Stress is a common problem in developed societies. There are three main types of stress that may occur in our daily lives: acute stress (a short-term event, such as a heated argument or getting stuck in traffic); acute episodic stress (frequent acute events, such as work deadlines); and chronic stress (long-term events, such as job loss, physical or mental abuse, drug abuse or family conflict). Many of us may experience a combination of these three types of stress.
Our body responds to all types of stress through the same mechanism, which occurs regardless of whether the stress is caused by a real or imagined event. Both acute and chronic stressors trigger the fight-or-flight reaction. Hormones are released, which within a couple of seconds cause a rapid pumping of blood and oxygen to the cells, acceleration of heart rate and an increase in mental alertness. In prehistoric times this quick reaction was necessary to quickly escape a dangerous situation or ward off a predator. All types of stress may trigger this reaction described in more detail as follows:
• A small part of the brain called hypothalamus triggers the activation of the autonomic nervous system (ANS). The autonomic nervous system directs the functions of internal organs, over which we have no conscious control, such as changes in blood pressure, heart rate, breathing, digestion, etc. During the fight-or-flight reaction the ANS triggers the release of the hormone adrenaline from the adrenal glands.
• Adrenaline accelerates heart rate and increases blood pressure causing more blood and oxygen to circulate to the muscles and heart leading to a rush of energy, sharpening of hearing and vision, increased attention and high reactivity.
• If the stress continues the adrenal glands release another hormone called cortisol, which stimulates the release of glucose into the blood and increases the brain’s use of glucose for energy. Some secondary systems in the body are suppressed, such as digestion, reproduction and growth to allow the body to focus on the source of stress.
• These hormones do not go back to normal levels until the stress is gone. If the stress does not go and becomes chronic the autonomic nervous system continues to trigger physical reactions that may lead to prolonged inflammation, oxidative stress and cell damage in the body.
In acute stress the event is short-term, hormone levels gradually go back to normal and no significant physical or mental problems are induced. However, frequent episodic or chronic stress repeatedly triggers the fight-or-flight reaction, resulting in a steady increase in stress hormones and a risk of developing the following health problems (20):
• Digestive problems (heartburn, flatulence, diarrhea, constipation)
• Weight gain
• Increased blood pressure
• Chest pain, heart diseases
• Immune system problems
• Skin diseases
• Muscle pain (headache, back pain, neck pain)
• Sleep disorders, insomnia
• Infertility
• Anxiety, depression
Eustress and distress
We often use the term stress to describe negative experiences or situations. This leads many people to believe that all stress is unhealthy, which is not always true. Stress is an inevitable part of life and can be both healthy and unhealthy. Understanding the differences between the types of stress is crucial to making sure you are coping with it in an informed and healthy way.
Stress is divided into two different forms depending on a person’s perception and the emotions it causes, eustress and distress.
Eustress, sometimes called good stress, is actually acute short-term stress that can be good for the body. It motivates and mobilizes people to take action, fuels ambition and helps reach goals. It is short-term, is perceived as being within our coping abilities, generates excitement and improves concentration and performance (for example when taking an exam or speaking in public).
Distress is the unhealthy form of stress that is perceived as being beyond our coping abilities, usually represents frequent acute episodic or chronic stress, causes unpleasant emotions of worry and anxiety, reduces performance and concentration, leads to mental exhaustion and physical problems such as depression, fatigue, insomnia, etc. (e.g. death of a loved one, divorce, illness, etc.)
How does distress affect eating habits?
Distress leads to increased body demands for more oxygen, energy and nutrients, lack of motivation or time to prepare nutritious and balanced meals. It causes a change in eating rhythm often representing unhealthy fasting during the day and overeating in the evening.
Individuals experiencing distress may resort to increased consumption of easily accessible and comforting foods, representing a quick source of dopamine. These are most often high-calorie processed foods rich in simple carbohydrates, fats, salt and added sugar and poor in nutrients – snacks, crisps, sandwiches, sweets, chocolates, cold meats, French fries, breaded foods, alcohol, etc.
Stress can disrupt sleep by causing lighter sleep or more frequent awakenings, leading to daytime fatigue. To cope with daytime fatigue, people often resort to stimulants to boost energy and concentration, such as caffeine and nicotine. Excessive caffeine and nicotine consumption, on the other hand, further deteriorates sleep quality and a vicious cycle is formed.
Chronic stress and poor quality sleep lead to a significant increase in cortisol levels, which causes an increase in the levels of the hormone ghrelin responsible for increasing appetite and feeling of hunger (especially for the said unhealthy nutritional sources) and suppressing the hormone leptin responsible for feeling of satiety.
Cortisol promotes accumulation of fat in the abdominal area, which is associated with insulin resistance and increased risk of type 2 diabetes, cardiovascular diseases and certain cancers.
Recommendations to cope with stress
Healthy diet
A good, balanced and varied diet ensures all necessary nutrients, vitamins, minerals and energy the body needs to cope with stressful events. Studies show that diets rich in Omega-3 polyunsaturated fats and vegetables, similar to the Mediterranean diet, can help regulate cortisol levels.
Regular exercise
Physical activity helps lower blood pressure and stress hormone levels. Aerobic exercises, such as walking, running, cycling, dancing, and weight-bearing strength exercises, increase breathing and heart rate so that more oxygen can reach the cells throughout the body. This improves muscle and heart function, triggers the release of endorphins and reduces tension.
WHO recommendations on healthy levels of physical activity for adults over 18 years old are to have 150 to 300 minutes of moderate-intensity aerobic physical activity a week or 75 to 150 minutes of high-intensity aerobic physical activity a week, spread evenly across the days of the week.
Adding weight-bearing resistance exercises according to individual abilities that train the major muscle groups on 2 or more days of the week further contributes to health, muscle tone and building lean muscle mass.
Replacing time spent sitting with physical activity of any intensity (including light intensity or standing) has additional health benefits.
Meditation and deep breathing techniques
Rapid, shallow breathing and chaotic thoughts occur in response to stress.
Deep breathing and meditation techniques result in reduction in muscle tension, removal of carbon dioxide from the body, lowering of the heart rate and control over emotions by activating the parasympathetic nervous system.
Good balance between work and rest
Make the most of your time off and take time for yourself whenever you feel that stress is getting the better of you. Even when you can’t take time off, you can get up earlier and set aside an hour a day in the morning before work to wake up, have breakfast, meditate or exercise in peace. In this way you can take care of yourself every day without rushing and without worrying about work or personal commitments.
Escaping from work pressure at regular intervals can do wonders for reducing stress, increasing productivity and reducing the risk of physical and mental diseases that are associated with workplace burnout.
Good sleep hygiene
Stress may lead to difficulty falling asleep as well as frequent interruptions of deep sleep at night, which can leave you tired the next day.
Aim to establish a healthy circadian rhythm by falling asleep at the same time every night and getting up at the same time every morning. Try to get 7 to 9 hours of uninterrupted sleep every night by avoiding exposure to screens, alcohol consumption, simple carbohydrates, nicotine and caffeine in the hours before bedtime. Getting 10 to 15 minutes of direct sunlight in the morning immediately after waking up helps normalize your biological clock by reducing the levels of the sleep hormone melatonin and helps you wake up quickly and feel refreshed and energized.
