General Adaptation Syndrome
Stress can be both positive and negative. Eustress is a positive stressor such as getting married, moving, going on vacation, getting a promotion at work, a surprise party and making new friends. Distress is a negative stressor which are frustrating, traumatic, and unpleasant situations that induce the emotions of fear, anger, and shock. Other stressors include anything that threatens survival like malnutrition, sleep deprivation, infection, medication, dehydration, excessive exercise, toxic beliefs, negative self talk, and un-forgiveness. Stressors are physical or emotional responses that trigger a physiological reaction to stress. The body responds to internal and external stressors in predictable biological patterns, so that internal balance, or homeostasis, can be maintained or restored.
Dr. Hans Seyle divides GAS into three stages, but I have identified four stages.
The alarm stage is the body’s initial reaction to stress it labels as a threat or danger to balance. It immediately activates the fight or flight response system, and releases “stress” hormones (adrenaline, noradrenaline and cortisol). These hormones enable you to have abilities you don’t usually have, like more speed, strength and greater pain tolerance. The body wants things to be resolved quickly and easily, so it releases hormones in its response to stress because they act immediately. However, the body’s ability to control or reduce stress has its limits. The survival mode, fight or flight mechanism is designed to last not longer than four minutes, because something will happen within 2-4 minutes. Either you will get away or the enemy will kill you.
The alarm stage is the body’s reaction to sudden exposure to anything it has not qualitatively or quantitatively adapted. In other words, something the body has not evolved with. Then the body responds to an immediate threat or challenge by going into shock phase and then counter shock phase of the alarm stage. Shock occurs when the body experiences a drop in its resistance to the stressor leading to a release of adrenaline, an increase in heart rate, and a decrease in muscle tone, body temperature, and blood sugar. Counter shock occurs when the body reverses most of the physiological signs of the shock phase, leading to an increase in blood volume, blood sugar, and temperature. These phases can last from a few minutes to 24 hours depending on the intensity of the stressor.
As the body goes through the phases of the alarm stage, defensive mechanisms are activated through the Hypothalamus-Pituitary-Adrenal Axis to fight against the stressors. The HPA axis unites glands, hormones, cytokines, glucose regulation, other metabolic processes and parts of the brain that deviate the GAS into a complex set of feedback interactions among the hypothalamus, the pituitary gland, and the adrenals. This forms a major part of the neuroendocrine system. The endocrine system controls reactions to stress and regulates many body processes, such as digestion, immune function, mood and emotions, sexuality, and energy storage and use. The hypothalamus activates adrenal functions and prepares the body for fight or flight by increasing heart rate and blood flow to the muscles, heart, and brain.
Symptoms associated with the alarm stage include heart palpitations, shallow breathing, muscle tension in lower back and neck, nausea, anxiety, dizziness, sweating, and numbness of the limbs. Continued exposure to stressors cause the body to transition from the alarm stage to the resistance stage of General Adaption Syndrome.
The resistance stage is when the body attempts to return to normal after the physiology has responded to the stressor, because the stress level has been reduced or eradicated. The fight or flight response robs the body of its vital force and makes it weaker. It needs to allocate energy to the repair of damaged muscle tissues and lower the production of stress hormones. The body remains on-guard, even though it has shifted to this second stage of the stress response, especially when the cause of stress persists. The body could respond again to the threat, but not as strong as during the initial response.
The body was not designed to live in a state of chronic stress. Living in survival mode every day is causing the symptoms many people suffer and those symptoms are the body’s way of telling them that their lifestyle is not working for them. Medication tells the body to ‘shut-up,’ but that doesn’t solve the underlying problem. Chronic stress exhausts the body’s limited energy supply and reduces its ability to handle future stressors. Chronic stress has the potential to interfere with your enjoyment of life, your ability to perform ordinary daily activities, causes you to age more quickly, and dramatically increases your susceptibility to chronic illness and diseases. Dr. Hans Selye says, “Every stress leaves an indelible scar, and the organism pays for its survival after a stressful situation by becoming a little older.” He observed how stress affects the human body through aging and other natural body processes that occur as we encounter stressors in our daily lives.
Prolonged stress continually activates the Hypothalamus-Pituitary-Adrenal (HPA) axis, affecting hormone balance and cell mediators. Cortisol is the primary glucocorticoid hormone involved in the adaptation process that helps maintain homeostasis and stimulates the release of other hormones to maintain balance. Cortisol is released by the adrenals in response to stress to regulate physiological reactions to stress, but continued release of cortisol affects hypothalamic and pituitary feedback loops in a way that can lead to persistent activation. HPA axis activation and cortisol issues can persist for years, affecting most major body systems; gastrointestinal, neurological, musculoskeletal, endocrine, respiratory, and immune systems. Stress can affect physical, behavioral, and neurophsychiatric function.
The adaptation stage is when the body tries to function with the status quo, but with much lower performance in an attempt to ration all available resources in order to survive. This is the gateway to chronic illness, and makes itself known through chronic symptoms, which can lead to chronic health problems and disease if not resolved immediately.
You enter the exhaustion stage when tissues in the body become susceptible to dysfunction. During this stage, the stress has been persistent for so long that the body begins to lose its ability to combat stressors and reduce their harmful impact because the adaptive energy is exhausted. This is physiological burn-out, which shows up as chronic health problems and disease conditions.
Think of yourself as a plant. When a plant receives the proper amount of light, moisture, nutrients from healthy soil and is protected from damage by external elements, it is able to thrive. It produces phytochemicals that repel insects that would eat it. The healthy plant would enjoy a state of homeostasis.
When a plant is deprived of any one of the things it requires to stay healthy, it stresses the plant and homeostasis is threatened. This is the alarm stage.
The resistance stage is an attempt to survive, the plant begins to slow down its metabolic processes to need less water, nutrients or sun while waiting for conditions to improve.
When conditions do not improve, the plant tries to adapt to the prolonged stress. This is when parasites, viruses, bacteria, molds and fungus invade the plant and the weakened immune system cannot defend it against the pathogens. Think about it! Mold and fungus grow on dying and dead things. Many of these invaders were designed to decompose a dead body. What does that tell you about the state of your health when yeast infections occur?
When the plants resources are exhausted, systems begin to break down and the plant begins to succumb to disease. Restoring the plant to homeostasis at this point is not impossible, but it will take a tremendous amount of time, effort, close attention, a carefully planned strategy, experimentation, re-adjusting, expense and patience to obtain optimum results. There are two approaches to this.
A holistic plant doctor will notice the undesirable changes, identify the problem, develop a plan of action and provide the appropriate remedy; the correct amount of pure water, organic nutrients, the proper exposure to real sunlight. The plant instantly responds and has a better chance for a full recovery and thrive because it receives and recognizes these nutrients in the forms that nature intended and it was designed to utilize.
The other kind of plant doctor will medicate the plant with pesticide to kill the bugs, apply synthetic nutrients and put it under an artificial grow light. The plant may survive longer than if nothing was done, but it will never be truly healthy and present with a false or artificial appearance of 'health'.
The effects of chronically high levels of cortisol due to chronic stress:
Under normal conditions, plasma cortisol peaks just before awaking and decreases throughout the day. When cortisol levels are weak upon waking, this can indicate HPA axis disruption. Cortisol secretion should ideally peak between 6-8 am, with a natural decline throughout the day and the lowest levels achieved between 9pm-12am.
• Cortisol levels increasing between 80-100 indicates accelerating activity.
• Levels decreasing from 100-50 indicates decelerating activity, usually mid-afternoon, when people reach for coffee to get through the day.
• Winding down occurs when levels decrease further, to 30.
• Physical repair occurs when cortisol levels are around 20-10 and below 10 psychological repair occurs.
My personal experience: I progressed into the exhaustive stage, after a three decades of prolonged chronic stress, when cortisol levels are always high, resulting in two more decades of chronic illness and disease conditions. The phases of awake and sleep became blurred, so that I existed somewhere between ‘asleep and awake’ most of the day. I couldn’t get sleep and when I did, I didn’t sleep for very long or well (not restorative or rejuvenating). I was a zombie during the day.
Salivary cortisol monitoring throughout the day can provide valuable clinical information. Patients who are under stress may have surges of cortisol that are superimposed on the innate circadian patterns. HPA activation can affect normal sleep cycles, and the lack of sleep can alter HPA axis function and the glucocorticoid feedback loop. Supporting hypothalamus and pituitary sensitivity to cortisol, maintaining a healthy circadian rhythm, and supporting limbic system activity to reduce inappropriate threat perception is key to achieving clinical goals. The limbic system is a complex system of nerves and networks in the brain, involving several areas near the edge of the cortex concerned with instinct and mood. It controls the basic emotions (fear, pleasure, anger) and drives (hunger, sex, dominance, care of offspring).
Stress can affect the function of metabolic processes regulated by the HPA axis. Changes in metabolic function may be adaptive at first, but on-going stress necessitates additional support from various metabolic parameters. We are familiar with ‘adrenal fatigue’ and focus on supporting adrenal function, however, the effects of stress impact more than just the adrenals. Focusing on cortisol and adrenal function may overly simplify complex interactions among several systems and overlook the contributions of the central nervous system, environmental factors, and other metabolic factors.
The clinical utility of identifying the stages of General Adaptation Syndrome is helpful, however, it never occurs in its pure form, but is always complicated by superimposed specific actions of the eliciting stressors. The impact of stress is a spectrum that has an individualized and varied outcome. Individuals react differently to stress. The impact of stress is unique to each person and it can manifest through a range of symptoms which are affected by blood type, nutritional status, sleep, past exposure to stress (PTSD) and other differences. Approximately 90% of visits to primary care physicians are stress-related. The spectrum of responses to stress resistance as the body progresses through these four stages are a guideline.
Early-stage symptoms in response to high stress levels include, appearing high strung, anxious or agitated, occasional sleeplessness, but little fatigue (tired, but wired) and higher pulse.
Laboratory values - check cortisol, DHEA, blood pressure and blood glucose.
Mid-stage symptoms in response to moderate stress levels include, being tired.
Laboratory values - check serotonin.
Late-stage symptoms in response to low level stress include, fatigue/exhaustion, very tired in the evening, occasional sleeplessness (difficulty falling asleep and staying asleep), low pulse, low body temperature, chronic pain.
Laboratory values - check cortisol, DHEA, serotonin and blood pressure.
Understanding the impact of stress on the HPA axis will help to accurately assess common and complex symptoms within various stress response stages. Being able to recognize and respond appropriately to eliminate stressful stimuli is the first step to recovering your energy, restorative sleep and creating a healthy stress response. Health professionals should assess a patient’s stressors and identify symptoms associated with each stage of the General Adaptation Syndrome, but of all 23 doctors I have been to, conventional and alternative alike, not one has ever mentioned it.
Supporting proper functioning of the HPA axis should be a critical goal for patients. Appropriately-designed nutritional, behavioral and lifestyle support are critical to help support healthy HPA axis function and restore homeostasis. Specific recommendations differ based on the stage of stress resistance. Generally speaking, movement on a regular basis that is appropriate for your biochemistry, establish regular bed times and obtain optimum sleep, practice relaxation on a daily basis, stop smoking, avoid alcohol and sugar, increase food quality and remove foods that are not biocompatible with your blood type. I provide a comprehensive, yet flexible, and individualized approach to client coaching.
Note: Cortisol is a steroid hormone, in the glucocorticoid class, that your body makes naturally. When used as a medication, it is known as hydrocortisone. When the body is continually bombarded with steroid, it can develop something called 'Topical Steroid Withdraw' or 'Red Skin Syndrome.' See article.
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