Dr. Gabrielle Francis

What is stress?

The Body’s Stress Response

When you perceive a threat, your nervous system responds by releasing a flood of stress hormones, including adrenaline and cortisol. These hormones rouse the body for emergency action.

Your heart pounds faster, muscles tighten, blood pressure rises, breath quickens, and your senses become sharper. These physical changes increase your strength and stamina, speed your reaction time, and enhance your focus – preparing you to either fight or flee from the danger at hand. 

Stress is a normal physical response to events that make you feel threatened or upset your balance in some way. When you sense danger – whether it’s real or imagined – the body's defenses kick into high gear in a rapid, automatic process known as the “fight-or-flight” reaction, or the stress response

The stress response is the body’s way of protecting you. When working properly, it helps you stay focused, energetic, and alert. In emergency situations, stress can save your life – giving you extra strength to defend yourself, for example, or spurring you to slam on the brakes to avoid an accident. 

The stress response also helps you rise to meet challenges. Stress is what keeps you on your toes during a presentation at work, sharpens your concentration when you’re attempting the game-winning free throw, or drives you to study for an exam when you'd rather be watching TV.

But beyond a certain point, stress stops being helpful and starts causing major damage to your health, your mood, your productivity, your relationships, and your quality of life.   Going through a series of steps, your body consistently works to regain stability. With the general adaptation syndrome, a human’s adaptive response to stress has three distinct phases: 

Alarm Stage

Your first reaction to stress recognizes there’s a danger and prepares to deal with the threat, a.k.a. the fight or flight response. Activation of the HPA axis, the nervous system (SNS) and the adrenal glands take place. During this phase the main stress hormones cortisol, adrenaline, and noradrenaline, is released to provide instant energy. Too much adrenaline results in a surge of blood pressure that can damage blood vessels of the heart and brain – a risk factor in heart attack and stroke. The excess production of cotisol can cause damage to cells and muscle tissues. Stress related disorders and disease from cortisol include cardiovascular conditions, stroke, gastric ulcers, and high blood sugar levels.  At this stage everything is working as it should – you have a stressful event, your body alarms you with a sudden jolt of hormonal changes, and you are now immediately equipped with enough energy to handle it.

Resistance Stage

The body shifts into this second phase with the source of stress being possibly resolved. Homeostasis begins restoring balance and a period of recovery for repair and renewal takes place. Stress hormone levels may return to normal but you may have reduced defenses and adaptive energy left. If a stressful condition persists, your body adapts by a continued effort in resistance and remains in a state of arousal.  Problems begin to manifest when you find yourself repeating this process too often with little or no recovery. Ultimately this moves you into the final stage.

Exhaustion Stage

At this phase, the stress has continued for some time. Your body’s ability to resist is lost because its adaptation energy supply is gone. Often referred to as overload, burnout, adrenal fatigue, maladaptation or dysfunction – Here is where stress levels go up and stay up!  The adaptation process is over and not surprisingly; this stage of the general adaptation syndrome is the most hazardous to your health.  Chronic stress can damage nerve cells in tissues and organs. Particularly vulnerable is the hippocampus section of the brain. Thinking and memory are likely to become impaired, with tendency toward anxiety and depression.  There can also be adverse function of the autonomic nervous system that contributes to high blood pressure, heart disease, rheumatoid arthritis, and other stress related illness. 

Signs and Symptoms of Stress

The following table lists some of the common warning signs and symptoms of stress. The more signs and symptoms you notice in yourself, the closer you may be to stress overload. 


Stress Warning Signs and Symptoms


Cognitive SymptomsEmotional Symptoms
  • Memory problems
  • Inability to concentrate
  • Poor judgment
  • Seeing only the negative
  • Anxious or racing thoughts
  • Constant worrying 
  • Moodiness
  • Irritability or short temper
  • Agitation, inability to relax
  • Feeling overwhelmed
  • Sense of loneliness and isolation
  • Depression or general unhappiness 
Physical SymptomsBehavioral Symptoms
  • Aches and pains
  • Diarrhea or constipation
  • Nausea, dizziness
  • Chest pain, rapid heartbeat
  • Loss of sex drive 
  • Frequent colds 
  • Eating more or less
  • Sleeping too much or too little
  • Isolating yourself from others
  • Procrastinating or neglecting responsibilities
  • Using alcohol, cigarettes, or drugs to relax
  • Nervous habits (e.g. nail biting, pacing) 

Keep in mind that the signs and symptoms of stress can also be caused by other psychological and medical problems. If you’re experiencing any of the warning signs of stress, it’s important to see a doctor for a full evaluation. Your doctor can help you determine whether or not your symptoms are stress-related.

Physical and Emotional Effects of Stress

  • Adrenal Fatigue symptoms occur when over-stimulated adrenal glands have reached exhaustion and no longer function properly
  • Brain cell damage or death in the hippocampus - the area of your brain needed for memory, concentration and learning.
  • Chronic pain – migraine, inflammation, arthritis
  • Diabetes - fluctuating blood-sugar levels and insulin-dependent diabetes in those who may be predisposed to the disease.
  • Gastrointestinal problems – heartburn, acid reflux, upset stomach, nausea, ulcers, cramps, constipation, diarrhea, irritable bowel syndrome
  • Heart disease (cardiovascular disease) –angina, heart attack, stroke
  • High blood pressure (hypertension) - which has been referred to as the silent killer, is many times discovered only during routine blood pressure checks
  • High (LDL) cholesterol, triglycerides
  • Insomnia – fatigue, poor sleep
  • Sexual dysfunction disorders, PMS, infertility
  • Depression and Anxiety
  • Post Traumatic Stress syndrome
  • Acne, Eczema, Psoriasis and other skin conditions
  • Muscle tension, back pain, neck pain
  • Headaches and TMJ/Jaw pain

Adrenal Glands and Cortisol

To better grasp the importance of these two “stress glands” and how adrenal exhaustion can occur, let’s take a look at just what they do.

The adrenals sit atop the kidneys and are a significant part of the endocrine system. Their main purpose is to furnish your body with the type of energy it needs to handle any sort of distress. They do this by manufacturing and releasing essential hormones, particularly Cortisol. 

Cortisol deals in all aspects of energy production and metabolism relating to blood sugar (glucose), protein and fats. It further regulates blood pressure, heart and blood vessel tone and contraction, immune and anti-inflammatory responses. 

Adrenal Fatigue

Activation of the relaxation response is needed for a period of time in order to fully recuperate and conserve energy following a stressful event. The endocrine glands and cortisol levels can then return to a balanced state.

Unfortunately, that doesn’t always happen in our hurried-hectic lives. In fact, it would be hard to find people who did not have a surplus of circulating cortisol on a regular basis.

You may not have any obvious signs of real illness… yet, you feel unwell.

Adrenal fatigue symptoms become more apparent as over-stimulated glands lose their ability to keep up with the body’s demand. Eventually, the hormone supply dwindles to below the necessary level. Your body does its best to make up for the adrenal exhaustion (under-functioning glands), but it does so at a price. 

Signs and Symptoms of Adrenal Fatigue

  • The most obvious adrenal fatigue symptom is continuous and excessive fatigue that is not relieved despite getting a normal night’s sleep. In more serious cases of non-Addison’s hypoadrenia (adrenal fatigue), you may find it difficult to function for more than a few hours per day.
  • Not feeling refreshed you have trouble getting up and out of bed in the morning
  • You don’t really “wake up” until 10:00 AM
  • You drag from an afternoon low between 3:00 – 4:00 PM
  • Most of your energy of the day comes after 6:00 PM, following the evening meal
  • Craving snacks high in salt and sugar
  • Everyday tasks seem to take much effort
  • Decreased sex drive
  • Decreased ability to cope with stress
  • Compulsive eating, smoking, or drug use
  • Slow recovery from illness, injury, or trauma
  • Light-headed when standing up too quickly
  • Mild depression
  • Increased PMS or menopausal symptoms
  • Dependence on coffee, colas, or energy drinks
  • Difficulty concentrating or making simple decisions
  • Impaired memory, absentmindedness, losing your train of thought
  • Intolerant, lack of patience
  • Decreased productivity, hard to stay focused, tasks take longer to complete

Adrenal fatigue is marked by a collection of signs and symptoms known as a syndrome that for the most part goes undiagnosed. Finding help for your adrenal fatigue symptoms is unfortunately not easy.  There’s a tendency in the medical profession to largely ignore adrenal fatigue. The tests they use do not test for it, and the treatments they use do not alleviate it.  Most doctors are trained only to officially diagnose extreme forms of adrenal dysfunction such as Addison’s and Cushing’s disease