Stress

Lubna is an officer at a private bank in Motijheel, a mother of two and the only daughter of a mother with diabetes. Her day starts in Mirpur at six with medicines and ends after midnight with homework, with three hours of buses and traffic and a branch target in between. She will relax, she says, once her son’s exams are over. Last year she said the same about her mother’s operation.

An illustration drawn from common experience. The person is invented; the pattern is not.

Understanding stress

Stress is the body’s response to pressure: a faster heart, tense muscles, a busy mind. In short bursts it helps. When pressure is constant, from work, money, caring for family, illness or the city itself, the stress response stays switched on, and sleep, mood, digestion, blood pressure and patience start to pay for it. Long-term stress is linked with depression and anxiety.

The finding worth knowing

WHO has developed a guided self-help course for stress, called Self-Help Plus, built around a short illustrated guide, “Doing What Matters in Times of Stress”. In a randomised trial among Syrian refugees in Turkey who were in distress but had no mental disorder, those offered the five-session group course were about half as likely to have developed one six months later.

Movement helps low mood too: a 2024 BMJ review of 218 trials in people with depression found that walking or jogging, yoga and strength training eased it, though the authors rated their confidence in the evidence as low.

Signs worth noticing

• Feeling constantly on edge, with no time ever truly off
• Headaches, stomach problems, tight shoulders, poor sleep
• Irritability, forgetfulness, difficulty deciding
• Leaning more on caffeine, cigarettes, alcohol or food to cope

How care helps

A consultation looks at what can change and what cannot, and checks whether stress has turned into depression, anxiety or a physical problem such as high blood pressure. Therapy then teaches practical skills: problem solving, setting limits, relaxation and breathing techniques, and protecting sleep.

What getting better can look like

For someone like Lubna, the exams will end and something else will begin. Getting better might mean half an hour that belongs to her, every day, on the roof with her tea as the city lights come on, without waiting for the next thing to be over.

Common questions about stress

Can long-term stress make you physically ill?

Constant stress keeps the body’s stress response switched on, and sleep, mood, digestion, blood pressure and patience start to pay for it. Long-term stress is also linked with depression and anxiety. A doctor can check whether stress has turned into one of these, or into a physical problem such as high blood pressure.

What are proven ways to cope with stress?

In a randomised trial among distressed Syrian refugees in Turkey, those offered WHO’s five-session Self-Help Plus group course were about half as likely to have developed a mental disorder six months later. Movement helps low mood too: a 2024 BMJ review of 218 trials in people with depression found that walking or jogging, yoga and strength training eased it, though the authors rated their confidence in the evidence as low. Therapy adds practical skills such as problem solving, setting limits and protecting sleep.

When to see a psychiatrist

If “once this is over” has been your answer for years, it is time to talk.

Care here is personal: built around your history, your health and what you want to change, and reviewed with you as it goes.

If you or someone else is in immediate danger, call 999 or go to the nearest hospital emergency department.

Sources

• Acarturk et al., World Psychiatry, 2022 (PMID 35015365)
• Noetel et al., BMJ, 2024 (PMID 38355154)