Stress and the body: how 'tension' affects your health
Stress triggers the body's fight-or-flight response: adrenaline and cortisol raise heart rate, blood pressure and blood sugar so you can deal with danger. That is useful in short bursts. When stress is constant — the 'tension' of money, family or illness — the same hormones keep blood pressure and blood sugar higher, disturb sleep and digestion, and weaken defences against infection. Regular activity, sleep, slow breathing and talking help. But chest pain, weight loss or new symptoms should be checked, not blamed on stress.
Health writers · Aslam Clinic
Stress is the body's built-in response to a threat. Within seconds, hormones raise your heart rate, blood pressure and blood sugar to give you energy to act. In short bursts this is healthy — it gets you through an exam or a near-miss on the road. When the pressure never lets up, the same system stays switched on, and over months it contributes to high blood pressure, higher blood sugar, poor sleep, stomach trouble and more infections.
In Pakistan most people call this simply 'tension'. It is real, it is common, and a great deal can be done about it. But 'tension' is also the easiest label to put on a symptom that needs a doctor, so this page ends with the signs that should never be put down to stress.
What happens in your body under stress
When you sense danger, the — the brain's alarm centre — signals the hypothalamus, which acts as a command centre. Two systems then go to work.
- The fast system (adrenaline). Nerves trigger the adrenal glands to release adrenaline. Your heart beats faster, blood pressure rises, breathing quickens, senses sharpen, and sugar and fat are released into the blood for fuel. This is the , and it happens before you have consciously thought about the danger.
- The slower system (cortisol). If the threat continues, the hypothalamus, pituitary and adrenal glands — the HPA axis — release . It keeps the body on high alert, raises blood sugar, and increases appetite so that energy used up can be replaced.
When the threat passes, cortisol falls and the 'brake' side of the nervous system calms everything down. The problem is not the stress response itself but a brake that rarely gets used.
Short-term stress versus chronic stress
| Short-term (acute) stress | Long-term (chronic) stress |
|---|---|
| Lasts minutes to days | Lasts weeks, months or years |
| Linked to a clear event: an interview, an argument, a hospital visit | Linked to ongoing problems: debt, conflict at home, caring for a sick relative, unemployment |
| Body returns to normal afterwards | Stress hormones stay raised; the body rarely fully settles |
| Can sharpen focus and performance | Wears down sleep, mood, concentration and physical health |
Stress and blood sugar
This matters most for anyone with diabetes. Cortisol and adrenaline make insulin work less well, so glucose stays in the blood rather than entering the cells. Diabetes UK notes that if stress does not go away, it can keep blood sugar high and add to the risk of complications. Stress also acts indirectly — comfort eating, skipping walks, forgetting tablets and sleeping badly all push sugar up.
Stress alone does not cause diabetes, though research is looking at whether long-term stress hormones contribute to type 2 diabetes in people already at risk. What is certain is that a stressful few months often shows up in the .
If your readings rise during a hard period, do not simply double your tablets on your own. Tell your doctor: the plan may need adjusting, and the stress itself deserves attention.
Stress, blood pressure and the heart
Each adrenaline surge raises blood pressure. Harvard Health summarises research suggesting that chronic stress contributes to , promotes the build-up of deposits in the arteries, and — through repeated surges — raises the risk of heart attack and stroke.
The INTERHEART study compared more than 11,000 people who had a first heart attack with more than 13,000 who had not, across 52 countries including South Asia. People who reported permanent stress at work or at home had roughly twice the odds of a heart attack, even after accounting for smoking and other factors. Depression was also more common among those who had heart attacks.
That does not mean relaxation replaces blood pressure tablets. It means managing stress is part of looking after your heart, alongside medicines, not instead of them.
Sleep, digestion and immunity
- Sleep — a racing mind makes it hard to fall asleep and easy to wake at 3 am. Poor sleep then raises stress hormones and blood sugar further, and can become insomnia in its own right.
- Digestion — the stress response diverts blood away from the gut. Many people get acidity, nausea, loose stools or constipation when stressed, and stress commonly makes irritable bowel syndrome flare.
- Immunity — in a classic study, healthy volunteers were deliberately exposed to cold viruses; the more stressed they were beforehand, the more likely they were to become infected. Other research has found that wounds heal more slowly in people under long-term strain.
- Muscles — tight neck and shoulders, jaw clenching and tension headaches are among the commonest physical signs of stress.
'Tension' — what Pakistanis mean by it
'Mujhe bohat tension hai' can mean worry, sadness, anger, exhaustion, or all of them at once, and it is often felt in the body — a heavy head, 'dil ghabrata hai', aching limbs. The causes are familiar: money and inflation, conflicts in a joint family, marriage pressure, exams, caring for an ill parent, loadshedding that ruins sleep in the summer heat.
Sometimes 'tension' is ordinary stress. Sometimes it is the word a person uses for an or depression. Useful questions to ask yourself or a relative: Has this lasted more than two weeks? Are you sleeping? Do you still enjoy anything? Are you managing work and home? If the answers worry you, it is worth seeing a doctor.
What actually reduces stress
Some approaches have good evidence behind them; many products sold for 'stress' do not.
- Physical activity — a brisk 30-minute walk most days lowers stress hormones, blood pressure and blood sugar at the same time. An evening walk after maghrib works well in summer.
- Slow breathing — breathing out for longer than you breathe in, for a few minutes, switches on the body's brake. It can be done anywhere.
- Regular sleep — the same bedtime and waking time, with phones away before sleep.
- and relaxation — Harvard's summary of the 'relaxation response' includes deep breathing, focusing on a calming word, and repetitive prayer. Many people find that unhurried namaz, dhikr or recitation calms body as well as mind.
- Talking — to a friend, relative, religious leader or professional. Putting a problem into words often makes it smaller.
- Solving what can be solved — write down the problems, separate what you can change from what you cannot, and take one small step on one of them.
- Cutting back on tea late in the day, cigarettes and naswar, which all add to the body's alarm.
If stress has become an anxiety disorder or depression, is an effective treatment. Tranquillisers such as alprazolam ('Xanax') or bromazepam ('Lexotanil') are not a solution for everyday stress: they are habit-forming and are for short-term use only under a doctor.
Symptoms that need checking, not blaming on stress
Stress causes many physical symptoms, but so do heart disease, diabetes, thyroid problems and infections. A doctor should rule these out before a symptom is called 'just tension' — particularly if you have diabetes, which can mask heart symptoms.
| Symptom | Could be |
|---|---|
| Chest pain or tightness on exertion, or with sweating, breathlessness or nausea | Angina or heart attack |
| Fast heartbeat with fainting or near-fainting | A heart rhythm problem |
| Tremor, weight loss, heat intolerance, fast pulse | An overactive thyroid |
| Constant thirst, passing urine often, blurred vision | High blood sugar |
| Weight loss you cannot explain, night sweats, blood in stool or vomit | Infection, bowel disease or cancer |
| A new, severe headache, or one with weakness, confusion or vomiting | Stroke, bleeding or other serious causes |
When to see a doctor about stress itself
- You feel unable to cope, or stress has lasted for weeks without easing
- You have palpitations, panic attacks or constant worry
- Low mood, poor sleep or loss of interest have lasted more than two weeks
- You are drinking, smoking or using tablets more to get through
- Your blood pressure or sugar readings have risen and stayed up
What you can do today
- Name the main source of your stress, and one small thing you could do about it this week.
- Take a 20- to 30-minute walk.
- Try five minutes of slow breathing before bed.
- If you have diabetes or high blood pressure, check your readings and take your medicines on time — stress makes both easy to forget.
- Tell one person how you are really feeling.
Common questions
Still not sure what to do?
Reading about a symptom only goes so far. A doctor who can ask you questions and examine you will get further in ten minutes than any article can.
