How to Work with Your PCP to Reduce Your Stress

We all experience stress to some degree – it’s part of life and can actually be positive because it’s an inherent and essential physiological reaction that helps us react to danger or sense the heightened thrill of experiences.

What is stress?  

Medically, stress is defined as a state of emotional or mental tension or worry in reaction to difficult situations that might cause alarm, fear, anger, nervousness, grief or sadness. It’s a natural human response we all experience when we feel challenged or threatened. In short amounts, it can help us cope. But depending how we individually handle it or if we’re feeling overwhelmed, long-term stress can be very harmful to our health.

Read on to understand our body’s physiological reaction to stress, how it impacts our health and wellbeing, tactics for reducing stress in your life, and how your doctor can help.

Types of Stress 

Stress is a built-in physiological and biological response to perceived threats that causes escalation in release of specific hormones.  thaThink of stress as an early alert system for the bodyt puts the body on alert. When you experience a threat, first the hypothalamus at the brain’s base triggers an alarm system through nerve signals that then prompts our adrenal glands to release increased amounts of the hormones cortisol and adrenaline, responsible for a fast reaction of major body systems to danger.

• Cortisol is the driver of a complex system that shuts down or slows down non-essential functions such as the digestive, reproductive and growth systems and controls mood, fear and motivation by communicating with the brain.
• Adrenaline immediately increases energy by making our heart beat faster, causing an increase in blood pressure. As the primary stress hormone, adrenaline gets the systems that repair tissues prepared for emergency response; it increases glucose levels in the bloodstream and optimizes the brain’s glucose use.

However, stress response is not a one-size-fits-all. Individually we have different stress tolerance levels before our body reacts with a surge in hormones that help us react to and cope with the three different types of stress: acute stress, episodic acute stress and chronic stress.

Acute stress

This is the short-term stress we all experience when something bad or exciting happens, such as short-term work stress or interviewing for a new job, fighting with our kids or partner, hearing someone screaming or crying, skidding on an icy road, or tobogganingriding our bike down a steep icy hill. Acute stress is our body’s response to help manage the flight-flight-or-freeze response to dangerous situations and manage our physical and emotional reaction. It's temporary and passes in a short amount of time.

Episodic acute stress

When instances of acute stress occur frequently or you endure a life of multiple recurring difficult situations – such as from having a disability or a dangerous job – or your life is full of one stressor after another, making you feel constantly under pressure, this is called episodic acute stress. It’s also experienced by people who put too much demand and pressure on themselves causing undue worry. If not managed, episodic acute stress can cause health issues such as heart disease or clinical depression. And research has identified episodic acute stress as well as chronic stress as unique predictors of depression.

Chronic stress

This is long-lasting stress experienced over a significant amount of time or as a general state of being, such as homelessness, poverty, ongoing financial struggles, or having a dysfunctional marriage or deeply dissatisfying or stressful job. Chronic stress is a constant feeling of being overwhelmed and can present with emotional, behavioral, physical and cognitive symptoms, including insomnia, low energy, aches and pains, untypical emotional reactions or withdrawal, clouded thinking, an inability to focus, appetite changes, or increased use of alcohol or drugs. Chronic stress can be debilitating and even life threatening if not treated, and is linked to other health conditions including obesity, metabolic syndrome, diabetes, arthritis, hypertension and heart disease.

Stress vs. Anxiety

The difference between stress vs. anxiety is nuanced. People often use the terms interchangeably, but they are different if only by a very fine line in their emotional responses and symptoms.

Stress is typically the result of either a short or long-term external trigger – a situation or event – and results in symptoms that include stress-related digestive issues, trouble sleeping or fatigue, anger or irritability.

Anxiety is the state of being continually and excessively worried without the existence of a true trigger or stressor. Think of it as more of an ongoing feeling rather than a reaction to something happening. Anxiety symptoms are predominantly fatigue, insomnia, muscle aches and tension, irritability and difficulty focusing.  

According to the latest data from the National Institute of Mental Health:

• 31% of Americans will experience an anxiety disorder during their lifetime.
• One in four (26%) reported more stress in 2023, up from one in five (20%) in 2022.
• Approximately 19.1% of U.S. adults had any type of anxiety disorder in the past year (23.4% for females; 14.3% for males).
• An estimated 31.9% of adolescents (ages 13-18) in the U.S. suffered an anxiety disorder.

 The most recent annual survey by the American Psychological Association found that:

• 1 in 4 Americans (26%) reported an increase of stress since the onset of the COVID pandemic.
• Pandemics, global conflict, inflation, and political and racial tensions were the biggest causes of stress and anxiety.

According to joint research by Occupational Health and Safety News and the National Council on Compensation of Insurance: Up to 90% of all visits to primary care physicians are for stress-related complaints. 

Causes of stress

 There are numerous and varied causes of stress with different events, circumstances and issues triggering different levels of stress response across individuals. According to the Centers for Disease Control (CDC), work-related stress leads as the No. 1 cause, directly resulting in 120,000 deaths annually, with stress triggers typically falling into the following categories:

• Work stress or school problems.
• Financial troubles.
• Major life changes.
• Relationship difficulties.
• An overly busy life
• Family and children

Risk factors

Susceptibility to stress is fundamentally driven by your tolerance level, believed to be linked to genetics, circumstances and lifestyle choices. If you have a high-pressured or high-risk lifestyle, you will likely be more susceptible to stress vs. if you live a calm lifestyle with an easy-going job.

Genetics The genes that manage stress response and control release of stress hormones adrenaline and cortisol keep most people at an even emotional level, appropriately priming the body’s reaction for fight, flight or freeze only when the threat is real. However, differences in these genes can cause some people to be more, or less, at risk to suffer from stress.

Circumstances and lifestyle Stress reaction can often be correlated to traumatic experiences. People who endure poverty, suffer abuse as children, have high-risk jobs such as police officer, EMT or the military, or who’ve experienced violent crime or events such as a plane crash or death of a child can be more at risk of short-term acute stress as well as longer-term chronic stress.

Symptoms & warning signs

The combination and severity of symptoms varies person to person – they can be emotional, physical, or both – and together result in feeling overwhelmed. Following are the most common signs you may be experiencing stress that needs managing:

Physical symptoms:

• Weight gain or weight loss
• Upset stomach or digestive issues
• Constipation or diarrhea
• Headaches
• Lack of energy
• Continuous or untypical aches and pains
• Feeling stiff – especially in the jaw and neck
• Sexual problems
• Ongoing fatigue
• Insomnia, trouble sleeping, or sleeping too much
• Increased use of alcohol or drugs to relax

Emotional symptoms:

• Sadness or depression
• Increased anger
• Irritability
• Memory problems
• Difficulty focusing
• Forgetfulness
• Anxiety
• Restlessness

How stress affects your health

Chronic stress and severe cases of acute stress can have a debilitating and potentially life-threatening impact on your health.

Beyond milder symptoms such as upset stomach or trouble sleeping, ongoing high levels of constant stress can cause increased blood pressure, cardiac disease, heart attack and chronic digestive issues.

The National Institutes of Health reports research showing that emotional stress is a “major contributing factor” to the six leading causes of death in the U.S.: cancer, coronary heart disease, accidental injuries, respiratory disorders, cirrhosis of the liver and suicide. They go as far as to state that the mortality and morbidity due to stress-related illness is “alarming.”

Stress and mental health

When stress becomes prolonged and overwhelming, it can lead to mental health conditions ranging from mild to clinical anxiety and depression if not managed.

According to research reported in the Journal of Neuropsychiatry and Clinical Neurosciences, this can be caused by inflammatory processes associated with our brain and body’s responses to stressful situations causing the release and synthesis of proinflammatory cytokines. This can result in our neural and neuroendocrine systems not responding appropriately and causing depressive symptoms.

How to reduce your stress  

According to the Centers for Disease Control (CDC), one of the easiest ways to relieve stress is to take frequent 10-minute breaks throughout the day, which it states is enough to improve our mental health. Additionally, the CDC also recommends several other healthy coping mechanisms, including doing things to stay active or that lift your spirits and calm your mind. Below are the CDC’s top easy ways to help ease and manage stress:

Check in with yourself — take time to acknowledge how you’re feeling in the moment.

Practice mindfulness — close your eyes, take deep breaths, stretch, practice yoga, Tai Chi or meditate.

Keep a daily gratitude journal — each day write down three things for which you’re grateful.

Get active — Build in easy ways to exercise. Take a break for a short walk, kick around a ball for a few minutes, do some sit-ups or running on the spot, or take a quick dance break.

Play an inspiring song.

Keep positive quotes on hand — take a screenshot on your phone to quickly pull up or carry a small book of quotes.

Laugh! Listen to a comedy podcast or watch a laugh-out-loud movie you love.

Connect with others — a growing body of research proves that feeling supported, cared for and valued with a sense of social connectedness is key to resilience and coping better with stress.

Keep in touch with family, friends or someone with whom you can share your feelings.

Prioritize spiritual and faith-based activities.

Volunteer, because giving help to others can help uplift your sense of wellbeing, too.

Medical treatment options  

If you’ve tried to incorporate healthy coping mechanisms but are still feeling overwhelmed by stress, there are many stress-management medications available for your doctor to prescribe depending on the type and level of your symptoms. The most common medications to help relieve stress are SSRIs – selective serotonin reuptake inhibitors (SSRIs),  – betablockers and tranquilizers. In subtle and different ways, they help manage and influence your mood by increasing serotonin levels, the feel-good neurotransmitter. They can help improve your mood, elevate a more positive affect and improve sleep.

However, medications for stress, anxiety and depression all have side effects, so it’s important to have regular check-ins with your doctor.

How to talk to your doctor about managing stress

 It can be intimidating to bring up a sensitive topic like stress with our doctors because of its association with mental health and because they hold a position of authority over us. Taking time to prepare before your appointment can help build your confidence and ensure you cover everything you need to. Here are some tips:

Be completely honest with your doctor

Sometimes, it’s temping to be less than truthful with our doctors when it comes to fraught topics like diet, exercise and weight. It’s understandable to feel embarrassed or even guilty if you struggle with things like obesity, binge eating or addiction.  

Smoking, obesity and a poor diet can all factor into stress, so it is important to tell your doctor if you struggle with any of them (and you won’t be their first patient to struggle with these!). You can also communicate to your doctor that you are anxious or embarrassed about these topics, and that you could use reassurance.  

Make a list of your questions and concerns.

It’s easy to forget important questions at the doctor, especially if your appointment is short or rushed. A simple solution is to write out your questions and concerns ahead of time. You could even keep a list on your phone or a pocket notebook and add to it whenever you think of something else you want to bring up.  

If you are planning to make (or have already made) major lifestyle changes, it’s recommended that you check with your doctor to ensure these changes are safe and appropriate for you. Good general questions to ask include:

• What steps do you recommend for managing my stress?  
• Are there any tests I should undergo to measure how stress may be impacting my health?
• Do you have patients who have successfully learned to manage their stress?
• Is there any medication or other medical treatment I should try?
• Are there stress-related books, podcasts or literature I should check out?
• What lifestyle changes do you recommend?

Bring a spouse or trusted friend.

Not everyone knows that you are allowed to bring someone with you when you go to the doctor. Having a confidante by your side can make you feel more secure and help you remember what you want to talk about with your doctor. It also shows your doctor that you have a strong support system, and research has shown that strong social and emotional support are associated with better health.

Take notes

Doctor’s appointments can be overwhelming. In order to remember your doctor’s recommendations, it can be helpful to take notes during your appointment. If you bring someone with you, you can ask them ahead of time to take notes for you. You should also get a visit summary from your doctor after each appointment. If you are not sure how to access this summary, ask your doctor or a member of your doctor’s front desk staff.

Experiencing some level of stress during difficult times in life or in response to highly negative, threatening or dangerous events or circumstances is normal. The key to managing stress lies in making positive lifestyle changes to reduce and manage stress, practicing stress-relieving techniques, and knowing when to reach out to friends, family and your doctor for help when your stress becomes overwhelming or causes additional health issues.

FAQ about stress

Does stress raise blood pressure? 

Increased blood pressure from stress is a result of the body releasing a surge of hormones, which causes narrowing of blood vessels and the heart to beat faster.

What is toxic stress? 

Toxic stress is the result of prolonged exposure to severe stress without coping mechanisms or support from caregivers. It’s most often seen in children and caused by abuse, neglect, poverty, exposure to violence or chronic illness.  

Can stress cause diarrhea?

Research has shown that stress can cause intestinal distress and changes to gut bacteria triggering intestinal cramping, which in turn can cause diarrhea.

How do you lower cortisol levels?

Lowering stress by practicing stress management techniques and making positive lifestyle changes is key to reduce cortisol levels. These include practicing relaxation techniques such as yoga, breathing exercises and meditation; getting enough sleep; eating a balanced diet high in omega-3 fatty acids, dietary fibers and fermented foods; reducing caffeine and alcohol consumption; quitting smoking; learning to laugh; pursuing hobbies; and maintaining strong social connections.  

Why am I stressed for no reason?

Feeling stressed for no reason is likely a result of subconsciously or consciously ignoring or refusing to acknowledge stressors in your life or a past stressor that still has impact. Self-reflection into current, past and potential stressors can help you acknowledge and manage the source of your stress and seek help if necessary.

What’s the difference between stress vs. anxiety?

While very similar, stress is defined as the result of a short- or long-term trigger, whereas anxiety is a general state of worry and overall life pressure that may not have one direct trigger source.