Skip to main content

The Physiology of Stress

  • Chapter
  • First Online:
Medical Student Well-Being


All humans feel stress. In response to emotional or physical stress, the human body induces a complicated physiologic response that is known and yet still incompletely understood. The biology of stress is discussed using the terms allostasis (the normal stress response and the reason that stress exists), allostatic load (when the stress response becomes dysfunctional and leads to disease), and allostatic load index (researching stress in humans). Stress induces a response via the autonomic nervous system and the hypothalamic-pituitary-adrenal axis in order to activate various areas of the brain through mediators such as dopamine, serotonin, and many others. It is important to understand the biology of the stress response and recognize when this response becomes pathologic.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
USD 54.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others


  1. Sterling P, Allostasis EJ. A new paradigm to explain arousal pathology. In: Handbook of life stress, cognition and health. New York: Wiley; 1988. p. 629–49.

    Google Scholar 

  2. Thayer JF, Ahs F, Fredrikson M, Sollers JJ, Wager TD. A meta-analysis of heart rate variability and neuroimaging studies: implications for heart rate variability as a marker of stress and health. Neurosci Biobehav Rev. 2012;36(2):747–56.

    Article  PubMed  Google Scholar 

  3. De Kloet ER, Joëls M, Holsboer F. Stress and the brain: from adaptation to disease. Nat Rev Neurosci. 2005;6(6):463–75.

    Article  CAS  PubMed  Google Scholar 

  4. Joëls M, Baram TZ. The neuro-symphony of stress. Nat Rev Neurosci. 2009;10(6):459–66.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Champagne DL, et al. Maternal care and hippocampal plasticity: evidence for experience-dependent structural plasticity, altered synaptic functioning, and differential responsiveness to glucocorticoids and stress. J Neurosci. 2008;28(23):6037–45.

    Article  CAS  Google Scholar 

  6. McEwen BS, Nasca C, Gray JD. Stress effects on neuronal structure: hippocampus, amygdala, and prefrontal cortex. Neuropsychopharmacology. 2016;41(1):3.

    Article  CAS  Google Scholar 

  7. McEwen BS. Physiology and neurobiology of stress and adaptation: central role of the brain. Physiol Rev. 2007;87(3):873–904.

    Article  PubMed  Google Scholar 

  8. Huang M, et al. Association of depressive symptoms and heart rate variability in Vietnam war–era twins: a longitudinal twin difference study. JAMA Psychiat. 2018;75(7):705–12.

    Article  Google Scholar 

  9. Wulsin L, Herman J, Thayer JF. Stress, autonomic imbalance, and the prediction of metabolic risk: a model and a proposal for research. Neurosci Biobehav Rev. 2017;86:12–20.

    Article  Google Scholar 

  10. Mirescu C, Gould E. Stress and adult neurogenesis. Hippocampus. 2006;16(3):233–8. Web

    Article  CAS  Google Scholar 

  11. Mirescu C, Peters JD, Gould E. Early life experience alters response of adult neurogenesis to stress. Nat Neurosci. 2004;7(8):841.

    Article  CAS  Google Scholar 

  12. Radley J, et al. Chronic stress and brain plasticity: mechanisms underlying adaptive and maladaptive changes and implications for stress-related CNS disorders. Neurosci Biobehav Rev. 2015;58:79–91.

    Article  Google Scholar 

  13. Alt SR, et al. Differential expression of glucocorticoid receptor transcripts in major depressive disorder is not epigenetically programmed. Psychoneuroendocrinology. 2010;35(4):544–56.

    Article  CAS  Google Scholar 

  14. Seeman TE, et al. Price of adaptation—allostatic load and its health consequences: MacArthur studies of successful aging. Arch Intern Med. 1997;157(19):2259–68.

    Article  CAS  Google Scholar 

  15. Juster R-P, McEwen BS, Lupien SJ. Allostatic load biomarkers of chronic stress and impact on health and cognition. Neurosci Biobehav Rev. 2010;35(1):2–16.

    Article  PubMed  Google Scholar 

  16. Karlamangla AS, Singer BH, Seeman TE. Reduction in allostatic load in older adults is associated with lower all-cause mortality risk: MacArthur studies of successful aging. Psychosom Med. 2006;68(3):500–7.

    Article  Google Scholar 

  17. Crimmins EM, Kim JK, Seeman TE. Poverty and biological risk: the earlier “aging” of the poor. J Gerontol A Biol Sci Med Sci. 2009;64(2):286–92.

    Article  PubMed  Google Scholar 

  18. Sabbah W, Watt RG, Sheiham A, Tsakos G. Effects of allostatic load on the social gradient in ischaemic heart disease and periodontal disease: evidence from the Third National Health and Nutrition Examination Survey. J Epidemiol Community Health. 2008;62(5):415–20.

    Article  CAS  PubMed  Google Scholar 

  19. Barboza Solís C, Kelly-Irving M, Fantin R, et al. Adverse childhood experiences and physiological wear-and-tear in midlife: findings from the 1958 British birth cohort. Proc Natl Acad Sci U S A. 2015;112(7):E738–46.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Dana Zappetti .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Cool, J., Zappetti, D. (2019). The Physiology of Stress. In: Zappetti, D., Avery, J. (eds) Medical Student Well-Being. Springer, Cham.

Download citation

  • DOI:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-16557-4

  • Online ISBN: 978-3-030-16558-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics