Dr. Ayush PandeyMBBS,PG Diploma

March 08, 2017

March 06, 2020



Stress is a coping mechanism of the body to anything that can pose a threat. Stress is a ‘fight or flight’ response and helps a person to determine how to react to an event or a stimulus – whether to combat it or avoid it. A certain amount of stress is required to help people test their limits and realise their potential. However, undue amounts of stress can cause people to suffer and may lead to a breakdown. Stress can be caused due to internal and external factors, and sometimes a combination of both. Family discord, work and academic pressure and money constitute external factors. Low self-esteem, pessimism and rigidity are some internal causes. It can actuate in any one form – acute stress, episodic acute stress or chronic stress. While symptoms vary for each stage, some generalised features include palpitation, lack of clear thinking, self-doubt, anger and anxiety. Being alert and aware of triggers and finding healthy alternatives are the two principal ways of preventing stress. While there are certain tests and screeners which can help diagnose the condition, elaborate discussions with qualified professionals still provide the most accurate diagnosis. Treatment includes a combination of medication, counselling and alternate therapy and lifestyle modification. While the prognosis for those recovering from stress is encouraging as long as they stay positive, complications that may arise include alcohol and drug abuse, and suicidal tendencies.

What is mental stress

Although the word ‘stress’ is viewed negatively, it is, in fact, a very natural coping process for the body. Stress can sometimes bring about great outcomes, including improved performance, innovative outcomes and better teamwork. When there is too much of stress and when it is dealt with inadequately, it can affect the way we think and feel, thereby throwing us off balance.

What is stress?

Stress is what is most commonly referred to as a ‘fight or flight’ response. It is a reaction of the body to a threatful situation. Stress is a way by which the body protects you and helps you deal with challenges. It can help you stay focused, motivated and extract great performance. When experienced beyond a certain limit, however, stress starts to break you down, affecting your health, efficiency and your relationships.1

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Types of stress

While the term stress is used in a generic sense, the situation can be classified into 3 types. It is important to know and understand the nature of each kind since the mechanism for dealing with each varies.

  • Acute Stress
    This is the most commonly experienced form of stress. It is an extreme form that is experienced either due to a past experience or perception and the anticipated pressure around the experience occurring in the near future. Acute pressure is great when it exists for a short period of time. However, when the experience is prolonged, it causes fatigue and a breakdown of both physical and mental capacities. Since acute stress is only short-lived, it is not as damaging as other forms of the condition can be. This is the most easily addressable forms of stress.
  • Episodic Acute Stress
    Episodic acute stress is an acute form experienced by those who tend to get disturbed very often. Such people are usually always in a rush to do something, filled with chaotic schedules and always pressured. Most people who experience episodic acute stress tend to believe it to be a part of their life. They tend to believe that external factors are responsible for their stress and are often resistant to change.
  • Chronic stress
    While acute stress can be stimulating, chronic stress is purely debilitating. Chronic stress is experienced when the pressure does not wear off for a long period of time. It is hard to see a way out, and the individual often tends to give up. Sometimes chronic pain may stem from childhood experiences, or from a traumatic experience. The pain and baggage of such events are carried forever. Such people often tend to become accustomed to the stress and are usually unaware that it even exists as time goes by.

Stages of stress

When faced with stress, the body goes through what is known as a general adaptation syndrome. This syndrome, commonly known as GAS, is simply the three stages the body experiences under such a situation.

  • Alarm reaction
    In this stage, the body is alert and most responsive. This is the stage at which the ‘fight and flight’ principle is best demonstrated. The body readies itself and tries to ascertain the best course – fighting the stressor or fleeing from it.
  • Resistance
    This is the period following the initial phase of shock. During this phase, the body starts to repair itself. Over time, the body slowly normalises and heart rates, blood pressure and rates of breathing return to normal. If stress persists through this state, the body starts to adjust to it and gets used to it. Exposure to great levels of stress for long periods of time eventually leads to exhaustion.
  • Exhaustion
    This stage is typical of chronic stress. The body, at this stage, is drained of all resources and is no longer capable of functioning optimally. There is a lack of hope and determination. Physical health is also compromised.

Stress symptoms

Symptoms of stress can vary depending on the nature of the stress, and also on the stage at which the individual is. Some symptoms may be extremely generic, making it easy to ignore or confuse with another condition.

  • Symptoms of acute stress include:
  • Traits symptomatic of episodic acute stress include:
    • Aggression, impatience, general feeling of hostility and deep-rooted insecurity.
    • Unending worry about everything, feeling of pessimism and distrust.
    • Hypertension, chest pain, migraine and heart problems.
  • Chronic stress comes with fairly severe symptoms, some of which include:
    • The feeling of being perceived and judged at all times.
    • The need to appear perfect at all times.
    • A seeming unawareness of prolonged stress that is being experienced.
    • Increased chances of heart ailments and strokes, and cancer.
    • Violent and suicidal tendencies.
    • Severe breakdown from having to cope with the stress for such long periods.

Stress causes and risk factors


Anything that causes stress is known as a stressor. Stressors can be divided into external stressors or extraneous factors, and internal stressors.

  • External factors that influence stress include financial issues, relationship problems, family and children, work and school.
  • Internal factors contributing to stress include having a negative outlook, rigidity, lack of self-belief, pessimism, need to appear perfect for others and a negative self-concept.

No real risk factors have been identified for stress.

Prevention of stress

There are some simple techniques that can help prevent stress and also help in coping with stress better.

  • Being watchful
    Knowing the potential causes of stress helps to be more aware and prepared for stressful situations. Those less aware and prepared are more likely to feel greater levels of stress.
  • Being realistic
    It is important to have a realistic outlook in order to prevent stress. Often stress arises from being over-ambitious, setting unrealistic goals and expectations and from expecting more than what is possible. Maintaining a reality check will help set sights on achievable targets and help prevent stress.
  • Being assertive
    Those who cannot stand up for themselves often find they are victims of stress. Others can easily influence them and compromise their self-belief. They also find themselves unable to say no and doing more than they have time for, or are capable of. Developing an assertive personality will help form more meaningful relationships, value the self and also stand ground.
  • Being active
    An active lifestyle which includes plenty of rest and exercise alleviates stress significantly. Exercise helps to maintain better health, allows for the release of hormones that boost the mood and also improve self-concept. In the same way, rest reduces irritability, anger, impulsivity and improves quality of work, thereby preventing stress.
  • Being open
    The best way to prevent stress is by surrounding yourself with people who make you feel valued, wanted, worthy and loved. Not only does a support system improve your perception of yourself, but also pitches in at times when you are unable to cope by on your own.
  • Being optimistic
    Nothing can help prevent stress like a little optimism. Some self-belief, good faith and a more future-oriented outlook can help tide through tough times, give you much-needed strength and the mental courage to face challenges without being adversely affected by them.
  • Being healthy
    Those who have healthy, balanced diets are known to be less edgy, more controlled and reactive. Having foods high in sugar or too much fast food can alter moods significantly.

Diagnosis of stress

Since stress causes increased activity in the body, and especially in the adrenal and pituitary systems, diagnosing it becomes slightly complex. A common method of diagnosis includes questionnaires, biometrics and psychologic techniques. In addition, biochemical measures have also been used to diagnose stress. While effective, all of these tools are prone to error. The greatest technique in identifying stress continues to remain medical interviews which are conducted with the patient in person. It is the most thorough, clear technique employed yet.

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Stress treatment

A combination of the various forms of treatment available is usually considered ideal for stress.

  • Medication
    Although there is no medication that can be prescribed to treat stress directly, medication can be used to address problems related to stress. Medication may be aimed at treating sleeplessness, anxiety, depression and stomach related ailments.
  • Counselling
    Talking can be a great stress reliever. Professionals can use techniques like Cognitive based therapy (CBT) and Mindfulness-Based Stress Reduction (MBSR) to help channelize energy and reduce stress.
  • Alternative treatments
    Methods like yoga, acupuncture, aromatherapy and other forms of healing are other preferred alternatives.
  • Recreation
    Recreational activities can help reduce stress and also promote a sense of well-being. Taking up projects that reinforce self-belief and make constructive contributions are good tools for treatment.

Lifestyle management

There are several management techniques that can help bring about a more positive outlook.

  • Support groups
    In the long run, support groups make for great platforms to allow relief through sharing of experiences. They help boost self-esteem and allow the individual to realise he/she isn’t alone or inadequate. They also help provide support and help to one another.
  • Pursuing a hobby
    Using spare time to follow one’s passion can allow great release from stress. Hobbies help relax and also give a great sense of accomplishment.
  • Relaxation techniques
    Observing regular practice of relaxation techniques like meditation, yoga and visualization help calm down the individual and also prevent them from making impulsive decisions.
  • Diet and exercise
    These form an important part of maintaining a healthy lifestyle and help keep the body and mind agile and positive.
  • Goal setting
    Setting realistic, attainable goals helps provide a sense of accomplishment and also reduce stress. It may be necessary to seek some external assistance in setting goals and assigning priorities initially, but in time individuals will be able to view their capabilities more objectively and set themselves targets.

Stress prognosis & complications


The outcome for stress depends almost entirely on the manner in which it is handled. In cases where constructive, timely help is provided, stress can be overcome completely, and can, in the process also equip the individual with life skills that support him/her ably. On the other hand, there is also the likelihood that people may be unable to address the stress by themselves. In such cases, stress can end up being extremely harmful.


When not addressed appropriately, stress can lead to serious complications. Those with chronic stress can develop anxiety disorders and depressive tendencies. Some cases of chronic stress also lead to alcoholism and drug abuse. Over time, the person may also develop suicidal and violent tendencies.


  1. Selye, H. (1950, June 17). Stress and the general adaptation syndrome. British Medical Journal, 1(4667), 1383-1392. PMID: 15426759.
  2. American Psychological Association [internet] St. NE, Washington, DC. Stress.
  3. Anxiety and Depression Association of America [internet] Silver Spring, Maryland, United States. Physical Activity Reduces Stress.
  4. National Institute of Mental Health [Internet] Bethesda, MD; 5 Things You Should Know About Stress. National Institutes of Health; Bethesda, Maryland, United States
  5. Noble RE. Diagnosis of stress. Metabolism. 2002 Jun;51(6 Suppl 1):37-9. PMID: 12040539
  6. Center for Disease Control and Prevention [internet], Atlanta (GA): US Department of Health and Human Services; Stress at work

Medicines for Stress

Medicines listed below are available for Stress. Please note that you should not take any medicines without doctor consultation. Taking any medicine without doctor's consultation can cause serious problems.