Coping with Stress

Can stress make you sick?  The answer is a resounding yes.  If you want to know how to handle stress, it helps to know what stress is, how it affects your body, and what you can do about it.

What is Stress?

Anything that an individual perceives as a problem can cause stress.  When we perceive a problem and don’t have the resources (or believe we don’t) to cope with it, we can experience stress.  Stressors can be physical, such as an illness or injury, or emotional, such as family, job, or financial problems. Stress is a reaction to a situation where a person feels threatened or anxious.[1]  The body’s response to stress is natural and adaptive.[2] However, chronic stress harms our health, causing psychological and biological changes that increase our chances of becoming ill.

Stress Hormones

When faced with stress (for example a physical threat), your body responds with a “fight or flight reaction” to enable you to fight back or run away from danger.  The adrenal glands release the hormone epinephrine (adrenaline) and the neurotransmitter norepinephrine into the bloodstream. The adrenal glands also release corticosteroid hormones that release fatty acids for energy, causing digestion to stop, blood sugar levels to rise, and the heart to pump more blood to the muscles.

At the same time, the pituitary gland releases a hormone that stimulates the release of cortisol.  In the short term, cortisol helps the body divert energy to muscles and organs that are needed to avoid danger.  However, the same hormones that help defend the body in the short-term can hurt it when produced for longer periods. Because one action of cortisol is to suppress the immune system, chronic stress causes wounds to heal more slowly than normal and leaves the body prone to infections.  This is why chronic stress is also associated with gastrointestinal conditions such as ulcers and irritable bowel syndrome. Since cortisol changes blood sugar and heart rate, cortisol is also associated with diseases of the cardiovascular system, including hypertension, stroke, and heart disease.

What Causes Stress?

According to the 2017 Stress in America Survey by the American Psychological Association, 62% of participants reported being stressed about money and 61% said work was a stressor.[3]  Genetics play a part in determining someone’s stress response, as does an individual’s experience with stress and their learned perceptions of specific events or situations as stressful. So, the way we see ourselves and others, our methods of handling stress, and our genetic makeup all affect the immune system, and therefore, our health.  Not everyone is the best judge of what reduces his or her own level of stress. For example, smokers depend on cigarettes to relax, but the nicotine in cigarettes does exactly the opposite. Watching TV may feel relaxing, but, depending on the program and on how TV interferes with sleeping or other responsibilities it may sometimes increase stress and decrease the ability to cope with stress.

Women and Stress

Studies show that women and men cope with stress differently.[4]  The friendships and other social support systems that are more common in women may help them cope more effectively with stress, enhancing their immune response and resistance to diseases.[5]  Studies have shown that women with breast cancer who have strong social supports have significantly longer life spans than women who do not.[6] Interestingly, researchers found that social support provided by women is more effective at lowering blood pressure responses to stress in both males and females than support from men.

On the downside, scientists find that women are two times more likely to develop depression in reaction to the stress in their lives.[7]  Women are often under considerable stress as they try to balance work, marriage, and children. Some experts have found that chronic stress can cause a chemical imbalance that can lead to depression.[8]  In addition, those who care for sick and elderly family members are usually women. Studies indicate that these caregivers have high cortisol levels and, therefore, weakened immune systems.[9]

Tips to Reduce Stress

Experts indicate that there are many different ways to manage our levels of stress.  It is important to keep in mind that different strategies work for different people. You can try to manage stress levels by meditation, exercise, and doing things that you find relaxing.  Here are some tips you can try to help you deal with stress:

Exercise:  Regular exercise is an effective stress-reduction method for many people.  Physical exercise causes your body to release endorphins (a type of hormone), which make you feel better and boost your immune system. For example, a recent review of 15 studies involving hundreds of thousands of patients found that even just 2.5 hours of brisk walking in a week can decrease the risk of developing depression by 25%.[10]

Take a Deep Breath: If you need to immediately reduce stress, try taking slow and deep breaths.  Slow breathing has been shown to have a calming effect that can lower blood pressure, reduce muscle tension, and decrease heart rate.  Mediation and yoga can also be effective methods for reducing stress. For example, a study published in the Journal of Science and Sport Medicine investigated the effect of Bikram yoga on sedentary and stressed adults, and found that 16 weeks of practice greatly improved stress, self-efficacy, and health related quality of life.  In addition, those who attended more classes found their stress was reduced more. [11]

Maintain a Healthy Diet: Our eating habits can affect our immune systems’ response to stress. A balanced diet emphasizing fresh fruits, vegetables, legumes, raw nuts and seeds, and whole grains can help the body better respond to stress.  Reducing caffeine can also help. Studies have found that blood pressure during stress is higher if caffeine has been consumed. This suggests that people who have a high intake of caffeine might experience more stress and produce more stress hormones.  According to a researcher from Harvard Medical School, studies comparing the typical “Western” diet to “traditional” Mediterranean or Japanese diets, found that those who eat “traditional” diets have a 25% to 35% lower chance of developing depression.[12] To learn more about healthy eating habits check out our article.

Get Enough Sleep: Many Americans get only 7 or fewer hours of sleep a night but research indicates that most adults and children do better with 8-9 hours.  In fact, most teens in a sleep lab slept more than 9 hours each night when given the opportunity. It can be a vicious cycle: lack of sleep can make an individual more susceptible to stress, and stress often interferes with the ability to sleep.

Find Social Support: Researchers have found that expressing emotions affects health.[13]  It can be difficult to talk about life’s challenges, but reaching out to supportive friends or family is important.  Knowing that your feelings are validated and you are supported can help tremendously to alleviate stress. Try talking to others, whether friends, family, a counselor, or a professional, if you are having trouble managing your stress.

Talk to a Professional:  If you feel overwhelmed by the stress in your life, it’s a good idea to seek professional help. You can work with a mental health professional to identify your stressors and learn strategies on how to deal with your stressors while maintaining a healthy life.


Bottom Line

It’s worth making the effort to think through how stress affects your life.  If you’re aware of how physical and emotional stresses affect your body, you will be better prepared to cope with stressful situations, modify the way you react to them, feel better, and live longer. It is important to remember that often we can’t do it all on our own – in that case, try seeking help from a professional.

If you or someone you know needs immediate help, please contact the one of the following crisis hotlines:

–Disaster Distress Helpline: 1-800-985-5990

–National Suicide Prevention Lifeline: 1-800-273-TALK

–Youth Mental Health Line: 1-888-568-1112

For more information, we recommend Dr. Esther Sternberg’s book, The Balance Within: The Science Connecting Health and Emotions (Holt, Times Imprint).

Also, check out our Survival Guides for Working Moms for more tips and research based information about coping with stress

All articles are reviewed and approved by Dr. Diana Zuckerman and other senior staff.

The National Center for Health Research is a nonprofit, nonpartisan research, education and advocacy organization that analyzes and explains the latest medical research and speaks out on policies and programs. We do not accept funding from pharmaceutical companies or medical device manufacturers. Find out how you can support us here.



  1. “Coping With Stress.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 09 Apr. 2013. Web. 15 July 2013.
  2. Butts, C., and E. Sternberg. “Neuroendocrine Factors Alter Host Defense by Modulating Immune Function.” Cellular Immunology 252.1-2 (2008): 7-15.
  3. American Psychological Association (2017). “Stress in America: The State of Our Nation.” Stress in America™ Survey.
  4. Matud, M. “Gender Differences in Stress and Coping Styles.” Personality and Individual Differences 37.7 (2004): 1401-415.
  5. Hobfoll, Stevan E., Carla L. Dunahoo, Yossef Ben-Porath, and Jeannine Monnier. “Gender and Coping: The Dual-axis Model of Coping.” American Journal of Community Psychology 22.1 (1994): 49-82.
  6. Funch, Donna P., and James Marshall. “The Role of Stress, Social Support and Age in Survival from Breast Cancer.” Journal of Psychosomatic Research 27.1 (1983): 77-83.
  7. Nolen-Hoeksema, Susan. “Gender Differences in Depression.” Current Directions in Psychological Science 10.5 (2001): 173-76.
  8. McEwen, Bruce S. “Early Life Influences on Life-long Patterns of Behavior and Health.” Mental Retardation and Developmental Disabilities Research Reviews 9.3 (2003): 149-54.
  9. Bauer, Moisés E., Kavita Vedhara, Paula Perks, Gordon K. Wilcock, Stafford L. Lightman, and Nola Shanks. “Chronic Stress in Caregivers of Dementia Patients Is Associated with Reduced Lymphocyte Sensitivity to Glucocorticoids.” Journal of Neuroimmunology 103.1 (2000): 84-92.
  10. Pearce M, Garcia L, Abbas A, et al. Association Between Physical Activity and Risk of Depression: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2022;79(6):550–559. doi:10.1001/jamapsychiatry.2022.0609
  11. Hewett, Zoe L., et al. “The Effects of Bikram Yoga on Health: Critical Review and Clinical Trial Recommendations.” Evidence-Based Complementary and Alternative Medicine, Oct. 2015, pp. 1–13., doi:10.1155/2015/428427.
  12. Selhub, Eva. “Nutritional psychiatry: Your brain on food.” Harvard Health Publishing. November, 2015.
  13. Tyrka AR, Price LH, Kao HT, Porton B, Marsella SA, Carpenter LL; Childhood maltreatment and telomere shortening: Preliminary support for an effect of early stress on cellular aging; Biological Psychiatry, 2010, 68(6) pp. 531-4.