The general physiological response of fish to threatening situations, as with all vertebrates, is referred to as stress. A stress response is initiated almost immediately following the perception of a stressor. Mildly stressful situations can have beneficial or positive effects (eustress), while higher severities induce adaptive responses but also can have maladaptive or negative consequences (distress). The stress response is initiated and controlled by two hormonal systems, those leading to the production of corticosteroids (mainly cortisol) and catecholamines (such as adrenaline and noradrenaline and their precursor dopamine). Together these regulate the secondary stress response factors that alter the distribution of necessary resources such as energy sources and oxygen to vital areas of the body, as well as compromise hydromineral imbalance and the immune system. If fish can resist death due to a stressor, they recover to a similar or somewhat similar homeostatic norm. Long-term consequences of repeated or prolonged exposures to stress are maladaptive by negatively affecting other necessary life functions (growth, development, disease resistance, behavior, and reproduction), in large part because of the energetic cost associated with mounting the stress response (allostatic load).

There is considerable variation in how fish respond to a stressor because of genetic differences among different taxa and also within stocks and species. Variations within the stress response are introduced by the environmental history of the fish, present ambient environmental conditions, and the fish's present physiological condition. Currently, fish physiology has progressed to the point where we can easily recognize when fish are stressed, but we cannot always recognize when fish are unstressed because the lack of clinical signs of stress does not always correspond to fish being unstressed. In other words, we need to be aware of the possibility of false negatives regarding clinical signs of stress. In addition, we cannot use clinical data to precisely or accurately infer severity of a stressor.