Stress has a myriad of impacts on individuals, both physically and mentally. Some of these include impairment of healthy coping skills such as spending time with supportive others and engaging in pro-health and wellbeing behaviours (e.g. relaxation and exercise). In addition, stress can increase the risk of engaging in unhelpful coping strategies such as avoidance and spiraling worry and concern about past, current and future events.  


The impact of stress

While we can typically handle high levels of stress for limited periods, we find that extended periods of stress can be associated with an increased risk of both depression and anxiety. There are range of biological and psychological underpinnings to this relationship. Let’s have a think about these…

Chronic stress increases the release of chemical messengers like adrenalin (called noradrenalin in the brain) and serotonin. Increased levels of noradrenalin in the emotional centers of the brain in response to stress can lead to physical and psychological symptoms of anxiety.

In terms of depression, chronic stress can also lead to reductions in the amount of serotonin in these regions which may lead to depressive symptoms. Importantly, chronic stress can actually lead to both noradrenalin and serotonin systems being dysregulated. This means that often people experience both symptoms of depression and anxiety is varying quantities.

Psychological changes go along with the physical and chemical changes in the brain. When we have been very stressed or stressed for long periods of time (or perhaps are more vulnerable to stress due to genetics or personal history), we tend to see situations through a lens that may filter or sometimes distort information in a negative or threatening way. This is what we call a cognitive bias and it impacts how we view our past, current and future experiences, coping skills and responses. As people become more tuned into believing they didn’t handle things well in the past, present or into the future, there is a natural increase in depression and anxiety levels as people can begin to feel hopeless or helpless (often leading to depression) or overwhelmed (associated with anxiety).   

Managing anxiety, depression and stress

When we consider managing anxiety and depression, we first ask how serious the symptoms are. If someone is struggling with significant symptoms, they may need to try using medications that stabilize levels of serotonin and adrenalin in the brain.

For mild to moderate levels of symptoms, people often benefit from working on their thinking styles and cognitive biases to reduce feelings of hopelessness and being overwhelmed. Other forms of therapy can also help. The right ones are tailored to each individual’s needs.

Finally, if these mental health issues were as a result of chronic stress, we need to return to managing this contributing factor by increasing resilience. This may include working on strengthening supports, improving physical health through exercise, nutrition and good sleep, increasing engagement in meaningful and relaxing activities and learning new self-care strategies.

The relationship between stress, depression and anxiety is a little complex, but importantly, complex problems can be managed through a combination of simple strategies. The key is putting these strategies together in a way that works for each individual, based on their own needs and situation.

About Dr Karen Hallam

Dr Karen Hallam is the Mental Health Advisor for Moving Mindz and the Principal Clinical Psychologist at Northcote Consulting in Melbourne. You may contact Dr Hallam through Moving Mindz or via