Get out of constant stress – how we get back into balance

Work, family, constant availability: More and more people feel like they're just functioning – without a break, without a buffer. They rush through everyday life, lose their sense of self, and run on empty. The physical and psychological consequences often don't become apparent until it's almost too late.

But what exactly is stress – and how can you better deal with it?

Many people view stress as something unpleasant. However, "A life without stress would not only be unrealistic, but probably not particularly worth living," says Mazda Adli, chief physician of the Fliedner Clinic Berlin and head of the Affective Disorders Research Department at the Charité. "The ability to experience stress ensures our survival," says Adli.

And there are evolutionary reasons for this, as Magdalena Wekenborg, psychobiologist and research group leader at the Else Kröner Fresenius Center for Digital Health (EKFZ), explains: "In the past, a saber-toothed tiger would suddenly appear in front of us, and we would have to react." In the face of an acute threat, stress was and remains a healthy response: The body mobilizes energy to overcome challenges, solve problems, or escape danger. "Psychologically, stress also makes us more alert and ready to act. In many situations—be it a presentation or a sporting competition—this state is even necessary for performance," says Wekenborg.

The problem with stressors in today's everyday life: Project deadlines or family conflicts often drag on for weeks or months. This means that when stress becomes chronic and recovery phases are lacking, the body loses its ability to regenerate – and this can lead to long-term illness. "Not just mentally, but also physically," says Adli.

Stress is primarily harmful to health when it is experienced as "uncontrollable, unpredictable, and persistent." According to the physician and stress researcher, chronic stress is linked to depression, cardiovascular disease, high blood pressure, and metabolic disorders.

While some people can handle stress well, others are overwhelmed much more quickly. How is it that different people perceive stress so differently?

"How intensely we experience stress depends not only on the external trigger – but above all on how we evaluate it internally," explains Wekenborg. What matters is not just what happens – but how someone assesses the situation and whether they believe they can handle it. "Those who perceive a difficult task as a challenge are more likely to feel motivated. Those who perceive the same situation as overwhelming experience stress," says Wekenborg. This interplay between external stimulus and internal evaluation explains why people react so differently to stress.

What's interesting is that "our inner attitude toward stress acts like a filter," says Wekenborg. A study of hospital staff during the coronavirus pandemic showed that people who generally viewed stress as something helpful—that is, as something that helps them cope with difficult situations—reported less frequently emotional exhaustion, regardless of their objective stress level.

The underlying mechanism: "If I feel stressed in a stressful situation and at the same time am convinced that stress is bad, this increases my tension even further. On the other hand, if I believe that stress is fundamentally useful and adaptable, this attitude can calm me down—I then know that stress is not automatically dangerous," explains Wekenborg.

But environmental factors also play an important role in the experience of stress: According to Adli, people who live or grew up in cities are more sensitive to stress. "In imaging studies , we see that the stress-processing brain regions fire more strongly in city dwellers than in rural people," he explains. "Their stress antennas fire up more quickly—which can be beneficial, but it also increases the risk of mental illness."

But how do you know if a lot of stress is too much stress? Wekenborg explains that there are measurable early indicators of critical stress – such as heart rate variability. This value describes how flexibly the heart reacts to changing demands. " Studies have shown that persistently low heart rate variability significantly increases the risk of exhaustion and burnout." This value can be determined by a family doctor or cardiologist and can thus provide an indication of one's own stress level.

It's important not only to recognize stress, but also to do something about it. Even simple breathing techniques can help reduce acute stress. Wekenborg recommends slow-paced breathing—inhaling for about four seconds, exhaling for six seconds. "This activates the parasympathetic nervous system, which is responsible for relaxation." This exercise not only has an immediate effect—those who practice it regularly will train their resilience to stress in the long term.

Mindfulness exercises – such as consciously perceiving sounds, smells, or touches – can also help, according to Wekenborg, to arrive in the moment and break out of the spiral of thoughts. Adli generally recommends consciously integrating self-care into your daily routine – not just when your body is sounding the alarm. "The body needs regeneration – regularly," says Adli. Exercise, breaks, music, nature – all of these help reduce stress levels.

However, according to experts, one of the most important protective factors of all is interpersonal connection. According to Adli, those who have stable relationships, can communicate, or simply feel like they're not alone experience stressful situations as less threatening. "We have a social brain," he says. "Proximity, exchange, and support are essential." Wekenborg also confirms: "Social connection is one of the strongest stress buffers we have – and it costs nothing."

In addition, according to Wekenborg, external changes may also be necessary: ​​"In addition to individual strategies, structural relief is often also needed - at work, in the family, in everyday life." Anyone who is permanently overwhelmed must not only ask themselves how they can better deal with stress, but also where it actually comes from.

However, according to the experts, one thing is particularly important: "Stress management must not become an additional task," warns Wekenborg. It is problematic if the responsibility lies solely with the individual – for example, solely through calls for greater mindfulness or resilience training. "Many structural stresses cannot be breathed away," says the psychobiologist. The reason for this: "Our world has become more complex, stressors are increasing – including structural ones. It would be wrong to blame those affected for being overwhelmed while others appear calm," says Wekenborg.

Adli advocates for a societal shift in thinking: stress prevention must begin early. "We need a culture in which mental health is taken just as seriously as physical health. Stress management skills are as much a part of everyday life as brushing your teeth – and ideally, part of school curriculum," Adli says.