Chronic Stress: What It Is and What Its Symptoms Are
Articles
Chronic stress is a common part of life today. A short-term stress response is a natural mechanism that helps us cope with demanding situations. The problem starts when stress lasts for a long time and the body has no room to recover. One of the main hormones of the stress response is cortisol. We cover how it works, how it affects sleep, immunity, metabolism and fat storage, and how to influence its levels in detail in our article What Is Cortisol and How to Lower It.
In this article, we therefore focus mainly on chronic stress, its symptoms and its link to cortisol and fat storage around the abdomen.
What will you learn from this article?
- What is chronic stress
- Symptoms of chronic stress
- How is cortisol related to chronic stress?
- What is a cortisol belly?
- High cortisol levels and vitamin D deficiency
- How to reduce chronic stress?
- Key takeaways
What is chronic stress
Stress is the body's natural reaction to a situation it judges as demanding or threatening. In the short term, it can help us mobilise energy, sharpen our attention and react quickly.
Chronic stress develops when the stress load lasts for a long time or keeps coming back, and the body does not have enough time to recover.
This can be, for example, long-term pressure at work, lack of sleep, psychological strain, long-running conflicts, financial insecurity, but also physical strain or insufficient recovery.
Under stress, the hypothalamic–pituitary–adrenal (HPA) axis, which controls cortisol production, is activated, among other systems. A short-term rise in cortisol is normal and useful. However, if the stress response stays active for too long, the natural regulation of the stress response can be disrupted.
Symptoms of chronic stress
Long-term raised cortisol levels can have a negative effect on overall health. The most common signs and symptoms of chronic stress include a disrupted circadian rhythm and poorer sleep quality, a weakened immune system, fatigue and increased fat storage, especially around the abdomen.
Sleep disorders:
When cortisol levels are too high, especially in the evening, the body produces less melatonin, the hormone that is key to falling asleep and sleeping well. This can lead to difficulty falling asleep, poor sleep quality and frequent waking.
Chronic inflammation:
Visceral fat that builds up as a result of stress is also a source of pro-inflammatory cytokines. These are signalling molecules of the immune system that trigger an inflammatory response. When their levels stay raised for a long time, the body is kept in a state of chronic inflammation, which has a negative effect on metabolism and health. Fat cells, together with immune cells in this area, release cytokines into the bloodstream and keep the body in a long-term inflammatory state. This persistent state increases the risk of insulin resistance, type 2 diabetes and cardiovascular disease, and can harm metabolism and organ function.
Reduced immunity:
Cortisol has a dual effect on immunity. A one-off release of cortisol can have a positive effect on the immune response: it dampens an excessive inflammatory reaction and stops the immune system from "overshooting". In the long term, however, raised cortisol levels reduce the body's immune response. A chronically raised stress hormone mainly disrupts the mucosal immunity of the respiratory and digestive systems and gut permeability. It also disrupts antibody production and reduces the activity of NK cells, which are key to protecting against viruses. The result is a higher susceptibility to infections, slower healing and more frequent returns of viral illnesses. In some people, dormant viruses (such as herpesviruses) can even be reactivated.
Metabolic disorders:
Chronically raised cortisol levels change the way the body processes glucose and works with the hormone insulin. Over time, this can lead to insulin resistance, a state in which cells cannot respond to insulin and so cannot take up glucose into tissues such as muscles. The body then increases insulin production just to keep blood sugar levels normal. This creates a key vicious circle in the development of type 2 diabetes and is often linked to metabolic syndrome (dyslipidaemia, high blood pressure and visceral fat around the abdomen). Studies show that higher cortisol levels are associated with poorer glucose control, higher blood sugar, and the presence of insulin resistance or type 2 diabetes in clinically monitored populations.
Negative effect on mental health:
Long-term raised cortisol levels have a negative effect on how the nervous system works and can show as symptoms such as fatigue, mood changes, increased anxiety and poorer recovery after physical and psychological strain. At high concentrations, cortisol acts on different areas of the brain that are key to regulating emotions, memory and adapting to stress. Long-term activation of the stress response can upset the balance of neurotransmitters such as serotonin, dopamine and GABA and worsen sleep quality, which further adds to fatigue and irritability.
How is cortisol related to chronic stress?
Cortisol is one of the main hormones of the stress response. It is produced by the adrenal glands, and its job is to help the body cope with strain, for example by mobilising energy and making more glucose available. Cortisol is involved in regulating a whole range of metabolic processes linked to stress.
So the problem is not cortisol itself. It is essential for the body to work properly. What matters most is its regulation and its natural daily rhythm.
With chronic stress, the regulation of the stress axis can be disrupted, and cortisol may not be released in its optimal daily rhythm. This can then affect sleep, metabolism, mental resilience and recovery.
If you want to know more about cortisol itself, read our article What Is Cortisol and How to Lower It.
What is a cortisol belly?
The term "cortisol belly" is used for fat storage around the abdomen that is linked to long-term stress and the action of cortisol. It is not, however, a medical diagnosis in its own right.
Studies show that higher cortisol reactivity to stress is also linked to how body fat is distributed: people with a higher waist-to-hip ratio produce more cortisol under stress. Visceral fat is not just a cosmetic problem: it affects the health of the internal organs and, because of its metabolic activity, increases the risk of inflammation, insulin resistance and cardiovascular disease.
Abdominal fat is particularly sensitive to cortisol because it contains more glucocorticoid receptors, which this hormone binds to. Here, cortisol promotes the formation of new fat cells and makes it easier to store energy, while preventing it from being burned. As a result, under chronic stress, the body tends to store fat around the waist, even if overall weight does not change much.
To assess visceral fat (the fat around the internal organs), non-invasive methods based on body measurements and body composition indices are used most often. The simplest is the WHR (waist-to-hip ratio): the ratio of waist circumference to hip circumference, where a higher ratio suggests more visceral fat.
WHR values above 0.90 in men and 0.85 in women are linked to a higher risk of raised visceral fat.
High cortisol levels and vitamin D deficiency
Insufficient vitamin D levels in the body can reduce its ability to regulate stress, leading to higher and longer-lasting cortisol production, lower mental resilience and poorer sleep quality. Vitamin D influences the activity of receptors and signalling pathways in the brain that are involved in controlling the secretion of cortisol and other stress-related hormones. In some studies, low vitamin D levels have been linked to dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis.
Some research also suggests that vitamin D may act as an anti-inflammatory and modulate stress pathways that affect both the immune and the endocrine response, including by regulating enzymes linked to cortisol and neurotransmitters linked to mood and stress.
How to reduce chronic stress?
Stress management:
- Practise mindfulness, meditation or breathing exercises: regular techniques help lower baseline cortisol levels.
- Physical activity: light to moderate exercise (yoga, walks, strength training) supports hormonal balance and stress relief.
- Quality sleep: aim for 7–9 hours of sleep, and consider a screen-free bedtime routine in a dark, cool room.
Nutrition and eating habits:
- Eat protein-rich foods, healthy fats and fibre, which help keep blood sugar stable and support adaptation to stress.
- Limit refined sugars and ultra-processed foods, which raise insulin levels and can worsen fat storage.
- Add adaptogens (such as ashwagandha or rhodiola) and herbal support that may help regulate cortisol production (we recommend consulting a professional first).
Lifestyle and recovery:
- Make time for relaxing activities: meditation, yoga, hot baths, massage.
- Make sure you get enough rest and time for yourself: stress becomes a problem when it is not balanced.
- Monitor and adjust your daily routine: a regular schedule, healthy habits and fewer stimulating drinks (caffeine) in the evening.
- Consider testing your cortisol levels (for example from saliva or blood) to find out whether they are raised.
- If your cortisol is high for a long time, talk to a doctor or endocrinologist: further tests may be needed (for example for Cushing's syndrome).
Key takeaways
Cortisol is a hormone essential for survival: it helps the body cope with stress and regulate energy and the immune response. Under chronic stress, however, this natural helper can become a health risk factor.
Long-term stress promotes belly fat storage: excess cortisol is linked mainly to the storage of visceral fat around the abdomen, also known as "cortisol belly".
Visceral fat increases health risks: it is metabolically active and contributes to chronic inflammation, insulin resistance and a higher risk of type 2 diabetes and cardiovascular disease.
Abdominal fat is especially sensitive to cortisol: it contains more receptors for stress hormones, so it reacts more strongly to long-term raised cortisol than other fat tissue.
Chronic stress disrupts sleep and immunity: long-term raised cortisol can reduce melatonin production, worsen sleep quality and weaken the body's defences.
Cortisol and chronic stress affect glucose metabolism: long-term cortisol dysregulation can contribute to insulin resistance and disrupted blood sugar regulation.
High cortisol also affects mental health: it can contribute to fatigue, anxiety, mood changes and a reduced ability to cope with everyday stress.
Balancing cortisol needs a comprehensive approach: long-term hormonal balance is supported by quality sleep, a balanced diet, regular exercise, effective stress management techniques and healthy daily habits.
Sources:
[1] Verywell Mind. How Stress Can Cause Weight Gain. Updated April 15, 2024. https://www.verywellmind.com/how-stress-can-cause-weight-gain-3145088
[2] Life Extension. What Is Cortisol Belly? https://www.lifeextension.com/wellness/stress-anxiety/cortisol-belly
[3] Parsley Health. Cortisol Belly: What It Is and How to Get Rid of It. https://www.parsleyhealth.com/blog/cortisol-belly-how-to-get-rid-of-it
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[6] Diminished FKBP5 DNA methylation mediates child abuse-induced risk for stress-related psychopathology. Molecular Psychiatry. 2018;23:174–182. doi:10.1038/mp.2016.120. https://www.nature.com/articles/mp2016120
