Neurology and Neurosurgery

Stressed out? Discover the effect of stress on the brain and ways to manage it.

A young woman relaxing on a yellow couch with a beige blanket, reading a book and drinking coffee.


Find out what happens in your brain when you feel stress, and ways to manage stress for overall health.


By Paul Wright, MD, Senior Vice President and System Chair of the Neuroscience Institute, Nuvance Health


Most people experience some form of stress. Some can be positive and motivating, like an adrenaline rush before a job interview, first date or from trying something new. Some can also be helpful to protect you from dangerous situations, like slamming on your brakes to avoid a car accident. But too much or chronic stress can be detrimental to your health. Common triggers of chronic stress are difficulties with relationships, work, finances or health.


Understanding what happens in your brain from stress can help you recognize the signs and manage it. Keep reading, as long as it does not stress you out (side note: humor can help manage it).



Why do we feel stress?


Stress is your body’s response to challenges or demands. You probably have heard of the fight-or-flight response, which is our biological survival mechanism. Historically, threats from predators and other dangers in nature triggered the fight-or-flight response to protect our ancestors from things like hunger and pain.


Today, our brains and bodies still react to stress similarly, although triggers have evolved. Common stress triggers include problems with relationships and work, financial challenges and major life changes such as buying a home and losing a loved one.


What is the effect of stress on the body and brain?


When we experience stress, the brain releases adrenaline and cortisol hormones to prepare us for action. This response is essential in acute situations, like staying alert during turbulence on an airplane.


However, chronic stress, or stress that occurs often and long-term, can take a toll on your brain and overall health. Prolonged exposure to stress hormones can cause:


  • Inflammation and dysfunction in the brain that affect mood and memory.

  • An increased risk of developing neurological conditions, including dementia, depression, headaches, migraines and stroke.



In addition to changes in the brain, chronic stress is linked to:




What are the most common signs of stress?


Stress can manifest with cognitive, emotional and physical symptoms. Symptoms may differ from person to person and can be like other health conditions. See your doctor for an evaluation if your symptoms do not go away or worsen. 


Common cognitive signs of chronic stress include:


  • Brain fog, including memory, remembering and thinking problems.

  • Difficulty making decisions or impaired judgement.

  • Trouble completing tasks.

  • Inability to concentrate.


Common emotional signs of chronic stress include:


  • Anxiety or excessive worry.

  • Feeling depressed or sad.

  • Feeling overly nervous or showing signs of nervousness, including nail biting, fidgeting or pacing. 

  • Feeling overwhelmed, leading to procrastination and not completing tasks.

  • Isolation from family and friends.

  • Irritability.

  • Negative outlook.

  • Trouble regulating emotions; in particular, anger.


Common physical signs of chronic stress include:


  • Headaches or migraines.

  • Unexplained muscle tension or pain, particularly in the neck, shoulders and back.

  • Unexplained fatigue or lack of energy.

  • Difficulty sleeping.

  • Stomach problems, including indigestion, nausea or changes in appetite (overeating or not eating enough).

  • Using alcohol or drugs to cope with emotional distress.


Cognitive impairment and memory problems from stress


Did you forget items at the grocery store, or why you went into a room after a particularly difficult time, such as the loss of a loved one? That could have been from stress. High levels of stress at any age can cause changes to the brain from prolonged exposure to the hormones adrenaline (epinephrine), cortisol and norepinephrine. In particular, chronic stress affects the hippocampus, a crucial part of the brain for learning and memory.


Try not to let the effects on your cognitive health stress you out! By engaging in activities that stimulate the brain, like puzzles, reading or learning new skills, you can build cognitive resilience and offset some of the impacts of stress.


Neuroplasticity and brain changes from stress


The brain is fascinating — it adapts and changes throughout your life. Neuroplasticity is the brain’s ability to evolve and help you learn. Stress affects neuroplasticity in two ways: Acute stress can temporarily boost brain function, while chronic stress can lead to negative changes in the brain, including shrinking the hippocampus.


There are ways to maintain your brain’s neuroplasticity and learning, remembering and thinking skills. Stimulate your hippocampus with positive experiences and a healthy lifestyle, including exercising and staying social. You can also nourish your brain with meditation to enhance its function and maintain its structure.


The effect of stress on emotional well-being and mental health


Stress can greatly affect your emotional well-being and mental health. Consider the stress we experienced during the COVID-19 pandemic and subsequent increase in burnout, depression, and alcohol and drug use to manage anxiety.



There is a link between prolonged stress and mood disorders, including anxiety and depression. The constant barrage of stress hormones can alter brain chemistry and wiring or circuitry, making us more susceptible to these conditions.


Stress and neurodegenerative diseases


Chronic stress can accelerate brain aging and increase the risk of neurodegenerative diseases, such as dementia and Alzheimer’s disease. Stress can cause inflammation, and chronic inflammation can damage brain cells.



Stress can worsen age-related cognitive decline, too. Isolation, loneliness and depression are risk factors for dementia, which can all trigger a stress response. Learn more about risk factors for dementia.


To reduce this risk, it is important to eat a healthy diet full of whole grains, fruits and vegetables, and to exercise your body and brain. Try cognitive activities including crossword puzzles, playing games (chess, checkers and Sudoku are great) and learning a language or musical instrument. Cognitive activities not only reduce stress but also promote overall brain health, potentially delaying the onset of neurodegenerative diseases.



How can you relieve stress?


Stress relief will vary from person to person. Here are ways to manage stress.


Try the following proven tactics to reduce stress and promote relaxation by calming the brain:



Creative ways to manage stress


Newer ways to relieve stress are slam rooms or rage rooms, where you can leave it behind after smashing furniture. You might also find stress relief by practicing gratitude and giving. Learn more about what happens in your brain when you give and practice gratitude.


Empathy and resilience to manage stress


Putting things in perspective and having empathy can also contribute to resilience and managing stress. Life is precious and fragile; I urge you to enjoy every moment as much as possible and find ways to reduce stress using the above ideas.


Having empathy can help you manage stress by seeing other perspectives and communicating about how you feel. For example, if a relationship is causing you stress, consider where the other person is coming from, what might also be stressful for them and talk with them about it. 


Developing resilience can help you bounce back from stressful situations. You can develop resilience through positive thinking, developing problem-solving skills and having a strong support network. Consider the Greatest Generation, known for their resilience because they lived through World War II, the Great Depression and many more challenging times. Consider another scenario, where encouragement and support from your manager to find a solution to a difficult situation at work can minimize or even remove your stress.


Get help for stress


Most importantly, speak with a healthcare provider if you need help managing stress. Primary care providers and mental health professionals, including psychiatrists, psychologists and licensed behavioral health therapists can help you through cognitive behavioral therapy (talk therapy), stress management techniques and in some cases, medication.



The bottom line: Stress is an inevitable part of life and even helpful in some cases. Watch out for chronic stress because it can wreak havoc on your brain and overall health. Stress less with coping strategies and a healthy lifestyle, by practicing empathy and developing resilience. You do not have to manage stress by yourself; connect with family and friends and get help from a primary care or mental health professional for support.