Stress has a lot to answer for when it comes to our mental health, but in recent years it has become clear that extreme stress can impact our physical health, too. Its links to various health conditions may have you wondering; could chronic stress cause a stroke? 

Here, we are exploring the ways in which stress negatively affects the body, the main causes of a stroke, and whether or not one could be brought on by high levels of stress. We will also provide advice on how to handle constantly high levels of stress, when you should seek help for this, and the support available.

At Augmentive, we aim to provide holistic, tailored mental health support to everyone so they can live their life to the fullest, so if you have questions about the link between stress and strokes, we’re here to help. 

What is stress?

Stress is our body's natural response to any challenging or threatening situations which trigger the release of hormones like cortisol and adrenaline, and may prompt the ‘fight or flight’ response. This reaction can be useful to prepare us for danger or make us more alert in certain situations, such as if we are running in a race. However, in most cases long-term stress can have negative impacts on both mental health and physical health. 

There are several different types of negative stress; acute stress (short-term), chronic stress (long-term), or episodic acute stress (short-term and recurring). These types of stress could be the result of things like work pressures, financial worries, interpersonal relationship issues, major life changes, and more. It is important to remember everyone feels stress differently and for different reasons – it is an entirely subjective experience. Ultimately everyone has their own life experiences and thresholds for the stress response, so it is always OK to acknowledge this feeling and take steps to relieve any stress in your life. 

You may recognise stress from the negative emotions it brings up, such as overwhelm, irritability, anger, impatience, anxiety, fear, depression, an inability to enjoy yourself, a loss of interest in life, a loss of your sense of humour, and more. 

According to the Mental Health Foundation, 74% of adults in the UK have felt so stressed at some point in the previous year that they felt overwhelmed or unable to cope, and 32% said they had experienced suicidal feelings as a result of stress. No matter how short or long term your feelings of stress are, it is crucial to address them as soon as possible. 

Identifying stress can be difficult, but you may find more useful information in our guide: Stress vs Burnout: What's The Difference?

How can stress affect the body? 

It can be difficult to imagine how something intangible like stress can have physical impacts on the body, but it has become clear in recent years that stress can cause a number of physical issues as well as mental health issues. According to Dr. Arthur Barsky, professor of psychiatry at Harvard Medical School, "Doctors see it all the time – patients with real pain or other symptoms, but nothing is physically wrong with them.”

Some of these symptoms might include:

• Breathing troubles 
• Panic attacks
• Sleep issues or fatigue
• Headaches or muscle aches 
• Chest pain, indigestion or heartburn
• Stomach troubles, constipation or diarrhoea
• Feeling sick, dizzy, fainting, or experiencing vertigo 
• Sudden weight gain or weight loss
• Sweating, rashes or itchy skin
• Menstrual cycle changes 
• Exacerbated physical health issues 

Studies have also linked long-term stress to a heightened risk of serious health conditions such as cardiovascular disease, diabetes, autoimmune diseases, and even some types of cancer, giving new meaning to the phrase ‘worried sick’.

What is a stroke? 

A stroke is a medical emergency that occurs when blood flow to a part of the brain is interrupted or reduced, depriving the brain tissue of oxygen and nutrients. When this happens, cells in the brain can begin to die within just a few minutes. 

There are 2 types of stroke which occur for different reasons:

• Ischemic Stroke – This can happen due to a blocked blood vessel, and this is the case in just under 90% of strokes 
• Haemorrhagic Stroke – This type of stroke is much less common, but happens due to a ruptured blood vessel leaking blood into the brain

The signs of a stroke can be anything from mild physical weakness to paralysis, and one of the main visible signs of a stroke is when the muscles on one side of the face droop. Other signs can include things like a sudden, severe headache, vision problems, sudden physical weakness, difficulty speaking, or difficulty understanding communication. 

A stroke should always be considered a medical emergency, so if you suspect you or someone else is having a stroke, call 999 immediately and request an ambulance. A 2021 study found that stroke is the second leading cause of death globally, and the third leading cause of death and disability combined. For this reason, understanding your own risk of stroke and how to reduce this is important.

What can cause a stroke?

The risk of stroke can increase due to several factors, including things like:

• Lifestyle – Physical inactivity or a sedentary lifestyle 
• Substance use – Heavy drinking, use of illegal drugs, and cigarette smoking or secondhand smoke exposure
• Personal or family history – History of stroke, heart attack or TIA (transient ischemic attack)
• Weight – Being overweight or obese
• Medical risk factors – High blood pressure, high cholesterol, diabetes, COVID-19 infection, obstructive sleep apnea and more 
• Cardiovascular disease – Heart failure, heart defects, a heart infection or irregular heart rhythm

It is also thought that the risk of stroke increases for men, people over the age of 55, people of African American or Hispanic ethnicity, and those taking birth control pills or hormone therapies that include oestrogen.

Is there a relationship between stress and stroke risk?

There is thought to be a relationship between chronic stress and stroke risk for a number of reasons. Firstly, chronic stress can cause the heart to work harder due to an increase in stress hormones, which can lead to high blood pressure. A 2021 study identified psychosocial stress to be a key contributing factor to hypertension and cardiovascular disease, which is also a major risk factor for stroke. 

'Stress itself does not cause a stroke, however it can cause changes in the body that put you at risk of a stroke. It is therefore important to get your blood pressure checked regularly, have a physical exercise routine and do activities to help manage stress. Putting practises into your daily life such as mindfulness and meditation are known to reduce stress levels and help with metabolic parameters. It can help manage these and reduce your risk of having a stroke.' - Dr Kapil Bakshi, Consultant Psychiatrist

Stress can also lead to unhealthy behaviours like eating a poor diet, physical inactivity, smoking or excessive alcohol consumption, which can all further increase stroke risk. It is thought that working long hours and not having enough contact with other people could raise the risk of stroke, too. 

In addition, stress can exacerbate existing health conditions like diabetes and heart disease, which are linked to higher stroke risk. It can also increase the risk of TIA (transient ischemic attacks). In a 2014 study, higher levels of stress and depression were linked to increased risk of TIA in middle-aged and older adults, and these attacks are known to increase the risk of later strokes. 

Work stress could be one of the main culprits, with 79% of people saying they frequently feel work-related stress, making it the most common source of stress. Studies have suggested high strain job roles are associated with an increased risk of stroke, particularly in women.

It is believed those with a low risk for stroke (i.e. no family history of stroke, no underlying health issues, etc.) could experience high levels of stress without having an additional risk of stroke, whereas those who already have a higher risk of stroke (i.e. older adults, those who smoke, those with high blood pressure, etc.) could have a further increased risk of stroke as a result of high levels of stress, and therefore should take this risk into account when considering their stress. 

Ultimately, there is no one cause of stroke, and some people could live for years with chronic stress and higher stroke risk without ever experiencing one. However, if you think you have an increased risk of stroke you should discuss this with your GP and take steps to lower this, as well as any stress you are currently experiencing.

How should constant high stress be handled? 

If you are experiencing high levels of stress and want to take action to change this for the sake of your health, it can be difficult to know where to begin. Just as different people respond to stress in various ways, they may also find different stress relief methods more helpful than others. Some things you could try to help reduce chronic stress include: 

• Increasing your physical activity – Studies have found higher levels of physical activity were associated with less subsequent stress and a more positive affect, so regular activities like walking, running or a gentle yoga practice could help to alleviate stress by releasing endorphins.
• Adopting regular mindfulness practices – Things like meditation and breathwork exercises have been found to show positive effects on stress and calm the mind. One 2021 study on nurses found mindfulness-based interventions helped to significantly decrease stress, improve burnout, and increase self-compassion. 
• Maintaining a balanced diet – Studies have found things like caffeine, alcohol and artificial sweeteners can negatively impact stress, whereas adding enough fibre, omega-3 fatty acids and fermented foods to your diet could help lower stress levels. 
• Ensuring adequate sleep – Good sleep hygiene is thought to help reduce stress levels. While stress can have a negative impact on sleep due to heightened alertness, focusing on getting enough quality sleep each night by going to bed early, taking steps to properly wind down before bed, and giving yourself 7-9 hours of sleep each night can help with mood regulation and controlling stress. 
• Avoiding burnout at work – A 2023 review of studies suggests a link between job stress (working long hours, shift work, etc.) and an increased risk of stroke, so addressing work stress could be a major factor in reducing this health risk. Try to make any environmental changes you believe might help, set realistic goals, prioritise tasks, and take regular breaks. You may find some more useful information in our article: Why Workplaces Should Do Stress Risk Assessments
• Seeking therapy – Regularly working with a trained, experienced therapist could help you to address the root cause of your stress and take control of certain areas of your life. Talking therapies can be helpful as a way to release emotions, and if you seek help from a psychiatrist they may be able to prescribe appropriate medications to help reduce your stress levels. 

When should you seek help for stress?

Stress can feel so overwhelming at times that it can be difficult to identify when it is happening, and when the time has come to make a change. You should seek help for chronic stress when it starts to interfere with daily life, affect your mental health, or you notice physical symptoms that you believe could be related. Also, if you begin to turn to unhealthy coping mechanisms to reduce stress, such as alcohol or drugs, you should reach out for help. 

If you have any of the above mentioned reasons for increased stroke risk – such as high blood pressure – you should also speak to a medical professional so they can offer appropriate advice and possibly medication to keep you healthy and lower your stroke risk. Do not delay this; the longer stress lingers, the greater the risk can become over time. 

What support is available for those with high stress?

There are a number of routes you can take to seek help for high stress levels. A trained therapist with experience in stress-reduction techniques may be best placed to help you begin to unravel the cause of your stress and face it head on to finally make a change. Even if you are unsure about why you feel the way you do, a therapist can provide insight, help you discover what the problem might be, and support you as you begin to work through this. 

If you would like to explore therapy options, you can reach out to Augmentive and take our free 15 minute consultation to guide you to the most relevant specialist for you. You may also find more useful information in our guide to finding a private psychiatrist near you.

In addition, you could look for local support groups who may offer a place to share experiences and offload any thoughts you have that are contributing to your stress. Family and friends can provide support if you feel comfortable opening up to them, or if work stress is your main issue, speak to your manager to find out if they offer any employee assistance programs (EAPs) such as counselling services or online stress management resources. 

At Augmentive, we work with organisations to provide their workforce with access to mental health support whenever needed – speak to your HR department or manager to see if they offer something similar.  

What is the prognosis after a stroke?

The prognosis after a stroke will vary depending on factors such as the severity of the stroke, and how quickly medical help was able to reach the person. With early and comprehensive treatment, outcomes can be positive and some people make a full recovery after a stroke and subsequent rehabilitation. However, recovery takes time, and significant physical, occupational and speech therapy, so it is not an easy road. Many people can be left with lasting symptoms that require long-term support. 

Understanding what preventive measures you could take and lifestyle changes you could make now to reduce your likelihood of having a stroke could be crucial to your long-term health. If you have a higher risk of stroke and feel you are experiencing chronic stress, do not delay taking action to improve this.  

While stress can seem insignificant and manageable to some people, its connection to stroke risk makes it something that should be addressed as soon as possible to avoid putting your health in jeopardy. 

Whether you’re feeling off-kilter or want to shake up your routine, our state-of-the-art mental wellbeing platform gives you quick and seamless access to world-class support on your terms, from private psychiatric assessments to helping you find a therapist near you for support on your journey.

If you have a question about mental health, like if stress can cause vertigo, we’re here to assist on your journey. Our free 15 minute consultation can guide you to the most relevant specialists to answer your questions and discuss next steps.

DISCLAIMER: The content published by Augmentive is not designed to treat, diagnose, cure, or prevent any disease or condition. Always consult your GP or a qualified healthcare provider with any questions regarding a medical condition and before starting any therapy, diet, exercise, or any other health-related programme.