What is stress? The underlying reason why we get burnout…

Stress is a response to something. It’s either an inner or outer stimuli, a thought or an emotion that increases physiological activity in the individual. A reaction to a situation that is threatening or challenging. The stress response from the sympathetic nervous system is actually a lovely thing that have increased our ability to survive throughout the ages. Again – it’s there to increase your chance of survival. A companion and lovely function since millions of years. Essential and primal. It makes you wind up and mobilize energy, which is really useful.  It used to help us to be more alert and on our toes when it was necessary, or even start out that way prior to the event that needed it. You either fight or you run for your life. To play dead is another option which is less commonly referred to; practically the opposite to the first two. The option is to faint or become apathetic. “Freeze” is another word for it; fight – flight – or FREEZE. This one occurs when the stress is all too much and overwhelms us.

Today stress is rarely life threatening for most of us – but long term instead. Using the turbo that over time works as a double edged sword is where it went wrong.

Today we “don’t have time”, we’ve got anxiety because we’re producing and doing too little. You wake up at night and think about your projects. Rush from one place to another from nine to five. Kids at home and stuff to do until bedtime. Projects in your spare time, projects in your workspace. Tough conversations and economy. Keeping up with the Joneses and tending to the mortgage. People might think things and there’s infinite stimuli to check, keep track of and remember – as well as to analyze and judge. There’s food to think about, kids to drive, someone to please and a home to keep tidy. Every little thing times a million turns into an inhuman load of tasks. And oooops! The stress response was ever present. There was no immediate threat of any kind, but that didn’t matter. You felt it, acted on it and made it so. Demands from yourself and/or those around you, regardless of actual threats, are stressful – and over time a huge issue.

It seems as if everything gets threatening if the brain gets a chance to see it that way. Hurry to get things done “or else” leads to stressful which leads to a feeling that it’s practically dangerous. As well as the fact that people will always find problems, you’ll just have to find what problems you’d like. A prince with no problems what so ever – will find the smallest of flaws and make them huge. Those who starve won’t notice what you might be bothered by; a hole in the sleeve, a blister between toes or neighbors doing this or that. If you don’t have any problems, the smaller ones will feel big. If you don’t have any food – that’s likely your problem.

So, what truly haunts, hunts and stress you out? Is it necessary and there for a good reason? Why does it stress you out and what can be done about it?

More and more often ever present, rather than just for a while when it’s needed. Is a parallel to horses and other animals running until they drop dead at its place here? The inventor of the marathon who ran to get the message through – who then supposedly dropped dead once it was delivered?

Generally, we get more threatening and stressful when we lack control. So more pressure, high speed and uncertainty without enough chance and resources to influence, affect and change the situation will be more stressful. Big responsibility and a large workload will likely have an impact as well, but if you can affect those, they might not be a problem of equal magnitude. High demand and little control increase the risk for ill health. It’s even been shown that little control is stressful when it’s not really “necessary”. If it’s not very important – and you’re without control – it might still be stressful. That’s likely just applicable to some, however, and not to those who tend to focus on what they actually can control.

Low demands and low control makes the situation passive. Might be a decent position to get depressed or a burnout from practically becoming bored-out.
High demands and low control makes the situation tense and likely bothersome. This is a situation where you’d become exhausted from long term stress. You’re under pressure and the load is on you without any chance of getting away (or so it seems).
Low demands and high control makes the situation relaxed. No problem here. You’ll likely be quite fine. Perhaps you should do something to get stimulated, though?
High demands and high control makes the situation active. Demanding and stressful – but it feels positive. A challenge rather than a threat. You’ve got power, resources and influence. It’s a kick to get to work. It doesn’t necessarily have to matter if you’re amused and energetic. Something lovely can get too much, regardless. Cake is great – having too much is not. Doing awesome stuff and being amused is great – having too much of something very stimulating what gives quite a stress response for too long is not. So if this is the case – be careful. Stress might be bothersome over time even though it feels positive and lovely. You’re just one person.

What happens when we get stressed?
A quite complex physiological reaction to mobilize body and brain to focus on the danger and have enough energy to do what’s necessary and improve memorization to make sure it’s remembered until next time. “There’s obviously something important going on, better remember it.” Where was that lion?/I almost died HOW?” The part of memorization is quite new, but Posttraumatic stress disorder, PTSD, and panic attacks underline this fact really well.

The lower degrees of stress starts by activating attention, energy and memory. Stressing further goes beyond that in the activation of the sympathetic nervous system, which is a part of the autonomic nervous system. The body becomes more activated and a wide variety of functions get activated. Pragmatic parts of it when fighting would be to redirects blood to muscles to be ready to act, increases heart rate, increase muscle tone and widens pupils to take in more light to see better. Less useful things here would be a dry mouth and soaked clothes from sweat when talking in front of people. All of these functions of the increased physiological activation is on a scale from “slightly increased attention” to “panic attack”. The opposite to the sympathetic nervous system is the parasympathetic; this part makes functions go the other way. Where one of them dilates, the other one contracts. If one increase muscle tone, the other one decrease. Redirect blood from something – or to the same thing.

The stress response

How it works more or less is explained decently by explaining the Hypothalamic–Pituitary–Adrenal axis or “HPA-axis” and it’s parts, including the amygdala that interprets the threats.

The amygdala

It is shown to have a role in the processing of memory, decision-making and emotion, primarily the negative ones, including fear, anxiety, and aggression which makes it into something of a “panic button” or “little area of interpreting threats”. Hunting, being hunted, winning something grand or loosing everything. Survive or prosper. If it’s quite big, new and something to react to – it’s stressful and off it goes thinks the amygdala. Some of what it reacts to is rational, because it’s connected to the prefrontal cortex. Some less so, since it’s also connected to parts that are less rational. Connect to everything – to be able to react to everything and quickly. Missing something might be fatal. Like a horse and something rattling – first fear, then think.
The stress is initiated by the amygdala as a result if it’s something threatening. A distress signal is sent to the hypothalamus.

Hypothalamus, “below thalamus”.

The hypothalamus is a bit like a command center. It’s regulates metabolic processes and the autonomic nervous system and produce and secretes certain neurohormones to tell the pituitary gland to do the same. It controls body temperature, hunger, thirst, fatigue, sleep, and circadian rhythms.
Plenty go through here but the relevant parts here are: It excrete Corticotropin-Releasing Hormone (CRH) to the pituitary gland.It activates the autonomic nervous system.

Pituitary gland

The pea-shaped tiny structure at the bottom of the hypothalamus reacts to the CRH from the hypothalamus it produces AdrenoCorticoTropic Hormone (ACTH) to stimulate production and release of cortisol from the adrenal gland.

Adrenal glands

The small glands on top of the kidneys gets the ACTH which is the message to produce and excrete cortisol, epinephrine/adrenaline and norepinephrine/noradrenaline into the blood stream.The activation of the autonomic nervous system at the hypothalamus makes for a quicker path to excrete epinephrine and norepinephrine.
Adrenaline/epinephrine increase blood flow to muscles, output of the heart by acting on the SA Node[sinoatrial/sinus node; cellgroup in the heart with ability to spontaneously produce an electrical impulse] pupil dilation response and blood sugar level. It does this by binding to alpha and beta receptors and stimulating the sympathetic nervous system. Increase frequency of breathing and dilate small airways in the lungs. Sight, hearing, and other senses become sharper. Release blood sugar and fats from storage sites to supplying energy to necessary parts.
Norepineprine excreted into the blood affect the sympathetic nervous system, where it’s the most important substance for signalling. Increase performance of the heart by elevating pulse, blood volume pumped when doing so and power. It contracts blood vessels which increase blood pressure. Aids in keeping you awake, alert and attentive.
Cortisol increases blood sugar [gluconeogenesis], suppress the immune system, and aid the metabolism of fat, protein, and carbohydrates.

This happens quickly. The amygdala and the hypothalamus start the cascade before you’ve even processed decently what’s going on.

In short – you get going!
Energized and on your feet!
Less blood to irrelevant things like the prefrontal cortex, which keeps you thinking logically, everything that tend to digestion and smaller things like hands.
More of that blood to large arm- and leg muscles and they increase their tension.
Blood coagulates better.
If you’re going to war, let’s make sure you won’t bleed out first!
Vision, hearing and most things related to senses increase. You need to be alert, attentive and notice everything.
Quicker breathing.
More nutrition in the blood.
Elevated pulse and blood pressure.

If the stress becomes overwhelming you won’t be of much use however. If it’s far too much or if you’re rather prone to “freezing” rather than fight or flight, you’ll get a response in the parasympathetic nervous system and it’ll try to make you play dead. You’ll get powerless and perhaps even faint.

The HPA axis relies on this serie of hormonal signals to keep this “gas pedal” going. As long as you continues to find things that are dangerous you’ll get some CRH [corticotropin-releasing hormone] from the hypothalamus  and then ACTH [adrenocorticotropic hormone] from the pituitary gland which then will get the adrenal glands to do their thing and release stuff like cortisol. You’ll be up and alert until you’re done. When the threat passes however, your cortisol levels can return to normal and at last the parasympathetic nervous system gets to do its thing, which does the opposite.


How and why do we get sick?
We’re made for stress, but that’s for minutes and hours. Not months or years. Just as we’re made for some things in moderation too much have consequences, everything from water and food to pharmaceuticals and physical activity.

Muscles increase their tone, that’ll give pain and troubles in the purely physical parts. Tension headaches which might turn into migraines. Back-pain or more widely spread in the body and sometimes harder to pinpoint.
Sleep disorders are more common than not. You can’t hurry sleep. Your physiology knows that, regardless of if you do. It’s not uncommon to crash entirely a short period of time after insomnia sets in. Once you can’t sleep you’re going down quickly. The sleep was the last part keeping things together. That’s when you got to recover. Once that’s gone, the slippery slope gets too slippery.
Persistent epinephrine surges can contribute to cardio vascular disease by damaging blood vessels through an increased blood pressure. Constricting the vessels, making blood coagulate easier and go faster puts an unnecessary load on the system which might result in dire consequences such as heart attack or stroke.

High levels of cortisol will over time lead to a variety of consequences.
A newer finding is that it seems to erode the connections between nerve cells in the brain. This could be THE, or part of the reason why so many get so much cognitive symptoms from long term stress.
It will try to keep elevating the blood glucose levels for as long as it’s present. That might definitely increase the likelihood to get diabetes type 2, just as if you kept eating at all times.
Is it the cortisol itself or something that correlates with the cortisol that make people eat more or even use comfort food?
It will break down bone, just as if you kept eating cortisone, which might lead to osteoporosis.
It will break down muscle which makes the body composition worse; more fat, less muscle. That might contribute to ill health.
It seems to have a negative effect on the immune system. In the short term, that’s useful, it prevents the production of inflammatory mediators and decrease inflammation, just as exogenous cortisone does. Over time that’ll make immune cells produce fewer receptors and become more immune to the substance which will lead to an increased inflammatory response or “chronic inflammation”. Which is likely to be the reason autoimmune problems seem to blossom when the individual get too stressed for too long.

The effects on digestion seems to be able to give long term troubles. This is more fuzzy, but it’s not uncommon for people to get IBS-symptoms that tend to last even after tending to the long term stress. Perhaps the autoimmune response earlier might be a part of the reason?

Emotional issues is another really common one. It’s been shown that long term stress might affect areas of the brain that tend to regulating emotions, memory and focus which might result in more emotions – and it’s rare that those are primarily the good ones.

Depression could come from long term stress, which shrink certain areas of the brain and further diminish connections between neurons, just as the cortisol did. One thing leads to another which gives you what you don’t want.

It’s actually a really good thing that we do get a few heads up once we get too stressed.
Perhaps some tension headache,
an upset stomach,
stiffness in your shoulders or something similar.
They’re quite forgiving.
It’s not a big problem.
You’ll survive.

Listen when it’s on that level. If you don’t the signs will increase. Check in on the body often enough to have a clue about what’s going on and you’ll be fine. The big consequences won’t jump you in the middle of the night without any warning. You’ll get your warnings. Probably not even just once or twice. Listen to them and change things up once you’re warned – that way you won’t have to suffer from the serious long term consequences.

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