How Chronic Stress and Unresolved Trauma Affect Your Body
You can be highly functional and still be carrying a significant amount of chronic stress.
You may be working, parenting, caring for other people, exercising, and keeping up with your responsibilities while your body is spending much of its time in a state of fight, flight, or freeze.
In a recent episode of the Hope Natural Health Podcast, I sat down with Shari B. Kaplan, a trauma-informed psychotherapist specializing in integrative mental health, to talk about what happens when stress becomes chronic, how unresolved trauma can affect the body, and why mental and physical health can’t always be separated.
This conversation stood out to me because chronic stress is something I see repeatedly in my own practice.
I often call it an “obstacle to cure.”
That doesn’t mean stress explains every symptom. It means that when you’re trying to understand fatigue, digestive problems, hormone symptoms, poor sleep, anxiety, or difficulty recovering, stress deserves a place in the conversation.
What Is Chronic Stress?
Stress is your body’s response to a perceived demand or threat.
In the short term, this response is protective. Your body releases hormones and activates physiological changes that help you respond to what is happening around you.
Chronic stress is different because the stress response continues over an extended period.
Shari explained that chronic stress can come from many different places. It may begin in childhood through family instability, caregiving responsibilities, financial stress, illness, addiction, or other difficult circumstances.
It can also develop later in life through relationships, work, chronic illness, financial pressure, caregiving, or simply the ongoing demands of being responsible for other people.
Sometimes there isn’t one major event.
There may simply be years of living with demands that never seem to let up.
What Happens When Your Body Stays in Fight, Flight, or Freeze?
Your nervous system is designed to help you respond to threats.
When your brain perceives danger, your body shifts into a survival response. Your heart rate and breathing can change, blood sugar becomes more available for energy, and digestion can be altered while your body prioritizes immediate survival.
This is useful when you need to respond to an immediate threat.
It becomes more complicated when your body repeatedly receives the message that it isn’t safe to come out of that state.
Shari described what happens when someone becomes stuck in fight, flight, or freeze.
Over time, the repeated physiological demand can contribute to wear and tear across multiple systems of the body.
This is one reason chronic stress shouldn’t be reduced to simply “feeling stressed.”
Chronic stress is a physiological experience, not just an emotional one.
The Freeze Response Can Look Very Different From Anxiety
When people hear about chronic stress, they often imagine someone who is constantly anxious, overwhelmed, or unable to sit still.
But the nervous system doesn’t respond to stress in only one way.
Some people move toward fight or flight.
Others move toward freeze.
Freeze can look like shutting down, disconnecting, feeling stuck, or having difficulty knowing what you’re feeling.
Shari shared an example from her own life that I found especially relatable for women who spend much of their time caring for other people.
She described going for acupuncture and being asked how she was feeling, only to realize that she needed time to actually scan her body and figure out the answer.
She had spent so much of her day focused outward, helping other people, that checking in with herself wasn’t automatic.
I see versions of this in my own practice.
Women can become so accustomed to functioning that they don’t recognize how much stress they’re carrying until their body starts making it harder to ignore.
Chronic Stress Can Show Up as Physical Symptoms
One of the most important parts of this conversation was recognizing that stress doesn’t always look like stress.
It can show up through the body.
That may include changes in digestion, sleep, energy, mood, concentration, appetite, or other areas of health.
This doesn’t mean that every physical symptom is caused by chronic stress.
That’s an important distinction.
If you’re exhausted, for example, I don’t want you to assume the answer is simply “reduce your stress.” There can be many contributors to fatigue, including nutritional deficiencies, thyroid dysfunction, sleep problems, blood sugar issues, medications, and other medical conditions.
But I also don’t want you to ignore your stress physiology.
Both things can be true.
The Connection Between Stress and Digestion
Your brain and digestive system are constantly communicating.
Shari talked about seeing people with gastrointestinal symptoms whose doctors may not always ask about the person’s history of chronic stress or what’s happening in their relationships and environment.
That doesn’t mean digestive symptoms are psychological.
It means the digestive system doesn’t operate independently from the nervous system.
When your body is under prolonged stress, changes in nervous system activity can influence gastrointestinal function.
That’s why I want to look beyond the food itself when a woman comes to me with digestive complaints.
What is she eating?
Is she eating enough?
How is she sleeping?
What is happening with her stress?
What medications or supplements is she taking?
What other symptoms are happening at the same time?
The more pieces we can put together, the more useful the clinical picture becomes.
Why Stress Can Matter When You're Dealing With Hormone Symptoms
This is particularly important for women who are dealing with hormone-related symptoms.
Your endocrine system and nervous system are closely connected.
When you’re already experiencing changes in your cycle, sleep, energy, mood, or weight, ongoing stress can become another factor influencing the picture.
In my practice, I don’t want to look at one hormone value and decide that it explains everything you’re experiencing.
I want to understand the pattern.
That means looking at your symptoms alongside your nutrition, sleep, stress, digestion, movement, medical history, medications, and other relevant factors.
Your symptoms are data, but context helps you understand what that data means.
Why High-Functioning Women May Not Recognize Their Stress
One of the most interesting parts of our conversation was the idea that you can be doing well on the outside while your nervous system is struggling underneath.
You may have a successful career.
You may take care of your family.
You may exercise regularly and eat well.
You may even have a good morning routine.
None of those things automatically mean your body is getting enough recovery.
This is something I see often in practice.
A woman will tell me she isn’t particularly stressed, but when we walk through her actual day, there are responsibilities coming at her from every direction.
Sometimes that level of stress has become so normal that she doesn’t identify it as stress anymore.
It’s simply her baseline.
That’s why body awareness matters.
You don’t have to wait until you completely burn out to pay attention to what your nervous system is telling you.
What Is Unresolved Trauma?
Trauma and chronic stress aren’t interchangeable terms.
Trauma generally refers to experiences that overwhelm a person’s ability to cope and can have lasting effects on emotional and physiological responses.
Unresolved trauma describes situations where the effects of those experiences continue to influence how a person responds to themselves, other people, or perceived threats.
But there is an important clinical boundary here.
Not every difficult experience is trauma, and not every physical symptom is caused by trauma.
We shouldn’t turn every health problem into a trauma story.
What we can do is recognize that your history is part of your health context.
Your relationships, childhood experiences, medical history, injuries, illnesses, work, caregiving responsibilities, and current environment can all contribute to the bigger picture.
Shari Kaplan's Repair, Release, Reorganize, Rebuild Framework
One of the most valuable parts of my conversation with Shari was learning more about her four-part framework: repair, release, reorganize, and rebuild.
Repair
Shari begins with a very thorough biopsychosocial assessment.
That means looking at the whole person rather than starting with one isolated symptom.
She considers developmental history, relationships, medical history, beliefs, lifestyle, strengths, and other experiences that may help explain the person’s current patterns.
The goal is to understand the broader picture before deciding where to intervene.
Release
The release phase involves working with emotions and experiences that may be contributing to ongoing patterns.
Shari described approaches that can include breathwork, self-regulation practices, and therapeutic techniques that help someone process emotions such as anger, sadness, and grief.
This isn’t about repeatedly reliving painful experiences.
In fact, Shari specifically described being cautious about having people tell detailed trauma stories if there isn’t a therapeutic reason to do so.
Reorganize
Once someone begins developing new beliefs and perspectives, the next step is learning how to live differently.
Your brain and body have patterns.
Changing a thought doesn’t automatically change a behavior.
The reorganizing phase focuses on creating new patterns so that your nervous system, thoughts, beliefs, and behaviors begin working together differently.
Rebuild
The final phase is about putting those changes into everyday life.
What does your life look like when you’re no longer organizing everything around old patterns?
What do your mornings look like?
How do you spend your time?
What relationships are you choosing?
What do you want your life to look like?
This is where the work becomes part of how you actually live.
Start Low and Go Slow
There was another concept in our conversation that applies well beyond mental health: start low and go slow.
I use this same principle in my practice when we’re considering supplements, nutrition changes, exercise, and other interventions.
People often want to change everything at once.
They see something online, decide they need it, and add it to an already long list of things they’re doing.
I’ve had women come into my office taking a dozen or more supplements without being able to tell me why they’re taking half of them.
Sometimes they’re taking something because someone online said it helped them.
That isn’t individualized care.
Before adding another intervention, I want to know what your body actually needs.
Are you deficient?
Can you absorb it?
Is there a reason to use it?
Is it helping?
The same principle applies to nervous system regulation.
You don’t need to copy someone else’s routine.
You need to find what is appropriate for your body and your current capacity.
Nervous System Regulation Isn't a One-Size-Fits-All Routine
There are plenty of nervous system practices online.
Breathwork.
Meditation.
Exercise.
Cold exposure.
Journaling.
Walking.
Sunlight.
All of these can have a place.
But the right practice depends on the person.
Shari emphasized the importance of starting where you are rather than going “guns blazing” into a new routine.
I agree.
If you’re already exhausted, adding an intense workout program may not be the answer.
If you’re overwhelmed, adding another complicated morning routine may become another obligation.
The goal is to create something your body can actually tolerate and that you can consistently incorporate into your life.
Why Connection Matters
One of my favorite parts of this conversation was Shari’s answer when I asked her for her favorite health tip.
Her response centered on connection.
Connection with yourself.
Connection with safe people.
Connection that creates a sense of belonging, worth, and purpose.
That idea is especially important when you’re accustomed to taking care of everyone else.
Before you can understand what your body needs, you sometimes have to slow down enough to notice your body in the first place.
That might mean noticing your breathing.
Noticing tension.
Noticing whether you’re hungry.
Noticing that you’re exhausted.
Noticing that a relationship consistently leaves you feeling unsafe or depleted.
These observations don’t fix everything.
But they give you information.
And information gives you somewhere to begin.
When Mental and Physical Health Need to Be Considered Together
This is ultimately what I took away from my conversation with Shari.
We need better communication between the psychological and physical sides of healthcare.
A woman with digestive symptoms may also be under chronic stress.
A woman with anxiety may also have nutritional or metabolic factors that deserve attention.
A woman with fatigue may be dealing with poor sleep, hormone changes, chronic stress, inadequate nourishment, or a medical condition.
There isn’t always one explanation.
And there doesn’t have to be.
The goal is to understand the patterns well enough to know what to investigate and what to address first.
That’s how I approach care in my own practice.
I want to understand the person sitting in front of me, not just the symptom written at the top of the chart.
FAQ
Chronic stress is prolonged or repeated activation of the body’s stress response over an extended period. Unlike an acute stress response that resolves after a specific event, chronic stress can continue when ongoing demands don’t allow sufficient recovery.
Chronic stress can contribute to physical symptoms involving areas such as sleep, digestion, energy, mood, and cardiovascular function. Persistent symptoms should still be evaluated for other possible medical contributors.
Chronic stress activates neuroendocrine systems involved in the body’s stress response, including the HPA axis. Prolonged stress can interact with broader endocrine function, which is one reason stress may be relevant when evaluating hormone-related symptoms.
A freeze response can involve feeling shut down, disconnected, stuck, or unable to identify what you’re feeling or what you need. It doesn’t always feel like obvious anxiety.
Trauma can influence physiological stress responses and behavior, which can affect health over time. However, physical symptoms shouldn’t automatically be attributed to trauma because many medical and lifestyle factors can produce similar symptoms.
Nervous system regulation is individualized. Consistent sleep, adequate nourishment, appropriate movement, social connection, and stress-management practices can all be relevant, while people with significant symptoms may benefit from individualized professional support.
No. Chronic stress can develop from ongoing life circumstances such as caregiving, relationship difficulties, financial strain, work demands, chronic illness, or other prolonged pressures. Chronic stress and trauma are related but distinct concepts.
A Different Way to Look at Your Symptoms
You don’t need to decide that stress is the cause of everything you’re experiencing.
You also don’t need to dismiss it because you’re still functioning.
Start by looking at the patterns.
What has changed?
What symptoms are happening together?
How are you sleeping?
Are you eating enough?
How is your digestion?
What does your stress actually look like?
And are you giving your body enough opportunity to recover?
These questions can help you move beyond chasing individual symptoms and toward understanding the bigger picture.
That’s the conversation I wanted to have with Shari, and I hope it gives you a different way to think about your own health.
When you’re ready to understand the patterns behind your hormone-related symptoms, take the Hope Natural Health Hormone Quiz. It can give you a clearer starting point for understanding what may be contributing to the way you’re feeling.
Listen to the full episode of the Hope Natural Health Podcast to hear our complete conversation, including Shari’s Repair, Release, Reorganize, Rebuild framework and how she developed Shari AI to support people between therapy sessions.
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