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“It’s unfair to put all of the responsibility for staying healthy on the individual,” says Zamperoni. Middle-aged women, in particular, shoulder the burden, often working full-time while also caring for young children and elderly parents. So any discussion of ways to cope must acknowledge that the solution lies in structural societal change, such as welfare reform, more protective labour laws and more support and resources for caregivers. Much prolonged stress is a product of poverty, financial struggle and health conditions and exacerbated by cuts to benefits and support services. “Stress is often a legitimate response to difficult circumstances, that no amount of resilience or self-care can overcome,” Boyd says. “If someone is struggling, they should reach out for help.” Be aware of the bigger picture “Stress is a really important physical influence and it deserves to be taken seriously,” says Zamperoni. It impairs your memory, thinking and judgment in the present, and has been linked to developing depression, anxiety and perhaps even Alzheimer’s disease. Ongoing stress can cause or exacerbate many serious health problems including cardiovascular disease, high blood pressure, heart disease and heart attacks, and stroke. But it’s important to take whatever steps you can. When your situation is so overwhelming, protecting your wellbeing can seem irrelevant or even impossible. Toxic stress response can result from strong, frequent or prolonged adversity without adequate support – and the health effects can accumulate and last for a lifetime. Harvard University’s Center on the Developing Child distinguishes between positive, tolerable and toxic stress (the terms refer to the effects on the body, not the stressful event or experience itself – though questions of context, intensity and duration are relevant). “But if stress is really intense, frequent or chronic, that’s when you see it having knock-on effects … and the threshold will be different for everybody.” Short-term bursts of stress can be weathered without a negative impact and can even be productive, says Victoria Zamperoni, senior research officer for the Mental Health Foundation.