Phase 3―Entrenched Cumulative Stress This phase occurs when the above phases continue to be ignored. Stress starts to create a deeper impact on career, family life and personal well-being.
increased use of alcohol, smoking, non-prescription drugs
physical and emotional fatigue
loss of sex drive
The help of medical and psychological professionals is highly recommended.
Phase 4―Severe/ Debilitating Cumulative Stress Reaction This phase is often considered “self-destructive” and tends to occur after 5 to 10 years of continued stress.
careers end prematurely
inability to perform one's job
inability to manage personal life
uncontrolled anger, grief, rage
suicidal or homicidal thinking
extreme chronic fatigue
over-reaction to minor events
SOURCES AND CAUSES 
Living in a constant conflict relationship (marital)
Feeling trapped in poverty
Playing a care giver role for someone with significant illness or disability
Been overwhelmed by a job or feeling trapped in a career that doesn’t feel right
Living with unresolved childhood trauma
The death of a spouse, children or loved ones.
Marriage filling for divorced/separation from a spouse or committed relationship partner/single parent.
Losing contact with a loved one/Bereavement
Hospitalization of one’s self or family member (s)
Injury or illness of one’s self of family member (s)
Been abused or neglected
Bankruptcy/money/ financial problem
Legal problems/tenancy issue
Children’s problem at school
Receiving a promotion or pay rise at work
Buying a home
Excessive job demands
Significant intervention from professionals.