Easy talking about stress! Scientists distinguish 7 forms of mental stress - which is yours?

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There's one thing almost everyone takes for granted when talking about mental stress: that it's a singular feeling, more or less intense, more or less manageable. A vague burden, hard to describe, that brings with it some anxiety, some insomnia and moments of irritability. However, that assumption might be incorrect, or at least quite incomplete.

A study published in the journal eClinicalMedicine calls this starting point into question once again, with results that concern anyone who has ever wondered why certain difficult periods leave different marks than others, or why two people with the same diagnosis can feel so bad in completely opposite ways.

Mental stress is not one and the same thing

Tom Bresser, a researcher at the Netherlands Institute for Neuroscience (NIN), analyzed the responses of hundreds of adults looking for recurring patterns in their mental symptoms. What he found is that so-called hyperarousal - the technical term for a state of persistent alertness, a mental and physical tension that just won't go away - is not at all a uniform phenomenon. It falls into seven distinct forms, each with its own profile.

The seven profiles that emerged from the study are: anxious, physical, sensitive, sleep-deprived, irritable, alert and a so-called sudomotor' profile, which has to do with sweating and reddening due to nerve activation. These are not separate categories that occur in different people: these patterns overlap within the same person, but in different proportions, depending on the disorder from which a person suffers.

In depression, for example, the irritability profile is more evident. In generalized anxiety disorder, the anxious profile dominates, while people with panic attacks mostly show the physical component: palpitations, rushed breathing, the physical sensation of impending danger. Post-traumatic stress disorder (PTSD) stands out because of vigilance and the sudomotor profile: the activation of the nervous system that causes sweating and hot flashes. Social anxiety correlates more strongly with sensitivity, while in ADHD, no clear dominant profile stands out, but rather a more widely distributed activation.

A new tool to measure what old questionnaires mixed up

For years, clinical research leaned on questionnaires built around separate disorders, instruments that tended to capture mixed signals rather than separate the different components of stress. As a result, studies in similar groups seemed to contradict each other, simply because they were unconsciously measuring different things.

Bresser's team developed a 27-item questionnaire that could capture all seven profiles simultaneously. This instrument was then validated on a second sample of 592 people, which confirmed its reliability, Bresser said.

Instead of having to search endlessly for the right combination of questionnaires, researchers can now use this instrument to chart hyperarousal much more easily and completely.

Some sleep labs are already using it. The practical implications are significant. When a patient reports with insomnia, there may also be a latent predisposition to anxiety or a trauma-related disorder, without anyone noticing it. Finding out which form of tension is most active at that time can help the practitioner understand what is really fueling the symptoms, even before there is a fully crystallized diagnostic picture.

The research also opens up an interesting neurobiological perspective. Different brain systems - those for threat response, attention, sleep and bodily signals - function independently of each other. According to Bresser, it's quite possible that each of the seven profiles corresponds to the activation of separate neural circuits. The implications would be significant: instead of treating stress as a single target, therapies could focus on the specific pattern that is currently driving that person's symptoms.

There is one final indication of large-scale epidemiological databases. The analysis showed that the data from the UK Biobank (more than 500,000 participants) make it possible to estimate three of seven profiles: the anxious, the irritable and the sleep-related profile. That opens the door to large-scale studies linking stress patterns to genetic data, neuroimaging and long-term health outcomes.

The authors also point out some limitations: the main sample was predominantly female and comprised mostly of older participants, recruitment was through a sleep registry - which may have attracted people who already had nocturnal problems - and the measurements were based on self-report, not objective physiological data. Future research will need to include younger and more balanced samples, with measurements such as heart rate or brain activity.

Still, the study shifts something fundamental: it's no longer just about how bad a person is, but more importantly in what ways a person feels bad. A distinction that could eventually change both diagnosis and treatment.

(©eClinicalMedicine via GreenMe.It 2026 / Managing Editor: Julie Morgan - The Press Junction / Picture: ©Miguel Bruna via Unsplash)