I Thought I Was Handling Stress Fine. My Cardiologist Disagreed.

A few months after my heart attack, I sat down with my cardiologist. He asked if I had a stressful job. I said yes, but I'd gotten pretty good at compartmentalizing it. He said, so you're telling me you've dealt with chronic stress for almost 20 years.

I brushed it off at first. Compartmentalizing sounded like a skill to me, a good thing even. Until my body said, absolutely not. Turns out it's just a nicer word for ignoring something until it stops asking nicely.

So what's actually happening in your body during all those years you think you're handling stress fine? We hear about stress constantly, but most of us never stop to notice what it's actually doing.

Basically, your body has one stress response, and it was built for a much simpler world. We've all heard of fight or flight, right? See a lion, get a jolt of adrenaline and cortisol, run, survive, calm back down. Miss a deadline, watch a client account wobble, get the same jolt. Cleveland Clinic explains that your body releases those same fight-or-flight hormones anytime it perceives a threat. For me, that threat is rarely a predator. It's usually just a Monday morning inbox that won't quit.

The problem isn't the jolt. It's that most of us in high-stress jobs never let the "calm back down" part happen. The switch just stays on. There's a new fire to put out, another deadline looming, a sick kid or an aging parent to worry about once the work day is done.

Cortisol running high for years, not minutes, starts doing real damage. It keeps blood pressure elevated beyond what it should be. Cortisol is normally anti-inflammatory, but when it stays elevated too long, your body develops a resistance to it. Your immune cells stop listening, your immune system runs amok, and you're left more open to getting sick and to the very inflammation researchers increasingly point to as a driver of heart disease separate from cholesterol entirely. It messes with your sleep too, which makes it harder for your body to recover from the day's stress or get ready for the next one. It's a loop, and most of us don't notice we're in it until something breaks. It's not weakness. We're just not built for this, not for years on end.

And something does break, more often than people think. One of the largest studies ever done on heart attacks, INTERHEART, looked at people across 52 countries and found that psychosocial stress factors accounted for roughly a third of the risk of a first heart attack. Not smoking, not cholesterol. Stress alone accounted for about a third.

The one that got me, though, was newer. A 2023 study published by the American Heart Association followed close to 6,500 white-collar workers and found something specific: men who reported high job strain and also felt they were putting in a lot of effort for very little in return, recognition, security, pay, had double the risk of heart disease. Researchers said the effect was on par with obesity as a cardiovascular risk factor.

Read that again if you're the kind of person who runs toward the fire because it's your job to. High effort, low reward, is apparently just as hard on your heart as it is on your motivation. This is not me telling you to quit the job that pays your bills, that would just add more stress. So is it a trap? Not entirely, not if you can find the exit ramp to take a breather.

I realized I had to actually change how I think about it. I wasn't lying when I told my cardiologist I'd learned to handle stress. I had gotten better at not showing it. What I hadn't done was actually process any of it. There's a difference, and my body apparently knew it even when I didn't.

Mayo Clinic's research backs this up. Stress that isn't dealt with doesn't just disappear, it shows up as shoulder and back tension, stomach issues, disrupted sleep, the stuff most of us just accept as "getting older" or "being busy." For me, it's my jaw. I actually caught myself clenching it while writing this, proof I'm still working on it.

Jaw, shoulders, stomach, 3am, wherever it shows up for you, that's not a coincidence. That's your body's version of a check engine light.

I'm not going to tell you to quit your stressful job. Most of us aren't in a position to do that, and honestly, a lot of us wouldn't want to. I still like the work. I just don't like what it was doing to me for 20 years without my permission. I realized I needed to figure out how to actually calm back down.

What actually changed things for me was simpler than I expected: talking about it, out loud, with someone, instead of absorbing it and moving on like always. For a while I had a therapist who told me, "It's just a job." Impossible, I thought. So I saw an executive coach instead. That was more about setting boundaries, but also about learning to process and reframe things so they lost their grip on me. I got curious enough about the process that I ended up getting certified as an executive coach myself, mostly because I wanted to understand what I'd been doing wrong for two decades.

If it were me, and it is, I'd start by just noticing where you feel it. Then find one person, a friend, a therapist, a coach, whoever, to actually say it out loud to instead of carrying it alone. That's it. That's the whole first step. Add in long walks, deep breathing, foods with good omega fats, magnesium, better sleep. They all work together, and you can build every one of them around the job you already have.

Stress itself was never really the problem. Some stress is good, it keeps you safe, it helps you get things done. Ignoring it? That's the problem.

Because you only get one heart.

'Til next time,

Stephen

Sources

Rosengren, A., Hawken, S., Ôunpuu, S., et al. (2004). Association of psychosocial risk factors with risk of acute myocardial infarction in 11,119 cases and 13,648 controls from 52 countries (the INTERHEART study): case-control study. The Lancet, 364(9438), 953–962. PMID: 15364186.

Lavigne-Robichaud, M., Trudel, X., Talbot, D., et al. (2023). Psychosocial stressors at work and coronary heart disease risk in men and women: 18-year prospective cohort study of combined exposures. Circulation: Cardiovascular Quality and Outcomes, 16(10), e009700. PMID: 37724474.

Cleveland Clinic. (2025). Cortisol: What It Is, Function, Symptoms & Levels. Cleveland Clinic Health Library. my.clevelandclinic.org/health/articles/22187-cortisol.

Mayo Clinic Staff. (2023). Stress symptoms: Effects on your body and behavior. Mayo Clinic. mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress-symptoms/art-20050987.