Emotional Distress: Signs, Causes and Getting Help

What emotional distress is

Emotional distress is not a diagnosis. It describes how much a person is struggling emotionally. Everyone experiences distress at times, for example after a breakup, a job loss, a death in the family or a frightening diagnosis. It is the mind's response to a threat, loss or demand that feels bigger than your ability to cope at that moment.

The term is also used in law, where "emotional distress" refers to psychological harm caused by another person's actions. This page covers the health meaning.

Signs and symptoms of emotional distress

Distress shows up in feelings, thoughts, behavior and the body.

Children may show distress through clinginess, tantrums, bedwetting, stomachaches or falling behind at school. Teenagers often become irritable or withdrawn rather than obviously sad.

Common causes

• Loss and grief: bereavement, divorce, loss of a job, home or health
• Ongoing stress: work pressure, caring for a sick family member, financial worries, discrimination
• Relationship problems, including conflict, loneliness and abuse
• Traumatic events: accidents, violence, assault, disasters
• Physical illness and chronic pain, and the uncertainty they bring
• Major life changes, even positive ones such as a new baby or a move
• Hormonal changes: after childbirth, around periods and in perimenopause
• Alcohol, drugs and withdrawal

When emotional distress may be a mental health condition

Distress becomes a health concern when it is severe, persistent or out of proportion to the situation, and interferes with daily life. Conditions to consider include:

• Depression: low mood or loss of interest most of the day, nearly every day, for at least 2 weeks, with changes in sleep, appetite, energy and concentration
• Generalized anxiety disorder: excessive, hard-to-control worry on most days for 6 months or more
• Adjustment disorder: distress that is stronger than expected after a specific stressful event, starting within 3 months of it
• Post-traumatic stress disorder: flashbacks, nightmares, avoidance and feeling constantly on edge for more than a month after trauma
• Panic disorder: repeated sudden surges of intense fear with physical symptoms
• Postpartum depression and anxiety after childbirth

Physical conditions can also cause emotional symptoms, including thyroid problems, anemia, vitamin B12 deficiency and side effects of medicines such as steroids. A doctor can check for these.

How to cope with emotional distress

These steps help most people and can be started today:

• Talk to someone you trust. Saying what is happening out loud often reduces its weight.
• Keep a basic routine: regular meals, getting up at the same time and some daylight.
• Move your body. A 20 to 30 minute walk improves mood and reduces anxiety.
• Protect sleep: limit caffeine after midday, keep screens out of bed and keep a regular bedtime.
• Limit alcohol and avoid drugs. They give short relief but worsen mood and sleep.
• Slow your breathing: breathe in for 4 counts and out for 6 counts for a few minutes when you feel overwhelmed.
• Break problems into small steps and deal with one at a time.
• Limit news and social media if they increase your distress.
• Write it down: a few minutes of journaling can help sort out thoughts.

Getting professional help

See your primary care doctor, a counselor or a mental health professional if distress lasts more than 2 weeks, is getting worse, or affects your ability to function. They will ask about your mood, sleep, appetite, energy, stresses, alcohol and drug use, and any thoughts of self-harm. They may use short questionnaires such as the PHQ-9 for depression or the GAD-7 for anxiety.

Effective treatments include:

• Talking therapies, such as cognitive behavioral therapy (CBT), which teaches practical ways to change unhelpful thinking and behavior, and trauma-focused therapies for PTSD
• Problem-solving support and practical help with money, housing or legal issues
• Medicines such as antidepressants, when depression or an anxiety disorder is diagnosed
• Support groups for bereavement, caregiving, illness and other shared experiences

Helping someone in emotional distress

• Ask how they are, directly and privately, and listen without rushing to fix things.
• Take any mention of suicide seriously. Asking directly whether someone is thinking about suicide does not put the idea in their head.
• Help them contact a doctor, counselor or crisis line.
• Stay with them if they are in immediate danger, and call 988 or 911.

Frequently asked questions

What are the signs of emotional distress?

Common signs are persistent sadness, worry, irritability or anger, feeling overwhelmed or numb, poor sleep, tiredness, changes in appetite, trouble concentrating, withdrawing from others and physical symptoms such as headaches, a tight chest or stomach upset.

What is the difference between emotional distress and depression?

Emotional distress is a general term for emotional suffering and can be a normal response to hard events. Depression is a medical condition with specific symptoms, such as low mood or loss of interest, that last at least 2 weeks and affect daily functioning. Distress can develop into depression.

How long does emotional distress last?

Distress after a stressful event often eases over days to weeks as you adjust and get support. Grief can take months. Distress that is not improving after 2 weeks, is getting worse, or prevents you from working or caring for yourself should be discussed with a doctor or counselor.

Can emotional distress cause physical symptoms?

Yes. Stress hormones affect the whole body, causing headaches, muscle tension, a racing heart, stomach upset, diarrhea, chest tightness, fatigue and poor sleep. A doctor can check that physical symptoms are not caused by another condition.

Where can I get help right now?

In the US, call or text 988 to reach the Suicide and Crisis Lifeline 24 hours a day. If you or someone else is in immediate danger, call 911 or your local emergency number. Your primary care doctor can also arrange counseling and treatment.