Stress is how your brain and body respond to a challenge or demand. When you are stressed, your body releases chemicals called hormones. The hormones make you alert and ready to act. They can raise your blood pressure, heart rate, and blood sugar levels. This response is sometimes called a "fight or flight" response.

Everyone gets stressed from time to time. There are different types of stress. It can be short-term or long-term. It can be caused by something that happens once or something that keeps happening.

Not all stress is bad. In fact, it can help you survive in a dangerous situation. For example, one kind of stress is the jolt you may feel when a car pulls out in front of you. This jolt of hormones helps you quickly hit the brakes to avoid an accident. A little short-term stress can sometimes be helpful. For example, the stress of having a deadline for school or your job may push you to get your work done on time. Once you finish it, that stress goes away.

But stress that lasts a long time can harm your health.

Everyone feels stressed from time to time, but what is stress? How does it affect your overall health? And what can you do to manage your stress?

Stress is how the brain and body respond to any demand. Any type of challenge—such as performance at work or school, a significant life change, or a traumatic event—can be stressful.

Stress can affect your health. It is important to pay attention to how you deal with minor and major stressors, so you know when to seek help.

Here are five things you should know about stress.

1. Stress affects everyone.

Everyone experiences stress from time to time. There are different types of stress—all of which carry physical and mental health risks. A stressor may be a one-time or short-term occurrence, or it can happen repeatedly over a long time. Some people may cope with stress more effectively and recover from stressful events more quickly than others.

Examples of stress include:

• Routine stress related to the pressures of school, work, family, and other daily responsibilities.
• Stress brought about by a sudden negative change, such as losing a job, divorce, or illness.
• Traumatic stress experienced during an event such as a major accident, war, assault, or natural disaster where people may be in danger of being seriously hurt or killed. People who experience traumatic stress may have very distressing temporary emotional and physical symptoms, but most recover naturally soon after.

2. Not all stress is bad.

In a dangerous situation, stress signals the body to prepare to face a threat or flee to safety. In these situations, your pulse quickens, you breathe faster, your muscles tense, and your brain uses more oxygen and increases activity—all functions aimed at survival and in response to stress. In non-life-threatening situations, stress can motivate people, such as when they need to take a test or interview for a new job.

3. Long-term stress can harm your health.

Coping with the impact of chronic stress can be challenging. Because the source of long-term stress is more constant than acute stress, the body never receives a clear signal to return to normal functioning. With chronic stress, those same lifesaving reactions in the body can disturb the immune, digestive, cardiovascular, sleep, and reproductive systems. Some people may experience mainly digestive symptoms, while others may have headaches, sleeplessness, sadness, anger, or irritability.

Over time, continued strain on your body from stress may contribute to serious health problems, such as heart disease, high blood pressure, diabetes, and other illnesses, including mental disorders such as depression or anxiety.

4. There are ways to manage stress.

If you take practical steps to manage your stress, you may reduce the risk of negative health effects. Here are some tips that may help you to cope with stress:

• Be observant. Recognize the signs of your body’s response to stress, such as difficulty sleeping, increased alcohol and other substance use, being easily angered, feeling depressed, and having low energy.
• Talk to your health care provider or a health professional. Don’t wait for your health care provider to ask about your stress. Start the conversation and get proper health care for existing or new health problems. Effective treatments can help if your stress is affecting your relationships or ability to work.
• Get regular exercise. Just 30 minutes per day of walking can help boost your mood and improve your health.
• Try a relaxing activity. Explore relaxation or wellness programs, which may incorporate meditation, muscle relaxation, or breathing exercises. Schedule regular times for these and other healthy and relaxing activities.
• Set goals and priorities. Decide what must get done now and what can wait. Learn to say “no” to new tasks if you start to feel like you’re taking on too much. Try to be mindful of what you have accomplished at the end of the day, not what you have been unable to do.
• Stay connected. You are not alone. Keep in touch with people who can provide emotional support and practical help. To reduce stress, ask for help from friends, family, and community or religious organizations.
• Consider a clinical trial. Researchers at the National Institute of Mental Health (NIMH) and other research facilities across the country are studying the causes and effects of psychological stress as well as stress management techniques.

5. If you’re overwhelmed by stress, ask for help from a health professional.

You should seek help right away if you have suicidal thoughts, are overwhelmed, feel you cannot cope, or are using drugs or alcohol more frequently as a result of stress. Your doctor may be able to provide a recommendation.

The Stress Reaction

The stress reaction is produced by your body's autonomic nervous system (ANS), which controls functions that happen more or less automatically in your body, like respiration, heart rate, and digestion. The sympathetic nervous system (SNS) and parasympathetic nervous system (PNS) are both parts of the ANS, and they act in opposition to one another. The SNS generally increases physiological arousal and creates the "fight-or-flight" response, while the PNS generally decreases physiological arousal and is responsible for calming your body down after a stressful incident.

In times of stress, the SNS stimulates the adrenal glands to increase the amount of noradrenaline, a neurotransmitter, they secrete into the bloodstream along with another, more powerful neurotransmitter, adrenaline. These neurotransmitters affect the entire body, and their effects last for hours. The adrenal glands also secrete cortisol, the primary stress hormone, which increases organ sensitivity to adrenaline and noradrenaline. These events take place through a complex series of interactions between the hypothalamus, pituitary gland, and adrenal glands, which together constitute the HPA axis.

Adrenaline:

• Increases your heart rate
• Elevates your blood pressure
• Increases energy supplies (glucose and fatty acids) in the bloodstream
• Increases blood flow to the liver and skeletal muscles while constricting smaller vessels

Cortisol:

• Increases sugars (glucose) in the bloodstream
• Enhances your brain's use of glucose
• Heightens your immune system
• Increases availability of tissue-repairing substances
• Suppresses the digestive system
• Inhibits growth processes
• Suppresses the reproductive system

The PNS is responsible for recuperation and allowing your body to return to a balanced state, known as homeostasis, after stress.

Chronic Stress

Originally the fight-or-flight response of the SNS protected us against threats from predators and other aggressors. It was designed as a temporary response to occasional threatening situations, and when the situation had been resolved the body's PNS took over, returning the body to homeostasis in what may be termed the "relaxation response."

But times have changed. Now, stressors may be anything from high-pressure jobs, to being stuck in traffic, to living on a tight budget. These sorts of stressors aren't temporary and infrequent: they're ongoing. We experience them day in, day out. If you are very frequently stressed, your body is subjected to a constant deluge of stress hormones and kept in a state of physiological arousal. You can end up becoming chronically stressed by the endless stream of stressors you face in the course of a day. This chronic stress can literally wear you out, and your body can become exhausted.

Chronically high levels of stress can:

• Lead to hypertension
• Increase levels of LDL ("bad") and decrease levels of HDL ("good") cholesterol
• Impair cognitive performance
• Suppress thyroid function
• Decrease muscle tissue
• Create blood sugar imbalances like hyperglycemia
• Decrease bone density
• Suppress the immune system
• Increase abdominal fat

In the long run, being chronically stressed can lead to heart disease, kidney disease, and stroke.

The Relaxation Response

The relaxation response of the PNS allows ANS functioning to return to normal. The body moves from a state of physiological arousal, including increased heart rate and blood pressure, decreased blood flow to the extremities, slowed digestive functioning, and increased levels of stress hormones, to a state of physiological relaxation. Your heart rate, blood pressure, blood flow, digestive functioning, and hormone levels return to their normal state.

Your fight-or-flight reaction occurs automatically and without any effort on your part. But under conditions of chronic stress, the relaxation response may never be activated. To undo the negative impact of ongoing stress, you need to consciously elicit the relaxation response.

Fortunately, there are many ways to bring the stress response under control. You can seek out support from family, friends, or professional counselors. Aerobic exercise, like running, cycling, and swimming, is usually an effective stress reducer. You might find that activities as spontaneous and unstructured as singing, gardening, playing with kids, or having sex are sufficient to put you into a relaxed state of being. Some people find that having a good cry relieves their stress. Or, you might find you need to use more structured approaches to destressing, such as meditation, deep breathing exercises, yoga, t'ai chi, self-hypnosis, and guided imagery.

Deep Breathing

Deep breathing is a popular, effective, and easy-to-do stress reliever that you can practice at home or at the office. Try the following: sit in a comfortable position with your feet flat on the floor. Relax your shoulders. Exhale slowly through your nose, counting to five. Tense your abdominal muscles to help empty your lungs. At the bottom of your exhalation, pause for two counts. Now inhale slowly while counting to five. Expand your belly as you breathe in. Pause for two counts at the top of your breath, close your eyes, and begin your exhale. Repeat 5-10 times.

Whatever method you choose, it should produce a feeling of calm and deep well-being in you. Once you experience that feeling, you'll probably find that you want to return to it again and again, making it easier to acquire the good habit of relaxation.

Stress is how the body reacts to a challenge or demand.

Change is often a cause of stress. Even positive changes, like having a baby or getting a job promotion, can be stressful.

Stress can be short-term or long-term.

Common causes of short-term stress:

• Needing to do a lot in a short amount of time
• Having a lot of small problems in the same day, like getting stuck in traffic jam or running late
• Getting ready for a work or school presentation
• Having an argument

Common causes of long-term stress:

• Having problems at work or at home
• Having money problems
• Having a long-term illness
• Taking care of someone with an illness
• Dealing with the death of a loved one

When you're under stress, you may feel:

• Worried
• Angry
• Irritable
• Depressed
• Unable to focus

Stress also affects your body. Physical signs of stress include:

• Headaches
• Trouble sleeping or sleeping too much
• Upset stomach
• Weight gain or loss
• Tense muscles
• Frequent or more serious colds

Acute Stress Disorder (ASD) is a mental health problem that can occur in the first month after a traumatic event. The symptoms of ASD are like PTSD symptoms, but you must have them for longer than one month to have PTSD. Learn more about ASD and treatment options.

How Common Is ASD?

Studies of ASD vary in terms of the tools used and the rates of ASD found. Overall, within one month of a trauma, survivors show rates of ASD ranging from 6% to 33%. Rates differ for different types of trauma. For example, survivors of accidents or disasters such as typhoons show lower rates of ASD. Survivors of violence such as robbery, assaults, and mass shootings show rates at the higher end of that range.

Who Is at Risk for ASD as a Result of Trauma?

Several factors can place you at higher risk for developing ASD after a trauma:

• Having gone through other traumatic events
• Having had PTSD in the past
• Having had prior mental health problems
• Tending to have symptoms, such as not knowing who or where you are, when confronted with trauma

Does ASD Predict PTSD?

If you have ASD, you are very likely to get PTSD. Research has found that over 80% of people with ASD have PTSD six months later. Not everyone with ASD will get PTSD, though.

Also, those who do not get ASD can still develop PTSD later on. Studies indicate that a small number (4% to 13%) of survivors who do not get ASD in the first month after a trauma will get PTSD in later months or years.

Are There Effective Treatments for ASD?

Yes, a type of treatment called cognitive behavioral therapy (CBT) has been shown to have positive results. Research shows that survivors who get CBT soon after going through a trauma are less likely to get PTSD symptoms later. A mental health care provider trained in treatment for trauma can judge whether CBT may be useful for a trauma survivor.

Another treatment called psychological debriefing (PD) has sometimes been used in the wake of a traumatic event. However, there is little research to back its use for effectively treating ASD or PTSD. It should also be noted that with more severe trauma or reactions such as PTSD, debriefing is not recommended.

Have you been feeling more stressed than usual? Many people are during these challenging times. The COVID-19 pandemic has many people feeling overwhelmed.

Everyone feels stress sometimes. It’s a natural response to a challenge or demand. Stress can come from the day-to-day pressures of work and family.

But stress is much more than just being busy, explains Dr. Janice Kiecolt-Glaser of The Ohio State University, who studies the effects of stress on the body.

“It’s the feeling that you’re overloaded, out of control, and unable to cope,” she says.

Stress can also come from a sudden negative change in your life like a divorce or losing a job. Traumatic events like a major accident, assault, or natural disaster can cause severe stress.

It’s important for your health and well-being to learn how to cope with stress. Researchers are working to understand how stress affects health. They’re also studying ways to relieve stress. These techniques may help you to feel calmer and more relaxed.

Stress and the Body

Stress isn’t always bad. It’s actually a survival response. It helps you leap into action in the face of a threat. Your heart rate speeds up, and you breathe faster as you prepare to fight or run to safety.

Short-term stress can even help you perform—you’re more able to ace an interview or meet a project deadline. But when stress lasts a long time, it may also harm your health. Your body is constantly acting as if it were in immediate danger.

“There’s a really big body of research now that says that chronic stress promotes inflammation ,” says Kiecolt-Glaser.

Inflammation is associated with many diseases, including heart disease, cancer, arthritis, and some mental health conditions.

Stress may also affect your metabolism—the chemical changes in the body that release energy and produce the substances you need to grow, move, and stay healthy.

Kiecolt-Glaser’s research shows that stressful events can cause the body to burn fewer calories at rest. Stress can also cause changes in mood and increase irritability with those around us.

Ways to De-Stress

The first step is to recognize the signs that you’re stressed beyond a normal level. Trouble sleeping can be one. Some people get headaches or stomachaches. Stress can also cause changes in appetite that lead you to gain or lose weight.

Once you know you need to reduce stress, there are practical steps you can try. Getting regular exercise can be helpful. Doing an activity you enjoy can also help with stress. This can be anything—from dancing to making art or getting out into nature or having fun with friends.

Making sure to get enough sleep is important, too. “People are more sensitive to stress when they don’t have enough sleep,” says Kiecolt-Glaser.

Staying socially connected is important, too. Close personal relationships are key to reducing stress. Reaching out to friends and family by phone, video chat, and email can help you stay in touch even when you’re not able to see them in person.

“Make a conscious effort to reach out and to maintain contact,” says Kiecolt-Glaser. “Loneliness is really destructive.”

Eating regular, well-balanced meals and avoiding alcohol and other drugs also help reduce stress.

Mindfulness Approaches

Using mindfulness helps some people cope with stress. It teaches you to focus on being present in the moment. Research shows that simply being aware of what you’re doing can improve well-being.

One study showed that people spent nearly half of their waking life not paying attention to what they were doing, says Dr. Richard Davidson of the University of Wisconsin-Madison, an expert on mindfulness. “And when they were not paying attention to what they’re doing, they were significantly less happy.”

Davidson’s research is shedding light on how mindfulness affects the brain to improve mood. “Regular mindfulness practices can have an impact on specific circuitry in the brain that we know to be important in emotion regulation,” he explains.

For those starting to practice mindfulness: One size is not likely to fit all. Davidson recommends starting modestly with three to five minutes, a few times a day. That way you don’t get overwhelmed and stop. There are many mindfulness apps available that teach different techniques.

Just Breathe

The simple act of controlled breathing can bring stress relief.

“It’s well known that slow breathing techniques have a positive effect on emotional state,” says Dr. Jack Feldman of UCLA, an expert on the neuroscience of breathing.

His research has identified the brain circuits responsible for breathing and sighing. Now he’s working to understand how breathing techniques affect the brain to improve mood.

Breathing techniques can be used to help people who are depressed or anxious. Controlled breathing may disrupt the brain circuits involved in depression, he explains.

There are many different breathing techniques you can try. Practicing a few minutes a day can help you get started.

“People who start up a breathing practice may find that it reduces their stress and anxiety considerably,” he says.

If you want to try controlled breathing, “belly breathing” is a simple form. Sit or lie down in a comfortable position. Place one hand on your upper chest and the other on your belly. Take a slow, deep breath in through your nose, taking air into your lower belly. The hand on your stomach should rise, while the hand on your chest remains still. Slowly exhale through your mouth.

Feeling Overwhelmed?

Ways to manage stress:

• Be observant. Recognize signs of excessive stress. These include difficulty sleeping, being easily angered or irritable, feeling depressed, and low energy.
• Exercise regularly. Just 30 minutes per day of walking can help boost your mood and reduce stress.
• Schedule regular times for a relaxing activity. Activities that use mindfulness or breathing exercises, such as meditation, yoga, or tai chi, may help.
• Get enough sleep. Adults need about 7 or more hours of sleep per night. School-age children need 9–12 hours, while teenagers need 8–10 hours.
• Set goals and priorities. Decide what must get done now and what can wait. Learn to say “no” to new tasks if you start to feel like you’re taking on too much.
• Build a social support network. Stay connected with people who can provide emotional support.
• Show compassion for yourself. Note what you’ve accomplished at the end of the day, not what you’ve failed to do.
• Seek help. Talk to a health care provider if you feel unable to cope, have suicidal thoughts, or use drugs or alcohol to cope. If you or someone you know is in crisis, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). Or text “HOME” to the Crisis Text Line at 741741.

First, determine how much your symptoms interfere with your daily life.

Do I have mild symptoms that have lasted for less than 2 weeks?

• Feeling a little down
• Feeling down, but still able to do job, schoolwork, or housework
• Some trouble sleeping
• Feeling down, but still able to take care of yourself or take care of others

If so, here are some self-care activities that can help:

• Exercising (e.g., aerobics, yoga)
• Engaging in social contact (virtual or in person)
• Getting adequate sleep on a regular schedule
• Eating healthy
• Talking to a trusted friend or family member
• Practicing meditation, relaxation, and mindfulness

If the symptoms above do not improve or seem to be worsening despite self-care efforts, talk to your health care provider.

Do I have severe symptoms that have lasted 2 weeks or more?

• Difficulty sleeping
• Appetite changes that result in unwanted weight changes
• Struggling to get out of bed in the morning because of mood
• Difficulty concentrating
• Loss of interest in things you usually find enjoyable
• Unable to perform usual daily functions and responsibilities
• Thoughts of death or self-harm

Seek professional help:

• Psychotherapy (talk therapy)—virtual or in person; individual, group, or family
• Medications
• Brain stimulation therapies

Winter holidays—do they fill you with joy or with worries about gift-giving and family gatherings? Do summer vacations leave you relaxed or fretful over travel and money? If you’re feeling stressed out over supposedly fun things, it might be time to reassess. Take a few moments to learn how stress affects your health and what you can do about it.

Everyone feels stressed from time to time. Stress can give you a rush of energy when it’s needed most—for instance, competing in sports, working on an important project, or facing a dangerous situation. The hormones and other chemicals released when under stress prepare you for action. You breathe faster, your heartbeat quickens, blood sugar rises to give you energy, and your brain uses more oxygen as it shifts into high alert.

But if stress lasts a long time—a condition known as chronic stress—those “high-alert” changes become harmful rather than helpful. “Stress clearly promotes higher levels of inflammation, which is thought to contribute to many diseases of aging. Inflammation has been linked to cardiovascular disease, diabetes, arthritis, frailty, and functional decline,” says Dr. Janice Kiecolt-Glaser, a leading stress researcher at Ohio State University. She and other researchers have found that stress affects the body’s immune system, which then weakens your response to vaccines and impairs wound healing.

Research has linked chronic stress to digestive disorders, urinary problems, headaches, sleep difficulties, depression, and anxiety.

“Some studies have found the physical, emotional, and social effects of a disease like cancer to be stressful for patients, caregivers, and long-term cancer survivors,” says NIH’s Dr. Paige Green McDonald, an expert on stress and cancer biology. “However, there’s no definitive evidence that stress causes cancer or is associated with how long one survives after a cancer diagnosis.”

The top causes of stress in the U.S. are money and work-related pressures, according to a 2013 survey from the American Psychological Association. Stress can also arise from major life changes, such as the death of a loved one, divorce, illness, or losing a job. Traumatic stress is brought on by an extreme event such as a major accident, exposure to violence, or a natural disaster such as a hurricane or flood.

Caring for a person with severe illness—such as dementia or cancer—can also be a significant source of stress. More than a decade ago, studies by Kiecolt-Glaser and others showed that the stressful demands placed on caregivers can lead to poorer health, lower responses to vaccines, increased inflammation, and a more than 60% higher death rate compared to non-caregivers.

It’s not clear why some people can sidestep or recover more quickly from stress than others. These resilient people seem to “bounce back” more easily after stressful situations. Recent studies of animals suggest that resiliency may depend at least in part on our genes. But learning healthy ways to cope with stress can also boost your resilience.

“There are many different ways to cope with stress. We know from a lot of different studies that having close personal relationships—people with whom you can talk, with whom you can share your feelings—can be helpful,” says Kiecolt-Glaser. “So spending time with family and friends in order to maintain those relationships is perhaps one of the most crucial things you can do as a stress reducer.”

Unfortunately, Kiecolt-Glaser adds, “when we’re stressed, we tend to do the worst things that are not at all helpful to our health.”

For instance, stressed out people may tend to isolate themselves and not seek social support. “Exercise is a great stress reducer. But when people are stressed, exercise becomes less common and less appealing,” Kiecolt-Glaser says. “Instead of maintaining a healthy diet—also important to reducing stress—some people who are stressed tend to eat more donuts than vegetables.”

You may think that the agitation brought on by stress might help to burn calories. But evidence hints that the opposite is more likely. Kiecolt-Glaser and colleagues found that, compared to nonstressed people, those who were stressed burned fewer calories after high-fat meals and they produced more of the hormone insulin, which enhances fat storage. “So stress may contribute to weight gain and obesity through these biological routes,” Kiecolt-Glaser adds.

Getting enough sleep is also key to resilience and stress relief—although stress itself can interfere with sleep. To improve your sleep habits, go to bed the same time each night and get up the same time each morning, and limit the use of light-emitting electronics like computers and smartphones before bed. The light can reduce production of a natural sleep hormone called melatonin, which then makes it hard to fall asleep.

Beyond recommendations for exercise, healthy diet, social contacts, and getting enough sleep, Green McDonald says, “studies have also shown that mindfulness (focused attention on one’s own emotions) and other meditative practices can effectively relieve stress.”

“Mindfulness means staying aware and conscious of your experiences. No matter what we’re doing, we can always make time to bring our attention to our breath and body and stay there for a short period of time,” says NIH psychologist Dr. Rezvan Ameli, who specializes in mindfulness practice. “Recent studies show that even short periods of mindful attention can have a positive impact on health and well-being.”

Other NIH-funded studies have shown that mindfulness meditation can reduce stress, alter brain structure and function, and have a positive effect on the immune system.

“Mindfulness is a simple and effective tool that anybody can use to reduce stress,” Ameli says. Although the concept is simple, becoming more mindful requires commitment and practice. You can learn more about mindfulness meditation from local resources like yoga or meditation classes, mindfulness-based stress-reduction programs, or books.

If you feel overwhelmed by stress, talk with a health care provider or mental health professional. Medications or other therapies might help you cope. In the long run, reducing stress may help you to slow down and enjoy your time with the people and activities you really care about.

To Reduce Stress

• Get enough sleep.
• Exercise regularly. Just 30 minutes a day of walking can boost mood and reduce stress.
• Build a social support network.
• Set priorities. Decide what must get done and what can wait. Say no to new tasks if they are putting you into overload.
• Think positive. Note what you’ve accomplished at the end of the day, not what you’ve failed to do.
• Try relaxation methods. Mindfulness, meditation, yoga, or tai chi may help.
• Seek help. Talk to a mental health professional if you feel unable to cope, have suicidal thoughts, or use drugs or alcohol to cope.

If you or someone you know is in crisis, call the toll-free, 24-hour National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).