Understanding Stress in the Context of Disability

Stress is one of those words everyone uses but few truly understand in depth. It gets blamed for everything from headaches to heart disease – and rightly so. But stress is not simply a feeling of being overwhelmed. It is a complex biological and psychological process rooted in survival, shaped by our environments, and experienced differently depending on who we are and what we face. For people living with disability, stress carries additional layers – social, emotional, and physiological – that make understanding its foundations all the more important.

What is stress?
Biological aspects of stress
The fight-or-flight response
The HPA axis and cortisol
Psychosocial aspects of stress
Acute vs. chronic stress
Acute stress
Chronic stress
Distress vs. eustress
Distress
Eustress

What is stress?

At its core, stress is the body’s response to any demand placed upon it. Hans Selye, often called the “father of stress medicine,” defined it as the body’s nonspecific response to any demand – pleasant or unpleasant. This definition is important because it tells us that stress is not inherently negative. It is simply a reaction, a signal that the body and mind are being called to respond to something.

Stress is recognized as a major area of research spanning physiology, psychology, and neuroscience. The foundational understanding of stress emerged largely from two scientists: Walter Cannon and Hans Selye. Their discoveries, made decades apart, remain central to how we study and understand stress today.

Biological aspects of stress

When you perceive a threat – whether it’s an approaching deadline, a difficult conversation, or a physical danger – your body doesn’t wait for you to think through a response. It reacts immediately and automatically.

The fight-or-flight response

First described by physiologist Walter Cannon in 1915, the fight-or-flight response is the body’s built-in emergency system. Cannon proposed that this reaction occurs when a person experiences very strong emotions – especially those associated with a perceived threat. During this response, the body is rapidly aroused by the activation of both the sympathetic nervous system and the endocrine system, preparing a person to either confront the threat or escape it.

Cannon showed that when an animal is strongly aroused, the sympathetic division of its autonomic nervous system combines with the hormone adrenaline to mobilize the animal for an emergency response. He described this coordinated system as the “sympathico-adrenal system,” noting that it orchestrates the body’s physiological readiness under threat.

In practical terms, this means a rush of epinephrine (adrenaline) and norepinephrine from the adrenal glands causes your heart rate to accelerate, your pupils to dilate, your breathing to quicken, and your muscles to tense. The fight-or-flight response triggers increased heart rate, heightened blood flow to muscles, and the release of stress hormones like adrenaline – all designed to prime the body for rapid action.

The HPA axis and cortisol

Beyond the immediate adrenaline surge, the body activates a second hormonal pathway: the hypothalamic-pituitary-adrenal (HPA) axis. This system, first described by Selye, regulates how the body copes with stress by controlling the release of cortisol from the adrenal cortex. Cortisol helps sustain the stress response over a longer period – regulating energy, suppressing non-essential functions like digestion, and maintaining alertness. While cortisol is essential in short bursts, chronically elevated levels are associated with serious health risks, including immune suppression, cardiovascular disease, and cognitive impairment.

Psychosocial aspects of stress

Not all stress originates from physical threats. A great deal of the stress people experience is psychosocial – arising from social pressures, life circumstances, relationships, and how we perceive and interpret events around us.

Psychosocial stress refers to the emotional and psychological strain experienced in response to adverse social conditions and life demands, and it can significantly affect an individual’s well-being. Its sources are wide-ranging: financial insecurity, discrimination, social isolation, loss of a loved one, early childhood adversity, or living with a chronic health condition.

The impact of psychosocial stress goes well beyond mood. Research has established a well-known link between prolonged exposure to psychosocial stress and the risk for major depressive disorder. Studies have also documented its effects on memory and cognition – particularly on the hippocampus, the brain region critical for forming new long-term memories, and the frontal lobes, which govern attention, judgment, and executive function. Stress hormones may decrease the functioning of neurons in the hippocampus, leading to difficulties concentrating, trouble learning new information, or problems with decision-making.

For people facing disability-related challenges – stigma, reduced autonomy, limited access to social support, or navigating complex healthcare systems – chronic stress, psychosocial adversities including life events, stigma, and reduced coping capacity are more prevalent and compound over time. These are not abstract concerns; they translate into measurable, long-term health consequences.

Acute vs. chronic stress

One of the most important distinctions in understanding stress is the difference between acute stress and chronic stress.

Acute stress

Acute stress is short-term. It arises from a specific situation – giving a presentation, sitting an exam, narrowly avoiding an accident – and resolves once the situation passes. Acute stress responses in young, healthy individuals are typically adaptive and do not impose a health burden. In fact, a well-functioning stress response is essential – animals that lack stress responses entirely require special care to survive.

Chronic stress

Chronic stress is a different matter entirely. It develops when stressors persist over time without adequate resolution – such as ongoing financial hardship, long-term caregiving responsibilities, persistent discrimination, or living with a painful health condition. Chronic stress is a consistent sense of feeling pressured and overwhelmed over a long period of time, and its consequences touch nearly every body system.

Research shows that the duration of stressors is a much stronger predictor of depression severity than their intensity, meaning that ongoing, low-grade stress can be more damaging than a single intense event. Robust evidence links the experience of chronic stress to the onset of major depressive disorder – the leading cause of disability worldwide – as well as bipolar disorder and PTSD.

Physically, chronic stress increases the levels of circulating inflammatory leukocytes, which can exacerbate pre-existing medical conditions, including cardiovascular disease. Chronic stress is also linked to hypertension, heart disease, obesity, type II diabetes, arthritis, and addiction – forming a web of interconnected health consequences that can be difficult to untangle.

Financial stress and having no one to turn to with problems are among the psychosocial stressors most strongly associated with adverse health behaviors, including uncontrolled eating and physical inactivity – patterns that further compound the burden of chronic stress on long-term health.

Distress vs. eustress

Here is something that surprises many people: not all stress is harmful. Hans Selye spent years building this case, and it reshaped how psychology thinks about stress.

Selye argued that stress differs from other physical responses in that it is identical whether the provoking impulse is positive or negative. What differs is the type and perception of that stress. He coined two terms to capture this distinction: distress and eustress.

Distress

Distress is the familiar, negative form of stress. Selye argued that persistent stress that is not resolved through coping or adaptation should be known as distress, and may lead to anxiety, withdrawal, and depressive behavior. This is the stress of exam failure, financial crisis, social rejection, or overwhelming caregiving demands. It feels debilitating, narrows thinking, and erodes wellbeing over time.

Eustress

Eustress (from the Greek prefix eu-, meaning “good”) is the positive cognitive response to stress that is healthy, or gives one a feeling of fulfilment or other positive feelings. Starting a new job, preparing for a sporting competition, or taking on an exciting project all generate a form of stress – but one that motivates, engages, and energizes rather than depletes.

Crucially, eustress is not defined by the type of stressor, but rather by how one perceives it – as a negative threat versus a positive challenge. The same event can produce eustress in one person and distress in another. Research shows that a moderate amount of stress can enhance both immediate and delayed recall of educational material, with athletes and students often performing better under the motivating push of manageable stress.

Selye differentiated eustress as the positive, challenging type of stress that helps people grow, in contrast to distress, the negative, destructive type that can lead to illness. Understanding this distinction is not merely academic – it has real implications for how individuals interpret their stress responses and whether they approach difficult situations with resilience or avoidance.

The boundary between the two is not fixed. Distress can be tackled and unlearned through a process of learning to react to the same stressors with positive emotions like gratitude, hope, and goodwill. This reframing is not about denial – it is about perception, and perception is something that can, with practice and support, change.

What do you think? Considering the distinction between eustress and distress, how might the way a person with a disability perceives their daily challenges influence their long-term mental and physical health? And if chronic stress has such measurable effects on the brain and immune system, what kinds of psychosocial support do you think could make the most meaningful difference?

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References

PDF 📄

Table of Contents

What is stress? 🔗

Biological aspects of stress 🔗

The fight-or-flight response 🔗

The HPA axis and cortisol 🔗

Psychosocial aspects of stress 🔗

Acute vs. chronic stress 🔗

Acute stress 🔗

Chronic stress 🔗

Distress vs. eustress 🔗

Distress 🔗

Eustress 🔗