The pressure of exam season can push some to perform at their best, while others can react badly to the stress and struggle to complete the exam to their best of their ability.

If you're starting to feel the heat, here's some practical advice on managing stress levels throughout your exams from the GP clinical lead at Treated.com, Dr Daniel Atkinson.

• Read more: your guide to handling revision and exam stress

“Cramming last minute revision in before an exam starts can be overwhelming and unproductive. It’s better to consign the last of your revision to the night before, and start the day with a clear head,” said Dr Atkinson.

“Try and eat a good breakfast in the morning and drink plenty of water to stay hydrated. If you need a caffeinated drink to perk you up, try not to overdo it; limit yourself to one or two cups of coffee so your energy levels don’t spike and crash. Your natural adrenaline levels should be enough to keep you going.

“When the exam is over, don’t dwell on how you did. Be kind to yourself, take a step back from the exam ‘gossip’ and do something relaxing to take your mind off it.”

• Read more: what to expect from an exam

While people with different personalities will handle exam pressure differently, the fundamental physical responses most of us have will be very similar.

The exam date is set

This is the point where your teacher, lecturer or study leader tells you that you’re going to have an exam.

If you tend to get anxious about them, the mention of an exam may cause your heart rate to speed up slightly.

You may feel a bit nauseous, as the stress of previous exams triggers a ‘fight or flight’ response, releasing cortisol and adrenaline. This essentially halts the digestive process temporarily, freeing energy up to do other things (like run away).

If you’re not particularly anxious about the thought of an exam, but aren’t fond of them either, the revelation of the date may trigger some feelings of dread, but no physical feelings of consequence.

• Talk to people. Even at this early stage, it can be reassuring that other students have the same anxieties as you, and this can enable you to talk about useful strategies well before the event.
   
• If you’re feeling particularly anxious, tell your teacher. If they’re an academic, they’ll likely be quite practised in exams and may be able to offer some wisdom on how to limit exam stress.

Days before

Revision may or may not be going well at this point. Some students may feel lost under a pile of workbooks or perhaps in denial about the upcoming exam. Negative thoughts can intrude during revision and lead to poor sleep at night.

Long hours spent revising can lead a student to rely on quick and convenient comfort food which might not always provide the best nutrients or fuel for the brain.

Stress can also impact appetite so that fewer calories are eaten than normal which over a prolonged period of time can lead to weight loss.

• Schedule regular short breaks into your revision, and ideally take some time away from your books and computer screen. Physical activity is a great way to spend some leisure time and can even help your mental outlook.
   
• Plan some quick and healthy meals that you'll be happy to cook when you are short on time. Oily fish (such as salmon and sardines), eggs and leafy green vegetables are all great brain-fuelling options.
   
• Keep your cupboards stocked with healthy snacks (such as fruit and nuts), so that you don’t always turn to snacks high in fat, sugar or salt.

Hours and minutes before

Stress increases the amount of cortisol being pumped around the body. This can upset our stomach and lead to several trips to the toilet. It can even make some people feel sick.

• Cramming last minute revision right before an exam starts can be overwhelming and unproductive. Finish your revision the night before, and start the day with a clear head.
   
• Try and eat a good breakfast in the morning and drink plenty of water to stay hydrated. If you need a caffeinated drink to perk you up, try not to overdo it - limit yourself to one or two cups of coffee so your energy levels don’t spike and crash.

When you're sitting in front of the paper, your brain recognises the stressful situation and begins to prepare your body for its ‘fight or flight’ response - it will trigger a release of adrenaline and cortisol into the bloodstream to keep you focused on the task in hand.

You might notice that your heart rate and breathing rate are quicker than usual, and as your blood pressure rises you might become conscious of your heart beating (you might feel in your chest or hear it in your ears).

The release of these hormones increases the amount of oxygenated blood being pumped to your vital organs and muscles, including your brain.  

• Take some steady breaths in through the nose and out through the mouth to calm your nerves.

Exam starts

Your hands may feel sweaty as you pick up your pen. This is because muscle cells under the skin contract and cause perspiration.

The increased heart rate, caused by the release of adrenaline into the bloodstream, will improve blood flow to the brain and thus mental capacity. This means that your ability to focus on the important task should be at its peak.

• This spike in adrenaline is, in a roundabout way, your friend - it’s your body attempting to help you cope with a stressful situation. Try to use it to your advantage and channel this focus into the task in front of you.

30-60 minutes in to an exam

The average concentration span is estimated at around 10-20 minutes for adults. Therefore it can be a push to maintain focus throughout a long exam. However, the spike in stress hormones can be used to your advantage and keep you focused for longer.

• If you find yourself getting distracted or starting to panic it can help to repeat a positive statement in your head such as: ‘I can do this’ or ‘I will be fine’.

Last 15 minutes of an exam

Your brain may start to fatigue and the quality of your handwriting may have started to decline as your hand begins to tire.

• Try not to panic. It can help to take a few seconds break to relax and shake your hand out and ease muscle tension, before carrying on.

Hopefully the end of the exam will be accompanied by a sense of relief. Your heart rate and breathing may take some time to return to normal. You may still feel a bit shaky as the adrenaline leaves your body.

Aftermath

The time after an exam can be difficult, especially if you speak to friends who have taken the same exam as you.

So try and put it behind you, and don’t talk about the exam until your result is ready - overanalysing will only cause extra stress.  

• The time following on from an exam should ideally be spent relaxing - your body and mind have completed a tough workout and need some time to recover.