Chronic stress symptoms: what long term stress does to your body and what a stress scan measures

In this article you can read what the symptoms of chronic stress are, what long-term stress does to your body, and what a stress scan measures. That matters, because the complaints come one by one and almost never announce themselves as stress: a short night, a headache, a name you cannot find again, a morning in which the list on your desk refuses to fall into order. The BioProfile stress scan measures how much of that load you are carrying with you, and gives you an indication of where you stand today in this area, as one of the 11 health areas the full scan assesses. This is not a diagnosis. It is insight, to see where you stand today, and to help you make better choices in your food and your way of living. What this scan does not do: point to a cause or say what you have. Only a doctor can do that.

What are chronic stress symptoms

For stress that has lasted a long time, Thuisarts gives a list with not a single number in it: quickly feeling anxious or restless, often forgetting things, trouble concentrating, trouble organising and planning, getting angry more quickly, and doing things without thinking about them first.⁠¹ Most of that is not what people picture when they think of stress. It reads like a memory problem or a mood problem, and that is why long-term stress is usually named last.

The same source is more concrete about overstrain. Overstrain counts when 3 or more of these complaints are present: being tired, sleeping badly, getting angry quickly, not tolerating crowds or noise, crying easily, worrying a lot, a rushed feeling, trouble keeping your attention on things, trouble remembering things. The physical complaints named there are headache, dizziness, chest pain, a fast heartbeat, stomach complaints and abdominal pain.⁠⁴ So the rule a GP works with is a counting rule: three or more of those, at the same time, mind and body together.

When stress counts as long-term

Thuisarts puts the course of overstrain at about 3 months, with contact moments every 2 or 4 weeks, and says that symptoms lasting longer than 6 months point to burnout.⁠⁴ That gives you a rough clock: weeks are an episode, half a year is a different word.

How often this happens has a Dutch number. In 2025, 20.7 percent of workers aged 15 to 74 in the Netherlands reported work-related burnout complaints a few times a month or more often, 18.0 percent of male workers and 23.5 percent of female workers. The share was highest between 25 and 34 years, at 28.2 percent, and lowest between 65 and 74 years, at 8.5 percent. The indicator is measured with five statements from the Utrechtse Burnout Schaal about emotional exhaustion and fatigue connected to work.⁠³ One in five workers, then, and highest in the years when careers and young households collide.

What stress does to your body

Cortisol that is stored in growing hair gives a record of the months behind you. A meta-analysis brought together 124 subsamples from 66 independent studies, 10,289 participants in total: groups with chronic stress had 22 percent more hair cortisol than comparison groups. The difference came out mainly when the stress was still going on at the time of the study, at plus 43 percent, while for stress in the past or without stress it came out at minus 9 percent, a difference that did not become significant. Hair cortisol also decreased from the first to the second proximal 3 cm hair segment.⁠²

In those same subsamples there was no consistent link between hair cortisol and what people themselves reported about their perceived stress, while hair cortisol did come out higher with body mass index, waist-to-hip ratio and systolic blood pressure.⁠² That is the uncomfortable outcome: your own sense of how much stress you have and what your body has been carrying are two separate measurements.

Blood pressure is the part with years behind it. A meta-analysis of prospective cohort studies in adults, published between January 1970 and December 2006, screened 2,043 studies, found 110 cohort studies and 6 suitable studies, and so arrived at 23 comparison groups and 34,556 people, with a median follow-up of 11.5 years and 21 percent loss to follow-up. Adults with a stronger reaction to stressor tasks had a rise in arterial blood pressure 21 percent more often than adults with a lower reaction (OR = 1.21; 95 percent CI 1.14 to 1.28; p < 0.001).⁠⁵ In plain words: yes, stress and a rising blood pressure do run together over the years, and the size of that is modest rather than dramatic.

What long-term stress at work costs

A Dutch prospective cohort of 2,312 older workers in the Maastricht Cohort Study followed the need for recovery after work for 4 years. A raised need for recovery came with a higher risk of leaving the labour market (HR 1.39; 95 percent CI 1.09 to 1.78). The link was stronger where early retirement arrangements were available (HR 2.79; 95 percent CI 1.29 to 6.02) and disappeared where such arrangements were not available. The same workers reported earlier retirement plans and a lower perceived physical and mental ability to keep working until the official retirement age.⁠⁶ Read it like this: the feeling that you are never quite caught up on a Monday morning is something that can be measured. It coincided, four years later, with leaving working life.

Part of that need comes from the night. Among 405 nurses working irregular shifts, sleep quality was strongly linked to the need for recovery (beta = 0.554; p = 0.001), and that held after correcting for confounding variables; sleep quality was poor overall, and nurses working night shifts reported significantly worse sleep than the others.⁠⁷ One measurement per person, so this shows that the two move together. Which one comes first is another question.

What has been measured for what you can do yourself

Thuisarts is clear about the first step: working on the cause of the stress matters most, and with stress that has already lasted a long time the advice is to make an appointment with the huisarts or the praktijkondersteuner.⁠¹

Of the things you do yourself, a mindfulness programme is the most clearly measured. A meta-analysis of 17 randomised controlled trials with 1,641 adults from the general population, measured with the Perceived Stress Scale, found that the mindfulness group came out lower than the control group directly after the programme (SMD = -0.53; 95 per cent CI -0.72 to -0.33; p < 0.00001). In the mindfulness group the scores fell from before to after (SMD = 0.93; 95 per cent CI 0.62 to 1.23), while the control group barely moved (SMD = 0.23; p = 0.05), from a comparable starting point. The measurements were taken only directly after the intervention, and the review reports no long-term follow-up for those 17 trials.⁠⁸ So the effect was measured at the end of the programme. The picture six months later has not been measured.

Exercise has a Dutch number. The advice of the Gezondheidsraad of 22 August 2017 asks adults for at least two and a half hours of moderately intensive exercise a week, plus muscle and bone strengthening activities, and asks people to move more and sit still less, permanently.⁠⁹ Two and a half hours a week is about twenty minutes a day, and that is a smaller ask than the number sounds.

What a stress scan measures and what the scan does not measure

The stress scan asks five questions about the past two weeks. The answers get points, are added up and converted into a stress score from 0 to 100, with the reading band the score falls into. Higher is better. The questions are modelled on the Perceived Stress Scale, and a systematic review of 19 articles about that scale found that the version with 10 items had better psychometric properties than the versions with 14 and 4 items, in populations that consisted mainly of students and working people; internal consistency, factorial validity and hypothesis validity were well reported, while test-retest reliability and criterion validity have rarely been studied.⁠¹⁰ Our questions are worded by us rather than copied, so what you get is a picture of your own burden and a starting value. It is not a validated clinical score.

A questionnaire does not point to a cause for that load. A demanding job, a loss, an overactive thyroid, poor sleep and depression all read the same on a form. So a stress scan is not a diagnosis. Blood values, blood pressure and sleep data are the layers that turn a picture of load into an explained picture, and those you ask a doctor for.

Two lines point to that door. Tell your GP if you think you may be overstrained,⁠⁴ and for stress that has lasted a long time, make an appointment with your GP or the practice nurse.⁠¹

In summary

This article showed which symptoms chronic stress gives, as Dutch GP care names them, how long stress has to last before the stress gets another name, what long term stress does to your body, what the stress costs at work, what has been measured for the things you can do yourself, and what a stress scan measures. The symptoms sit in the mind and in the body at the same time, and the counting rule is three or more together.⁠⁴ Your body keeps a record of its own, in hair cortisol and in blood pressure over years, and that record does not match what you would say yourself.⁠² A score from today is your starting value: repeat the scan in two weeks and you have two numbers instead of a memory. Naming the cause remains work for a doctor. It is not a diagnosis.