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Cohen, S., Janicki-Deverts, D. and Miller, G.E. (2007) ‘Psychological stress and disease’, JAMA, 298(14), pp. 1685–1687. doi: 10.1001/jama.298.14.1685.
Websites
Choices, N. (2016) Struggling with stress? Available at: http://www.nhs.uk/conditions/stress-anxiety-depression/pages/understanding-stress.aspx (Accessed: 8 November 2016).
Palmiter, D. J. Wilson, D. (2016). Teens and Stress. Available: https://www.apa.org/helpcenter/stress-teens.aspx. Last accessed 08/11/2016.
Bickerstaff, L. 2008. Stress: Coping in a challenging world: Easyread super large 20pt edition. (s.l.): Read How You Want.Com.

Cherney, K. 2015. Extreme fatigue in teenagers [Online] LIVESTRONG.COM. Available at: http://www.livestrong.com/article/300008-extreme-fatigue-in-teenagers/ [Accessed: 8 November 2016].

Choices, N. 2016. Struggling with stress? [Online] Department of Health. Available at: http://www.nhs.uk/conditions/stress-anxiety-depression/pages/understanding-stress.aspx [Accessed: 8 November 2016].

Mind, the mental health charity - help for mental health problems. 2013. Available at: http://www.mind.org.uk/information-support/tips-for-everyday-living/stress/signs-of-stress/#.WCGiceGLTBI [Accessed: 8 November 2016].

Stress symptoms. 2009 WebMD Boots. Available at: http://www.webmd.boots.com/stress-management/physical-stress-symptoms [Accessed: 8 November 2016].
http://www.hse.gov.uk/statistics/causdis/stress/
Dictionary, Oxford. (2016) Oxford English Living Dictionary. Available at: https://en.oxforddictionaries.com/definition/stress (Accessed: 11 November 2016).
Ranabir, S. and Reetu, K. (2011) ‘Stress and hormones’, Stress and hormones, 15(1).

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In 2013, figures from the Bauer Media News and YoungMinds State of Mind survey revealed that teenagers in the UK are under  extreme pressure from exam stress, social media, bullying  and body image and parents are battling to support them.

The survey of 16-19 year olds revealed that when it comes to exams:

68% feel very stressed about not doing well in their exams and it affecting their futures

49% said they would feel devastated if they did not achieve the grades they wanted in their exams

On the pressure to have a perfect body it revealed:

81% said they felt under pressure to have the perfect body

40% said they felt the pressure to have a perfect body came from pictures on social media

And 42% wouldn’t talk to anyone if the stress or pressure became too much for them.

(http://www.youngminds.org.uk/news/blog/2347_survey_reveals_teenagers_facing_constant_onslaught_of_stress)

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There are many ways to manage stress in adolescents without the use of medication. Physical activities like yoga, running, swimming, hiking, etc. are great ways to relax and release stress in a positive way. Physical group activities are also very beneficial, as long as they are not too competitive, because they have a social element that will also aid in relaxation and unwinding.
Sleep is essential to managing stress, especially in adolescence. It is recommended that teenagers get between 7 to 9 hours sleep a night. This can be difficult to achieve due to having to wake up early in the morning for school and staying up late at night studying. “To maximise your chance of sleeping soundly, cut back on watching TV or engaging in a lot of screen time in the late evening hours. Don’t drink caffeine late in the day and try not to do stimulating activities too close to bedtime.” Palmiter, D. J. (2016).
Having a hobby can help relieve teenagers of stress, so listening to music, socialising with friends, going to the cinema, etc. are all activities that are good to do when feeling stressed. Hobbies are great ways to relieve stress as they will distract an individual from feeling stressed and worried about things that are going on in their everyday life.
It is important for teenagers to feel like they can trust and confide in a person when they are feeling stressed. Talking through problems can often make them seem smaller and less worrying. Sharing problems with trusted individuals can also help teenagers feel more able to confront them and tackle them.

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Epidemology of stress in Wales (Sophie and Sian) 

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Epidemology of stress in Wales (Sophie and Sian) 

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Stress can have a major impact on someone's day to day life. "The total number of cases of work related stress, depression or anxiety in 2015/16 was 488,000 cases, a prevalence rate of 1510 per 100,000 workers." You are more likely to find that in deprived areas of wales are where the most stress related cases are. Stress is becoming more of a problem. Geographical location has an impact on stress. "In 2015/16 stress accounted for 37% of all work related ill health cases and 45% of all working days lost due to ill health." Social class can also have an impact of stress.

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Stress can have a negative impact on an individual's social life, especially a teenagers. This is because individuals that deal with stress can become withdrawn from social interactions and may develop a short temper, which can make it difficult for others to communicate with them. The social development of teenagers with stress may be hindered because they are less likely to involve themselves in social interactions that will teach them important social skills.

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Stress can affect the body in many ways; it does this by affecting the amount of hormones that get released or withdrawn/suppressed by the body.
Vasopressin - is a hormone released from the paraventricular nucleus of the hypothalamus, it helps with the secretion of adrenaline. (Ranabir and Reetu, 2011).
Cortisol - also known as the stress hormone is released to promote the flight or fight response but in modern as individuals are prolonged to long periods of stress(e.g. adolescence during exam time) can have impacts on the body such as high blood pressure. (Ranabir and Reetu 2011).
Catecholamines - when released stimulates the pituitary-adrenal axis, which in turn causes increased heart rate, the body holding onto salt, stops digestion, an increase in glucose etc. (Ranabir and Reetu 2011).
Gonadotropins - suppressed during levels of stress which affects the menstrual cycle and prolonged suppression can lead to damage to the reproductive system. (Ranabir and Reetu 2011).
Thyroid Hormones - stress reduces the release of the hormone. (Ranabir and Reetu 2011).
Growth Hormone - During Physical stress (prolonged exercise) the growth hormone is released in a significant rate in turn increasing the metabolic rate, whereas during psychological stress this release of this hormone is rarely seen. (Ranabir and Reetu 2011).
Prolactin - levels can either increase or decrease depending on the hormones released and is though to impact on the immune system or homeostasis (Ranabir and Reetu 2011).

Insulin - may decrease during stress leading to hyperglycemia. (Ranabir and Reetu 2011).

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Emotional symptoms include:

·      Being moody or becoming easily agitated

·      Feeling overwhelmed

·      Having difficulty relaxing

·      Unable to enjoy yourself

·      Feeling depressed

·      Being lonely and feeling worthless

·      Avoiding others

·      Loss of sense of humour

Physical symptoms include:

·      Low energy

·      Headaches and other aches, pains and tense muscles

·      Upset stomach

·      Chest pains and rapid heartbeat

·      Insomnia

·      Frequent colds and infection

·      Nervousness and shaking with cold or sweaty hands and feet

·      Excess sweating

·      Dry mouth, difficulty swallowing and clenched jaw

·      Shallow breathing or hyperventilating

·      Panic attacks

Behavioural symptoms include:

·      Finding it hard to make decisions

·      Snapping at people

·      Biting nails

·      Picking skin

·      Unable to concentrate

·      Eating too much or too little

·      Smoking or drinking alcohol excessively

·      Being restless

·      Feeling tearful and crying

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The amount of stress that is felt in different situations can depend on:

·      The perception of the situation

·      How skilled a person is at dealing with pressure

·      The emotional resilience to stressful situations

Things that an cause stress in adolescences include:

·      Being under lots of pressure

·      Facing big changes

·      Worrying about something

·      Not having any control over the outcome of a situation

·      Having responsibilities that may be overwhelming

·      Not having enough work or activities in life

Stress is often caused by common life events, such as:

·      Personal

·      Friends and family

·      Employment and study

·      Money

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The Oxford dictionary describes stress as "A state of mental or emotional strain or tension resulting from adverse or demanding circumstances". (Dictionary 2016). But it can be added that a stress is individualized meaning that different people find different things more or less stressful. This can also mean people react to stress in many ways in order to cope with it; examples can be that people run away from problems, get aggressive, become silent etc. (Choices 2016).