HEALTH PSYCHOLOGY
When Stress Becomes More Than a Feeling:
The Hidden Health Costs of Chronic Stress
By [Petronella Rufaro / Psychology Student /Department of Psychology GZU
“Stress is a normal part of life. But when pressure never seems to switch off, the consequences can reach far beyond our emotions.”
Stress in everyday life
The alarm goes off. Work needs to be done. Bills need to be paid. A student has an assignment deadline approaching. A parent is worrying about their children. Someone else may be dealing with unemployment, relationship problems or financial uncertainty.
Stress has become such a normal part of modern life that many people simply accept it as something they have to live with. Health psychology, however, recognises that stress is not only an emotional experience. When stressful experiences become persistent, they can affect the mind, behaviour and physical functioning of the body.
The World Health Organization describes stress as a state of worry or mental tension caused by a difficult situation. Stress is a natural response that can help people meet challenges, but excessive or prolonged stress can contribute to health problems.
Biopsychosocial lens
The biopsychosocial model associated with George Engel (1977) provides a useful way of understanding chronic stress because it avoids treating stress as purely psychological.
Biological factors include sleep disruption, physiological stress responses, fatigue and other bodily effects. Psychological factors include thoughts, emotions, appraisal, coping and perceived control. Social factors include unemployment, financial pressure, relationships, working conditions, family responsibilities and access to support.
This means two people exposed to a similar stressor may experience different outcomes because their biology, psychological interpretation and social resources differ. The model therefore supports a whole-person approach to health rather than blaming the individual for circumstances they may not control.
Not all stress is harmful
Stress is not automatically an illness. A certain amount of short-term stress can help a person concentrate, prepare for an examination, respond quickly to danger or meet an important deadline.
Hans Selye’s General Adaptation Syndrome (GAS) helped establish stress as a physiological process. Selye (1950) described stages through which the body responds to prolonged demands, highlighting the importance of recovery when pressure is sustained.
The distinction between acute and chronic stress is important. Acute stress may occur before an examination, interview or difficult event and may reduce when the event ends. Chronic stress may continue for weeks, months or longer when the source of pressure remains unresolved.
Psychological theories of stress
Lazarus and Folkman’s Transactional Model of Stress and Coping (1984) argues that stress depends partly on how a person appraises a situation and evaluates their ability to cope.
For example, one student may think, “This is difficult, but I can divide it into smaller tasks and ask for help,” while another thinks, “I will never finish this; I am going to fail.” The external demand is similar, but their appraisal and coping responses differ.
Cognitive Behavioural Theory, associated with Beck (1976), also helps explain why repeated negative interpretations can influence emotional and behavioural responses. This does not mean that people can simply “think positively” and remove poverty, unemployment or unsafe conditions. Instead, cognitive approaches explain one part of a wider biopsychosocial picture.
When the body stays on alert
The body has sophisticated systems for responding to challenges. During stressful situations, physiological systems become activated to help an individual cope. This is useful when the response is temporary.
Constant physiological activation can therefore become an important health concern. A 2024 systematic review identified an association between allostatic load and cardiovascular disease outcomes, although the strength and nature of the relationship varied between conditions and populations.
Stress does not mean that every person will develop cardiovascular disease. Genetics, lifestyle, existing illness, social circumstances and access to healthcare also influence health.
Behaviour, learning and coping
Stress can affect behaviour as well as physical functioning. A person experiencing prolonged stress may struggle to sleep, exercise less, eat irregularly or increase their use of alcohol, tobacco or other substances. Concentration, relationships and performance at work or school may also be affected.
Bandura’s Social Learning Theory (1977) is relevant because coping behaviours can be learned through observation, modelling and reinforcement. If a person repeatedly observes others using unhealthy coping strategies like eating unhealthy foods oand sees those behaviours reinforced, they may be more likely to reproduce them.
Conversely, observing constructive coping, such as exercise, problem-solving, relaxation or seeking social support, can provide alternative behavioural models. This illustrates why social environments can either reinforce risk or support healthier coping.
Stress is not just an individual problem
The biopsychosocial model makes it clear that chronic stress cannot always be understood by looking only at the individual.
Maslow’s Hierarchy of Needs (1943) suggests that unmet physiological and safety needs can affect motivation and wellbeing. Persistent financial insecurity, unemployment or unsafe living conditions may therefore create pressures that are difficult to resolve through individual coping alone.
Bronfenbrenner’s Ecological Systems Theory (1979) adds that development and wellbeing are influenced by several interacting environments, including family, education, employment, community and wider social structures. This supports the idea that stress can be produced or maintained by circumstances surrounding the individual.
Social support and psychological wellbeing
Social relationships can influence how people experience and manage stress. Bowlby’s Attachment Theory (1969) emphasises the importance of secure relationships and emotional support across development. Strong supportive relationships may provide reassurance and a sense of security, while relationship difficulties can become an additional source of stress.
Self-Determination Theory, developed by Deci and Ryan (1985), proposes that autonomy, competence and relatedness are important psychological needs. Environments that allow people some control, help them develop competence and provide meaningful connection may support wellbeing.
These theories complement the biopsychosocial model by showing how psychological needs and social relationships can interact with physical health.
What does stress look like in Zimbabwe?
Stress is not an abstract psychological concept. Research conducted among healthcare workers in Zimbabwe during the COVID-19 pandemic provides an important example.
Between July 2020 and July 2021, an occupational health programme was accessed by 3,577 healthcare workers from 22 facilities. The study reported that 41.7% felt fearful about COVID-19, while 12.1% had symptom scores suggestive of a common mental disorder. Financial insecurity, working conditions, unmet health needs and difficulties providing care in a resource-constrained system were identified as important stressors.
The findings illustrate the biopsychosocial principle that stress occurs within social and material environments, not in isolation.
Why context matters
The Zimbabwean example also demonstrates why psychological theories should not be used to blame individuals for structural pressures. Lazarus and Folkman’s model helps explain differences in appraisal and coping, while the biopsychosocial and ecological perspectives emphasise the resources and environments available to the person.
A person experiencing unemployment, financial pressure or an unsafe workplace may have limited control over the source of stress. Psychological coping strategies can still be useful, but they should be accompanied by practical, social and institutional responses where possible.
Understanding context therefore produces a more balanced explanation of chronic stress.
What can be done?
Managing stress does not necessarily mean eliminating every difficult situation. Some sources of stress are outside an individual’s immediate control.
WHO guidance highlights regular routines, adequate sleep, physical activity, balanced nutrition and strong social connections. Psychological approaches can include cognitive-behavioural strategies, relaxation techniques and structured self-help.
From a biopsychosocial perspective, support should operate at several levels: biological health and recovery, psychological coping and emotional support, and social or institutional changes that reduce avoidable pressures.
Practical application of the theories
A person under chronic stress could be supported through a combination of approaches:
• Biological: improve sleep routines, physical activity, nutrition and access to healthcare.
• Psychological: identify unhelpful thought patterns, develop problem-solving skills and use relaxation techniques.
• Social: strengthen supportive relationships and reduce isolation.
• Environmental: address excessive workloads, unsafe conditions, financial pressures or other modifiable stressors.
This integrated approach reflects Engel’s biopsychosocial framework and avoids assuming that one intervention will work for everyone.
A health issue worth taking seriously
Stress will never disappear completely. The goal is not to create a life without stress, but to recognise when normal pressure becomes persistent and begins to affect health and daily functioning.
Health psychology reminds us that mind and body cannot be separated. Chronic stress should therefore be taken seriously without assuming that stress alone causes every health problem.
A balanced understanding considers physiological responses, psychological appraisal and coping, behaviour, relationships and wider social circumstances.
Key message
Chronic stress is best understood as a process involving several interacting factors. Selye’s work highlights physiological adaptation; Lazarus and Folkman explain appraisal and coping; McEwen explains cumulative physiological burden; and theories such as Social Learning, Attachment, Self-Determination and Ecological Systems Theory show how behaviour, relationships, needs and environments can shape wellbeing.
Together, these perspectives strengthen the biopsychosocial argument: health is influenced by biological, psychological and social factors rather than by one factor alone.
