Occupational Health Services Archives

While most of us accept a certain level of pressure as part of modern life, there is a crucial difference between the short-term stress that sharpens focus and the chronic, unrelenting stress that quietly damages your health. If you regularly feel overwhelmed, wired but tired, or find that you cannot switch off, your body may already be bearing the physical cost.

As April is Stress Awareness Month, we take a closer look at what chronic stress is doing inside your body – and what you can do about it.

The cortisol problem

When you encounter a stressful situation, your body activates the hypothalamic-pituitary-adrenal (HPA) axis, triggering the release of cortisol, your primary stress hormone. In short bursts, cortisol is essential. It mobilises energy, heightens alertness, and prepares you to respond to threat.

The problem arises when the stress never lets up. In a state of chronic stress, cortisol levels remain persistently elevated. Over time, this disrupts nearly every major system in the body. Blood sugar regulation becomes less efficient, increasing the risk of insulin resistance.

Fat distribution shifts, with more being stored viscerally – around the abdomen – which is independently associated with cardiovascular and metabolic disease. Inflammatory pathways remain switched on when they should be powering down.

The cardiovascular impact of stress on your heart

Chronic stress places a significant burden on the cardiovascular system. Persistently elevated cortisol and adrenaline raise heart rate and blood pressure, accelerating arterial wall wear. Over time, this contributes to endothelial dysfunction – damage to the inner lining of blood vessels – and increases the risk of atherosclerosis, hypertension, heart attack, and stroke.

Research from University College London (UCL) highlights a significant link between chronic stress and cardiovascular disease, often showing a roughly 1.5-fold increased risk among those experiencing high levels of stress, such as chronic workplace strain, particularly in men and women under the age of 50.

For patients who are concerned about the cardiovascular effects of prolonged stress, we offer extended cardiovascular screening at GP London W1. This goes beyond a standard blood pressure check to assess a broader range of markers, including lipid profiles, inflammatory indicators such as hsCRP, and resting ECG, where appropriate, giving a more complete picture of cardiovascular health and risk.

Immune suppression and chronic stress

You may have noticed that you tend to fall ill after a period of intense pressure – this is not a coincidence. While a short burst of stress can temporarily enhance immune function, chronic stress has the opposite effect. Sustained high cortisol suppresses the activity of immune cells, reduces antibody production, and impairs the body’s ability to mount an effective response to infection.

Chronic stress is also associated with a low-grade systemic inflammatory state. This is a paradox in which the immune system is simultaneously suppressed and over-activated in unhelpful ways. This has implications not only for susceptibility to illness but also for the development of autoimmune conditions and longer-term disease risk.

The vicious cycle of sleep disruption

Stress and sleep are deeply intertwined, and the relationship is rarely healthy. Elevated cortisol in the evening disrupts the circadian rhythm, hindering the body’s transition into restorative sleep. The result is difficulty falling asleep, frequent waking, or sleep that leaves you feeling unrefreshed.

Poor sleep then compounds the problem. Sleep deprivation raises cortisol levels the following day, heightens emotional reactivity, impairs cognitive function, and increases appetite for calorie-dense foods – all of which make it harder to cope with stress. Without intervention, this cycle can become self-sustaining and increasingly difficult to break.

A balanced approach to treating stress

Stress management is a balance of diagnosis and monitoring, medication as needed, and supporting our patients in making sustainable behaviour changes.

Lifestyle medicine is an evidence-based approach that addresses the root causes of ill health. Stress sits at the intersection of several of lifestyle medicine’s six pillars.

Mental well-being is central, and this may mean identifying and reducing stressors where possible, building in structured recovery time, and exploring evidence-based approaches such as mindfulness or cognitive-behavioural techniques.
Physical activity is one of the most effective ways to regulate the stress response – even moderate, regular exercise lowers cortisol over time and meaningfully improves mood.
Nutrition also plays an important role; a diet rich in whole foods, vegetables, and healthy fats supports both immune function and metabolic resilience.
And sleep, as outlined above, is not a passive luxury – it is an active pillar of stress management and one that deserves clinical attention when disrupted.

Stress Awareness Month is a timely reminder that stress is not simply a state of mind. It is a physiological process with real, measurable consequences. If you are concerned about the impact that chronic stress may be having on your health, we would encourage you to book a consultation with one of our GPs to discuss stress management.

Can we expect to see a four-day week implemented soon?

Sadly, one of the limitations of the study was that participants were self-selecting, meaning that those companies taking part were likely to already have an interest in flexible working and improved work-life balance. So, while it would be great to see this reduced working week rolled out across the UK, the likelihood is that more traditional organisations will be slow to take it up.

Why was there a need for this study in the first place?

Employee burnout is at an all-time high in the aftermath of the Covid-19 pandemic, when the line between work and home became blurred, and many of us are struggling to re-establish that separation.

Symptoms of burnout can include:

Physical and mental fatigue

A negative attitude to work

Reduced efficacy at work

We can see from that list that employees are not the only ones who suffer when burnout becomes a problem – work-related stress has an impact on your performance, which means that employers need to act, not just to improve their employees physical and mental wellbeing, but also to improve productivity.

What can be done about employee burnout without reducing the working week?

Occupational health is one of the key services we offer here at GP London W1, which means that we work together with employers to ensure that their employees needs are met, to reduce burnout, improve employees’ sense of work-life balance and satisfaction at work, and increase productivity and employee retention.

Some of the key steps employers can take to reduce burnout include:

Talk to your employees – find out who feels their workload is too much for them, who has things going on at home that might be affecting their performance at work, and who might benefit from a more flexible work schedule, for example due to caring responsibilities.

Look at your practices, to ensure workloads are evenly spread and that employees are provided with the resources they need to manage stress.

Bring in an outside organisation to check in with employees’ physical and mental health regularly and suggest ways this can be improved.

It would be fantastic to see a four-day working week implemented across the UK, as this trial has shown the benefits to far outweigh any perceived negatives – and in fact, productivity improved alongside employee wellbeing. In the meantime, however, an increased focus on occupational health will help to reduce workplace burnout.

For more information about our occupational health services, or to arrange a discussion, please contact us.

What chronic stress is really doing to your body