Omnipresence of Stress: The Hidden Crisis

Stress is ubiquitous in health and plays a vital role in the pathogenesis of many underlying diseases. Stress and health - this review highlights the interplay between stress and health, focusing on stress in noncommunicable diseases (NCDs) and communicable diseases. While acute stress can aid survival, chronic stress disrupts balance, creating "allostatic load" leading to prolonged activation of the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system causing elevated cortisol, inflammation, and immune suppression. With global morbidity and mortality being largely from NCDs, chronic stress is emerging as a common factor. Stress-induced inflammation exacerbates cardiovascular diseases, alters the gut-brain axis, dysregulates reproductive health, and increases risk for prematurity and low birth weight. Large as its impact is, stress is poorly understood and seldom treated appropriately in clinical settings that attend to physical disease. Stress assessments are infrequently carried out, and management guidance is seldom offered. This highlights the importance of standardized tools and interventions to assess and address stress in healthcare settings. Lifestyle factors such as diet and physical activity are often the focus while overlooking stress. The World Health Organization's Mental Health Action Plan lays the groundwork by calling for improved governance, access to services, and preventive approaches aimed at stress. However, its impact is limited by gaps in execution and resource allocation. Teaching students about how to combat stress can be incorporated into medical training, so providers can treat stress appropriately. Psychosocial support, lifestyle optimization, and resilience training should be integral components in high-quality care paradigms.