When Work Stress Shows Up in Your Body

She came about her sleep. She was waking at four in the morning, most nights, unable to get back to sleep. She said nothing about work for the first twenty minutes. Work, she said, "is fine, same as always." It was only when trying to date the start of the waking that another piece of information appeared: it had begun three weeks after her department was reorganised.

This sequence is extremely common. The body signals, and the person seeks help for the signal. The context arrives later — sometimes months later, sometimes never.

Let me say straight away what this article will not do. It will never claim that stomach pain "comes from stress", that insomnia "is caused by work", or that a given set of signs "means" something. Those sentences do not belong in a blog post. They belong to a doctor, who examines, asks questions and prescribes if needed. A physical symptom goes to a doctor first. Everything that follows only makes sense after that step, not before.

Why the body speaks first

The stress response is old and fast. A perceived demand triggers a cascade of activation — heightened vigilance, muscle tone, faster heart rate, energy mobilisation — within seconds. Putting it into words takes far more: you have to identify what is weighing on you, name it, agree to say it out loud, and sometimes admit something you would rather not see.

That difference in speed has a practical consequence. Many people have a symptom long before they have a story. They know they are sleeping badly. They do not yet know that something has changed at work.

There is a second reason, less physiological. Describing a symptom is socially acceptable; describing a difficulty at work is much less so. "I'm sleeping badly" commits you to nothing. "I can't hold my job any more" commits you to everything. The body offers a language that does not yet cost you a position.

What matters is not the intensity, it is the return to baseline

Activation is not a fault. It is useful: it prepares you to act. The problem does not appear when it switches on. It appears when it does not switch off.

Research models on work stress all describe the same thing in their own way. Karasek and Theorell cross demand (how much is required, and how urgently) with decision latitude (the room you have to organise your own work), then add support from colleagues. High demand is not the problem in itself: it is high demand with low latitude and absent support that wears people down. The JD-R model of Demerouti and Bakker frames this as two distinct processes: a strain process driven by job demands, a motivational process driven by resources, and the central idea that a resource can offset a demand.

Siegrist adds a third angle: the imbalance between the effort put in and the reward obtained — pay, security, prospects, but also esteem and everyday recognition. Effort that gets nothing back is never settled; it stays open.

What these models share is that they describe situations where mobilisation never finds an end. A deadline met and then closed is activation followed by recovery. A deadline followed by another, in an organisation where you decide nothing and nobody sends any signal back, is activation that keeps running. It is the missing return to baseline, repeated, that counts — not the peak.

What people report

The status of what follows needs to be precise. These are not criteria, this is not a checklist, and it allows you to conclude absolutely nothing. They are simply what people most often describe when they consult about a work-related difficulty.

Sleep comes first, in two distinct forms worth separating: the falling-asleep that does not come, with mental content aimed at tomorrow, and the end-of-night waking, around three or four, with no return to sleep. People also report sleep that lasts but does not restore.

The digestive system next: a knotted stomach, altered transit, appetite shifting in one direction or the other. The Sunday-evening "knot in the stomach" is its most frequently told version.

Muscle tension: neck, shoulders, jaw, back. Often discovered by a third party — a physiotherapist, or a dentist noticing worn teeth. Fatigue, finally, with a feature people point out themselves: it is out of proportion with what has actually been done, and it does not yield to rest the way it used to.

Some also describe palpitations, headaches, or a blood pressure reading higher than usual at a check-up. On that last point there is nothing to interpret yourself: blood pressure is measured under specific conditions, interpreted across several readings, and belongs entirely to a doctor.

The two-stage rule

This is the core of the article, and the order is not negotiable.

Stage one: a doctor, no exceptions

Every manifestation above has possible medical causes, many of them, sometimes with no connection to work at all. Disturbed sleep can involve a night-time breathing disorder, a thyroid problem, an ongoing medication, pain. Digestive trouble can involve a condition of the digestive tract. Persistent fatigue can involve a deficiency, anaemia, an infection, an endocrine disorder. Raised blood pressure is managed as such.

None of this can be ruled out by a text, by an online questionnaire, or by an intuition about your own case. Attributing a physical symptom to work straight away means risking not looking anywhere else. It is the most costly mistake in this whole field, and it is common precisely among people who are clear-sighted about their working conditions: because they have a plausible explanation, they do not go to the doctor.

Your GP or family doctor is the person for this first stage. Where an occupational health service exists, it is a second, different and complementary one: it knows the job, it can see the workplace, and above all its practitioners are bound by medical confidentiality. What you tell them does not go back to your employer. They can act on how the job is organised without disclosing what was said. Many people rule out consulting them because they believe the opposite. Arrangements vary considerably from one country and one employer to another, so it is worth checking what actually exists where you work.

Stage two: reading the conditions, once the medical side is handled

The second stage does not replace the first, it follows it. Once a doctor has taken care of or excluded what belongs to them, another question becomes useful — and it was not useful before.

That question has three parts: since when, alongside which change, and what varies.

Since when means a date, even a rough one. A month, a season, "after last summer".

Alongside which change means an inventory of what shifted at work in the preceding weeks: a new manager, a reorganisation, a departure not replaced, a widened remit, a difficult client, a project stopped. Dejours distinguishes prescribed work — what the job description and the procedures set out — from actual work — what you really have to do for things to function. The change has often happened in the gap between the two, without any document recording it.

The most informative test: what a break tells you

One element carries more information than the rest, and it requires nothing but observation: how the symptom behaves during a real break, and above all on returning.

Three patterns recur, and they are not equivalent.

The symptom eases during the break and takes several weeks to come back. Recovery still works in this pattern.

The symptom eases during the break and returns within two or three days of being back, sometimes from the Sunday evening before. That rapid return is strong information about the link with conditions — and it is also what makes the break misleading: rest gives the impression that the problem is solved.

The symptom does not ease at all, even after two weeks. This one is not to be read alone and calls for no self-interpretation: it goes back to a doctor, including if it has already been looked at, because a new element justifies a fresh opinion.

One honest caveat about this test: it proves nothing. A holiday changes many other things at the same time — sleep, food, light, physical activity, being with the people you care about. It gives you a lead, not a demonstration.

The dated record of facts

An appointment with an occupational health practitioner lasts a limited time, and a great deal of it depends on what you are able to lay out. "I'm exhausted and things are going badly at the moment" opens very little. A timeline opens a lot.

What is needed is simple and tedious: one line per item, with a date. The symptom and when it appeared. Work events and their dates. Absences, leave, returns. The requests you made and the answers you received, dated too.

The point of the exercise is not the complaint, it is the side-by-side comparison. Two dated columns reveal coincidences that no memory produces spontaneously — and sometimes the reverse: they show that the symptom preceded the change at work by six months, which is just as useful to know.

That is exactly what ScanMyJob produces: from what you describe, the tool returns a dated record of facts, with no labelling and no interpretation, that you can take to an occupational health service, an employee representative or an adviser. It does not tell you what you have. It puts order into what you have observed.

If the situation involves an organisation that does not move despite written requests, two further avenues exist: employee representatives or your union, who can raise the matter through internal channels so that you are not carrying it alone, and the relevant labour authority in your country, which can be approached about working conditions.

Key takeaways

The body signals faster than speech, and many people describe a symptom long before they describe a situation. That gap is normal; it licenses no shortcuts.

What wears people down is not the intensity of a demand but the repeated absence of a return to baseline. That is what Karasek and Theorell, the JD-R model and Siegrist each describe from a different angle.

The order is this, and it does not reverse: a doctor first, reading the working conditions second. A physical symptom has possible medical causes that no article can rule out, and a plausible work-related explanation is precisely what makes people skip the appointment.

Once that first stage is done, three questions do the work: since when, alongside which change, and what happens during and after a break.

Finally, what makes a conversation with an occupational health practitioner — bound by medical confidentiality — genuinely useful is not the intensity of the complaint. It is a dated timeline.

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FAQ

Can my insomnia be caused by my job?

That question cannot be settled from an article, and nobody should answer it at a distance. Disturbed sleep has many possible medical causes, some of which require examination. So the useful move is to raise it with a doctor first, who will see what belongs to them. Then, and only then, it becomes relevant to look at when your nights changed, what shifted at work over the same period, and how your sleep behaves during a longer break.

What if my doctor finds nothing?

"Nothing found" is not an empty result, it is a stage completed: the causes that needed excluding have been excluded, and that shapes what comes next. This is the moment to ask for an occupational health appointment if one is available to you, since those practitioners know jobs and can act on how work is organised. Bring a written timeline rather than a story: dates of onset, changes at work, requests made and answers received. That document, more than the narrative, is what makes the conversation usable.

Will an occupational health service tell my employer?

Not what you say to them: those practitioners are bound by medical confidentiality, and the content of the consultation does not travel. What can be passed to an employer concerns fitness for the job and any adjustments recommended, without exposing the medical reasons behind them. That is precisely what makes them a different interlocutor from your manager or HR. Exact arrangements vary by country and employer, so check what applies where you work before assuming either way.

Should I wait for my holiday to see if it passes?

No, and that reflex is costly. Waiting for a break pushes the appointment back by weeks or months, during which a possible medical cause goes unexamined. Observing what happens during and after a break is useful, but it is an extra observation, not an alternative to medical advice. You can perfectly well see a doctor now and then note what the symptom does over the holiday and in the first days back.