In college Sarah Jenkins was diagnosed with a mild case of irritable bowel syndrome (IBS), a condition causing gastrointestinal discomfort, bloating, diarrhea and constipation. Since then, "it's always been manageable," the now 31-year-old says, adding, "except when I’m under a lot of stress."

Stress can cause acne flareups, as well as stomach problems, depression and other problematic symptoms.Stress can cause acne flareups, as well as stomach problems, depression and other problematic symptoms. (iStockphoto)

Indeed, in the past six months as Jenkins's life spun out of control, her IBS followed. During this time, she was applying to graduate school for speech pathology, taking prerequisite classes, working at two restaurants and as a tutor and trying to maintain a relationship with her boyfriend.

The result: She either was endlessly on the toilet or the exact opposite. She also had heartburn so severe she slept sitting up. "I couldn't be intimate with my boyfriend sometimes because I couldn't lie down," Jenkins says.


In varying forms, Jenkins's situation is familiar to many, especially women and particularly mothers. According to the American Psychological Association's Stress in America annual survey, women consistently report higher levels of stress than men. What's more, women are more likely to report physical manifestations of stress like upset stomach, muscular tension and appetite change.

Among parents, mothers are more stressed than fathers — 15 per cent of moms reported high anxiety levels compared with only three per cent of dads — and they are also more likely to report sleeplessness and unhealthy eating.

So why might women be more prone to stress and the accompanying physical symptoms than men?

"Women carry multiple roles at once," says physician Elizabeth Ricanati, who heads Lifestyle 180, a wellness program at the Cleveland Clinic. "We're in the workforce, taking care of children, elderly parents, making sure the lunches are packed in the morning and taking care of the household. All that takes a toll."

Stress and your body

Evidence suggests that stress lowers immunity, which can lead to many of the physical symptoms outlined above as well as emotional problems, including irritability and depression. Anyone recognizing these signs should see a doctor first to rule out organic causes like viruses.

Once the ailment is diagnosed as stress-related, then there's the question of tackling the underlying issues. Stress management can mean different things to different people. Yoga, exercise and stashing your iPhone in a drawer for the night may be beneficial, but a little bit of vegging in front of the television can be, too.

"It's important to have a broad view of stress management," says Stephanie Smith, a psychologist with the American Psychological Association. "If watching Days of Our Lives at noon is relaxing for you, go with it."

That's an idea to hold on to as you look for the right lifestyle changes that can help reduce the physical symptoms.

Stressed-out stomach

One of the most common physical manifestations of stress is IBS. Twenty per cent of U.S. adults show symptoms and most of these sufferers are women. Stress can exacerbate an existing case, and can even lead a person to develop the disorder.

There are, however, stopgaps in the slippery slope of this intestinal disorder. Exercise can be an important tool in combating IBS, says physician Don Rockey, chief of digestive and liver diseases at UT Southwestern Medical Center in Dallas. An activity as simple as walking can help work off stressful energy and also help keep you regular. It's also important to avoid foods you know will trigger your upset stomach. For many, this can include spicy foods, caffeine and dairy.

Worrying and your waistline

Just as stress can cause discomfort in our gut, it can also cause it to expand. When we're stressed, we often don't take time to eat at regular intervals. So when we do eat, we eat too much or choose unhealthy options. An empty stomach can stress our bodies and our minds. "It can disrupt the body's usual regulatory cycle and that sets you up for weight gain," Ricanati says.

Sitting down and having a full breakfast accompanied by calm breathing every morning is not realistic for most, but even if you're in a hurry, you need to eat. Ricanati suggests something as simple as a yogurt in the car or an apple with a handful of nuts — healthy foods that you can take on the go that will also help you start the day thinking clearly.

Stress is skin deep

The signs of stress can also show up in a place even more obvious than your waistline: your skin. If you already have a mild case of skin diseases like acne, rosacea, eczema and psoriasis, they can flare up when you're stressed. "Almost every skin disease except for skin cancer gets worse with stress," says Pamela Jakubowicz, a dermatologist at Montefiore Medical Center in New York.

To a lesser degree, she says, wrinkles can also be caused by stress, particularly because of the tendency to frown or furrow our brows when we're worried. But for the most part, wrinkle lines are due to sun exposure and age. To keep these physical symptoms from getting worse, Jakubowicz suggests a common sense skin routine: Drink lots of water, wear sunscreen and only use makeup with phrases like "non-comedogenic" and "non-acne-forming."

Under your control

Physical symptoms such as weight gain, acne and constipation can compound the underlying stress, but "people should be optimistic," Ricanati says. "Managing stress is well within your control."

Jenkins, the IBS sufferer, recently found out that she got into grad school, which she says has helped her bouts in the bathroom. Her stomach still bothers her, though not as much, and she has taken active measures: avoiding foods she knows will upset her stomach and exercising four days a week.

She's also taking time for herself, tending her garden and riding bikes with her boyfriend. Says Jenkins, "My mental outlook is better, which helps my physical being."