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What is Stress?

The stress response is your body and mind’s reaction to perceived danger, whether from internal stressors or external.

External Stressors include physical conditions, such as an illness from an injury, concussion, stroke, chronic pain, or reaction to hot or cold temperature.

Internal Stressors can also be physical such as reaction to hot flashes, an infection or inflammation, or Lyme Disease. They can also be psychological.

Acute or Chronic Stress

Acute Stress

Acute Stress is short-term, and the reaction to an immediate threat. It triggers the fight/flight area of the limbic system called the amygdala. This is also called the fight/flight response. The threat can be any situation that is experienced, even subconsciously or falsely, as a danger. Acute stress causes the feeling of anxiety, resulting in an increase in cortisol to your system. Acute Stress includes a traumatic event such as 9/11, the death of a loved-one, an illness, or the loss of a job.

Common acute stressors include:

  • Noise
  • Lights
  • Crowds
  • Isolation
  • Hunger
  • Illness
  • Infection
  • Touch
  • Closeness of another person, called proxemics
  • Weather change
  • Animals
  • Imagining a threat or remembering a dangerous situation or event.

Under most circumstances, once the acute threat has passed, the responses become inactive and the level of cortisol is decreased and the body returns to a normal relaxed state.

Chronic Stress

Chronic Stress is ongoing and long term stress, feeling overwhelmed, living in chronic anxiety, experiencing fight/flight. It includes the loss of a job or home, being deported, going through a divorce, dealing with cancer or another chronic illness. It is a feeling of loss of control and security.

The emotional component is depression and sleep problems. The physical component is your immune system, muscles, joints, and bones.

Symptoms of Acute Stress

Acute stress affects your autonomic system that controls your saliva, pupils, breathing, blood pressure, heart rate, stomach, intestines, and bladder.

Under acute stress you may experience any or all of the following symptoms:

  • Breathing becomes rapid and the lungs take in more oxygen to the point of hyperventilation, you could even pass out.
  • Your heart is pounding in your chest so fast, thus not providing you with enough oxygen to your brain, which can also cause you to pass out. If you have any history or family history of heart problems, acute stress can cause a heart attack.
  • Your stomach and intestine can go into spasm, causing you to lose control of your ability to control your bowels, causing massive diarrhea.
  • Bladder control is often lost during acute stress, causing you to urinate uncontrollably.
  • During acute stress, your mouth may be dry and it may be difficult to swallow. You may even feel a lump in your throat.
    Your skin is an organ too. Under acute stress, your skin and scalp can either become tight, tingly, or itchy. Also, your skin may feel cool, clammy, or sweaty. The hairs on your body will often rise up in response to acute stress, similar to the back of a cat when scared.
  • Your immune system protects you from infections, especially your white blood cells. Under acute stress, this system can be shut down, allowing you to get sick from a cold, viral infection, or severe bacterial infection. Also, you are more vulnerable to illnesses or infections from others around you.
  • Metabolic response to Stress. When you are under acute stress, it shuts down your digestive activity.

Symptoms of Chronic Stress

  • Heart Disease
  • Stroke
  • Cancer
  • Susceptibility to Infection
  • Immune Disorders
  • Gastrointestinal Problems
  • Irritable Bowel Syndrome (IBS), Peptic Ulcers, and Inflammatory Bowel Disease. The latter is not caused by stress, however it is heightened by it.
  • Eating Problems
  • Diabetes
  • Pain- Muscular and Joint Pain and Headaches
  • Sleep Problems
  • Sexual and Reproductive Dysfunction- Effects on Pregnancy, Fertility, and Pregnancy
  • Memory, Concentration, and Learning
  • Allergies
  • Skin Disorders
  • Unexplained Hair Loss
  • Teeth and Gum Problems.

Self-Medication and Unhealthy Lifestyles Only Make the Symptoms of Stress Worse!

If you are one of the millions of people who try to resolve acute or chronic stress with alcohol, tobacco, drugs, and overeating, you might feel some comfort or relief at the moment. However, the long term effect compounds the physiologic effects of stress itself. It then becomes a vicious cycle, causing your stress response to only be more heightened, causing greater sleep problems and an increase in drug and alcohol abuse. Drinking four or five cups of coffee, for example, can cause changes in blood pressure and stress hormone levels, similar to the levels produced in chronic stress. Sugar is a major factor, especially if you have had some form of brain injury such as a concussion, stroke, or brain surgery.

Who is at Risk?


  • Early Nurturing
  • Personality Traits- Hearty, sensitive, or reactive
  • Genetic Factors- Family history of abnormality in serotonin regulation.
  • Immune Regulated Diseases- Rheumatoid Arthritis or Eczema.
  • The Length and Quality of Stressors- Wounded Warriors, PTSD.


  • Young Adults
  • Seniors
  • Women
  • Working Mothers
  • Sandwich Generation- Taking care of younger children and aging parents, while working one or more jobs.
  • Unemployed
  • Isolated individuals
  • People who are targets of racial or sexual discrimination.
  • Individuals without health insurance.
  • People who live in the city.
  • Caregivers


  • Lack of Social Network
  • Angry Personality
  • Work Related Factors-
    • Having no participation in decisions that affect one’s responsibilities.
    • Unrelenting and unreasonable demands for performance
    • Lack of effective communication and conflict-resolution methods among workers and employers.
    • Lack of job security
    • Long hours
    • Excessive time spent away from home and family.
    • Office politics and conflicts between workers.
    • Wages not commensurate with level of responsibility.

Conditions that have Similar Symptoms as Stress


The physical symptoms of anxiety disorder mirror many of those of stress, including a fast heart rate; rapid shallow breathing and increased muscle tension. Anxiety is an emotional disorder, however, and is characterized by the feeling of apprehension, uncertainty, fear, or panic. Unlike stress, the triggers for anxiety are not necessarily or usually associated with specific stressful or threatening conditions. Some individuals with Anxiety Disorders have numerous physical complaints such as headaches, gastrointestinal disturbances, dizziness, and chest pain. Severe cases of anxiety disorders are debilitating and interfere with career, family, and social spheres.


Depression can be a disabling condition, and like anxiety disorders may result from untreated chronic stress. Depression also mimics some of the symptoms of stress including changes in appetite, sleep patterns, and concentration. Serious depression, however, is distinguished from stress by feelings of sadness, hopelessness, loss of interest in life, and sometimes thoughts of suicide. Acute depression is also accompanied by significant changes in the person’s function. Professional therapy may be needed to determine if depression is caused by stress or if it is the primary problem.

Post-Traumatic Stress Disorder (PTSD)

Post Traumatic Stress Disorder is a reaction to a very traumatic event.

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Dr. Diane® Roberts Stoler, Ed.D.
7 Hodges Street
N. Andover, MA 01845
Phone: (800) 500-9971


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Image Credit Elaine Boucher

Within each person shines an inner light that illuminates our path and is the source of hope. Illness, trauma, suffering and grief can diminish the light and shroud hope. I am a catalyst for hope and change, offering a way to rekindle this inner light.

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