Most of us assume that our brains will stay pretty healthy until relatively late in life. But our lifestyles can make a major difference. In particular, chronic stress can lead to lower cognitive function—no matter our age.

This is major, because cognition plays a significant role in our daily lives. Specifically, neurologist Antonello Bonci, MD, of GIA Healthcare, says that cognition refers to the brain’s ability to focus, learn, complete tasks, solve problems, and memorize things. So if you want to be able to operate both effectively and efficiently throughout life, learning how to manage your stress is a must.

Symptoms of chronic stress

Feeling momentarily stressed is part of being human. Feeling chronically stressed, however, doesn’t (or at least, shouldn’t) have to be.

“Stress is a natural response that we [evolved] to protect ourselves from potential threats, or to make ourselves more aware of unsafe situations,” Dr. Bonci says. When faced with stressful encounters, the brain releases stress hormones—adrenaline, noradrenaline, and cortisol—which in turn leads to a faster heartbeat, quickened breath, and tense muscles ready to pounce; these are all signs of edging into a fight-or-flight response. “It’s a survival mechanism enabling mammals (including humans) to react quickly to a potentially life-threatening situation,” Dr. Bonci explains.

While this sequence of events is helpful when faced with dire situations, such as escaping dangerous encounters, stress-triggered responses aren’t always accurate, Dr. Bonci explains. “Our brain can overreact to stressors that are not life-threatening,” he says. When this happens—and a person becomes chronically stressed—we go into survival mode, and Dr. Bonci says that it can have a negative impact on our physical, mental, emotional, and, yes, cognitive functions.

“One of the most frequent cognitive effects is forgetfulness or misremembering things,” he says. “Chronic stress can also lead to a rigid thinking behavior, so that when we are under stress, we are more likely to make decisions based on our usual habits.”

“One of the most frequent cognitive effects is forgetfulness or misremembering things.” —Antonello Bonci, MD

That’s not all. Dr. Bonci says that chronic stress activation can also lead to constant worrying, which can potentially manifest into anxiety. What’s more, being perpetually stressed can take a notable toll on our concentration and focus.

“[Chronically-stressed individuals] can usually pay close attention to the situation causing stress, but they cannot direct their attention to nearly anything else,” he says. “In more severe cases, people can experience the wandering of their attention from one topic to another even during important meetings or conversations.” This inability to focus can, in turn, lead to poor performance at work, reduced function at home, and a lack of presence overall.

How stress affects the brain

Quite literally, stress has the ability to change our brains. “Short-term stress in the body—physical, mental, emotional, even existential—instigates cells to shift into ‘danger mode,’” says neurologist and herbalist Maya Shetreat, MD. “In danger mode, cell function favors survival rather than optimal function. In the brain, the effects manifest differently in [every] individual but can include insomnia, low mood, poor focus, forgetfulness, and even headaches.”

That said, human cells are resilient and built to bounce back once the stressor passes. The problem is, if you’re chronically stressed, cells don’t have the chance to recuperate.

“Repeated and prolonged stress can lead to both short- and long-term changes in our brain circuits’ activity, interfering with cognition, attention, and memory,” Dr. Bonci says. This happens because, in stressful situations, some areas of the brain are so engaged in survival mode, that others are left with a lack of energy to process, he explains.

While we can sustain this state for a short period of time, it can eventually overwhelm the body and mind, to the point that being in a perpetual fight-or-flight state can rewire the brain.

“Several scientific studies have demonstrated that animals experiencing prolonged stress have less activity in those brain areas controlling higher-order functions, such as the prefrontal cortex,” says Dr. Bonci. These systems are responsible for problem-solving, decision-making, personality expression, self-awareness, the ability to learn and remember, and more. So, without them intact, you could become a totally different person altogether.

Trauma and cognition

Not all stressful situations are dire, however, some stressors are so profound that they can change the state of cells permanently, Dr. Shetreat says. “This is known as trauma,” she says. “In those cases, the cells get ‘stuck’ in danger mode. When unaddressed, pathways in the brain can eventually change and chronic conditions can arise as a result. Together with other risk factors, people may present with PTSD, depression, anxiety, OCD, dementia, and more. Even addiction is thought to be related to this mechanism.”

How to reverse the effects of stress on cognition

Considering chronic stress can lead to long-lasting, if not permanent mental changes, it’s important to address the issue head-on. But if all these effects of stress are, well, stressing you out, know this: There are steps you can take to mitigate the problem.

“The brain changes induced by stress can be reversible depending on the type and duration of stressful situations, individual vulnerability, and social environment,” Dr. Bonci says. Counteracting the maladaptive brain changes induced by stress can reduce cognitive dysfunctions and lower the risk of developing chronic diseases, he says.

With that in mind, here are seven ways to relieve the burden of stress.

1. Talk to a healthcare professional

There’s no shame in working on your mental health—in fact, nowadays, it’s typically applauded. (See: Hats that joke “BRB Going to Therapy” and t-shirts that pronounce “I Love My Therapist.”) One of the best ways to seek help is to talk to a reputable healthcare professional well-versed in the topic. “Reaching out can help you cope better with stress and become more resilient,” Dr. Bonci says. “Earlier intervention may reduce complications induced by a prolonged-stressful situation.”

2. Establish a routine

You know all those TikToks and Reels putting morning and evening routines on a pedestal? While they may seem over-involved or even impossible to maintain, routines are key for handling stress, Dr. Bonci says.

“Stress is often unpredictable, so it can be helpful to focus on controlling the things that we can,” he explains. This can manifest in many ways but it’s most helpful when a routine is centered around health and connection. Think: adequate sleep, nutritious meals, regular exercise, and quality time with loved ones. Having an ongoing manageable to-do list centered around certain hours can help, too.

3. Prioritize good sleep hygiene

Stress can make falling and staying asleep more difficult, so it’s important to make your sleep space as relaxing as possible. “Stress can result in sleep difficulties, inducing a vicious cycle,” Dr. Bonci says. “Having healthy sleep habits, like avoiding tech devices before sleeping, going to bed and waking up at the same time each day, and not consuming caffeine after noon can really help.”

4. Make time to unwind

Life is about more than just AM and PM routines, work, and sleep. Dr. Bonci says that it’s important to make time to relax outside of your core self-care responsibilities so that you can truly recharge. Catch up on your favorite shows, grab lunch with a friend, take a bath, sit outside—you do you.

5. Get organized

Circling back to those to-dos, Dr. Bonci says that having a concrete list of tasks for each day can help make managing your daily workload less stressful. “It is also advisable to categorize your tasks by priority, accomplishing things that are more urgent first,” he adds.

6. Avoid drugs and alcohol

Here in 2023, more and more people are leaning into the sober-curious lifestyle, and for good reason. “While these substances may initially give the feeling of helping with stress or anxiety, many studies have shown that they can create major health problems as well as worsen your symptoms,” Dr. Bonci says.

That said, Dr. Shetreat points out that psychedelics are one of the most exciting therapies on the medical horizon. “What we’re discovering is that, with appropriate support before, during, and after, psychedelics can rewire the brain out of trauma and chronic stress pathways, and literally shift cells to function more optimally again,” she says. “Most top academic centers around the world now have research dedicated to exploring the benefits of psychedelics for treatment-resistant depression, OCD, PTSD, dementia, eating disorders, and sexual trauma.” (Important to note, however, is that psychedelics remain illegal in most of the U.S.)

7. Ask about TMS

If it feels like nothing is working to alleviate your stress, Dr. Bonci suggests looking into transcranial magnetic stimulation (TMS). “It’s a non-invasive and non-painful brain stimulation technique that modulates brain activity through the delivery of magnetic pulses,” he says. “Based on the frequency of pulses delivered, TMS can help our brain circuits to better function, and to reduce anxiety, insomnia, and depression.”

—reviewed by Smita Holden, MD