How Does Stress Affect Highly Sensitive People?

A highly sensitive person dealing with heavy stress

Highly sensitive people may respond to stress in a very different way than other people — physically as well as mentally.

My daycare plans had fallen through. My son was at home, shouting at me in his loudest three-year-old voice that he was a bullet train, and that I must try to catch him. My laptop was open, but the words on the screen looked like alien squiggles. I had been up late last night — very late, so late it was more like “early” — doing one of those oh-so-crucial last-minute projects that love to crop up. 

Lack of sleep, work pressure, and loud noises: the perfect storm of stress, as far as my highly sensitive system was concerned. And this time, my body was not going to let me “push through it.” It likes to inform me of stress with physical symptoms, and at that moment my eyes and temples hurt and I felt slightly dizzy. 

I looked over at my three-year-old, his eyes filled with delight as he bellowed a mighty “Chooo chooooo!” I knew that I would not be chasing the bullet train. In fact, I wouldn’t be doing much of anything. I was about to get a searing migraine.

Not everyone has such strong reactions to stress, but for highly sensitive people (HSPs) like me, it seems common. Stress may give us migraines, a rash, emotional overwhelm, or seemingly random pains in our body. That’s what made me wonder: how exactly does stress affect HSPs? Does it affect us differently than other people, and if so, how

The easy answer, of course, is “stress hits HSPs harder.” And sometimes that’s true — but not always. Plus, the ways in which stress affects HSPs are sometimes entirely different from how it affects other people. So much so that the de-stressing techniques other people use may not, on their own, do much for HSPs. It’s like we’re a different species.

Let’s look at what the science says about how stress affects highly sensitive people, why our stress response is a little different, and what you can do to keep stress under control once and for all — or even feel stress-free. 

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How Does Stress Affect Your Brain?

Before we look at HSPs, it helps to understand how stress affects people in general. The human stress response is actually much more complex than we give it credit for. Stress does not just make you feel on edge and give you a headache; nor does it “only” lead to anxiety and depression. In fact, your stress response is a whole-body phenomenon, and high levels of stress have physiological effects on your brain and dozens of other systems in the body — even your skin!

These changes start in the brain. When you experience stress, your brain floods your system with three chemicals: epinephrine and norepinephrine (both involved in your adrenaline response) and cortisol. Cortisol is the primary “stress hormone” and is responsible for keeping you in an alert state and motivated. That can be useful short-term, but it’s uncomfortable and becomes increasingly problematic the longer you have high levels of cortisol in your system.

These chemicals have ripple effects throughout the body, but they immediately affect the brain itself. Elevated cortisol levels can cause difficulty with planning, problem-solving, and sleeping, all of which in turn make it harder to overcome the stress. 

High cortisol levels also lead to a higher rate of “cognitive failures” — essentially, being suddenly unable to do a task you normally do successfully. Brain fog, inability to concentrate, and leaping around from task to task in your mind are all common side effects of the stress response. So is irrational behavior — such as hoarding behavior, which your body assumes will help it survive whatever stressful times are ahead; irrational fears; and inability to balance between rational thinking and emotions. 

Even your memory is affected, according to Wendy Suzuki, a neurologist at New York University. If stress continues long-term and cortisol levels stay high, Suzuki says they can actually interfere with — or even damage — the hippocampus, a brain region that’s crucial for long-term memory function. Just as alarming, Suzuki says your prefrontal cortex can also be damaged. The prefrontal cortex is the area of the brain that governs your most important conscious faculties, like attention, focus, impulse control, and executive function. 

These brain effects are only the beginning, however. The cortisol’s effects cascade into nearly every system of the body — sometimes in frightening ways.

How Does Stress Affect Your Body Physically?

Besides the obvious — faster breathing and a rapid heartbeat — here are some of the major physiological effects stress has on the body:

  • Immune system: Stress activates the immune system almost as if your body thinks it can fight off the stress like a disease. Unfortunately, it can’t, and the body’s inflammatory response can cause more harm than good. Long-term inflammation can worsen existing conditions and even cause serious harm to organs and systems throughout the body. It can lead to diabetes and heart disease, for example, and contributes to many of the other conditions below. 
  • Digestion and gut: Short-term, stress can cause butterflies in the stomach and lack of appetite. Long-term, stress can lead to digestive problems and upset stomach. It can also exacerbate — or even help cause — irritable bowel syndrome, inflammatory bowel disease, and ulcers.
  • Cardiovascular system: Besides the racing pulse mentioned above, stress can contribute to high blood pressure and heart disease, and ultimately to the risk of heart attacks. In fact, if you carry high levels of chronic stress and then experience a sudden new source of stress — such as losing your job after months of financial difficulty — it could be enough to trigger a heart attack or stroke on the spot. This may be part of the explanation for people supposedly dying when given a scare or receiving bad news. 
  • Skin: The skin has its own immune system, and it too is impacted by stress. Even short-term stress can cause acne breakouts or flare-ups of skin conditions such as eczema, rosacea, psoriasis, and hives. These effects can be immediate, and you may see your skin look visibly worse the very next day after a stressful circumstance. 

How Does Stress Affect Highly Sensitive People? 

There are three key ways in which highly sensitive people respond to stress differently than other people do:

1. HSPs Likely Have a Lower “Stress Threshold”

A 2006 study by University of Texas psychologist Grant Benham looked at the relationship between three factors: how sensitive someone is, how much stress they experience, and whether it results in physical symptoms. 

To assess this, Benham took a group of nearly 400 participants and administered a sensitivity assessment and two different health assessments. After controlling for other factors that may affect the numbers, the results were clear: highly sensitive people reported higher levels of self-perceived stress and were more likely to have physical health symptoms. 

Notably, the measure of “self-perceived” stress suggests that the HSPs may not have experienced more stressful circumstances than the non-HSPs, but experienced higher levels of stress or “felt” more stressed out nonetheless. In other words, they may have a strong stress response. 

One way to look at this is that HSPs have a lower “stress threshold” — that is, highly sensitive people will get stressed more easily than less-sensitive people, may experience stress over things that would not stress others, and are more likely to develop physical side-effects when they are stressed. 

This would explain why we seem to have categorically different stress reactions than others. Maybe most people, in my shoes, would not have gotten a searing migraine from pulling a late night. Maybe they would just have been tired and a bit brain fatigued or tense from the stress. But it’s not that we’re different species. It’s that they would eventually hit their threshold where stress causes migraines or other unpleasant symptoms, whereas I hit that threshold much sooner. 

2. Some HSPs Are at Higher Risk of Depression and Anxiety

There’s a large body of literature showing that HSPs are statistically more likely to develop anxiety and depression. There was been much less research, however, on why. 

This has led to a misconception that all HSPs are at higher risk of these disorders, both of which can be caused or exacerbated by stress. In reality, evidence suggests that only some HSPs are at higher risk — specifically those who had adverse childhoods. 

Because highly sensitive people respond more to their environment, those who have traumatic or unsupportive childhoods tend to get a double helping of the same bad outcomes anyone else might get, including the risk of anxiety and depression. HSPs who have average or highly supportive childhoods, however, seem to be more resilient — perhaps even more resilient than less-sensitive people, though this hasn’t been proven across the board yet.

What’s more, because highly sensitive people also respond more to their adulthood environment, they have a lot of ability to recover from the effects of a bad childhood (again, perhaps even more so than other people). In other words, what happened as a child does not have to hold you down as an HSP — and your sensitivity itself is what allows you to overcome it. 

Still, the fact remains that at least some HSPs have a higher risk for depression and anxiety, and stress can send us careening into them when it might not have that effect on others. 

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3. HSPs May Have Greater Stress Resilience, Too  

If this sounds like the opposite of everything above, in a way it kind of is — but both can be true at the same time. Think of it this way: just as HSPs who do not have supportive environments are at higher risk of stress, HSPs who do have supportive environments may be at lower risk of stress than the average person.

And a supportive environment is something you can cultivate on purpose, effectively boosting your own stress resilience. 

This is known as vantage sensitivity, a theory championed by psychologist Michael Pluess and embraced by other sensitivity researchers like Elaine Aron. 

What exactly counts as a “supportive environment”? Social support is a big part of it, meaning that you want to surround yourself with people who understand you, care about, you, and will encourage you and bolster you. (That may seem obvious, but a surprising number of us keep friends who constantly rag on us or dismiss our sensitivity.) 

Another key component is some kind of professional support system. For example, in one of Pluess’s studies, highly sensitive teenagers who were given a depression treatment program were far more likely to bear their depression than less-sensitive teens who got the same. Another study, from 2022, found that couples at risk of divorce were far more likely to benefit from a counseling program if at least one partner was highly sensitive. The couples with an HSP partner used the program to grow closer and happier, and their divorce rates went down. Couples without an HSP, however, got little benefit out of the program. 

In each of these examples, it’s the addition of a professional support program that really kicks “vantage sensitivity” into high gear, allowing the HSPs to thrive rather than suffer. Think of it this way: your sensitivity is a jet pack, and the two fuels it runs on are social support and professional support. Fuel it up, and you can rocket past stress (most of the time) and reach higher levels of happiness and fulfillment than non-HSPs. This is known as the sensitive Boost Effect. 

How to Overcome Stress as a Highly Sensitive Person

The first and most important thing you as an HSP can do to fight stress is the “rocket fuel” combination above: get therapy and start being mindful of who you surround yourself with, to build a positive environment of social support. However, there are other evidence-based steps that really do reduce stress and ease its effects. For example:

  • Have therapy before you need it. I am a big believer in viewing therapy as preventative maintenance, not an after-the-fact crisis response. 
  • Even if you’re an introvert, reach out to a friend to talk. Few things combat stress as well as human connection. When you have a meaningful interaction with someone you trust, it does more than just make you feel good; it communicates to your brain that you have people who care about you and, ultimately, that you are safe. As a bonus, your friend may have helpful insight or advice on your situation.
  • Extract yourself from stressful relationships and situations. It’s very difficult to get rid of stress if the sources of stress in your life are ongoing. Some stress we can’t easily get rid of (like a divorce or a demanding job). If certain people or situations in your life repeatedly stress you out, however, you absolutely can and should say no to them or even remove them from your life entirely (without a big confrontation). You can find advice on how to do that here
  • If at all possible, exercise. We hear this advice too often, but it really is one of the most effective ways to de-stress your body. Exercise flushes cortisol from the body — particularly aerobic exercise like jogging, ellipticals, or anything that gets the blood pumping. It improves mood, alleviates anxiety and depression, boosts executive function, and overall it just feels good. 
  • Develop daily rituals that help soothe and prevent stress. This can be almost anything that works for you. My two favorite options, which I use regularly, are a brief morning meditation and the practice of Morning Pages, where you write (by hand) three pages of whatever pops into your head. It’s shocking how quickly this opens a floodgate of getting unresolved issues onto the page — and out of my head — and how much insight and inner peace it provides. 
  • Learn new things. One of the dangerous things about stress is that it roots us in the past, constantly ruminating about what we should have done. Learning new things is an antidote to that; it provides us with new possibilities and fresh perspectives, allowing us to move on or better handle an uncertain future. In fact, learning creates what’s known as a “cognitive reserve” — basically a backup supply of mental energy and focus — which makes you more resilient to negative events in your life. In studies, people with more cognitive reserve are actually less likely to suffer from depression. 
  • Give to others. Altruistic behavior triggers a reward system in your brain, leading to more positive feelings about life and helping reduce stress. You can activate this system by volunteering (even if just for one day) or donating food, clothing or money — especially in ways where you can be personally involved or can clearly see the impact of what you do. (If you feel like it’s wrong to get something out of these selfless acts, don’t: we evolved to feel good about helping others for a reason, to help motivate us to do it even more. And the person on the receiving end would much rather you do it and feel good about it.) 
  • Get good quality sleep. Easier said than done, I know, especially since stress makes it harder to sleep well in the first place. (I sometimes bolt awake at 3 a.m. during stressful periods, unable to fall back asleep.). But there are several tricks that can help you get restful sleep even with high cortisol. One is to simply wear big, warm socks to bed — sacrilege, I know, but studies have found that wearing socks to bed gets you to fall asleep faster and get higher quality sleep. (The socks allow your feet to stay warm without your whole body having to run warmer, which inhibits sleep.) Another trick if you sleep alone is to take a normal bed pillow and put your arm around or or spoon it as if it were a person next to you. My sister shared this trick with me after she learned it from her therapist, and I can vouch it provides a surprisingly real feeling of comfort. Last, I personally use an over-the-counter sleep aid on an occasional, careful basis, which may be something to discuss with your doctor as well. 

The Slow, Successful Way to Overcome Stress

I never did get that migraine. I had experienced them enough before to know what I had to do: immediately close my laptop, get food into my system, and lie down while avoiding bright lights. Luckily, my three-year-old is the most loving and helpful kid you’ll ever meet (and happens to show a lot of signs of being highly sensitive himself). I told him Daddy wasn’t feeling well and I needed to rest, but offered to keep playing as long as we could do so on the bed. He agreed, and pretty soon I was lying on his bed with my eyes half-covered while he pretended we were on a train. Within an hour, the migraine risk had passed.

My response wasn’t perfect — ideally, I should have avoided the all-nighter, and not tried to bandage it the next day — but it worked. The reason it worked was that I reduced my stress load. Previously, I might have tried to push through long enough to finish the project before resting (which increases work stress and physical strain). Or I may not have understood that I needed to eat (which addresses the stress symptom of lack of appetite). These approaches never worked, and always resulted in a searing migraine as my body told me I was done. 

This time, I still hadn’t built a stress-free life, but I knew how to recognize and respond to my stress response when it came up. And that’s a victory, because the “slow and steady” approach is what we need as HSPs. It’s easier to stick to it without overwhelm, and it’s much more likely to pay off over time than making grandiose life changes that aren’t sustainable. In other words: it’s okay to take baby steps to fight your stress.

After all, do you really need one more thing to stress out about? 

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