Chronic stress is increasingly being recognised as more than an emotional or psychological concern. When stress becomes persistent, it can affect multiple organ systems, influence cellular health and potentially accelerate aspects of biological ageing. While chronological age tells us how many years a person has lived, biological age reflects the condition and functioning of the body relative to that age.
Stress is a normal physiological response that enables us to cope with challenges. When a person is confronted with a stressful event, the body activates the sympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis. This results in the release of stress hormones such as adrenaline and cortisol. These responses increase alertness, heart rate and energy availability. Helping the body to respond to immediate demands. Under normal circumstances, these changes subside once the threat passes.
The problem arises when stress becomes chronic, leaving the body in a prolonged state of physiological activation without adequate recovery.
How chronic stress affects the ageing process
One of the major mechanisms linking chronic stress with biological ageing is persistent inflammation. Long-term psychological stress can alter immune regulation and contribute to low-grade systemic inflammation. Over time, this inflammatory burden may contribute to cardiovascular disease, insulin resistance and other chronic conditions associated with ageing.
Chronic stress may also affect the body’s ability to regulate cortisol. Longer term stress can also alter how the body handles cortisol. An abnormal cortisol rhythm can affect blood glucose levels, blood pressure, distribution of abdominal fat, immune system function and sleep. The disturbance can increase the risk of metabolic and cardiovascular problems, especially when combined with physical inactivity, a poor diet and lack of sleep.
Another important area of research involves telomeres, the protective structures at the ends of chromosomes. Telomeres generally shorten as cells divide, and their shortening is associated with cellular ageing. Some studies have linked prolonged psychological stress with shorter telomeres or changes in telomerase activity, an enzyme involved in maintaining them. However, these associations do not establish that stress alone causes accelerated telomere shortening in every individual.
Researchers are also studying epigenetic ageing, which examines chemical modifications to DNA that influence gene activity without changing the underlying genetic sequence. Certain epigenetic clocks estimate biological age using these patterns. Studies suggest that major or prolonged stress exposure may be associated with changes in some biological-age measures. Importantly, these clocks are research tools, and a higher estimated biological age does not necessarily mean that a person has irreversible damage or will develop a particular disease.
Impact on sleep, metabolism and the brain
The effects of chronic stress often become interconnected. A person experiencing prolonged stress may struggle to fall asleep, wake frequently or experience poor-quality sleep. Sleep deprivation, in turn, can disrupt appetite-regulating hormones, worsen glucose control and increase inflammatory activity.
Stress can affect one’s eating behavior, leading to emotional eating and more intake of processed food. Physical inactivity and the use of alcohol and tobacco can further worsen the effects of stress.Over time, these behaviours can increase the risk of obesity, type 2 diabetes, hypertension and cardiovascular disease.
The brain is also affected.Chronic stress can affect one’s ability to focus, remember things, and regulate emotions. Some of these problems are alleviated once the issues of stress and sleep disturbances are taken care of, but sometimes professional intervention is needed.
Can we slow down stress-related biological ageing?
The encouraging news is that many of the pathways associated with chronic stress are modifiable. Although no single intervention has been proven to reverse biological ageing, consistent lifestyle measures can improve overall health and help the body recover from stress.
Regular physical activity, including aerobic exercise and strength training, supports cardiovascular and metabolic health. Adults should generally aim for at least 150 minutes of moderate-intensity physical activity each week, adjusted to their medical condition and fitness level.
Maintaining a consistent sleep schedule and obtaining approximately seven to nine hours of sleep each night can support hormonal regulation, immune function and cognitive health. A balanced diet rich in vegetables, fruits, whole grains, legumes, nuts and adequate protein can also support long-term health.
Mindfulness, meditation, breathing exercises, yoga and spending time outdoors may help reduce perceived stress. Equally important are social connections, realistic work expectations, regular breaks and seeking help when stress becomes overwhelming. Persistent anxiety, low mood or sleep disturbance should not be dismissed as an inevitable part of modern life.
Recognizing stress as a health problem
Don’t look at chronic stress as an absence of resilience or an inability to cope. It is a complicated interplay of psychological experiences, hormonal responses, immune activity, sleep and life style. Individual responses vary, and biological ageing is influenced by several factors, including genetics, environmental exposures, socioeconomic circumstances and existing health conditions.
The issue is not to get rid of all stressful experiences because this is neither feasible nor necessary. The goal is to ensure that one does not remain stressed out all the time physiologically. Recognizing persistent stress early and addressing its underlying causes may improve quality of life and reduce the risk of several age-related health problems.
Ultimately, ageing cannot be stopped, but healthy ageing can be supported. To help the body stay healthier for longer, practical steps include protecting sleep, maintaining physical activity, nurturing relationships and seeking timely professional support.
(Dr. Divya Gopal, Additional director, Internal Medicine, Sir HN Reliance Foundation Hospital, Mumbai)
