A new study has found a strong link between stress and the risk of early-onset cryptogenic ischemic stroke (CIS). This is a stroke where a blood clot blocks blood flow to the brain, it occurs in young people. Published on March 5 in Neurology, the research shows stress as a major but often overlooked risk factor, especially for women. ALSO READ: Eight major issues causing stress at work The study examined data from over 500 participants under 50 who had suffered from cryptogenic ischemic strokes (strokes without an identifiable cause), alongside a control group of healthy individuals. Conducted across 19 centers in Europe, the research used the Perceived Stress Scale (PSS) to measure stress levels and examine potential biological and lifestyle factors contributing to stroke risk. ALSO READ: How to manage stress Findings revealed that individuals with moderate to high self-perceived stress had an increased likelihood of experiencing an early-onset cryptogenic ischemic stroke. Even after adjusting for traditional risk factors such as hypertension, diabetes, smoking, and sedentary lifestyle, self-perceived stress remained a strong independent predictor of CIS. Particularly, stress had a greater impact on women than men. In sex-specific analysis, women with moderate stress or a higher PSS score remained at increased risk of CIS even after full adjustments. Among men, however, the association between stress and CIS weakened after controlling for vascular risk factors, suggesting that other lifestyle habits might play a larger role in their stroke risk. ALSO READ: The silence of men suffering from mental health issues Age-group analysis indicated that among individuals aged 18 to 39, stress was a strong risk factor for CIS even in fully adjusted models. However, in the 40 to 49 age group, the association weakened once vascular factors were considered, suggesting that stress plays a more prominent role in stroke risk for younger adults. Experts believe chronic stress contributes to stroke risk through various mechanisms, including heightened levels of cortisol and other stress-related hormones, which can lead to inflammation, blood vessel dysfunction, and increased clot formation. Additionally, stress may indirectly increase stroke risk by encouraging unhealthy behaviors such as poor diet, lack of exercise, and increased substance use. The researchers urged recognizing stress as a serious health risk, noting that psychological stress is not just a mental health concern but also a critical determinant of cerebrovascular health. Identifying and managing stress early could be crucial in preventing strokes in individuals who otherwise lack traditional risk factors. Medical professionals advise a more integrated approach to healthcare that considers both physical and mental health. Despite the strong connection between stress and CIS, researchers acknowledge the study’s limitations. The reliance on self-reported stress levels may introduce subjective bias, and further research is needed to determine whether stress interventions can directly reduce stroke incidence. Although there is a growing awareness of mental health in Rwanda, cultural barriers still prevent many from seeking help. For years, Alexandre Mugabo, a 38-year-old father of four, suffered in silence. Stuck in a strained marriage, his emotional distress took a physical toll, exhibiting as chronic pain. It was not until 2022 that he sought psychological support, a decision that marked a turning point in his well-being. Despite efforts to restore his marriage through therapy, it ended in divorce the following year. Now, Mugabo prioritizes his mental health while raising his children. According to the Rwanda Mental Health Survey (RMHS) in 2023, mental health conditions are prevalent among the youth in Rwanda, with rates ranging from 10.2% to about 20%. The RMHS findings reveal that a proportion of Rwandans aged 14 to 25 are struggling with psychological disorders like depression, anxiety, and trauma, among others. What is stress, and how is it identified? Jane Abatoni Gatete, the Executive Secretary of ARCT-RUHUKA, a national NGO of professional counselors, highlighted the impact of stress on women, particularly in marriage, parenting, and balancing work and home responsibilities. She explained that stress occurs when demands exceed one’s coping mechanisms, leading to both physical and emotional distress. Gatete differentiates between positive stress (eustress), which motivates individuals to meet deadlines and stay productive, and negative stress, which becomes overwhelming and manifests in symptoms such as persistent headaches, muscle tension, dizziness, and a weakened immune system. Chronic stress, she noted, can lead to high blood pressure, sleep disturbances, loss of appetite, and even reduced fertility due to hormonal imbalances. The counselor said that prolonged stress, if unresolved for months, can lead to burnout, marked by extreme exhaustion, anxiety, and an inability to perform daily tasks. “Burnout, in turn, increases the risk of serious health conditions, including heart problems, depression, and post-traumatic stress disorder (PTSD).” Gatete gave some common causes of stress in Rwanda, for instance, she said that the effects of GBV on mental health are extreme, leading to depression, anxiety, anger, isolation, and low self-esteem. She also added that poverty is another stressor when an individual constantly struggles to meet basic needs, such as food, education, and healthcare for their families. “Balancing work and family responsibilities further increases stress, with challenges such as meeting deadlines and fulfilling childcare duties.” Gatete added that managing work tasks alongside family obligations, like transporting children to school or medical appointments, can be overwhelming, especially when lacking reliable transportation. She added that cultural and societal pressures also play a role, particularly regarding expectations around marriage and childbirth. “Delays in conceiving can lead to societal stigma, with persistent questioning from the community causing psychological distress and potential marital strain.” She noted that the lack of financial independence within families can be a source of stress, and dependence on others for financial support and disagreements on fund utilization can create tension within households. The counslor said that exposure to abusive relationships, whether psychological, verbal, or physical, contributes to chronic stress, noting that living in abusive environments keeps individuals in a constant state of alertness, anticipating harm, which is mentally disturbing. Gatete urges individuals to seek professional help early to manage stress effectively, emphasizing that counseling can provide coping strategies to restore balance in life. She added that while chronic stress is serious, it is treatable with timely intervention. Dr Celestin Mutuyimana, a psychotherapist at Baho Smile Institute in Kimironko, explained that stress is a natural part of life, but when left unchecked, it can become chronic and pose serious health risks. “Stress can derive from biological, psychological, social, cultural, or digital sources. Chronic illness, unresolved trauma, work-related pressures, social comparison, and even digital bullying can all contribute to stress,” Dr. Mutuyimana said. He noted that stress can be like a guitar string, if it’s too loose, it produces a poor sound; if it’s too tight, it also sounds bad. A complete absence of stress means death, but too much of it can be life-threatening. According to Dr. Mutuyimana, stress becomes chronic when it lasts for an extended period, interferes with daily life, and leaves individuals feeling overwhelmed. “Chronic stress doesn’t have a specific time limit, but when someone feels constantly unable to cope, that’s when it becomes a serious concern.” He warns that certain individuals are more prone to distress, including those with high responsibilities, caregivers, people with mental or physical health conditions, and frequent digital device users. To prevent distress, he advises prioritizing time management, maintaining a balanced lifestyle, and engaging in enjoyable activities. “It’s essential to set realistic expectations, accept that not everything goes as planned, and seek professional help when needed,” Dr. Mutuyimana urges.
