Stress in your mind: mind the stress?

Stress in your mind: mind the stress?

Severe stress can affect our somatic well-being – but is part of this stress created in our minds? A recent meta-analysis on the link between worrying and the physiological stress response suggests that worrying does indeed affect our heart and hormones.

Any textbook on “stress” will tell you how important our stress reaction is for our own survival. It was of great importance for our ancestors to be able to run away quickly when faced with, for example, a dangerous bear. When we are faced with a threatening situation our stress response system is triggered, which sets in motion several physical changes: increases in heart rate and blood pressure, and the release of several energy-promoting hormones, such as cortisol. These changes enable us to run away from the threatening situation or to cope with it in some other way. It’s a beautiful system, which has great survival value. But let’s face it: how often do we encounter bears in our daily lives in modern society?

Modern stress

What has been overlooked in decades of stress research is that a lot of our modern stress is not due to real and acutely threatening situations. Instead, a lot of stress is psychological: we worry about not making a deadline at work, while also having to take care of two kids and a mortgage (and let’s not forget the golden retriever, to complete the stereotype). A lot of stressful situations are only present in people’s minds (as they keep on thinking about that deadline). We have great mind power, which allows us to dream about our upcoming vacation, but the downside is that we can also create a lot of stressful thoughts in our minds – we humans worry.

Worrying about stress

It’s only in the last 10 years that research has examined whether these worries also trigger a stress response. In 2006, stress researcher Jos Brosschot, together with his American colleagues Bill Gerin and Julian Thayer, formulated the hypothesis that for a stress response to occur, it doesn’t matter whether the stressful event is unfolding in reality (your boss blaming you for a mistake) or is only created in your mind (worrying about your work while in bed). Worrying will prolong the stress response, and this will add to the total ‘wear and tear’ effect that stressful events have on our bodies. Research had already demonstrated that people who experience a lot of stress are at heightened risk for somatic health problems. Could these detrimental effects of stress be due to stress ‘that’s only in the mind’? After all, for a lot of worries it holds that the worst case scenarios we anticipate never actually occur. Or, as Shakespeare’s Macbeth put it: “present fears are less than horrible imaginings”.

Physiological effects of worrying

Recently, we systematically inspected the research on the physiological aspects of worrying. Together with researchers from Italy and the USA, Jos Brosschot and I investigated how strong the relation was between worries and the stress response. What has research in the past decade revealed about the physiological effects of worrying? We found that worrying was indeed associated with increases in heart rate, blood pressure, and the stress hormone cortisol. These findings were consistently observed in several independent studies involving hundreds of participants (though to make stronger inferences we actually need thousands of participants – so keep participating in our research!). The sizes of the physiological effects of worrying on cortisol were comparable to those of ‘real’ stressful situations but lower than the effects of ‘real’ situations on blood pressure and heart rate. Yet, in daily life, worrying occurs much more often and lasts longer than stressful events. The impact of this worrying might be considerable.

How to stop worrying

Should we now all immediately try to stop worrying? Well, good luck! Trying not to think about something is pretty hard to do. (Want to try it out? Try as hard as you can to not think about a pink elephant for the next five minutes). Especially since worries usually revolve around topics you care about: health issues, work, children, finances, etc. The best medicine to stop worrying about these issues is probably to stop caring about them (become a robot?). Maybe a little bit of worry in your daily life makes you human? But it absolutely wouldn’t hurt to pay attention to your worries and try to find out how you can calm your mind. Yoga, mindfulness, relaxation exercises, or sports: experiment to find what works best for you.

Suffering from stress and worries about work? Participate in our ongoing study.


Janneke K

Dear Bart,

Thank you for your response. If you agree with me that in many cases people's worries do arise from situations that pose an actual threat, I think you should not have stated that 'a lot of our modern stress is not due to real and acutely threatening situations', and go on to contrast this stress due to 'real situations' with what you call 'psychological stress'. By doing that, you are saying that situations like these, for example stress about not making a deadline at work which could lead to job loss (your example, not mine) cannot be real. You go on to say that these situations 'are only present in people’s minds'. That doesn't make the threat any less real; the threat of the bear equally is only present in someone's mind until the bear actually attacks. Similarly, the threat of job loss is only present in someone's mind until the boss actually fires them. Both situations are equally real.

So, whereas many worries can be proved to be unsubstantiated, you cannot say a situation is not real because it only exists in someone's mind. As you say, a threat must be proven to be either substantiated (i.e. real) or unfounded (i.e. unreal). Whether the imagined threat is physical (bear) or 'just' on someone's mind (job loss) is irrelevant. Telling people that something just exists in their mind isn't just unhelpful; it's also meaningless.

Also, stress is always psychological. Stress arises because as humans we are mentally capable of constructing a scenario in our minds. This is helpful when it leads to problem solving, as it should, and unhelpful or even harmful if it leads to worrying which, if permanent, can lead to chronically high stress levels. Which means it is the habit of worrying that people need to learn to handle rather than the threat. Worrying is simply and inefficient and paralyzing response to threat.


Dear Janneke, you are of course right that there are a lot of situations where the worries that people experience are related to actually threatening situations! In my job as a counseling psychologist I frequently encounter people that are afraid of losing their jobs - which could be a real possibility - you gave a perfect example! So, it is pretty important to try to engage in reality checking (which is also what one is encouraged to do in cognitive-behavioral treatments) to find out how realistic these worries are (for example, there are also people that worry about losing their job, but find out - after talking to their boss - that these worries were unnecessary). And the way to handle your worries of course depends on how realistic these worries are.

Janneke K

PS Yoga is great, but it won't chase the bear away. It will only help you handle the situation. It is not a solution.

Janneke K

What bothers me about this analysis is that dangerous situations that we can envisage in our minds rather than see right in front of us, like a bear, are not considered real.

It's true that many people suffer from stress because they worry about worst-case scenarios that will never play out. However, I think it's unjust to conclude that the risk of losing your job because you are going to miss that deadline is not a 'real and acutely threatening situation', whereas the risk of getting killed when facing a bear is. I think both are equally real, even though the bear might kill you in ten seconds and you might not lose your job until the next week or the next month. Let me try to explain why.

The fact that the risk of losing your job doesn't look like a bear doesn't make it any less real. If your boss has threatened to sack you if you fail to make that deadline, it is as real as that bear standing ten metres away from you. In fact, your boss might be more of a danger than that bear: the bear will only be a danger if you are between her and her cub, or if she's hungry; otherwise she will probably be friendly. So although your adrenaline levels might shoot up at the sight of that bear, you might be more right in fearing your boss than that bear. If a danger isn't physical that doesn't make it unreal. This is the reductionist approach: whatever you can't see can't be there.

I think this is a very worrying approach to stress, especially when it is transferred to a therapy setting (which happens all the time). A psychologist telling their client that they can let go of their fear that they will lose their job, or that their husband will leave them, isn't being helpful, and can cause a lot of frustration. A better approach would be to help the client face that it is possible that they will lose their job or their partner, and then consider the likelihood of that scenario, and help them handle the various possible outcomes. Just as you would when you are facing a bear in the forest: is her cub behind me? No? Then I can probably speak some soothing words and slowly retreat to show her I am not a threat to her. If yes, then make the hell sure you run as fast as you can.

Looking forward to hearing other people's thoughts on this.