Mental wellbeing and coping with stress

What is it?

The World Health Organization describes mental health as a state of mental wellbeing that enables people to cope with the stresses of life, and says it is a basic value in itself and a basic human right, and not merely the absence of mental illness.

The CDC defines mental health as including a person's emotional, psychological and social wellbeing, and MedlinePlus notes that it shapes how we think, feel and act, and affects how we handle stress, our relationships with others and our decisions.

As for stress, MedlinePlus describes it as the brain's and body's response to a challenge or demand, known as the "fight or flight response", and the CDC agrees that everyone experiences stress as a physical and emotional response to new or difficult situations.

The two sources distinguish between short-term stress, which may be useful, and long-term (chronic) stress, which according to the CDC may lead to worsening health problems over time.

Why it matters

The World Health Organization says that more than a billion people worldwide live with a mental health condition, and that the need to act on mental health is "undeniable and urgent".

MedlinePlus states that short-term stress may weaken the body's ability to fight germs, whereas long-term stress may contribute to depression, anxiety, heart disease, high blood pressure and diabetes.

MedlinePlus adds that mental disorders themselves may raise the risk of physical problems such as stroke, type 2 diabetes and heart disease, but stresses that treatment is available and many people recover fully.

The CDC states that chronic stress may affect daily life and lead to worsening health problems, and that stigma associated with mental health may prevent a person from seeking care, delay it, or lead them to stop treatment.

According to the World Health Organization, individual factors (such as emotional skills, substance use and genetic factors) interact with social and environmental factors (such as poverty, violence, inequality and environmental deprivation) in determining the risk of mental health problems, and no single factor predicts the outcome alone.

The organisation describes bullying as among the most prominent risk factors for mental health problems, against protective factors such as social and emotional skills, positive relationships, education, decent work, safe neighbourhoods and community ties.

Key points

Signs of stress according to the CDC: fear, anger, sadness, worry, numbness or frustration; changes in appetite, energy, desires and interests; difficulty concentrating or making decisions; nightmares or sleep problems; physical symptoms such as headaches, body pains, stomach problems and skin rashes; worsening of existing chronic health or mental health problems; and increased use of alcohol, drugs or other substances.

MedlinePlus lists similar signs of short-term stress: frequent illness, stomach problems, difficulty sleeping, headaches, feeling sad, angry or easily irritated, and cautions that "you can get used to the symptoms of stress without realising there is a problem".

The NIMH says self-care means taking time for activities that help you live better, and that it can help in coping with stress, reducing the risk of illness and boosting energy, and that finding what works for you may need trying more than one technique.

When to seek specialist help: the NIMH and MedlinePlus agree that severe or troubling symptoms that last two weeks or more, such as difficulty sleeping, changes in appetite or weight, difficulty concentrating, loss of interest in activities or inability to complete usual tasks, call for talking to a healthcare provider.

How to put it into practice

For the mind, the CDC suggests: cutting down on watching the news and social media, taking time to relax (such as deep breathing, stretching, meditation, journaling and spending time outdoors), practising gratitude daily, and staying in touch with people you trust or your local community.

The NIMH suggests similar relaxation techniques such as meditation, muscle relaxation and breathing exercises, or enjoyable activities such as music, reading or time in nature, in addition to specific gratitude (writing down particular things you are grateful for) and reviewing unhelpful thoughts.

For managing tasks the NIMH advises separating what is urgent from what can wait, and declining new commitments when feeling overwhelmed; MedlinePlus advises setting priorities and focusing on what you have achieved each day.

Social connection: the NIMH advises staying connected with people who offer you emotional or practical support, and MedlinePlus advises seeking support from family and friends.

For the body, the CDC advises keeping regular sleep times and getting 7 or more hours of sleep a night for adults (see healthy sleep), doing physical activity gradually up to two and a half hours a week or 20 to 30 minutes a day, and eating healthy foods.

The NIMH advises walking 30 minutes a day as a helpful way, even if sessions are shorter and accumulate through the day, and eating balanced regular meals and drinking enough water, noticing the effect of caffeine or alcohol on your mood, and keeping sleep times steady and reducing screens before bed.

On alcohol and substances: the CDC advises that a man have two drinks or fewer a day and a woman one drink or fewer, or choose not to drink at all (see alcohol), and to avoid illicit drugs, misuse of prescription medicines, tobacco and vaping.

The CDC and MedlinePlus state that seeking specialist support is a useful step when needed, and the CDC also advises regular health follow-up such as check-ups and vaccinations.

Special groups

Children and adolescents: the World Health Organization describes early childhood and adolescence as sensitive stages for mental health, and states that bullying is among the most prominent risk factors at these ages, and that social and emotional learning programmes in schools are among the most effective approaches across economic levels, along with protective policies and support for caregivers and safer community and online environments.

Work environment: the CDC states that organisational changes in the workplace can support workers and protect them from burnout, and the World Health Organization states that mental health approaches at work include legislation, workplace policies, manager training and interventions targeted at workers.

Risks and cautions

Health risks linked to chronic stress: MedlinePlus states that it may contribute to depression, anxiety, heart disease, high blood pressure and diabetes, and that short-term stress may weaken the body's resistance to infection.

MedlinePlus cautions that "you can get used to the symptoms of stress without realising there is a problem", meaning symptoms may become chronic without being noticed.

Unhealthy ways of coping with stress: the CDC states that effects of stress include increased use of alcohol, drugs or other substances, so it advises limits on alcohol and avoiding illicit drugs, misuse of medicines and tobacco as part of healthy coping with it.

Stigma: the CDC states that stigma associated with mental health may prevent a person from seeking care, delay it, or lead them to stop treatment.

Mental disorders and physical health: MedlinePlus states that mental disorders may raise the risk of physical problems such as stroke, type 2 diabetes and heart disease, but stresses that talking therapy and medicine can treat these disorders and many people recover fully; the type and duration of treatment are decided by the specialist.

Limits of this information

This page is general information about mental health and coping with stress as presented by WHO, the CDC, the NIMH and MedlinePlus, and is not a diagnostic page for a specific mental illness such as depression or anxiety disorders; diagnosing and treating these conditions needs specialist assessment by a doctor or mental health professional.

The figures given here (such as hours of sleep, physical activity rate and alcohol limits) are from general US guidance according to the CDC, and may differ according to your age, health condition and country. What suits you is decided by your doctor or mental health specialist according to your condition.

Crisis lines and emergency centres differ by country; so specific phone numbers are not mentioned here. If you feel you need immediate help, contact your primary care doctor, the health authority in your country, or the nearest emergency service.

The relationship between stress and the chronic diseases mentioned here is mostly an association and increased risk as the sources describe, not a proven sole cause for every person.

Common questions