When people say, “I’m stressed out,” they’re usually describing a mental feeling of pressure or agitation. But while stress may begin in the brain, the process very much involves the body. Our bodies aren’t meant to be in a constant state of fight-or-flight. Over the long term, living with chronic stress can actually harm the body in several ways:

1. Panic Attacks

The symptoms of a panic attack mimic a heart attack in many ways. Some indicators of a panic attack include:

• Rapid, shallow breathing (hyperventilation)
• Pounding, racing heart
• Sweating
• Tingling of the arms, hands, legs, feet, or numbness around the mouth
• Weakness, dizziness
• Feelings of acute fear, in the absence of any threat
• Usually begins to subside after about 10 minutes

If you experience frequent panic attacks, you should see a health care provider for treatment. Panic attacks can seriously disrupt your life, but they are treatable. No one should live with the misery of panic on a routine basis.

2. Shoulder or Neck Pain

Any time your brain senses something wrong, like an imminent threat, it begins to activate the flight-or-fight response, which results in added muscle tension and bodily discomfort. Generally, this automated mechanism selectively tenses some muscles more than others. The muscles closest to your neck are preferentially tensed, which helps guard this vulnerable area. Chronic stress therefore causes contraction of and pain in the muscles of the neck and shoulders.

3. Insomnia

Chronic stress can also disrupt your ability to fall asleep, stay asleep, or experience restful sleep. Contrary to popular belief, insomnia doesn’t mean 100 percent sleeplessness night after night; it actually refers to any ongoing disruption to normal sleep patterns. And while the occasional sleepless night may be annoying, chronic sleep deprivation can lead to other health problems, such as obesity, decreased immunity, and high blood pressure.

4. Heart Disease

The classic film imagery of a man receiving bad news and then clutching his chest and dropping dead of a heart attack may be somewhat over-dramatized, but it can happen. Numerous studies link chronic stress to the development of heart disease, and there is also what’s known as “broken heart syndrome,” in which emotional stress can actually damage the heart. Untreated stress can affect your heart in many ways, from arrhythmia (an irregular heartbeat) to narrowing of the coronary arteries.

5. Decreased Coping Skills

Coping skills are key tools for surviving what life throws at you. Chronic stress literally makes it harder for you make good coping decisions by turning off the higher-functioning centers of your brain. That’s why some people turn to alcohol, food, or illicit drugs to self-medicate their stress.

Nipping Stress in the Bud

Stress is a natural part of life, but you don’t need to let it build up and hurt your health.One way to stay on top of it is to take note when you feel stressed. Doing so will help you identify your stress triggers–and then avoid them. You can also disrupt your stress cycle by doing something different than you would normally do once you feel a physical symptom of stress. Stand up. Stretch. Go for a walk.You can also treat your stress through daily stress reduction activities, such as meditation, mindful breathing, progressive muscle relaxation, walking or stretching.And if it gets to be too much for you, get help. Check with your health care provider to discuss whether you’d benefit from one-on-one strategies for stress reduction, group classes, or possibly even prescription medications, whether for stress or for related conditions like insomnia.

Is It Stress or Something Else?

Finally, how do you know whether your discomfort is due to stress or another cause? First, learn to recognize the difference. Generally, stress is episodic in nature (acute stress), but it can also persist over the long term (chronic stress). Stress typically occurs in conjunction with a known trigger (such as that unexpected email from your boss) and causes familiar patterns of the fight-or-flight reaction.While a key feature of episodic stress is shortness of breath, you should seek medical treatment immediately if that shortness of breath is accompanied by crushing chest pain, pain in the left arm or shoulder, left-sided pain that radiates up into the jaw, or pain in the back. You could be having an issue with your heart.No one enjoys living with chronic stress. But by recognizing your body’s stress response and incorporating stress-relieving techniques  into your daily life, you can make an immediate impact. Your body (and mind) will thank you for it!