We are in the midst of a silent epidemic that is having far-reaching effects on our health. And the underlying cause is chronic stress. Chronic stress is not just an occasional feeling of pressure or worry that comes and goes, it is a persistent nagging feeling that comes from the pressure of today’s fast-paced lifestyle. But it is not just the stress but the result of it on the body that is a matter of great concern. With diseases such as heart disease, diabetes, gut disorders and mental health issues linked to chronic stress, it has never been more critical to address the issue of stress. Chronic stress develops over time as we face ongoing challenges without an opportunity for recovery. Unlike Acute stress, which in small doses can help by preparing for an immediate threat, chronic stress remains constant and wears down the body. The prolonged stress response floods the body with stress hormones, such as cortisol and adrenaline. These hormones, in excess, canlead to damage at the cellular level, interfere with normal metabolic processes, and create a state of constant alert in the body. Over time, these changes can catalyse the development of various chronic illnesses.
One of the most significant impacts of chronic stress is its contribution to heart disease. Research has shown that people who experience high levels of stress constantly are at an increased risk of developing cardiovascular problems with high blood pressure, irregular heart rhythms, arterial damage and the build-up of plaque in arteries (atherosclerosis). For some people, their workplace is a source of stress with studies indicating that stress related to work may increase the risk of heart disease by up to 40%. These findings are consistent with reports from the American Heart Association, which emphasize that stress management can play a crucial role in preventing heart attacks and strokes. The economic implications are also staggering, with poor employee mental health costing Indian employers around US$14billion annually due to absenteeism, lost productivity, medical expenses, attrition and other related factors.
In addition to the heart, chronic stress also increases the risk of developing metabolic disorders such as diabetes.A constant rise in stress hormones impairs the regulation of blood sugar in the body. Cortisol encourages the liver to release glucose into the bloodstream, providing an energy boost during a crisis. In a state of chronic stress, consistently high blood sugar levels may promote insulin resistance, a key factor in the development of type 2 diabetes.
Several epidemiological studies have found a correlation between high levels of stress and a higher incidence of diabetes with a study in Tamil Nadu showing that 35% of patients with diabetes mellitus had high to very high stress levels. Chronic stress alters appetite and promotes obesity. It increases the likelihood of developing metabolic syndrome, a cluster of conditions that include high blood pressure, high blood sugar, and abnormal cholesterol levels, which precedes diabetes.
The impact of chronic stress on gut health is another area of growing concern. The relationship between the brain and the digestive system is complex and bidirectional,meaning that stress can affect the gut, and gut health can, in turn, influence stress levels. Major depressive disorders and functional gastrointestinal disorders such as irritable bowel syndrome (IBS) show high rates of co-morbidity. Chronic stress can lead to abdominal pain, bloating, and altered bowel habits. The gut is home to trillions of bacteria that play a critical role in digestion, immunity and even mood regulation. Stress disrupts the balance of these bacteria, leading to a condition known as dysbiosis, which is linked to a variety of gastrointestinal disorders such as irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). Studies have shown that stress-induced inflammation weakens the intestinal barrier, making it more permeable, and increasing the risk of systemic inflammation with the development of chronic diseases throughout the body.
Mental health issues are the most immediately recognizable consequence of chronic stress. The Relentless pressure of daily stress can lead to a wide range of emotional and psychological problems. Anxiety disorders, depression, and burnout are increasingly common today. 1 in 2 urban Indians have experienced stress to the extent that it impacts their daily life. Chronic stress can also aggravate existing problems and worsen symptoms. Stress also interferes with sleep, cognition, and emotional regulation, which further increases the risk of mental health disorders.
It is evident that chronic stress is not a standalone issue but is linked to a host of serious health conditions. It is the catalyst that can trigger multiple medical conditions,eventually leading to chronic diseases. It is therefore critical to incorporate stress management strategies into everyday healthcare as not just a preventive measure but an integral component of effective treatment regimens. Addressing stress can improve treatment outcomes and interventions such as mindfulness-based stress reduction (MBSR), cognitive-behavioural therapy (CBT), regular physical exercise, and proper sleep hygiene have all been shown to reduce stress levels and decrease the risk of developing chronic illnesses. Mindfulness techniques have been proven to lower blood pressure and reduce symptoms of anxiety and depression. Beyond its well-known benefits for physical fitness, exercise is a powerful antidote to stress, helping the body to release endorphins, improving mood and stabilizing blood sugar levels.
We must integrate stress management programs into the healthcare ecosystem. Awareness initiatives and regular screening for stress-related symptoms can help to significantly reduce the incidence of heart disease, diabetes, and mental health disorders over time. It is time we took a more holistic approach to healthcare and made stress management a routine part of medical care. It’s Time we all, healthcare professionals, policymakers, and individuals, acknowledge stress as a fundamental health issue andwork to manage and mitigate its effects. It is only then that we can stop this silent epidemic in its tracks!
(The author, Dr. Vanaja Reddy Puli, is a Consultant Psychiatric, at Apollo hospital Jubilee Hills, Hyderabad.)
