What is chronic stress, how does it affect the body and mind, and why does it go unnoticed? Read about the marks long-term stress leaves and how to recover.
"I've always been like this." I hear this sentence often. Someone whose sleep has been light for years, whose stomach is sensitive, whose neck is stiff and whose patience has worn thin describes it as if it were part of their personality. Yet when we go back a little, a completely different story emerges: a woman who has been caring for her mother, diagnosed with dementia, for four years; a shopkeeper whose debts never get paid off; a family who still haven't been able to move into a permanent home since the earthquake; an employee who waits for payday every month in fear of losing their job. Chronic stress is the name for the load that such long-lasting, never-ending difficulties build up in the body and mind. In this article I explain what chronic stress is, how it affects the body, why it so often goes unnoticed and what can be done to lighten this load.
What Is Chronic Stress?
Stress is the body's natural response when it encounters a difficulty. When you sit an exam, give a difficult talk or receive unexpected news, the body briefly speeds up, focuses and spurs you into action. When the difficulty passes, it calms down. This is called acute stress and it is a normal part of life; it even has a side that helps us grow and learn.
Chronic stress, on the other hand, is when the difficulty lasts for weeks, months or even years and the body gets no chance to calm down. The problem here is not so much the intensity of the stress as its duration. A light but never-ending load can be more wearing than a heavy but brief shock.
Researchers use the concept of "allostatic load" to describe this build-up. Put simply, the body pays a price to maintain balance with every difficulty. When there is an opportunity to recover between difficulties, this price is paid off. When there is no recovery, however, the debt accumulates and at some point shows itself in different systems of the body.
Chronic stress and anxiety can be confused. Stress is more a response to a concrete load or demand, whereas anxiety is often a worry about possible future threats. The two can feed each other; if you would like to understand the distinction in more detail, you can read the article on the difference between stress and anxiety.
The Effects of Chronic Stress on the Body
Long-lasting stress can affect many of the body's systems at the same time. Since each of the effects below can also arise for other reasons, a medical assessment is always important.
- Sleep: Difficulty falling asleep, waking frequently at night, getting up unrested in the morning. As sleep deteriorates, the capacity to cope with stress also falls.
- Digestion: Heartburn, bloating, changes in bowel habits and fluctuations in appetite. The close relationship between the gut and the brain explains why stress is so noticeable in digestion.
- Heart and blood vessels: Stress hormones raise heart rate and blood pressure. In the long run, stress can also affect heart and vascular health through behaviours such as sleep, diet and physical activity.
- Immunity: Long-lasting stress can upset the balance of the immune system; some people notice that they fall ill more often or recover more slowly.
- Muscles and pain: Tension in the neck, shoulders, back and jaw; tension-type headaches. Sensitivity to pain may also increase.
- Hormones and the cycle: In women the menstrual cycle may be disrupted; in general, changes in energy and appetite balance may be seen.
- Skin and hair: Flare-ups of some skin problems, itching or hair loss may increase during stressful periods.
Effects on the mind and emotions
Long-lasting tension leaves its mark not only on the body but also on the mind. Poor concentration, forgetfulness, difficulty making decisions and a constant feeling of not keeping up are common. Emotionally, the person gets angry more quickly, their patience shrinks, they may cry over small things or, on the contrary, they may experience a numbness as if they feel nothing at all. In the long run, this picture can also pave the way for anxiety and depression.
Changes in behaviour
When stress lasts a long time, people often turn to the most easily accessible comforts: cigarettes, too much tea and coffee, sugary foods, scrolling on the phone until late at night, alcohol. Withdrawing from social relationships, giving up hobbies and constantly postponing rest are also common. Although these behaviours bring relief in the moment, in the long run they reduce the body's capacity to recover.
Chronic stress does not look the same in everyone
Two people carrying the same load can react very differently. One talks constantly, complains and gets angry; the other gradually falls silent, lets nothing show and makes everything look fine. In some people stress speaks mostly through the body: the stomach, the skin, the muscles. In others, through mood: pessimism, impatience, anxiety. This difference depends on the person's temperament, past experiences, how they learnt to deal with emotions in childhood and their current sources of support. That is why comparing your own stress picture with other people's and saying "they're in a harder situation but aren't this affected" is hardly fair.
Why Does Chronic Stress Go Unnoticed?
The most insidious side of this kind of stress is that over time it becomes "normal". The human mind is a master of adaptation. Someone who has lived under tension for years stops hearing it, like background noise. They put stomach ache down to what they eat, sleeplessness to age, impatience to their character.
Another reason is that many people in Turkey see stress as a sign of weakness. Sentences such as "Everyone has their troubles", "In our day nobody knew anything about stress" and "Be grateful for what you have" make it harder for a person to take their own exhaustion seriously. Those who look after others and carry the family's load in particular feel that talking about their own needs is selfish.
Let me give an example: you are fifty-two and run a small hardware shop. For the last few years costs have been rising, customers have been falling and it has been getting harder and harder to keep up with cheque payments. You wake up at three in the morning doing sums, there is a constant heaviness in your stomach, and you snap at your partner and children more quickly than before. When someone asks you, "Are you stressed?", you say, "No, not really, it's just work." Yet your body has been saying something else for a long time. For more information on the effect of debt on mental health, you can read the article on debt stress.
Sources of Long-Lasting Stress in Turkey
Although the sources of chronic stress vary from person to person, there are some common themes frequently encountered in Turkey:
- Economic uncertainty and the rising cost of living: Wages not lasting until the end of the month, rent increases, savings losing their value.
- The burden of caregiving: Looking after an elderly or sick relative for a long time; this burden very often falls on the shoulders of a single person, frequently a woman.
- Processes after earthquakes and disasters: The years-long effort to rebuild by people who lost their homes, jobs or loved ones after the 6 February 2023 earthquakes; and, in big cities, the constant worry about earthquakes.
- Long working hours and traffic: Spending hours a day commuting to work and finding no time to rest on returning home.
- Ongoing family conflicts: Tensions in the same household, boundary problems with the extended family, unresolved hurt.
- Long legal or medical processes: Divorce proceedings, inheritance disputes, living with a chronic illness.
What these sources have in common is that they are too big and too long for the person to control in a short time. That is why coping with such a load is often not about removing stress entirely, but about opening up spaces within it in which to breathe.
What Can You Do to Cope with Chronic Stress?
Create recovery breaks
The biggest problem with ongoing stress is the lack of opportunity to recover. You may not be able to reduce the load in your life immediately; but you can create small recovery breaks during the day and the week. Ten minutes drinking your morning tea without your phone, an evening walk, a few hours' trip into nature at the weekend. These breaks are necessary for the body to lower its alarm level.
Separate what you can control
Divide a piece of paper in two. On one side, write the sources of stress you can control; on the other, those you cannot. For the ones you can control, plan small, concrete steps; for the ones you can't, think about how you can live with them. This distinction helps you avoid wasting your energy.
Support your body with its basic needs
Regular sleep, regular meals, daily movement and enough water. These may sound like ordinary suggestions, but under long-term stress they are the first areas to be neglected and the ones that make the biggest difference.
Lean on your relationships
In long-lasting difficulties, people often withdraw into themselves. Yet talking to someone you trust and feeling that you are not carrying the load alone helps the stress system calm down. Think of asking for help not as a weakness, but as taking a rest stop on a long journey.
Share the load and set boundaries
Talking again with your siblings about the caregiving burden, voicing unrealistic demands at work, not accepting every invitation. Setting boundaries may create tension at first, but in the long run it helps reduce stress.
Bring back something that nourishes you
When stress lasts a long time, the things a person enjoys disappear from their life one by one: gardening, music, a football match, meeting friends. Adding one of these back into your week, even in a small way, not only rests you but also reminds you of who you are.
When Should You Seek Professional Support?
If you have physical complaints, see a doctor first; many of the symptoms associated with long-lasting stress can also arise with other health problems. After a medical assessment, it may be helpful to see a mental health professional in the following situations:
- If you have felt exhausted, tense and unrested for months,
- If your sleep problems have been going on for a long time,
- If irritability or emotional numbness is affecting your relationships,
- If inability to enjoy things, hopelessness or feelings of worthlessness are present,
- If your reliance on cigarettes, alcohol or other substances has increased.
Ongoing stress sometimes shows itself in the workplace as burnout; for more information about this picture, you can read the article on burnout syndrome. If you feel you have lost hope in living or are having thoughts of harming yourself, tell someone close to you without waiting, and in an emergency call 112 (emergency services).
How Is Chronic Stress Addressed in Therapy?
When working with long-lasting stress, the first aim of therapy is to make the person's load visible. Many people put the things they have been carrying for years side by side for the first time in the therapy room and are surprised: "Have I really been going through all of this at once?" This awareness is the beginning of change. Then it is worked out together which of these loads can be changed and which are, for now, the kind that need to be accepted and carried.
In cognitive behavioural therapy, the sources of stress, the accompanying thoughts and ways of coping are examined together. It becomes clear how thoughts such as "I'm strong, I can take it", "There's no one but me to do it" and "Everything has to be finished before I can rest" wear the person down. Problem-solving skills, relaxation techniques and recovery breaks in daily life are planned. Acceptance-based approaches can also be used to live with difficulties that cannot be controlled.
A schema therapy perspective helps to understand why, in some people, stress is carried unnoticed for so long. Deep-rooted patterns such as self-sacrifice, unrelenting standards or suppressing emotions make it difficult for a person to see their own limits.
You may not be able to put down a long-lasting load all at once; but you can learn to set it down now and then to catch your breath while carrying it.
If you would like to draw up a road map that suits your own life circumstances, you can find information on the individual therapy page.
Frequently Asked Questions
Does chronic stress cause permanent damage?
A significant part of the effects of long-lasting stress on the body can ease as stress decreases and opportunities for recovery increase. However, stress that is neglected for a long time can pose a risk for some health problems. That is why it is important not to neglect either medical follow-up or skills for coping with stress.
How can I tell if I have chronic stress?
If you haven't felt rested for a long time, if physical complaints such as sleep, digestion or pain increase during busy periods, and if your patience is shorter than before, you may be under chronic stress. These signs do not on their own mean a diagnosis; but they are a good signal to stop and look at yourself.
Does long-lasting stress turn into depression?
Not every stressful period turns into depression; however, long-lasting stress without opportunities to recover is an important risk factor for depression and anxiety disorders. If inability to enjoy things, hopelessness and listlessness last for more than two weeks, it is a good idea to consult a professional.
Does going on holiday cure chronic stress?
A holiday can bring short-term relief, but if you face the same loads when you return, stress soon comes back. For lasting change, it is necessary to build recovery breaks into daily life and to work with the sources of stress. If you have been carrying this load alone for a long time, it is possible to walk part of the way together with a professional.
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Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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