In the 1990s, 276 healthy volunteers sat down for a long interview about their lives, and then let a team drip cold viruses into their noses.
The interview had sorted their stress two ways. Some had been through something severe but short: a crisis, a shock, a bad few weeks. Others were living with something that had lasted a month or more: no work, or too little of it, or a running problem with family or friends.
The short, severe stress made no difference to who caught a cold. The long stress did, and by a substantial margin. Our noses, it seems, keep count.
So the size of a stress tells us less than we think. How long it goes on tells us more. And that is one reason our stress management backfires so often: the meditation app that makes us more anxious, the breathing exercise that leaves us feeling short of air, the friend who says "just relax" when our bodies are running on rocket fuel or on empty.
Three kinds of stress
It helps to think of stress in three shapes.
The spike. A job interview, a near miss on the motorway, a difficult phone call. It rises fast and, once the moment has passed, it fades.
The repeats. Spikes that keep coming: the weekly crisis at work, the money worry that returns every month, the relative who brings drama to every visit. Each one on its own is manageable. The trouble is that there is never quite enough time to come all the way down before the next.
Months on end. Stress that does not leave: the job you cannot stand, the illness, the caring, the debt. It may be quieter than a disaster, but it lasts, and that is what does the damage.
The same tool can be perfect for one shape and almost useless for another. A few slow breaths before a presentation can settle a nervous speaker beautifully. The same breaths, taken in the car after another twelve-hour day in a year of them, barely touch the sides. Neither person is doing it wrong. They have different kinds of stress. Same breath, different weather.
The spike
Not every spike is equal, and it is worth knowing which ones hit hardest.
When 208 laboratory tests of stress were pooled, the tasks that made cortisol rise were the ones that were uncontrollable, or that carried the threat of being judged. Tasks with both, a performance in front of others with no way to control the outcome, brought the biggest rises and the longest recovery. A hard task with no audience and some control did not reliably raise it.
Laboratories now build the perfect spike from those two parts. Since 1993, the standard stress test, created at the University of Trier in Germany, has been a mock job interview and a spell of mental arithmetic in front of a panel of three judges, a camera and a recorder.
That is why a speech can floor someone who handles a burst pipe calmly. The pipe, at least, is not watching. It also points to two levers we can pull: take back whatever control we can, and take the audience out of our heads where we can.
Control matters even with no audience at all. In a 1971 test, rats that could avoid or escape an electric shock developed fewer stomach ulcers than rats wired to receive exactly the same shocks with no way to stop them. A warning signal before each shock helped both groups. Same shock, different damage, depending on whether there was anything to be done about it. Having something to do, it turns out, is a comfort.
There is a small help for people too. Daily Affirmations That Work (and the Kind That Backfires) has the people who wrote about a value that mattered to them before a stressful public-speaking and maths test, and had a lower stress-hormone response than those given a different writing task.
For the moment itself, the spike needs something quick and physical. Emergency Stress Relief: What to Do When You're Completely Overwhelmed has the toolkit: cold water on the face, hard movement to burn off the charge, naming what is around you, humming, and how to choose by the state you are in. Slow, long practices belong to calmer days.
The repeats
This is where some of us wear down, and others do not.
In 1995, 20 healthy men were put through the same stress on five days running: a speech and mental arithmetic in front of an audience. For most of them, 13 of the 20, the body learned. Their cortisol rose on the first day and stayed flat for the next four. The other seven never got used to it. Their cortisol rose sharply every single time, day after day, as if it were the first. Groundhog Day, in cortisol.
So "you'll get used to it" is true for some people and not for others. If you are one of the seven, the repeats will cost you more, and the answer is fewer repeats and more recovery between them, not more toughness.
And the repeats do not have to be big. When middle-aged adults rated their everyday hassles once a month for ten months, the small, daily irritations predicted their psychological symptoms, at the time and in the months after, better than major life events did.
Recovery is the part that slips. Why You're Always Tired: The Rest You're Missing has what makes it work, and switching off mentally from the job matters most of all. It also has the cruel twist: switching off gets harder exactly when the job is hardest, so the people who most need the rest get the least of it.
And a big break will not do the job on its own. The same article has the holiday findings: health and well-being rose while people were away, and faded soon after they went back to work. Small, regular recovery does more than a fortnight a year.
Worry stretches it
A stressful event has a start and an end. Our thinking about it often does not.
Worry, brooding and dread keep the body on alert well beyond the event itself: before it, while we rehearse what might go wrong, and after it, while we replay what did. A review of the findings put it plainly: the heart, the hormones and the immune system stay activated during those hours of thinking, even when nothing is happening in the room. The body cannot tell a rehearsal from the show.
That turns a spike into a long one, and a set of repeats into something close to permanent. It is also good news, because thinking is something we can work on. Writing the worry down and setting it aside for later, or giving the hands and head something absorbing to do, can shorten the tail. A small ritual that marks the end of the day gives the worry a place to stop: a pot of loose chamomile such as this , made instead of an evening coffee.
Setting it aside has been tested. For six days, 171 students kept a log of their worrying, and half of them were asked to put it off to a set worry period each day. Afterwards, the ones who postponed reported fewer bodily complaints than the others, among them back and neck pain, breathing trouble and stomach pain.
Months on end
The volunteers with the cold viruses showed what months of stress can do that a bad week cannot.
Stuck in Survival Mode, linked below, has why: the stress response is built to switch on and then switch off, the way a zebra's does after the lion has gone, and long stress leaves it ringing at a low volume for weeks and months. The running total has a name, allostatic load, and it shows up in places we rarely connect back to stress: sleep, the gut, the heart, the immune system.
It also has the correction to a popular story. "Adrenal fatigue", the idea that stress wears the adrenal glands out until they run dry, does not hold up: when stressed, exhausted people are measured, their adrenals are still making cortisol. Best Coffee Alternatives: What's Really in Each Cup adds that no endocrinology society recognises the condition. The glands are working. The timing is off, and timing can be retrained.
Stuck in Survival Mode has one of the plainest measures of what long stress costs: women caring for a relative with dementia took about nine days longer than other women to heal the same small wound on the arm.
Control matters over years, just as it did for the rats over minutes. When 10,308 London civil servants were followed for about five years, those with little control over their own work, whether they said so or their managers did, developed more new heart disease. Those with low control at both checks, three years apart, had nearly twice the odds of a coronary event.
One thing helped with the commonest long stress in the cold-virus test, losing work. How to Build Resilience When Everything's Falling Apart has the engineers who had been laid off and wrote about their thoughts and feelings on losing the job for a few days running. Eight months later, more than half had full-time work, against fewer than one in five of those who wrote about other things or nothing.
And it explains why quick fixes feel so small here. A breathing exercise cannot fix a job that is wrong for you, a debt, or a relationship that hurts. Months-long stress needs the source looked at, and often help from outside: someone to talk it through with, a medical check, a plan for the parts that can change.
The frog
Long stress is often compared to the boiling frog: put a frog in cold water, heat it slowly, and it will not notice until it is too late.
It is a useful picture and a poor piece of biology. Some experiments in the 1800s seemed to support it, but modern biologists say a frog that is gradually heated will simply jump out, because moving is how frogs control their temperature. A frog dropped into boiling water does not jump out at all. It dies. Sorry, frog.
So the frog is wiser than the story. The part that is true is about us. We are the ones who adapt to slowly rising heat, call it normal, and stay in the pot.
Mismatches
Most stress management that backfires is a good tool used on the wrong shape of stress.
Crisis tools for months-long stress. Breathing, quick resets and calming apps are spike tools. Used alone against a year of overload, they bring a moment's relief and then the same exhaustion, and we blame ourselves for doing them badly.
Months-long tools for a spike. A full life overhaul or a long meditation is no help in the waiting room before an interview. A spike needs something fast.
Activation for burnout. When we are already running on empty, hard exercise and "pushing through" can leave us more drained. Gentle movement, sleep and fewer demands come first. Nobody sprints on an empty tank. Sleep comes first, and a dark room helps: a contoured mask such as this blocks the light without pressing on the eyes.
And sometimes the tool is wrong for the person, not the stress. Why Your Nervous System Fights Some Stress Techniques, linked below, has why meditation and deep breathing leave some people worse, and what to try instead.
Which kind is yours
There is no score to add up, but a few plain questions sort it out quickly.
Is there a clear start and end? If the stress arrives with an event and leaves within the day, it is a spike.
Does it keep coming back? If the same kinds of event return week after week, and you rarely feel fully recovered before the next, it is the repeats.
Is it there when nothing is happening? If you feel stressed on a quiet day off, sleep badly however tired you are, and cannot remember the last time you felt properly rested, it has become months on end.
You may well carry more than one at once. That is normal. Start with the longest one, because it is the one that is costing the most.
The shape changes
Stress changes shape over time. A run of spikes becomes the repeats. The repeats, with no recovery, become months on end. And months on end, once the source is dealt with, can shrink back to the occasional spike.
So check every so often which shape you are in, and change the tools when it changes.
This week, write down your three biggest stresses and, next to each, how long it has been going on.
Tried the techniques and still feel worse? Why Your Nervous System Fights Some Stress Techniques — the meditators who got worse, the brake on your heart, which stress "types" hold up, warm water against cold, and the causes no technique can fix.
Wound up even on a quiet day? Stuck in Survival Mode: What Chronic Stress Does to the Body — why short bursts of stress rarely do lasting harm, the switch-off every zebra gets several times a day, and what months without it do to the body.
Know someone who has been "fine, just busy" for a year? Send them this, and ask them how long it has really been going on.
Disclaimer: This article is general information. For advice about your own health, talk to a qualified health professional, especially if stress has gone on for months, if your mood has stayed low, or if new physical symptoms have appeared. If you have thoughts of harming yourself, contact a crisis line or emergency services straight away.
Affiliate Disclosure: This article contains affiliate links. As an Amazon Associate, All For Life earns from qualifying purchases, at no extra cost to you. We only link to products we would recommend without the commission.
Sources
Cohen S, Frank E, Doyle WJ, Skoner DP, Rabin BS, Gwaltney JM (1998). Types of stressors that increase susceptibility to the common cold in healthy adults. Health Psychology 17(3):214–223. doi.org/10.1037/0278-6133.17.3.214
Wikipedia. Psychological stress. en.wikipedia.org
Dickerson SS, Kemeny ME (2004). Acute stressors and cortisol responses: a theoretical integration and synthesis of laboratory research. Psychological Bulletin 130(3):355–391. doi.org/10.1037/0033-2909.130.3.355
Wikipedia. Trier social stress test. en.wikipedia.org
Weiss JM (1971). Effects of coping behavior in different warning signal conditions on stress pathology in rats. Journal of Comparative and Physiological Psychology 77(1):1–13. doi.org/10.1037/h0031583
Creswell JD, Welch WT, Taylor SE, et al. (2005). Affirmation of personal values buffers neuroendocrine and psychological stress responses. Psychological Science 16(11):846–851. doi.org/10.1111/j.1467-9280.2005.01624.x
Kirschbaum C, Prüssner JC, Stone AA, et al. (1995). Persistent high cortisol responses to repeated psychological stress in a subpopulation of healthy men. Psychosomatic Medicine 57(5):468–474. doi.org/10.1097/00006842-199509000-00009
Kanner AD, Coyne JC, Schaefer C, Lazarus RS (1981). Comparison of two modes of stress measurement: daily hassles and uplifts versus major life events. Journal of Behavioral Medicine 4(1):1–39. doi.org/10.1007/BF00844845
Sonnentag S, Fritz C (2015). Recovery from job stress: the stressor-detachment model as an integrative framework. Journal of Organizational Behavior 36(S1):S72–S103. doi.org/10.1002/job.1924
de Bloom J, Kompier M, Geurts S, et al. (2009). Do we recover from vacation? Meta-analysis of vacation effects on health and well-being. Journal of Occupational Health 51(1):13–25. doi.org/10.1539/joh.K8004
Brosschot JF, Gerin W, Thayer JF (2006). The perseverative cognition hypothesis: a review of worry, prolonged stress-related physiological activation, and health. Journal of Psychosomatic Research 60(2):113–124. doi.org/10.1016/j.jpsychores.2005.06.074
Brosschot JF, van der Doef M (2006). Daily worrying and somatic health complaints: testing the effectiveness of a simple worry reduction intervention. Psychology & Health 21(1):19–31. doi.org/10.1080/14768320500105346
Wikipedia. Allostatic load. en.wikipedia.org
Cadegiani FA, Kater CE (2016). Adrenal fatigue does not exist: a systematic review. BMC Endocrine Disorders 16:48. doi.org/10.1186/s12902-016-0128-4
Kiecolt-Glaser JK, Marucha PT, Mercado AM, Malarkey WB, Glaser R (1995). Slowing of wound healing by psychological stress. The Lancet 346(8984):1194–1196. doi.org/10.1016/S0140-6736(95)92899-5
Bosma H, Marmot MG, Hemingway H, Nicholson AC, Brunner E, Stansfeld SA (1997). Low job control and risk of coronary heart disease in Whitehall II (prospective cohort) study. BMJ 314(7080):558–565. doi.org/10.1136/bmj.314.7080.558
Spera SP, Buhrfeind ED, Pennebaker JW (1994). Expressive writing and coping with job loss. Academy of Management Journal 37(3):722–733. doi.org/10.2307/256708
Wikipedia. Boiling frog. en.wikipedia.org