74% of UK adults have felt so stressed at some point over the previous year they felt overwhelmed or unable to cope, according to a survey by the Mental Health Foundation.

This number shoots up to 83% when just looking at 18–24 year olds, who were almost 5x as likely to self harm due to stress than adults aged 55 or over.

In preparation for this blog, I began to reflect that stress is a word we are all familiar with. We’ve come a long way in being able to openly talk about stress in our lives and, very often, my own patients in general practice often ask the question before I do: “could some of this be down to stress?” Interestingly though, I’ve found that it is often the patients suffering the worst symptoms of stress who have the hardest time recognising it.

And doctors don’t get a free pass. The first time I had a run of stress-induced palpitations, rather than blame the 60 hour work week and 5 hours of sleep each night, the finger was firmly pointed at the new box of Twinings Superblend Infusion Green Tea (contrary to popular belief, green tea is still rich in caffeine). Like a ‘functioning’ addict in denial, I was sat down by my loved ones and firmly told that I was doing far too much and it was starting to show.

Because stress can be hard to recognise, I wanted to share some of the more unusual signs of stress that I see in my consultation room, to help you to catch the signs early and get on top of your stress , before it gets on top of you:

1. Constant coughs and colds.

Stress leads to an increased production of Cortisol, your stress hormone. This is deliberate, as it prepares our body for ‘fight or flight’ but when we’re subjected to high levels of cortisol over a long period, cortisol supresses important parts of our immune system. This makes us more prone to coughs, colds and other viral infections. If you seem to be plagued by coughs and colds all winter, consider whether stress might be playing a part in slowing your recovery.

2. Palpitations, light-headedness, shortness of breath

All of these can be terrifying symptoms and many a patient has seen their GP or A&E consultant with these, concerned about their heart or lungs. These symptoms can also be the result of stress, anxiety or ‘panic attacks’.

Adrenaline, another hormone in our stress arsenal, can cause a rapid heart beat and as we feel increasingly tense, we begin to breathe from the top of our chest rather than our abdomen, causing the sensation of not-quite-getting-a-full-breath. This in turn leads individuals to hyperventilate which can alter the balance of gasses in our blood, causing a host of other symptoms from light-headedness to pins and needles. If these are occurring without you feeling stressed or anxious or do not pass after a couple of minutes though, they should be discussed with a doctor.

3. Bowel disturbance

Your gut has a rich network of nerves passing through it, termed the ‘gut-brain axis’, that link our brain and central nervous system to the intestines. Too much simulation from a stressed out nervous system can lead to over-active or under-active bowel movements, as well as other symptoms associated with Irritable Bowel Syndrome, such as bloating or abdominal spasms. Interestingly, recent evidence suggests that the reverse may also be true, with the ‘healthy bacteria’ of the gut helping to influence mental health and our reactivity to stress.

4. Trembling attacks

In fight or flight mode, your body primes for action; your heart rate and breathing quickens, your pupils dilate and blood is redirected to your muscles so they can move quickly and powerfully, at any moment. The problem is that when they don’t move, quickly or powerfully, they remain primed, desperate for use which can lead to uncontrolled movements, from minor twitches to full-body trembling. This can be dramatic to watch; the first patient I saw with trembling attacks wasn’t able to hold a cup of tea or even drive, and lay on my examination couch shivering as though she had a fever. After some deep breathing and relaxation exercises, the trembling stopped and we soon began exploring the overwhelm she felt in her life.

5. Excess thirst

There are lots of worrying causes of excess thirst, from diabetes mellitus to kidney disease, so this should always be discussed with a doctor. However, excess thirst can also be a manifestation of stress. We’ve all experienced the feeling of an anxious dry mouth , perhaps before having to speak in public, and this can lead to excess drinking and a feeling of thirst. But it’s also believed that stress changes the way in which our bodies respond to other hormones in our system, including vasopressin, our hydration hormone, which can drive up our feeling of thirst.

6. Clicking Jaw

As we’ve seen, stress primes our muscles for action, causing us to hold our muscles in a state of tension which, over a long-period of time, can start to cause problems. If you’re noticing pain on the side of your jaw, just in front of your ear, or if your jaw is clicking or popping when you chew food, you may be developing problems with your Temporomandibular Joint. This is the joint between your jaw and the bottom of your skull. It can be easily strained by overactivity of the surrounding muscles, muscle tension or teeth grinding, all of which commonly occur when we’re stressed.

7. Brain fog

Brain fog is the feeling of mental fatigue, like a ‘fog descending’ , characterised by memory problems, poor concentration and a difficulty focussing. It is often described by patients suffering with anxiety, depression and also stress. Prolonged exposure to stress hormone has been shown to kill neurones, or nerve cells, in the brain, reduce our ability to form memories and can overwhelm our attention with ‘noise’, that is, excess information about our environment that might be helpful in a fight-or-fight situation, but not when asked to present in a company meeting. In addition, fluctuations in cortisol affect our blood sugar levels, which we need to remain consistent for our brains to work at their best.

So what can we do about it?

Hopefully this has lifted the lid on some of the more unusual manifestations of stress. To find out more about stress and the more common feelings people experience, I recommend visiting mind.org.uk where you’ll find plenty of articles and resources to help.

After several personal run-ins with excess stress, I deliberately began planning a stress-busting routine which has its foundations in regular exercise and mindfulness meditation, with periodic trips into nature to help me gain perspective. Whilst researching this blog though, I came across some fascinating suggestions from other people, including baking, star-gazing and Guatemalan worry dolls! The consistent themes were to engage in activities which help you to bring perspective to your stressors, re-evaluate your priorities and give you space to do the things you love.

Stress Awareness Discussion

If you have any other stress-relieving strategies or have your own stress warning signs, in the spirit of sharing, let’s open up the discussion and help each other learn more about how our bodies manage in this exciting but stressful world.