site.btaExperts Describe Stress as Systemic Psychosocial Risk Leading to Chronic Disease

Stress is a systemic psychosocial risk and a driver of chronic non-communicable diseases (NCDs), and the state should play a proactive role in prevention, participants in the forum STRESS OFF - TECH ON agreed on Thursday. The event, dedicated to the link between science, technology and stress prevention as a factor for sustainable development, was organized by Somenso, Sofia Tech Park, the National Scientific and Research Development Fund (SNRDF) and Armed Forces Communications and Electronics Association.

"The problem is not stress itself, but that we detect it too late, after it has accumulated relentlessly," said psychophysiologist Silvia Kumanova, founder of Somenso. She compared stress to radiation - invisible, yet affecting health and quality of life.

According to Kumanova, chronic stress is a biological accelerator of NCDs, not merely a psychological issue. Elevated cortisol levels contribute to insulin resistance, increased blood sugar and visceral fat accumulation, leading to type 2 diabetes. Chronic cardiovascular strain can result in hypertension, atherosclerosis, heart attack or stroke.

She noted that cardiovascular diseases, type 2 diabetes, cancer, chronic respiratory illnesses and mental disorders share a common denominator - human behaviour shaped by accumulated stress. Smoking, poor diet, alcohol consumption, air pollution exposure and lack of physical activity are modifiable behavioural risk factors.

Alarming Health Indicators in Bulgaria

Kumanova pointed out that cardiovascular mortality in Bulgaria in 2024 and 2025 was three times higher than in other European countries. Nearly 20% of all deaths in Bulgaria are due to stroke. The probability of premature death from NCDs stands at 24%, with men facing twice the risk of women.

She also highlighted rising cancer mortality rates and warned that overall mortality is expected to remain high through 2030.

Health expenditure in Bulgaria amounts to 8.6% of GDP, compared with 10.4% in the EU. Average spending per capita on disease prevention is about EUR 200 in the EU, but only EUR 31 in Bulgaria. Public spending on medicines accounts for 32.5% of healthcare expenditure in Bulgaria, compared with 17.8% in the EU, while out-of-pocket payments reach 38% in Bulgaria versus 15% in the EU average.

Globally, around 60% of deaths are due to NCDs. By 2030, cancer deaths in Europe are projected to exceed 11 million annually, and cardiovascular deaths to surpass 23 million. Population ageing is a key factor, likely to increase pharmaceutical spending by nearly 50%.

Economic Impact of Stress and Mental Health

Between 75% and 90% of doctor visits are related to stress-induced conditions, Kumanova said. Worldwide, 40% of employees experienced significant stress the previous day, and 42% of managers report higher stress levels than their staff.

Depression and anxiety cost the global economy USD 1 trillion annually in lost productivity. Mental health problems cost the EU economy more than EUR 600 billion per year. Burnout alone accounts for USD 322 billion in lost global turnover and productivity.

An online survey conducted in April-May 2025 among 850 respondents listed the top ten most stressful professions. The survey found that 60% consider doctors to have the most stressful profession. Nearly half pointed to teachers, 30.2% to firefighters, 28.7% to nurses, 20.8% to police officers,15.7% to kindergarten staff, and 9.9% identified drivers as having a highly stressful job. 

Digital Solutions and Early Detection

Kumanova emphasized the growing role of digital therapeutics, offering behavioural interventions, disease management for diabetes and hypertension, stress reduction and improved treatment adherence.

Artificial intelligence is increasingly used for early detection of stress risk, enabling up to 40% earlier identification and reducing hospitalizations by up to 30%, she said.

Deputy Health Minister Petar Gribnev stressed that the Health Ministry has a responsibility to monitor these trends and expressed readiness to work toward developing a national programme to combat what he described as an "invisible killer". He added that investing in mental health today would yield long-term benefits for a healthier and more resilient nation.