April is Stress Awareness Month, a good opportunity to pause and ask a simple question: could your physical, mental or sexual health issues actually be connected to chronic stress?
I’m Dr Alessio Platania, a Neuropsychosomatic GP and Clinical Sexologist based in London. I work with people whose “mysterious symptoms” (like gut issues, fatigue, chronic pain, brain fog, skin reactions, mood changes, and sexual difficulties) are often different faces of the same underlying problem: chronic stress.
What chronic stress really is
Stress is the body’s normal response to a stimulus or threat. When your brain perceives danger, it releases hormones like cortisol and adrenaline to prepare you to fight, run away, or protect yourself from it.
Thousands of years ago, that “threat” might have been a wild animal. Today, it is more likely to be a difficult boss, ongoing financial pressure, caring responsibilities, or an argument with someone close to you, but your body cannot tell the difference. The same survival system switches on as if you’d just encountered a lion.
For people with trauma histories or those who are neurodivergent, even everyday situations like crowded spaces, noises in the environment and social interactions can be intensely stressful because their nervous systems are already working harder to process the world.
In the short term, this stress response can be useful: it keeps you alert and focused. But when it lasts too long or is triggered too often, the body can become stuck in a state of high alert.
Over time, chronic stress can literally reshape how your nervous system regulates concentration, pain, digestion, fatigue, sleep, mood, and the immune system. It becomes harder to rest, recover, and feel safe, while symptoms start to feel more intense, more frequent, and more unpredictable.
How chronic stress shows up in the body
People living with chronic stress rarely present with “just stress.” Instead, they arrive with a mixture of physical and psychological symptoms across different body systems.
Common experiences include headaches, muscle tension, chest tightness, fatigue, brain fog, poor sleep, or changes in appetite. Emotionally, many people describe feeling irritable, overwhelmed, tearful, or unable to switch off, even when they are exhausted.
The gut is particularly sensitive. The gut and brain are connected through the gut–brain axis, and long-term stress can disrupt digestion, contributing to weight changes, reflux, bloating, cramps, constipation, diarrhoea, and conditions such as irritable bowel syndrome (IBS).
The skin and immune system can also be affected. Chronic stress is associated with flare-ups of allergies, eczema, psoriasis, and other inflammatory or autoimmune conditions, as well as food intolerances.
For some, stress contributes to widespread pain, leading to syndromes such as fibromyalgia, where people may experience chronic pain, sleep disturbance, and cognitive difficulties. It can also worsen conditions like postural orthostatic tachycardia syndrome (POTS), where the autonomic nervous system struggles to regulate heart rate and blood pressure when changing position.
Sexual health is another area that is often quietly affected. Chronic stress can lead to changes in libido, difficulties with arousal, pain during sex, and challenges with erections or orgasms.
For neurodivergent people (for example ADHD/Autism), chronic stress can manifest as increasing sensory overload, emotional dysregulation and burnout.
How I approach diagnosis
Assessment does not start with a blood test; it starts with listening. I want to understand when symptoms began, what was happening in your life at the time, what makes them better or worse, and how they affect your day-to-day functioning.
There is no single blood test or scan that “proves” stress, but we sometimes use indirect markers such as heart rate variability (HRV) to help us understand how the nervous system is regulating itself.
At the same time, it is essential to rule out medical conditions that might contribute to or mimic these symptoms, such as anaemia, vitamin deficiencies, thyroid and other hormonal problems, gut inflammation, or autoimmune disease.
The key is to look at the whole picture rather than dismissing symptoms just because standard tests are normal. Many of my patients have been told “Everything looks fine” while clearly not feeling fine at all. Chronic stress and dysregulation of the nervous system often sit in that gap.
Treatment
Treatment for chronic stress-related conditions is usually not a single pill or quick fix. It can be a lengthy stepwise process, depending on which body systems are most affected and how long symptoms have been present.
My approach is holistic and tailored to the person. For some people this might include education about how stress affects the body, nutritional support for gut and brain health, evidence-based supplements, and medications where appropriate.
For others, the focus may be on improving sleep, pacing daily activities, gently increasing movement, and using tools such as vagus nerve neuromodulation to help the nervous system come out of constant “fight or flight.”
Mind–body work and regulation
I also almost always integrate mindfulness and somatic therapy. These are not about pretending symptoms are “all in your head” or ignoring what you feel.
Instead, they are about helping you reconnect mind and body, notice early signs of stress, and learn ways to bring your system back towards safety.
Mindfulness and body-based approaches can reduce reactivity to symptoms, increase body awareness, and gradually build your capacity for regulation and recovery.
If stress is affecting sexual function, it is important to be able to talk about that openly. Sexual difficulties related to stress are very common and often highly treatable when we address both the psychological and physical components together.
What you can do about it
There are also simple, realistic steps you can start at home, even before deciding whether to see a doctor. These are not a substitute for medical assessment, but they can create more “space” in your system and make any future treatment work better.
Start small with movement: gentle, regular activity such as walking, stretching, yoga, or Qigong can help discharge some of the stress response and improve sleep and mood, without pushing your body into more exhaustion.
Protect your sleep window by keeping a regular sleep–wake time, reducing screens and stimulating activities in the hour before bed, and avoiding heavy meals or large amounts of caffeine late in the day. Good-quality sleep is one of the most powerful regulators of the stress system.
Simple breathing practices can also help. A slow exhale that is slightly longer than the inhale, repeated for a few minutes, can signal to the body that it is safe enough to move out of high alert.
Reducing “background stress” where possible is equally important. Giving yourself permission to say no to non-essential demands can make a significant difference over time.
Keeping a stress and symptoms diary can help you notice patterns without blaming yourself, and can also provide useful insights during a consultation.
Finally, offering yourself some kindness matters. Chronic stress often comes with self-criticism and the feeling that you “should be doing better.” Small acts of self-compassion can reduce the overall stress load.
When to seek help
The most important message is this: chronic stress is real, and it can affect every part of the body, not just your mood.
If you are living with ongoing gut symptoms, pain, fatigue, sleep problems, skin reactions, sexual difficulties, or burnout, it is not “just in your head,” and you do not have to manage it alone.
Speaking to a doctor who will take the time to look at the whole picture — your body, your nervous system, your life story, and your environment — can be the first step in helping your system gradually recover.
If you’d like support
I offer consultations in London and online for people dealing with chronic stress, complex physical symptoms, sexual health concerns, and neurodivergent burnout.
Together, we can map out what is happening in your body, understand why, and build a plan that feels realistic and compassionate.
If this resonates with you, Stress Awareness Month might be a good moment to start listening to what your body has been trying to tell you.