How Much Is Too Much Stress?

Is there such a thing as stress overload? And what are some of the signs that we are approaching the breaking point? Finding an answer to those questions is harder than you might think.

Stress can build up in all sorts of ways, whether through major life events—such as losing your job or ending a marriage—or simply through a buildup of daily hassles until you reach the point of no return. But not all stressful experiences will affect us in the same way. According to stress pioneer Hans Selye, feelings of stress occur when our sense of homeostasis is disrupted and our body needs to draw on inner resources to restore the balance.

Which is fine until the stress builds up to the point that our inner resources are exhausted and we lose the ability to cope. That is when we reach that physiological and psychological breaking point more commonly known as stress overload. It is also when we become particularly vulnerable to a wide range of physical and mental problems linked to too much stress.

But what are some of the signs that stress overload is imminent? While there are any number of symptoms commonly linked to stress, including fatigue, insomnia, headaches, etc., these can apply in any stressful situation, whether we are overloaded or not. While these symptoms may tell us that we need to relax, they generally don't work as warning signs that we are on the verge of a health crisis.

A new study published in the International Journal of Stress Management takes a closer look at the kind of symptoms seen in people experiencing stress overload and how they are often overlooked until it is too late. Conducted by a team of researchers at California State University Long Beach, the study involved 440 adults recruited from the general community. The participants were almost evenly divided by gender (51 percent female) and well-represented across different age groups. In describing the study, lead researcher James H. Amirkhan and his co-authors focused on the stress symptoms experienced over the course of one week using questionnaires completed in two stages.

The first stage consisted of items from various stress inventories focused on the following categories:

• Event load (EL) items from the Stress Overload Scale (SOS). These measure perceived demands from stressful events experienced by participants, (e.g., “felt swamped by your responsibilities”)
• Personal vulnerability (PV) items from the SOS. These items focus on perceived inadequacy in dealing with stress, (e.g., “felt like you couldn’t cope”).
• A symptom checklist describing thirty-five somatic symptoms taken from stress inventories but which were carefully revised to prevent overlap with items from the SOS. Examples of symptoms include: appetite change, loss of sex drive, stomach pains, constipation/diarrhea, etc.
• A behaviour checklist describing thirty-five behaviour patterns often occurring due to stress. Again, they were carefully revised to prevent overlap with SOS items. Examples of behaviours include: cancelled appointments/dates, spending more money, using more alcohol/tobacco/drugs, lost temper, etc.

After completing the first assessment, participants were given an envelope marked with an identification code with instructions to complete the enclosed questionnaire at home and send it out a week later. The two-stage procedure was used to provide a greater time frame for detecting symptoms and behaviours linked to overload as well as to determine how stable the test scores would be over time. Only 161 participants (40 percent of the original sample) completed the questionnaires for the second phase.

Statistical analysis of the thirty somatic symptoms used in the study and how they related to different aspects of stress overload identified the following symptom clusters:

• Body complaints (BC) - symptoms reflecting physiological changes resulting from stress. Examples include: reduced sex drive, frequent urination, teeth grinding, fatigue/weakness, body aches, and itching, etc.
• Gastrointestinal disturbances (GD) - symptoms specifically linked to the gastrointestinal system. Examples include: stomach pains, complexion change, nausea, vomiting, skin sores/pimples, etc.
• Respiratory problems (RP) - stress-related symptoms focusing on the respiratory system and nasal tract. Examples are: stuffy/runny nose, earache, sore throat, temperature change, sneezing, etc.

For the thirty-five behaviours used in the study, statistical analysis identified the following clusters:

• Moodiness (M) - Behavioural symptoms linked to mood issues. Examples include: waking up tired, irritability, volatile emotions, impatience, increase in drug/alcohol use, nervous tics/twitches, losing ones temper, etc.
• Nervous habits (NH) - Behaviours suggestive of nervousness or compulsiveness. Examples include pacing back and forth, neglecting personal grooming, making mistakes, shaking or trembling, chewing nails/pencils/twitching, etc.
• Cognitive disruption (CD) - Signs of reduced cognitive functioning. Examples include losing focus, difficulty making decisions, memory problems, forgetting appointments, etc.

Though all of the different clusters identified in the study appear to predict stress overload to some extent, there were specific behaviour and symptom clusters that are especially strong predictors.

For example, gastrointestinal disturbances such as stomach pains, nausea, vomiting, etc. appear to be much more consistent indicators than either body complaints or respiratory problems. When looking at behavioural signs of stress overload, cognitive disturbances appear much more likely to occur in people dealing with stress overload than moodiness or nervous habits.

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Perhaps more importantly, the link between cognitive problems and stress overload remains strong over time and shows no sign of subsiding like many other symptoms do. That suggests that behaviour symptoms, particularly cognitive disruption, tend to be more useful as overload warning signs than somatic symptoms even though most stress literature tends not to make a distinction.

While some researchers have long suggested that stress overload should be made into a formal diagnosis, finding clear diagnostic markers has been difficult up to now. With further research studies such as this one, it may become possible to identify key symptom markers that can alert health care workers that patients are at risk and provide treatment in time to prevent stress-related medical problems.

Considering the impact that stress overload can have on all of us, an ounce of prevention may well be worth a pound of cure.