If you get enough back aches, someone will eventually tell you that’s where your body stores stress. If your stomach hurts, you’ll hear the same thing: Your emotions are trapped in your belly.
But what does that mean? Is your anxiety about work or money really coursing through your body and nestling into your organs and limbs?
In short, no. “We can and do manifest stress physically. There’s no question about it,” says Steven Tovian, a clinical professor of psychiatry and behavioral sciences at the Feinberg School of Medicine at Northwestern University. “But it’s not like there’s a stress reservoir to the left of our kidneys—and when it bubbles over or overflows, we’ve got problems. It’s not that kind of boiling-cauldron analogy.”
Unfortunately, the truth is that stress lives everywhere inside your body. Here’s what really happens in your body when you’re stressed.
How stress affects the body
The idea that stress is stored in specific parts of the body likely comes from Sigmund Freud’s work more than 100 years ago. “There was this idea that when people repress or deny their emotions, those emotions would appear as physical symptoms instead,” says Camelia Hostinar, an associate professor in the psychology department at the University of California, Davis. “And if you acknowledge those emotions, that would treat the symptoms, and the symptoms would disappear.” As scientists have learned more about stress, however, it’s become clear that such thinking is too simplistic, she says. Rather than causing us to store anger in our back, or fear in our stomach, stress triggers a dynamic whole-body response—and it happens not just when people repress their emotions, but even if they’re fully aware of them.
When you encounter a stressor, your hypothalamus (the control center in your brain) starts to orchestrate a hormonal stress response. It triggers a cascade of hormones that are released from the pituitary gland that, in turn, let the adrenal glands know it’s time to release the stress hormone cortisol into the blood supply, says Alicia Walf, a neuroscientist and assistant professor of cognitive science at Rensselaer Polytechnic Institute in N.Y. Meanwhile, the hypothalamus also orchestrates the release of adrenaline and noradrenaline from the adrenal glands. “These adrenal hormones have temporary physiological effects in the body, such as quickening of the heart rate, but they also have effects in the brain that alter cognition,” Walf says.
Hostinar likes to think of this response as a “stress symphony,” a metaphor coined by neuroscience researchers. “There are multiple stress systems that respond differentially—like musical instruments—to various stressors, some with more or less intensity than others, leading to potentially unique combinations of symptoms in different people,” she says. For example, one person might experience an increase in appetite and cravings for comfort foods, while another reports muscle tension and pain. “There are effects that happen within seconds, minutes, and even days,” Hostinar says. In the first few seconds, for example, you might experience an increase in heart rate or cold, clammy hands. Days later, your high stress load might dampen your immune system. “You could see both immediate and delayed effects from all these different musical instruments that are working at different time scales and different intensities to orchestrate this response,” she says.
Type of stress matters—and so does who you are
The type of stress you’re dealing with—and its frequency, duration, and intensity—plays a role in determining how it might manifest in your body. There are a number of different types: acute (sitting in a traffic jam), episodic (work projects that pop up occasionally), chronic (losing a job, getting divorced, or dealing with a long-term illness), and traumatic (childhood abuse). “Stress is not one entity,” Tovian says. While acute stress, for example, is typically fleeting and can be resolved by calming regimens like deep breathing, leaving no lingering effects in its wake, other types of stress require more vigilance.
Your overall health status, age, genetic profile, and past experiences also influence how your body reacts to stress. As you get older, you might feel the effects of stress more harshly—or in a mitigated way, thanks to learned experience, Tovian says. And if you have a history of lower back pain because of a slipped disc, you’ll have a greater-than-average chance of stress-related symptoms appearing in your lower back. Likewise, if digestive problems run in your family, that might be how your stress shows up. “Like any adversary, the effects of the stress are going to attack the weakest parts of your system,” Tovian says.
Our bodies are equipped to deal with a certain amount of stress based on all these factors, he adds. When stress exceeds our personal threshold—usually over a period of months or years—it’s more likely that it will cause physical harm.
What are the symptoms of stress?
Research suggests that stress can lead to problems with the musculoskeletal, respiratory, cardiovascular, endocrine, gastrointestinal, nervous, and reproductive systems. It’s called somatization—the medical term for expressing stress as physical symptoms.
Some of the most common stress-related symptoms include headaches, nausea, fatigue, dizziness, heart palpitations, and chest, back, or abdominal pain, says Dr. Ashwini Nadkarni, associate medical director of Brigham Psychiatric Specialties at Brigham and Women’s Hospital in Boston. Stress can contribute to inflammation in the circulatory system, including the coronary arteries; trigger migraines; throw off menstrual cycles; lead to stomach ulcers; and more.
Somatization affects plenty of people, Nadkarni says. “One-third of symptoms people report in a primary care visit are medically unexplained,” she says. “There’s no objective evidence to support a biological explanation. Or somebody might have a medical condition, but they’re reporting a set of symptoms that are out of proportion to that condition.”
Still, doctors treat stress as a diagnosis of exclusion. That means conducting a thorough physical exam and running tests to rule out medical conditions. That helps them ultimately determine if stress is the root cause of whatever’s going on. As Tovian puts it, “I can get a headache from too much stress, but I can also get a headache from a brain tumor.” It’s essential, he adds, not to diagnose yourself as suffering from stress and decide not to seek medical care for symptoms you’re experiencing.
Recovery is crucial
If your doctor determines your symptoms are stress-related, they’ll likely recommend mindfulness-based stress reduction, Nadkarni says. It’s a meditation therapy that helps people feel centered in the present moment—and it can encourage those experiencing somatization to adopt a non-judgmental acceptance of their physical pain or psychological distress. “You’re reducing that tendency to have hypervigilance about the symptoms or catastrophize about the symptoms,” she says. “It’s thought to reduce pain, reduce symptom severity, reduce any depression or anxiety that might be associated with somatization, and also improve people’s quality of life.”
It’s also important to find healthy ways to recover after a high-stress event; doing so can prevent symptoms from flaring up. One of Hostinar’s favorite ways to bounce back from stress is tapping into social support. “It can lower stress in real time and over the years,” she says. “People recover more easily and have a more muted stress response if they have someone to talk to or a hand to hold.” Plus, it’s universally beneficial across all ages, cultures, and backgrounds.
Given that stress is inevitable, it’s also important to boost resilience, Tovian says. Sound easier said than done? Focus on understanding yourself and your body, getting enough sleep, exercising, and eating well. The key, he says, “is being able to manage stress, so it doesn’t manage you.”