Chronic stress puts your health at risk
Chronic stress can wreak havoc on your mind and body. Take steps to control your stress.
By Mayo Clinic Staff
Your body is hard-wired to react to stress in ways meant to protect you against threats from predators and other aggressors. Such threats are rare today, but that doesn’t mean that life is free of stress.
On the contrary, you likely face many demands each day, such as taking on a huge workload, paying the bills and taking care of your family. Your body treats these so-called minor hassles as threats. As a result, you may feel as if you’re constantly under attack. But you can fight back. You don’t have to let stress control your life.
Understanding the natural stress response
When you encounter a perceived threat — such as a large dog barking at you during your morning walk — your hypothalamus, a tiny region at your brain’s base, sets off an alarm system in your body. Through a combination of nerve and hormonal signals, this system prompts your adrenal glands, located atop your kidneys, to release a surge of hormones, including adrenaline and cortisol.
Adrenaline increases your heart rate, elevates your blood pressure and boosts energy supplies. Cortisol, the primary stress hormone, increases sugars (glucose) in the bloodstream, enhances your brain’s use of glucose and increases the availability of substances that repair tissues.
Cortisol also curbs functions that would be nonessential or harmful in a fight-or-flight situation. It alters immune system responses and suppresses the digestive system, the reproductive system and growth processes. This complex natural alarm system also communicates with the brain regions that control mood, motivation and fear.
When the natural stress response goes wild
The body’s stress response system is usually self-limiting. Once a perceived threat has passed, hormone levels return to normal. As adrenaline and cortisol levels drop, your heart rate and blood pressure return to baseline levels, and other systems resume their regular activities.
But when stressors are always present and you constantly feel under attack, that fight-or-flight reaction stays turned on.
The long-term activation of the stress response system and the overexposure to cortisol and other stress hormones that follows can disrupt almost all your body’s processes. This puts you at increased risk of many health problems, including:
- Digestive problems
- Muscle tension and pain
- Heart disease, heart attack, high blood pressure and stroke
- Sleep problems
- Weight gain
- Memory and concentration impairment
That’s why it’s so important to learn healthy ways to cope with your life stressors.
Why you react to life stressors the way you do
Your reaction to a potentially stressful event is different from anyone else’s. How you react to your life stressors is affected by such factors as:
- Genetics. The genes that control the stress response keep most people on a fairly steady emotional level, only occasionally priming the body for fight or flight. Overactive or underactive stress responses may stem from slight differences in these genes.
- Life experiences. Strong stress reactions sometimes can be traced to traumatic events. People who were neglected or abused as children tend to be particularly vulnerable to stress. The same is true of airplane crash survivors, military personnel, police officers and firefighters, and people who have experienced violent crime.
You may have some friends who seem relaxed about almost everything and others who react strongly to the slightest stress. Most people react to life stressors somewhere between those extremes.
Learning to react to stress in a healthy way
Stressful events are facts of life. And you may not be able to change your current situation. But you can take steps to manage the impact these events have on you.
You can learn to identify what causes you stress and how to take care of yourself physically and emotionally in the face of stressful situations.
Stress management strategies include:
- Eating a healthy diet, getting regular exercise and getting plenty of sleep
- Practicing relaxation techniques such as yoga, deep breathing, massage or meditation
- Keeping a journal and writing about your thoughts or what you’re grateful for in your life
- Taking time for hobbies, such as reading, listening to music, or watching your favorite show or movie
- Fostering healthy friendships and talking with friends and family
- Having a sense of humor and finding ways to include humor and laughter in your life, such as watching funny movies or looking at joke websites
- Volunteering in your community
- Organizing and prioritizing what you need to accomplish at home and work and removing tasks that aren’t necessary
- Seeking professional counseling, which can help you develop specific coping strategies to manage stress
Avoid unhealthy ways of managing your stress, such as using alcohol, tobacco, drugs or excess food. If you’re concerned that your use of these products has increased or changed due to stress, talk to your doctor.
The rewards for learning to manage stress can include peace of mind, less stress and anxiety, a better quality of life, improvement in conditions such as high blood pressure, better self-control and focus, and better relationships. And it might even lead to a longer, healthier life.
There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit the form.
From Mayo Clinic to your inbox
Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health.
ErrorEmail field is required
ErrorInclude a valid email address
To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.
Thank you for subscribing!
You’ll soon start receiving the latest Mayo Clinic health information you requested in your inbox.
Sorry something went wrong with your subscription
Please, try again in a couple of minutes
- How stress affects your health. American Psychological Association. https://www.apa.org/topics/stress/health. Accessed March 19, 2021.
- Stress effects on the body. American Psychological Association. https://www.apa.org/topics/stress/body. Accessed March 19, 2021.
- Lower stress: How does stress affect the body? American Heart Association. https://www.heart.org/en/healthy-living/healthy-lifestyle/stress-management/lower-stress-how-does-stress-affect-the-body. Accessed March 18, 2021.
- Stress and your health. U.S. Department of Health & Human Services. https://www.womenshealth.gov/mental-health/good-mental-health/stress-and-your-health. Accessed March 18, 2021.
- AskMayoExpert. Stress management and resiliency (adult). Mayo Clinic. 2019.
- Seaward BL. Essentials of Managing Stress. 5th ed. Jones & Bartlett Learning; 2021.
- Seaward BL. Managing Stress: Skills for Self-Care, Personal Resiliency and Work-Life Balance in a Rapidly Changing World. 10th ed. Jones & Bartlett Learning; 2022.
- Olpin M, et al. Stress Management for Life. 5th ed. Cengage Learning; 2020.
- Hall-Flavin DK (expert opinion). Mayo Clinic. March 23, 2021.
See more In-depth
What is cortisol?
Cortisol is a glucocorticoid hormone that your adrenal glands produce and release.
Hormones are chemicals that coordinate different functions in your body by carrying messages through your blood to your organs, skin, muscles and other tissues. These signals tell your body what to do and when to do it.
Glucocorticoids are a type of steroid hormone. They suppress inflammation in all of your bodily tissues and control metabolism in your muscles, fat, liver and bones. Glucocorticoids also affect sleep-wake cycles.
Your adrenal glands, also known as suprarenal glands, are small, triangle-shaped glands that are located on top of each of your two kidneys. They’re a part of your endocrine system.
Cortisol is an essential hormone that affects almost every organ and tissue in your body. It plays many important roles, including:
- Regulating your body’s stress response.
- Helping control your body’s use of fats, proteins and carbohydrates, or your metabolism.
- Suppressing inflammation.
- Regulating blood pressure.
- Regulating blood sugar.
- Helping control your sleep-wake cycle.
Your body continuously monitors your cortisol levels to maintain steady levels (homeostasis). Higher-than-normal or lower-than-normal cortisol levels can be harmful to your health.
Is cortisol a stress hormone?
Cortisol is widely known as the “stress hormone.” However, it has many important effects and functions throughout your body aside from regulating your body’s stress response.
It’s also important to remember that, biologically speaking, there are multiple different kinds of stress, including:
- Acute stress: Acute stress happens when you’re in sudden danger within a short period of time. For example, barely avoiding a car accident or being chased by an animal are situations that cause acute stress.
- Chronic stress: Chronic (long-term) stress happens when you experience ongoing situations that cause frustration or anxiety. For example, having a difficult or frustrating job or having a chronic illness can cause chronic stress.
- Traumatic stress: Traumatic stress happens when you experience a life-threatening event that induces fear and a feeling of helplessness. For example, experiencing an extreme weather event, such as a tornado, or experiencing war or sexual assault can cause traumatic stress. In some cases, these events can lead to post-traumatic stress disorder (PTSD).
Your body releases cortisol when you experience any of these types of stress.
What does cortisol do to my body?
Almost all tissues in your body have glucocorticoid receptors. Because of this, cortisol can affect nearly every organ system in your body, including:
More specifically, cortisol affects your body in the following ways:
- Regulating your body’s stress response: During times of stress, your body can release cortisol after releasing its “fight or flight” hormones, such as adrenaline, so you continue to stay on high alert. In addition, cortisol triggers the release of glucose (sugar) from your liver for fast energy during times of stress.
- Regulating metabolism: Cortisol helps control how your body uses fats, proteins and carbohydrates for energy.
- Suppressing inflammation: In short spurts, cortisol can boost your immunity by limiting inflammation. However, if you have consistently high levels of cortisol, your body can get used to having too much cortisol in your blood, which can lead to inflammation and a weakened immune system.
- Regulating blood pressure: The exact way in which cortisol regulates blood pressure in humans is unclear. However, elevated levels of cortisol can cause high blood pressure, and lower-than-normal levels of cortisol can cause low blood pressure.
- Increasing and regulating blood sugar: Under normal circumstances, cortisol counterbalances the effect of insulin, a hormone your pancreas makes, to regulate your blood sugar. Cortisol raises blood sugar by releasing stored glucose, while insulin lowers blood sugar. Having chronically high cortisol levels can lead to persistent high blood sugar (hyperglycemia). This can cause Type 2 diabetes.
- Helping control your sleep-wake cycle: Under regular circumstances, you have lower cortisol levels in the evening when you go to sleep and peak levels in the morning right before you wake up. This suggests that cortisol plays a significant role in the initiation of wakefulness and plays a part in your body’s circadian rhythm.
Optimum cortisol levels are necessary for life and for maintaining several bodily functions. If you have consistently high or low cortisol levels, it can have negative impacts on your overall health.
How does my body control cortisol levels?
Your body has an elaborate system to regulate your cortisol levels.
Your hypothalamus, a small area of your brain involved in hormonal regulation, and your pituitary gland, a tiny gland located below your brain, regulate the production of cortisol in your adrenal glands. When the levels of cortisol in your blood fall, your hypothalamus releases corticotropin-releasing hormone (CRH), which directs your pituitary gland to produce adrenocorticotropic hormone (ACTH). ACTH then stimulates your adrenal glands to produce and release cortisol.
In order to have optimal levels of cortisol in your body, your hypothalamus, pituitary gland and adrenal glands must all be functioning properly.
What tests can check cortisol levels?
Healthcare providers can measure your cortisol levels through blood, urine (pee) or saliva (spit) tests. They will determine which test is best depending on your symptoms.
What are normal cortisol levels?
The level of cortisol in your blood, urine and saliva normally peaks in the early morning and declines throughout the day, reaching its lowest level around midnight. This pattern can change if you work a night shift and sleep at different times of the day.
For most tests that measure cortisol levels in your blood, the normal ranges are:
- 6 a.m. to 8 a.m.: 10 to 20 micrograms per deciliter (mcg/dL).
- Around 4 p.m.: 3 to 10 mcg/dL.
Normal ranges can vary from lab to lab, time to time and person to person. If you need to get a cortisol level test, your healthcare provider will interpret your results and let you know if you need to get further testing.
What causes high levels of cortisol?
Experiencing abnormally high levels of cortisol (hypercortisolism) for an extended period of time is usually considered Cushing’s syndrome, which is a rare condition. Causes of higher-than-normal cortisol levels and Cushing’s syndrome include:
- Taking large amounts of corticosteroid medications, such as prednisone, prednisolone or dexamethasone, for treatment of other conditions.
- Tumors that produce adrenocorticotropic hormone (ACTH). These are usually found in your pituitary gland. More rarely, neuroendocrine tumors in other parts of your body such as your lungs can cause high cortisol levels.
- Adrenal gland tumors or excessive growth of adrenal tissue (hyperplasia), which cause excess production of cortisol.
What are the symptoms of high cortisol levels?
The symptoms of Cushing’s syndrome depend on how elevated your cortisol levels are. Common signs and symptoms of higher-than-normal cortisol levels include:
- Weight gain, especially in your face and abdomen.
- Fatty deposits between your shoulder blades.
- Wide, purple stretch marks on your abdomen (belly).
- Muscle weakness in your upper arms and thighs.
- High blood sugar, which often turns into Type 2 diabetes.
- High blood pressure (hypertension).
- Excessive hair growth (hirsutism) in people assigned female at birth.
- Weak bones (osteoporosis) and fractures.
What causes low levels of cortisol?
Having lower-than-normal cortisol levels (hypocortisolism) is considered adrenal insufficiency. There are two types of adrenal insufficiency: primary and secondary. The causes of adrenal insufficiency include:
- Primary adrenal insufficiency: Primary adrenal insufficiency is most commonly caused by an autoimmune reaction in which your immune system attacks healthy cells in your adrenal glands for no known reason. This is called Addison’s disease. Your adrenal glands can also become damaged from an infection or blood loss to the tissues (adrenal hemorrhage). All of these situations limit cortisol production.
- Secondary adrenal insufficiency: If you have an underactive pituitary gland (hypopituitarism) or a pituitary tumor, it can limit ACTH production. ACTH signals your adrenal glands to make cortisol, so limited ACTH results in limited cortisol production.
You can also have lower-than-normal cortisol levels after stopping treatment with corticosteroid medications, especially if you stop taking them very quickly after a long period of use.
What are the symptoms of low cortisol levels?
Symptoms of lower-than-normal cortisol levels, or adrenal insufficiency, include:
How can I reduce my cortisol levels?
If you have Cushing’s syndrome (very high levels of cortisol) you’ll need medical treatment to lower your cortisol levels. Treatment usually involves medication and/or surgery. You’ll also need medical treatment if you have lower-than-normal cortisol levels.
In general, though, there are several everyday things you can do to try to lower your cortisol levels and keep them at optimal ranges, including:
- Get quality sleep: Chronic sleep issues, such as obstructive sleep apnea, insomnia or working a night shift, are associated with higher cortisol levels.
- Exercise regularly: Several studies have shown that regular exercise helps improve sleep quality and reduce stress, which can help lower cortisol levels over time.
- Learn to limit stress and stressful thinking patterns: Being aware of your thinking pattern, breathing, heart rate and other signs of tension helps you recognize stress when it begins and can help you prevent it from becoming worse.
- Practice deep breathing exercises: Controlled breathing helps stimulate your parasympathetic nervous system, your “rest and digest” system, which helps lower cortisol levels.
- Enjoy yourself and laugh: Laughing promotes the release of endorphins and suppresses cortisol. Participating in hobbies and fun activities can also promote feelings of well-being, which may lower your cortisol levels.
- Maintain healthy relationships: Relationships are a significant aspect of our lives. Having tense and unhealthy relationships with loved ones or coworkers can cause frequent stress and raise your cortisol levels.
When should I see my doctor about my cortisol levels?
If you experience symptoms of Cushing’s syndrome or adrenal insufficiency, contact your healthcare provider.
If you’re concerned about your daily stress levels, talk to your provider about steps you can take to minimize your stress and stay healthy.
A note from Cleveland Clinic
Cortisol is an essential hormone that impacts several aspects of your body. While there are several things you can do to try to limit your stress, and therefore manage your cortisol levels, sometimes having abnormally high or low levels of cortisol is out of your control.
If you experience symptoms of high or low cortisol levels, such as weight gain or loss and high or low blood pressure, respectively, it’s important to contact your healthcare provider. They can run some simple tests to see if your adrenal glands or pituitary gland are responsible for your symptoms.