Stress? What is stress?

Stress is a consequence of experiencing pressure or tension. It is a physical reaction which prepares our body for alertness. Stress can come from many different areas of life: work, hobbies, family, friends,.... It does thus not necessarily need to come from work. Stress must also be distinguished from pressure. Pressure namely looks at an amount of work/tasks, which need to be done properly within a certain period of time. Pressure can thus be a cause of stress, but is not the same thing. Stress is namely how we deal with this pressure. Based on previous explanation, we can now distinguish between two types of stress: healthy stress and unhealthy stress.

Acute stress reaction (QE84) Disorders of Bodily Distress and Bodily Experience include the following:
  • 6C20 Bodily Distress Disorder
  • 6C20.0 Mild Bodily Distress Disorder
  • 6C20.1 Moderate Bodily Distress Disorder
  • 6C20.2 Severe Bodily Distress Disorder
  • 6C21 Body Integrity Dysphoria

With healthy stress, we mean stress which pushes us to perform better. Some people namely need that extra push in the right direction. Healthy stress does not dominate our lives but instead makes it so that we perform better.

With unhealthy stress we mean stress which works against us. It causes us not to perform as well as we did before. It disturbs the way in which we function. It only becomes pathological when this stress also starts influencing other areas of our lives.

A scientific vision of stress

Stress has existed as long as mankind has. The function of stress, however, has changed with the years. In prehistoric times, stress helped people to survive. Stress only existed in the shape of a 'fight-or-flight' response. This means that one will be able to either fight or flee in dangerous situations. Stress causes this reaction, meaning people can escape from a dangerous situation.

In these situations, the body starts excreting adrenalin and cortisol. The latter is also called the stress-hormone. Your blood pressure will increase, muscles will tense up, our senses become stronger and our pain threshold decreases. All of this makes it so that we can fight or flight more easily or faster. In prehistoric times, stress thus had a useful function.

This 'fight-or-flight' response still exists in humans. People are namely genetically built up in such a way that stress is shown in dangerous situations. Because of the development of society over the past hundred years, people hardly end up in dangerous situations anymore. We therefore need this 'fight-or-flight' response less and less. Stress therefore got a different interpretation in our society.

Causes of excess stress

When does someone have excess stress? Stress can become excessive if the person cannot 'deal with' the stress anymore, and the stress starts to dominate the person's life. To explain excessive stress in a better way, we use the terms burden and carrying capacity. The burden is that burden caused by certain situations. This burden gives us negative feelings, making simple tasks more difficult. Examples of such burdens could be break-ups, a fight in the family, being overworked,.... Carrying capacity on the other hand refers to the positive factors in our lives, which support us and make us feel good. Examples of carrying capacity are humor, a good relationship, sports,....

In general, the burden and carrying capacity should counterbalance each other. They must keep each other balanced. The positive things will make it so that the negative things do not have a large impact on our lives. We can use the metaphor of a scale, with the burden on the one side and the carrying capacity on the other.

This is a display of healthy stress. Stress is present, but due to the positive things in life, the negative influence of this stress will not be large. However, it can also be so that we work less well, have trouble sleeping, have memory issues,.... These are influences of negative stress. Excessive, negative stress is caused when there is a much larger burden that carrying capacity. The carrying capacity is then unable to carry the load of this burden. The burden is also increased because this stress influences our daily functioning. This, too, can be illustrated with the help of a scale.

You can see that the weight is mainly found in the burden, while there is a severely lacking carrying capacity in comparison.

Symptoms of stress

Stress has a large impact on the daily life and functioning. Below we will shortly sum up the symptoms of negative stress. The symptoms are divided up into physical, psychological, and cognitive symptoms.

Physical symptoms

  • Consistent fatigue: you are constantly tired. Even when you sleep a lot, you are still tired. The stress requires a lot of energy, and that is why you will nearly always feel tired. Stress consumes a lot of your body's energy, and this combined with trouble sleeping means you will feel more and more tired.
  • Pain and illness: Because you have stress, your body and immune system can weaken. Because of the bodily overload caused by stress, you can start aching in different places. Examples are muscle ache, headache, stomach ache,... Also, you will get ill more easily. Stress namely uses a lot of your body's energy, meaning the body becomes weaker and is more vulnerable to illnesses.
  • Sleeplessness: You will notice that you have a hard time sleeping. You have trouble falling asleep and staying asleep. It often will be so that you start using medication to fall asleep, because you notice that you can no longer do it on your own. Staying asleep is a problem, too. You sleep less deeply than you otherwise would, and therefore feel like your nights of sleep are very short.
  • Eating issues: People with stress often feel like their stomach is knotted. They will therefore eat less. This can worsen the fatigue. Stress furthermore influences the digestion of food. It can thus be so that you develop stomach and bowel complaints.
  • Heart palpitations: Because your body secretes the stress-hormone cortisol, your body will continuously be tense. This includes a sped-up heartrate, tensed muscles, and a faster blood flow.
  • Addictive substances: It often is so that people with stress look for ways to reduce their stress, only to end up with addictive substances. For example, smoking and even marihuana smoking are used to reduce stress. Here, we must state that such substances do not work. Research even shows that people who smoke are more stressed than non-smokers.

Except for bodily symptoms, there also are psychological symptoms related to stress. Below we will sum up the most important symptoms.

Psychological symptoms

  • Being unable to relax. Because the body produces cortisol, you feel both physically and psychologically like you cannot relax. Especially long-term stress makes it so that you become psychologically exhausted. You are constantly busy and take very few breaks. When you do take a break, your body is still stuck in some sort of overdrive, meaning you cannot wind down. Even worrying can make it so that you cannot psychologically relax. You are constantly thinking of the tasks that cause you stress, and what you are supposed to do to work on said tasks.
  • Irritability: Because you bite off more than you can chew, you can become irritable after a while. This is mainly caused by the feeling of not getting any rest. You feel like you are constantly under pressure and can therefore respond in an irritated way when people ask you something.
  • Sombre moods and/or crying spells: After a while, the stress can become too much and cause sombre moods or crying spells. You feel like you are psychologically exhausted and no longer know what to do. Such unhappy spells will happen more and more frequently, if the stress is not dealt with.
  • Losing the ability to enjoy: You feel like you can no longer relax, and therefore feel like you cannot enjoy things anymore. Everything is decided by the stress, so there is less and less time for relaxation and enjoyable things. Often, when there actually is time for fun activities, you are still preoccupied with the tasks which cause the stress. This means you have a hard time slowing your brain down.
  • Less confidence: Because of the excessive tasks and stress, you can start doubting yourself. It can be so that, because of the amount of work, some parts of your work reduce in quality due to the stress. You do not pay the same amount of attention to details that you used to, or cannot do as many tasks in the amount of time you used to do the tasks in. This can cause self-doubt.
  • Social isolation: Because of the lack of confidence and the stress that affects numerous parts of your life, you might stop looking for social contact. When you have free time, you want to spend it alone. You also feel like you can no longer enjoy things. As a result you will look for less social contact. This can result in social isolation.

Except for the symptoms above, there is a third category, namely cognitive symptoms of stress. These are also called the symptoms of thought.

Cognitive symptoms

  • Lesser performance and increased mistakes: Because you are preoccupied by stress, you perform less well than you did before. This goes both for the time in which you perform and what you perform in general. Stress namely makes it so that you cannot think clearly, and can even cause issues with concentration. Because your mind is not focused, you cannot work in a focused manner. This way, you will also make an increased amount of mistakes in the work you deliver.
  • Loss of focus: Because stress messes up your thoughts, it will become more difficult to keep everything ordered and to remember things. You have a lot on your mind, and this can lead to loss of focus and concentration problems. You find it difficult to work on a project for a long time, which is something you used to do without a problem. In extreme cases you might even find it difficult to follow a conversation.
  • Memory issues: Because of the chaos in your head, issues with memory occur more often. You do not memorize things in the way you used to. You will also have a harder time transferring things to your long-term memory.
  • Worrying: You are more forgetful, do not know what to focus on, and mix everything up. This can be reasons to start worrying. Even before these symptoms appear, you will worry. You will think about things such as: 'Was my work good enough?' 'Is there going to be a lot of work on my desk when I get to work on Monday?' You will worry about things that cause you stress.
  • Indecisiveness: Because you do not feel good, you will not decide things like you normally would. You doubt yourself and your confidence lessens. Especially long-term decisions are something you will postpone.

What are the risk factors of stress?

Nervous exhaustion and burn-out are always consequences of a combination of a situation, the person, and the environment.


Situations that cause stress or recurring daily irritations (noise pollution from the neighbors or a computer which keeps crashing, a bad relationship with your boss or a bullying colleague) but drastic or traumatic events such as a divorce, the passing of a loved one, or resignation could also cause stress.


The way in which someone works, also plays an important role: something which is fun for one person, can be a very stressful task for someone else. People with burn-out often feel (too) strongly involved in their family or job. They are extremely motivated and ask a lot from themselves. They do not guard their limits, meaning they risk a burn-out. Other characteristics heightening the risk of unhealthy stress: having a hard time expressing your feelings, not being able to ask for help, not being able to say no, pessimism and a negative view of one's own performance.

Looking at it from a different perspective there are many factors which protect one of the negative influence of stress, increasing the ability to deal with it: humor, talking about feelings, asking for help, saying no, optimism, an objective view of one's own performance...


Your living environment also plays a large role: people who understand and support you, to whom you can talk about any problems you may have or simply people with whom you can spend time and enjoy yourself will help you deal with difficult, stressful situations.

What are the results of stress?

As you become more and more stressed, the symptoms will worsen. It can be so that you start out without memory issues, but start to notice such issues appearing. The current symptoms, too, will worsen. You will sleep less, have an even harder time concentrating, cannot make any decisions whatsoever,....

Stress also lies at the basis of numerous other problems, such as burn-out and depression. Stress can also pathologically develop into a burn-out. After a period of not sleeping well and long-term stress, the fatigue will increase. You will not have any energy left over. Stress can even lead to a depression. You namely worry more and more about yourself and feel worse and worse. Somber moods and crying fits can also be symptoms of a developing depression. It is therefore crucial to get rid of stress as soon as possible.

What can I do about it?

It is important to act as quickly as possible with stress. If you change nothing about the causes/symptoms, you namely risk stress turning into more serious problems, such as burn-out and depression. You will feel more and more fatigued and symptoms will worsen. It therefore is a bad idea to ignore the symptoms; instead you should do something about them. Stress can namely cause a vicious cycle, where can get out by simply doing something about the stress. You can deal with stress by either reducing your burden, or increasing your carrying capacity. With this we mean that you should either reduce the stress, or incorporate more enjoyable things into your life.

Online self-help against stress

People can deal with their stress themselves. After discussing it with your doctor, you can namely take a break. If the stress is not acute, you can also think about how you want to deal with your stress.

Another step could be making use of psychotherapy. With this help you can eliminate factors that are related to your stress, and learn how to get more out of life. This help does not always need to be face-to-face. You can namely decide to look for self-treatment online.

If one wants to make use of a caregiver, it is important that they get the right questions. Less important is whether the care is given by a computer or a person. From results it namely shows that stress reduces by up to 77% in the first month after starting to use Mijn Kwartier. It is, however, important to ask your doctor to give you a correct diagnosis and evaluate whether you need other treatment apart from therapy/self-help.


"" against stress

We developed the online self-help program ‘Mijn Kwartier’ to treat depression, stress, and burn-out. In this program you get daily guidance with solution based questions, which help you think about what helps and what does not help. In a series of videos, our doctors explain to you how you can recognize, treat, solve, and even prevent stress. This program will also send you a weekly report with your development in it. This is something you can discuss with your doctor. This way, they are also aware of your progress, if you want them to be.

You can even invite family members into the program to support you. We teach them how they can support you. We help them to understand you in a better way. However, you are not obliged to invite them. You can also opt to deal with stress on your own.