Stress

Stress is your body and mind’s response to pressure. Learn more with Doccy on how to deal with it and where to find help.

Dr. Louis J Sisk

BSc(Hons) MBChB MRCS(Glasg) MTrauma

Published: August 23, 2025

What You Need to Know – The Basics

• Stress is a universal human response. It prepares the body to act under pressure. Short bursts can be helpful, but chronic stress can damage health.¹
• Stress and mental illness are widespread in Australia. About one in five Australians experienced a mental disorder in the past year, and around one in six–seven report high or very high psychological distress.^{2 3}
• Young Australians are disproportionately affected. Nearly half of young women (16–24) met criteria for a 12-month mental disorder, and high distress is significantly more common in young women than men.^{2 4}
• Effective help exists. CBT and mindfulness-based therapies, lifestyle changes, and medicines (when needed) are effective. Medicare (Better Access) and the PBS can reduce costs.^{5 6 7}

⚠️ Urgent help: If symptoms are severe, worsening, or you feel unsafe, call 000 (Australia).

Overview

Stress is part of the human condition. It is a physiological and psychological reaction to perceived challenges or threats. When faced with stress, the brain activates the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system, releasing hormones like adrenaline and cortisol. These increase heart rate, sharpen focus, and mobilise energy reserves — the so-called fight-or-flight response.¹

In short doses, stress can sharpen performance, improve alertness, and motivate problem solving. But when stress is sustained, the same systems become dysregulated. Persistently elevated cortisol and adrenaline can impair sleep, immune function, cardiovascular health, and mental wellbeing. Chronic stress is linked with anxiety, depression, burnout, cardiovascular disease, and impaired immunity.

The Australian context

The National Study of Mental Health and Wellbeing (2020–2022) found:

• 21.5% of Australians aged 16–85 experienced a mental disorder in the past year.
• 17.2% had an anxiety disorder.
• 17% reported high or very high psychological distress.^{2 3}

Stress burdens are not evenly distributed. Rates are higher among younger people, particularly young women, and are influenced by social and occupational factors.⁴

Symptoms and Clinical Presentation

Stress affects multiple domains:

• Physical: headaches, muscle tension, jaw clenching, chest tightness, palpitations, stomach upset, appetite changes, fatigue, disturbed sleep.
• Emotional: irritability, anxiety, low mood, frustration, feeling “on edge”, loss of enjoyment.
• Cognitive: racing thoughts, indecision, poor concentration, memory problems, “mind going blank”.
• Behavioural: avoidance, procrastination, social withdrawal, increased alcohol or nicotine use, reassurance seeking.¹

Red flags (seek urgent care)

• Severe or sudden chest pain.
• Breathing difficulty, fainting, or new confusion.
• Thoughts of self-harm or suicide.

These symptoms warrant immediate medical review via 000 or emergency departments.

Causes and Risk Factors

Life pressures

Stress often arises when demands exceed coping capacity. Triggers include:

• High workloads, job insecurity, or unemployment.
• Financial strain or housing insecurity.
• Relationship conflict, caring responsibilities, or bereavement.
• Study pressures, deadlines, or transitions.¹

Health factors

Chronic illness, persistent pain, poor sleep, or substance misuse can amplify stress responses.

Psychosocial context

Social determinants matter. Bullying, harassment, discrimination, isolation, and trauma increase vulnerability.

Individual differences

Not everyone responds the same way. Personality traits like perfectionism or self-criticism, limited coping skills, and history of mental illness heighten risk.

The Whitehall studies

The famous Whitehall studies of British civil servants highlighted the social gradient in health: lower occupational grades were linked with higher rates of cardiovascular disease and earlier death, even after accounting for smoking and obesity. Chronic stress, lower control at work, and reduced predictability were key mediators.⁸

The workplace today

Australian research and policy reflect these lessons. Safe Work Australia and the National Mental Health Commission stress the importance of managing psychosocial hazards:

• Excessive job demands.
• Low recognition and reward.
• Poor support or unclear roles.
• Inadequate change management.^{9 10}

Work-related stress is not just a personal issue — it is a legal and occupational health priority.

Diagnosis (Australia)

What to expect at the GP

There is no single diagnostic test. Your Doccy or your GP will:

• Take a history of symptoms, onset, and daily impact.
• Ask about substance use, sleep, work, and relationships.
• Assess for co-existing conditions (anxiety, depression, trauma).
• Rule out physical causes such as thyroid problems, anaemia, or chronic illness.

Standardised tools

Clinicians may use:

• K10 (Kessler Psychological Distress Scale) for general distress.¹¹
• PHQ-9 for depressive symptoms.
• GAD-7 for anxiety.
• DASS for depression, anxiety and stress combined.
• PCL-C for trauma-related stress.¹²

Pathways of care

If stress is significant, Doccy can create a Mental Health Treatment Plan, enabling access to Medicare-rebated psychology sessions under Better Access.^{5 13}

Treatment Options in Australia

Psychological therapies

• Cognitive Behavioural Therapy (CBT): identifies unhelpful thoughts and behaviours, builds new coping strategies.
• Mindfulness-based therapies: teach awareness of present-moment experience, reduce rumination, improve emotional regulation.⁷
• Trauma-focused therapies: important if stress is linked to past trauma.

Lifestyle strategies

• Exercise: regular activity reduces cortisol and improves sleep/mood. Even 10–30 minutes of brisk walking daily can help.¹⁴
• Sleep hygiene: regular sleep/wake times, avoiding late screens and caffeine.
• Nutrition: balanced diet stabilises energy and mood.
• Social connection: buffers stress and improves resilience.

Medicines

Where stress is part of a diagnosable disorder (such as depression or anxiety), SSRIs or other antidepressants may be considered.

• Many are PBS-subsidised, reducing cost.^{6 15}
• Medicine decisions are individual and require discussion with a GP or psychiatrist.

Work-related stress care

Doccy and GPs may use RACGP guidelines for structured assessment and management. This may include collaborative care, workplace adjustments, and return-to-work planning.¹²

Living Well with Stress

Self-care and resilience

• Map your stress: notice triggers, early warning signs, and effective coping strategies.
• Plan recovery: build rest and downtime into your routine.
• Grounding tools: breathing exercises, progressive muscle relaxation, or short mindfulness pauses.⁷
• Routine: regular meals, activity, and sleep.
• Digital hygiene: manage news and social media exposure to prevent overwhelm.

Social support

Sharing experiences with friends, family, or support groups can reduce isolation. Employee Assistance Programs (EAPs) also provide confidential counselling.

Relapse prevention

Create a personal action plan:

• Identify early warning signs.
• Re-engage coping strategies promptly.
• Know when to contact your GP or psychologist.

Prevention and Early Action

Prevention does not mean eliminating stress altogether — some level of challenge is natural and even beneficial. The goal is to reduce harmful, prolonged stress and strengthen resilience so that everyday pressures do not escalate into mental or physical illness. Early action is particularly important: addressing stress before it becomes chronic improves outcomes and reduces the risk of depression, anxiety, cardiovascular disease, and burnout.

At home

• Maintain predictable routines: Consistency with meals, sleep, and activity helps regulate the body’s circadian rhythm and supports hormonal balance. Regular sleep–wake cycles are especially protective against mood disturbances.
• Nourish your body: A balanced diet with adequate hydration stabilises energy and reduces the impact of stress on blood sugar and metabolism. Limit highly processed foods, excessive caffeine, and alcohol.
• Move often: Daily activity, such as walking, cycling, or stretching, lowers cortisol, improves sleep quality, and boosts resilience. Even small bouts of exercise throughout the day can protect against the build-up of tension. [healthdirect-exercise]
• Create recovery time: After busy periods, plan deliberate downtime — whether through hobbies, creative activities, time outdoors, or relaxation practices. Rest is not “wasted time”; it is essential for nervous system reset.
• Strengthen social connections: Supportive family and friendships are among the most powerful protective factors against chronic stress. Scheduling regular check-ins helps maintain resilience.
• Digital hygiene: Manage your relationship with devices and news feeds. Limiting doom-scrolling, setting screen-free periods, and turning off notifications at night can reduce information overload and improve rest.

At work

The workplace is one of the most common environments where stress accumulates. Employers and workers share responsibility for prevention.

• Clarify expectations: Ensure roles, responsibilities, and reporting lines are clear. Ambiguity and role conflict are major stressors.
• Manage workload: Break down large projects into smaller steps, negotiate realistic deadlines, and flag concerns early.
• Promote psychological safety: Cultivate an environment where employees feel safe to raise issues without fear of stigma or punishment.
• Encourage recovery breaks: Short, regular pauses improve concentration and reduce error rates. Encouraging employees to take leave and disconnect after hours helps prevent burnout.
• Recognition and reward: Valuing contributions — through feedback, development opportunities, or acknowledgment — buffers stress and builds engagement.
• Address psychosocial hazards: Australian workplace law emphasises identifying and managing hazards such as excessive workload, low control, bullying, or remote/isolated work. [swa-code] [nmhc-workplaces]
• Leadership role-modelling: Managers who set boundaries (e.g., not emailing late at night) and show healthy coping strategies normalise good habits across teams.

After stressful events

Major stressors such as bereavement, natural disasters, relationship breakdowns, workplace accidents, or traumatic incidents require careful attention.

• Start with low-intensity supports: Sleep, routine, gentle activity, social connection, and basic self-care are the foundations of recovery.
• Normal reactions vs prolonged symptoms: Sadness, irritability, poor concentration, and fatigue are normal in the days after stressful events. When symptoms persist for weeks or worsen, this may indicate the need for professional help.
• Trauma-informed care: For those exposed to traumatic events, early trauma-informed support is recommended. The national Australian Guidelines for PTSD note that early, supportive interventions — not forced debriefing — are best. [phoenix-ptsd]
• When to escalate: Persistent nightmares, flashbacks, avoidance, emotional numbness, or hypervigilance beyond several weeks suggest post-traumatic stress disorder (PTSD) or related conditions. Specialist referral is indicated.
• Community and peer support: Group programs, community recovery centres, or peer support networks (such as for natural disaster survivors) can provide validation and shared learning.

Why early action matters

Delaying intervention allows stress responses to become habitual — neural pathways strengthen and behaviours like avoidance or substance use can entrench. Early, proactive strategies reduce the risk of progression to anxiety disorders, depression, or cardiovascular conditions, and improve productivity and quality of life.

When to Seek Help Now

• Call 000 for chest pain, trouble breathing, fainting, confusion, or if you feel unsafe.
• 24/7 crisis lines: Lifeline 13 11 14, Kids Helpline 1800 55 1800, Suicide Call Back Service 1300 659 467, Beyond Blue 1300 22 4636.
• If GP access is delayed and safety is at risk, go to the nearest emergency department.

Key Takeaways

• Stress is common and treatable. Habits plus therapy can make a major difference.¹
• Young people, especially women, are disproportionately affected. Early support prevents escalation.^{2 4}
• Better Access and the PBS reduce costs for therapy and medicines — ask your GP about a Mental Health Treatment Plan.^{5 6}
• Workplaces have responsibilities to manage psychosocial hazards and create safe environments.^{9 10}

This page is for general information only and is not a substitute for medical advice.

References & Useful Links