Stress and trauma

Key points

In 2020...

Stress and trauma affect the physical and emotional wellbeing of millions of Australians. From an analysis perspective, it is difficult to get accurate information about the prevalence of stress and trauma and associated impacts because of the complexity of events and variation in individual responses.

What is stress?

Stress is a common and normal physical response to challenging or new situations and can look and feel different for different people. Stress has both psychological and physical aspects and can be triggered by different life experiences. Stressors can be external (from environment, psychological or social situations) or internal (for example, serious illness) (NIMH 2019; Stöppler 2018).

Stress can initiate the ‘fight or flight’ response, a complex reaction of the neurologic and endocrine systems. Continuous or high-level stress can lead to physical symptoms such as headaches, loss of appetite, increased blood pressure, chest pain, sexual dysfunction, and problems sleeping. Stress can also cause or influence a broad range of physical health conditions such as heart disease, irritable bowel syndrome and mental health conditions such as depression or anxiety (NIMH 2019; Stöppler 2018).

What is trauma?

Any event that involves exposure to actual or threatened death, serious injury, or sexual violence has the potential to be traumatic. The trauma experienced can be of a physical and/or mental nature and not everyone will respond in the same way. 

A well-known trauma-related mental illness is post-traumatic stress disorder (PTSD). PTSD is a condition that can be diagnosed when fear, anxiety and memories of a traumatic event persist. For some, the feelings may last for a long time and interfere with how they cope with everyday life, while others may have some of the symptoms of PTSD in the first few days after the event. Most will recover by themselves or with the support of family and friends, while others may need professional help (Victoria State Government 2021).

Research suggests that for Australians, the most common traumatic events are:

• experiencing an unexpected death of a close loved one
• witnessing a person critically injured or killed, or finding a body
• being in a life-threatening car accident (Phoenix Australia 2019).

Traumatic injury survivors often suffer from physical, emotional, cognitive, and financial consequences that can affect their lives, their families, and society for prolonged periods of time (Herrera-Escobar et al. 2021).

Trauma and mental illness

Experience of trauma can contribute to the development of many different forms of mental illness such as depressive and anxiety disorders, alcohol and substance use disorders, and self-harm and suicide-related behaviours (Heim et al. 2010; Phoenix Australia 2019). Childhood trauma experiences not only increase the risk of developing mental illness but also affect clinical course and responses to treatment. For more information refer to Prevalence and impact of mental illness.

How common is stress?

Measuring stress is a challenge as people have varied stress responses when exposed to variants of stressors and there are varied practices used by health researchers across disciplines.

The Australian Bureau of Statistics (ABS) includes measures of stress in several national surveys: the National Health Survey (NHS), the General Social Survey (GSS) and, from 2020, the Household Impacts of COVID-19 Survey.

In 2020, it is estimated that more than half of Australians (59%) experienced at least one personal stressor in the last 12 months. This was similar to the findings from 2019 (56%), and a decrease compared with 2014 (63%) (ABS 2014, 2020).

The GSS also found that during 2020, people with a mental health condition were more likely to have experienced at least one personal stressor compared with those who did not (83% and 56%, respectively). People with a long-term health condition were also more likely to have experienced at least one personal stressor compared with those who did not (68% and 52%, respectively) (ABS 2020).

Psychological distress

Psychological distress can be described as unpleasant feelings or emotions that affect a person’s level of functioning and interfere with the activities of daily living. This distress can result in having negative views of the environment, others and oneself, and manifest as symptoms of mental illness, including anxiety and depression. Distress occurs when stress is severe, prolonged or both (National Research Council 2008). Stress responses are normal reactions to environmental or internal distresses and can be considered adaptive in nature.

Psychological distress is commonly measured using the Kessler 10 Psychological Distress Scale (K10), a scale based on questions regarding negative emotional states experienced in the past 30 days (ABS 2012). Someone experiencing psychological distress will not necessarily be experiencing mental illness, although high scores on the K10 are strongly correlated with the presence of depressive or anxiety disorders (Andrews and Slade 2001).

Among Australians aged 16–85 in 2020–2022, 15% experienced high or very high levels of psychological distress. Females aged 16–34 were more likely to experience psychological distress than any other sex or age group (26%, compared with 14% of males aged 16–34) (ABS 2022).

For more information refer to Prevalence and impact of mental illness.

How common is trauma-induced mental illness?

It is estimated that 75% of Australian adults have experienced a traumatic event at some point in their life (Productivity Commission estimates using ABS 2009). International studies estimate that 62–68% of young people will have been exposed to at least one traumatic event by the age of 17 (Copeland et al. 2007; McLaughlin et al. 2013).

While experiences of a traumatic event are common, most people do not go on to develop a mental illness, such as PTSD. According to the National Study of Mental Health and Wellbeing 2020–2022, an estimated 11% of Australians experience PTSD in their life (lifetime prevalence), with women being at almost twice the risk of men (14% and 8%, respectively) (ABS 2022).

Exposure to trauma is more common among specific groups such as people who experience homelessness, young people in out-of-home care or under youth justice supervision, refugees, people experiencing family and domestic violence, LGBTIQA+ people and certain occupation groups such as emergency services, armed forces and veterans (Bendall et al. 2018; Phoenix Australia 2013).

Cumulative exposure to work-related traumatic events is associated with increased risk of PTSD. This is particularly the case for first responders, such as emergency service workers, where the rates of the disorder may be more likely among long-term employees than new recruits (Phoenix Australia 2013). This finding is also supported by a study of the mental health of current and retired Australian firefighters, where the prevalence of PTSD was more than 2 times higher in retired than current firefighters (18% and 8%, respectively) (Harvey et al. 2016).

Historical and current trauma experienced as a result of separation from family, land, and cultural identity has also had a serious impact on the social and emotional wellbeing of Aboriginal and Torres Strait Islander (First Nations) people (AIHW 2018; Bendall et al. 2018). For more information refer to Indigenous health and wellbeing.

What is the cost of stress and trauma?

Stress and trauma impose considerable social, financial and economic costs on society. From 22 February to 5 April 2022, South East Queensland experienced unprecedented heavy rain and flooding and it has been estimated that this event cost Queensland $7.7 billion in social, financial and economic impacts. Given the far reaching and traumatic nature of this event, approximately $4.4 billion of the cost was attributed to mental health, disease and social issues (Deloitte Access Economics 2022).

The Economic Cost of the Social Impact of Natural Disasters study reviewed some of the intangible costs of natural disasters, including the 2010–11 Queensland floods and the 2009 Black Saturday bushfires in Victoria. It found that Queensland residents affected by floods were 5.3 times more likely to report poorer health than those not affected, and 2.3 times more likely to develop PTSD (Alderman et al. 2013). Mental health issues represented the largest financial impact of the floods, with a lifetime cost estimated at $5.9 billion. In addition to more than 170 deaths and 400 injuries caused by bushfires in Victoria, the lifetime cost of the mental health issues was estimated to be more than $1 billion (Deloitte Access Economics 2016).

Psychological distress increases absenteeism (unexpectedly absent) and presenteeism (present at work but not working) in the workplace (Holden et al. 2011). The 2020 Productivity Commission Inquiry on Mental Health estimated mental ill-health cost Australia between $13 and $17 billion per year. The typical compensation payment per claim for a mental condition was reported to be $25,650 (compared with $10,600 for all other claims) while the typical time off work was 16.2 weeks (compared with 5.7 weeks for all other claims) (Productivity Commission 2020).

Where can I find more information?

For more information on stress and trauma visit:

• Australian Bureau of Statistics (ABS) National Health Survey: first results, 2017–18
• ABS National Survey of Mental Health and Wellbeing
• Orygen 2008 Trauma and young people: moving toward trauma-informed services and systems
• Phoenix Australia

This report was last updated 14 February 2024.