Body on alert: physical signs of chronic stress and how to switch off

There are days when the body seems unable to switch off. The shoulders are always raised, the jaw clenched, the heart races at the slightest thing, the stomach is churning and, at night, sleep is light and interrupted. Even in moments of rest, there is a feeling of constant vigilance, as if something were about to happen.

It is what many people describe as living in “alert mode”. It is not imagination: it is the stress response, useful by nature, that has been switched on for too long.

What happens in the body

The stress response

The autonomic nervous system has two main branches, which work like an accelerator and a brake:

• Sympathetic (the accelerator): prepares the body to act. It speeds up the heart and breathing, raises blood pressure, tenses the muscles, releases glucose for energy, slows digestion.
• Parasympathetic (the brake): favours rest, digestion, recovery and sleep.

At the same time, the hypothalamic-pituitary-adrenal axis releases cortisol, which mobilises energy and helps the body maintain the response.

In a real danger or a one-off challenge (a presentation, a deadline, an argument), this response is useful and then switches off. The problem is when challenges follow one another without a break, or when the brain keeps interpreting everyday life as a threat.

Allostatic load: the cost of always being switched on

The researcher Bruce McEwen coined the term “allostatic load” for the accumulated wear that results from repeatedly, or for a prolonged time, activating the stress response systems (McEwen, 1998). In the short term, these mechanisms protect. In the long term, when they do not switch off, they are associated with:

• Increased blood pressure and cardiovascular risk.
• Changes in metabolism and accumulation of abdominal fat.
• Poorer functioning of the immune system.
• Changes in sleep, mood and memory.

Not all stress is bad. Occasional stress, followed by recovery, is part of life and even makes us more resilient. What takes its toll is the lack of recovery.

Signs that the body is on alert

Sustained stress often shows up in the body first, before a person realises they are under pressure. Do you recognise yourself in any of these signs?

Muscles and joints

• Raised shoulders and a stiff neck, especially at the end of the day.
• Clenched jaw or tight teeth. See Clenched jaw and tight teeth: causes, signs and what helps.
• Tension-type headaches.
• Back pain, especially between the shoulder blades and in the lower back.
• Clenched hands, furrowed brow, tensed abdomen without realising it.

Heart and breathing

• Racing heart or palpitations in ordinary situations.
• Short, high breathing, in the chest, with frequent sighs.
• A feeling of tightness in the chest or “shortness of breath” without exertion (which should be assessed).

Digestion

• Stomach “in knots”, heartburn, nausea.
• Changes in bowel habit (constipation or diarrhoea), worsening of irritable bowel.
• Changes in appetite.

Sleep and energy

• Difficulty falling asleep, with a racing mind.
• Waking in the middle of the night or very early.
• Waking up tired, even after hours in bed. See Tiredness that won't go away: common causes, when to investigate and what helps.

Mind and behaviour

• Irritability, impatience, difficulty concentrating.
• Difficulty “switching off” in free time or on holiday.
• More coffee, more sugar, more alcohol, more time on the phone.
• Falling ill more often, for example with colds.

None of these signs, on its own, proves that the problem is stress. Many may have other medical causes and deserve assessment if they are persistent. But a cluster of them, in phases of pressure, is a warning from the body that is worth listening to.

A 60-second exercise: the body “scan”

Right now, without changing anything, notice:

• Are your shoulders dropped or raised?
• Are the teeth apart or touching?
• Is the forehead smooth or furrowed?
• Are the hands loose or clenched?
• Do you breathe with your abdomen or chest?

If you found tension, release it on a slow exhalation. Repeating this exercise several times a day helps to build body awareness, which is the first step towards change.

How to help the body switch off

It is not possible to switch off stress by decision. But it is possible to activate the “brake”, the parasympathetic system, with simple techniques which, practised regularly, teach the body to return to rest more quickly.

1. Slow breathing

It is the most immediate tool and is always available. Breathing slowly, at around six breaths per minute, with longer exhalations than inhalations, increases heart rate variability (a marker of parasympathetic activity) and is associated with more calm and less anxiety (Zaccaro et al., 2018).

Try (2 to 5 minutes):

• Sit or lie down comfortably, with one hand on your abdomen.
• Breathe in through the nose for about 4 seconds, feeling the abdomen rise.
• Breathe out slowly, through the mouth or nose, for about 6 seconds.
• Repeat, without forcing. If you feel dizzy, slow down or go back to breathing normally.

Use before a difficult meeting, in traffic, before sleep or whenever you notice the body on alert.

2. Progressive muscle relaxation

It consists of tensing a group of muscles for 5 seconds and then releasing it for 15 to 20 seconds, working through the body from feet to head. It helps you to notice the difference between tension and relaxation. Relaxation techniques, including this one, were effective in reducing anxiety in a meta-analysis (Manzoni et al., 2008). It is particularly useful at night, for falling asleep.

3. Regular exercise

Exercise is a way of “using up” stress activation and of training the body to recover. Reviews show that regular physical activity reduces anxiety and depressive symptoms in adults (Rebar et al., 2015). Brisk walking, swimming, cycling, dancing: the best is whatever you can keep up, preferably outdoors.

4. Sleep as a priority

Sleep is the main moment of recovery for the nervous system. Regular schedules, a calm ritual before bed, screens off and a dark bedroom help. If insomnia persists, speak to your doctor.

5. Mindfulness and awareness

Mindfulness-based stress reduction programmes, generally lasting eight weeks, reduced stress, anxiety and depressive symptoms in healthy people, in a meta-analysis (Khoury et al., 2015). Even 10 minutes a day, with an app or a guided audio, is a good start.

6. Breaks and limits

• Short breaks every hour: stand up, drink water, look out of the window.
• Separate work and rest: set times for emails, notifications off at night.
• Reduce caffeine, especially in the afternoon, and alcohol.
• Time with people who do us good and in nature.

7. Massage as support

Massage helps the body switch from alert mode to rest mode: it reduces perceived anxiety and tension, especially with regular sessions (Moyer et al., 2004), and relieves muscle tension where stress builds up. It also works as a moment of protected pause, with no screens or demands. Find out more in Does massage really lower stress? What the science says.

Massage does not replace the other tools: it works best as part of a whole. But for those who find it hard to relax on their own, it can be the way in to understanding, in the body, what being relaxed feels like.

When to seek help

Stress is part of life, but it does not have to be faced alone.

Speak to your family doctor or a psychologist if:

If you have thoughts of despair or that life is not worth living, speak now to someone you trust and seek help: SNS 24 (808 24 24 24) offers psychological counselling, and in a situation of danger call 112.

Not everything is stress

Some symptoms look like stress, but may have other causes that need to be ruled out, such as thyroid problems, arrhythmias or anaemia. Call 112 if you have:

• Chest pain or tightness, especially on exertion, or radiating to the arm, neck or jaw.
• Sudden shortness of breath.
• Palpitations with severe dizziness or fainting.
• Sudden weakness on one side of the body, difficulty speaking or drooping of one side of the mouth.

For any questions, call SNS 24 (808 24 24 24).

At Luxmed Clinic

At Luxmed Clinic, in Algés, relaxing massages are designed to help the body come out of alert mode: slow rhythm, moderate pressure and attention to the areas where stress builds up, such as the neck, shoulders, jaw and back. Massages are carried out by a massage therapist.

Massage is a wellbeing complement and does not replace medical or psychological assessment or treatment. Results vary from person to person.

Frequently asked questions