments of hope and reflecting on times of stress and struggle when it was lost can help clients move from chronic stress or negative experiences to a place of resilience.

Understanding stressors is another way to overcome them. By identifying the subjective experience of stress and anxiety and imagining confronting it, clients can learn to overcome fear, anxiety, and stress, which in turn builds confidence and resilience.

Effective stress-management techniques can be implemented into daily life, which will help clients overcome and avoid the negative effects of chronic stress. This stress management article expands on the concept of stress and offers a variety of activities that can be used to manage stress.

If you’re looking for more science-based ways to help others manage stress without spending hours on research and session prep, check out this collection of 17 validated stress-management tools for practitioners. Use them to help others identify signs of burnout and create more balance in their lives.

A Take-Home Message

Learning to identify and embrace stress can help all of us avoid chronic stress and learn techniques that will make us stronger, healthier, and happier.

Stress is an unavoidable part of life, but it does not have to be seen as the enemy and is not a direct path to negative health consequences.

Taking steps to implement stress-reducing techniques, building skills of resilience, and reframing our idea of stress lead to a path of resilience and wellbeing.

We hope you enjoyed reading this article. Don’t forget to download our three Stress & Burnout Prevention Exercises (PDF) for free.