Erik ten Hag has urged Manchester United to match Everton’s energy ahead of Sunday’s (26 November) game, as he says players and fans will be “mad” about the 10-point penalty imposed on the club. United travel to Goodison Park this weekend to face a team fuelled by a sense of injustice after an independent commission imposed the sanction on the club for a breach of Premier League profitability and sustainability rules. “If they are mad and that’s their fuel, we have to match those standards. When we match the standards we have a very good chance to win the game,” Ten Hag said.

The increased focus on mental health in the last few years has seen more and more people turning to things like mindfulness, meditation and talking therapies to cope with stress. While these techniques can be very effective, it’s important to remember that stress isn’t ‘all in your head’ – it can have a serious physical impact as well. “Stress is how you feel and respond when life puts you under a lot of pressure,” says Dr Luke Powles, associate clinical director at Bupa Health Clinics. “A certain amount of stress can be positive, as it can help you prepare for challenges and respond to them,” Powles adds. “But too much stress, especially over a long period of time, can cause both mental and physical problems.” That’s why it’s vital to look at the sources of stress in your life and be aware of both the short and long-term symptoms. Here’s how stress can affect different parts of the body… Heart and lungs A sudden surge of stress can make you feel like you’ve just run up several flights of stairs. “Immediately, you’re going to get an increase in your heart rate, with that almost panic attack or anxiety-like feeling,” says Dr Alka Patel, aka the Health Hacktivation Doctor. “Your breathing rate is going to speed up as well, because you’re trying to oxygenate your blood.” That’s also why you might get sweaty palms or pits: “You get vasodilatation of your blood vessels – you’re basically trying to increase blood flow to your body, so sweating is a very immediate phenomenon for most people.” Stressful situations can raise your blood pressure temporarily too, Powell says: “If you’re stressed over a long time, you could possibly develop long-term high blood pressure.” The link between stress and heart disease is mitigated by other factors. “Stress may not directly cause coronary heart disease, such as a heart attack or stroke and cholesterol,” says Powell. “But if you smoke, drink, or eat more to cope with stress, you increase your risk of these. Stress may also increase the risk of type 2 diabetes.” Doctors also warn about heart rate variability (HRV), meaning the variation in the pauses between heartbeats. “You want a high HRV because you want to be adaptable,” Patel explains. “When you’re under chronic stress your HRV starts to drop, and that tells you that you’re not resilient in the face of stress.” Stomach and gut Feeling too anxious to eat? Or craving carbs when you’re under pressure? “You’re releasing this surge of cortisol, the stress hormone, very quickly, which is then trying to get as much sugar and fuel on board,” Patel explains. “A lot of people will then either notice the hunger response: ‘I’ve got to eat lunch to manage my stress’. Or you notice the dip, which is: ‘I don’t want to eat, I can’t eat anything else’.” You might experience digestive issues as well, she continues: “With an immediate stress reaction, everything else in your body has to stop. This means you can start to get those symptoms of diarrhoea, upset stomach, that kind of thing, because all of those digestive processes have to have to halt in order to manage your stress.” There are also some links between chronic stress and certain illnesses, including digestive complaints. “If you have a pre-existing health condition, stress could make it worse, or flare up,” says Powell. “Examples of conditions that can be aggravated by stress include irritable bowel syndrome, eczema, asthma and psoriasis.” Muscles A surge of stress can cause muscle spasms called fasciculation and tension in the cervical muscles of the neck, which might lead to a headache. “People don’t necessarily associate headaches with muscles, but you can get spasms in your upper neck muscles and shoulders,” Patel says. “You feel the tension in the muscles going over your scalp – and that’s why we call these tension headaches.” Teeth and mouth Stress can also harm your oral health, which should be dealt with by a dentist. “Teeth grinding (bruxism) is often linked to stress, but lots of people aren’t aware they have the condition because it happens in their sleep,” says Powell. “Symptoms include headaches, earache, stiffness and pain in the jaw or mouth; teeth which are breaking or look worn down; and facial swelling.” Inflammageing A hot topic among longevity specialists in recent years, ‘inflammageing’ means chronic inflammation that has a damaging effect and is caused by a variety of diet and lifestyle factors. “Stress accelerates ageing, and then there’s a whole cascade of stuff that goes on as a result of that,” says Patel. “[It affects] your immune response, the communication between your cells, muscle function and your bones.”

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