Stress, symptoms and management

Author: Nina Evans, Researcher & Trainer in Public Health/23 August 2018

Now the summer holidays are coming to a close and a new school year is about to begin, it could be a stressful time for some of us. This week’s blog is going to focus on stress; what is it and how we can manage it for the sake of our overall health?

What is stress?

Stress is our body’s natural reaction to a situation that puts us under pressure. Stress isn’t always bad; stress can give you that extra burst of energy which may be needed to run for a train or can sharpen your concentration to perform well under pressure such as in an exam or in a job interview. However, persistent activation of the stress response can take a toll on the body. Research has suggested that chronic stress can contribute to all sorts of physical and psychological complications such as high blood pressure, heart disease, obesity (read our blog here for further information), depression and anxiety. Stress is currently the most common form of work-related illness, 12.5 million working days were lost due to work-related stress, depression or anxiety in 2016/2017. This indicates how vital it is to manage stress for the sake of our overall health.

As you may guess, our stress response all begins in the brain. Information is sent to the amygdala (almond-shape set of neurons responsible for emotions, survival instinct, and memory) and if a threat is perceived, a distress signal is sent to the hypothalamus.

The hypothalamus is the communication between the brain and the rest of the body (through the autonomic nervous system [ANS]) that enables the ‘flight or fight’ response. The ANS has a direct role in signalling the physical aspect of our ‘fight or flight’ response. The ANS can be divided into the sympathetic nervous systems (SNS) and the parasympathetic nervous system (PNS), which typically function in opposition to each other. The SNS provides the body with the surge of energy that is needed for action against danger, whereas the PNS responds after the danger has occurred. The PNS response, also known as the rest and digest phase, enables the body to calm down and relax afterward.

The distress signal sent to the hypothalamus activates the SNS which sends signals to the adrenal gland to release the hormone, epinephrine (commonly known as adrenaline). The surge of this catecholamine hormone facilitates immediate physical reactions (such as acceleration of heart rate and rapid breathing) as well as the release of glucose to supply the body with energy. The second component of the stress response is activated minutes, or even hours after a stressor has occurred. This is called the hypothalamic-pituitary-adrenal (HPA) axis, which is dependent on hormonal signals, to keep the SNS running. If a threat is continued to be perceived then the hypothalamus releases corticotropin-releasing hormone (CRH), which travels to the pituitary gland to activate the secretion of adrenocorticotropic hormone (ACTH). ACTH travels to the adrenal glands, prompting the release of cortisol. This keeps the body on high alert and maintains the surge of energy which could potentially be required. After the threat has subsided, our stress hormones should quickly return to the neutral state (through the PNS), without any negative effects on our health.

Chronic stress, such as constant work pressure, is the repeated activation of the stress response (including the HPA axis) which doesn’t initiate the PNS. This constant activation, over an extended period of time, can have a negative impact on your health which is when stress-related complications can occur.

Identifying signs of stress could be the first stage of being able to manage and minimise the symptoms for overall health and wellbeing.

Identifying stress

Commonly, big life changes cause stress. Stress may be related to work (unemployment or high workload), family (having a baby or divorce), housing (moving house or neighbours) and/or personal issues (bereavement, health or financial problems).

However, stress is a hugely subjective experience so it’s not always solely big changes which present symptoms. It could also be little stressors throughout the day which can cause repeated activation of our stress response. As with causes of stress, symptoms of stress differ from person to person. Here are a few common examples;


Inability to concentrate, memory problems, poor judgement, negative thinking, racing thoughts, disinterested


General unhappiness, anxious thoughts, feeling overwhelmed, loneliness and isolation


Racing heart and/or palpitations, sweating, shallow breathing, panic attacks, nausea, blurred vision, frequent colds and infections


Biting nails, picking at skin, eating/sleeping too much or too little, smoking or drinking alcohol more than usual, restlessness and procrastination

Managing stress

Stress management is particularly important as it will reduce your risk of stress-related complications as well as maintain overall health. As people perceive and react to stress differently, stress management will also be individualised. Some common and proven ways to reduce are exercise, meditation, mindfulness, massage, yoga, socialising, good sleep and breathing exercises.

If you are struggling to manage stress, especially if you are experiencing symptoms of depression and anxiety, it is best to speak to your GP who will be able to signpost you to services who are there to help.

As with all our blogs and other work if you have any further questions or feedback, feel free to comment below, drop me an e-mail at, message us on Facebook, tweet us at @XPERTHealth or follow us on Instagram @XPERThealth.

For further information and research:

1. Lundberg, U. 2005. Stress hormones in health and illness: The roles of work and gender. [Online]. 30(10), pp. 1017-1021. [Accessed 23 August 2018]/ Available from:

2. Health and Safety Executive. 2019. Work-related stress, anxiety or depression statistics in Great Britain, 2019. [Online]. [Link updated January 2020]. Available from:

3. Fraser, R., Ingram, M.C., Anderson, N.H., Morrison, C., Davies, E., Connell, J.M. 1999. Cortisol Effects on Body Mass, Blood Pressure, and Cholesterol in the General Population. [Online]. 33(6), pp.1364-1368. [Accessed 30 March 2020]. Available from:

4. 2017. How to deal with stress. [Online]. [Accessed 16 August 2018]. Available from:


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