Throughout our lives we experience a lot of stresses. Most of these we can cope with without even thinking about, but sometimes they exceed our ability to be able to cope which leads to an increase in stress and anxiety levels, and may modify our behaviour so much that it leads to depression. Read on to find out more and how we may be able to help you.
The first part of this article addresses what constitutes a stress, how the body reacts and why people react differently. The second part is going to be discussing coping and the new therapeutic approaches that can treat emotional traumas to de-stress the system and return you toward 'normal'.
So what happens when we see something? And how do we judge whether it's a threat or not?
We judge new experiences that we encounter against similar encounters that we have experienced in the past and by judging how those around us act or would act (learned behaviours from parents, peers and so on). When we come across a stress or situation that we believe we cannot, or are unable to, cope with our brain will trigger the fight, flight, freeze or faint response in our system.
This stimulus sets off a cascade of hormonal responses that short term allow us to cope with the situation:
This is obviously a very normal response that is designed to promote our survival and after the stress has diminished or been removed we should revert back to our normal state of rest and relaxation. The problem comes when following these events we do not leave the fight, flight, freeze or faint response and we get stuck in it.
Why do we get stuck in the fight, flight, freeze or faint response?
When we have been unable to process, rationalise (if possible) and understand (if possible) what we have experienced then we can become emotionally trapped in the trauma and the emotions that it triggered at the time. Until we are able to move past it then we will continue to be stuck even if we no longer consciously think about the event, and this will mean that we continue to produce the stress hormones that will start to drive a lot of undesirable physical and mental responses that are associated with stress, anxiety and depression.
Some of these effects of being stuck in a fight / flight response can be seen in the diagram below.
Hormonal responses to stress (quick biological bit)
The sympathetic nervous system regulates our stress response via the hypothalamus. A stressful stimuli causes the hypothalamus to signal the adrenal medulla and the adrenal cortex which mediate the short term and long term stress responses respectively.
Initially the sympathetic nervous system stimulates an increase in energy levels in case we need to fight or flee by stimulating the release of adrenaline (epinephrine) and noradrenaline (norepinephrine) from the adrenal medulla. These two hormones stimulate the liver and skeletal muscle to breakdown glycogen and increase oxygen availability by increasing heart rate and dilating the bronchioles. Our brains prioritise survival thereby diverting blood flow to essential organs such as the brain, heart and skeletal muscles while decreasing blood flow to non essential organs in this situation such as the skin, digestive system and kidneys.
These short term responses are not sustainable and so when prolonged periods of stress are encountered the body switches in to a long term survival mode. It does this through the use of glucocorticoids which ensures we can meet long term energy requirements. Epinephrine and norepinephrine responses cannot be sustained and so the hypothalamus triggers the release of ACTH from the pituitary gland which in turn stimulates the release of corticosteroids. These hormones target the breakdown of fat which becomes used for energy production. There are two subsets of corticosteroids: glucocorticoids such as cortisol and cortisone; and mineralocorticoids such as aldosterone.
These hormones ultimately start to have a negative impact on the system compromising the resilience of our immune systems and leading to an increase in blood pressure. This also leads to prolonged healing times, reduction in ability to cope with vaccinations, and heightened vulnerability to viral infections. The long term, constant cortisol exposure associated with chronic stress also produces symptoms including impaired cognition, decreased thyroid function, an accumulation of body fat, as well as negatively affecting endocrine function.
When stuck in fight / flight for a long time this leaves us with a lower resilience than normal meaning that we are more likely to have panic attacks, feelings of anxiety and other physical or psychological responses as we have a smaller capacity to cope (because we are already stressed). We may also find every day events that wouldn't typically be considered stressful to cause us anxiety as our system may be in a state of hyper arousal. To try and illustrate this in as simple a way as possible I have created the Beaker Model which can be seen below. Here you can see an example of a 'Normal', a 'Stressed', and an 'Anxious' system which attempt to highlight how different people are able to cope, or not, with particular events, and how they may inter relate with one another.
The Beaker Model is a simplistic graphic which suggests that every person has the same capacity to hold or process stressful events, this is a finite amount. In a Normal System we are able to process every day activities easily and have plenty of 'capacity to cope' as shown by the yellow section and it would take something very large or stressful to put us above the first red dotted line into the Danger Zone. The second beaker shows that of a Stressed System and shows how previous emotional traumas that are still carried in our systems reduce our capacity to be able to cope with additional stressors. The bottom beaker shows that of an Anxious System, in this system it is seen that we over react or amplify every day stresses and additional stresses as well as worrying about abnormal things that someone with a Normal System does not worry about. Again this leads to a crossing into the Danger Zone and it is common to see anxious people having physical symptoms due to them being close to, or exceed, their ability to be able to cope with stresses.
How we react to a situation is a combination of learned behaviours and judging against previous similar experiences. So for example if you have anxious parents you are more likely to develop anxiety yourself, over reacting and worrying about things that people in a Normal System won't. It should also be noted that if someone has suffered a severe emotional trauma which is still in their system it may be the case that certain stimuli which remind them of the incident will send them straight in the red zone such is the stress that it caused. It is also not uncommon for these people with conditions (diagnosed or undiagnosed) such as PTSD to seem to be on autopilot, or in a bit of a zombie state, functioning perfectly but just going through the motions, almost emotionless, or ready to fly off the handle at any moment.
For those with Stressed Systems there is lots of research out there which highlights correlations between those who go on to have problems with alcoholism or drug abuse that were either abused as children or had a traumatic childhood and so they develop these habits to escape or cope. Anyone who has had any emotional traumas of some sort (so almost everyone) will have trapped emotions in their system and they are all more likely to suffer from anxiety or depressions or be unstable simply because they have a diminished capacity with which to cope with things that come their way. Of course in reality everyone is a mixture of all 3 beakers, the interesting question in my mind is what created the anxiety that people suffer with? Is it a purely learned behaviour or does it have more sides to it?
So what constitutes an emotional trauma?
Anything that we are emotionally unprepared to cope with at the time. The loss of a family member, an abusive relationship, a mugging, sexual assault, abuse, accidents (particularly those that you can see coming but not get out the way of), being diagnosed with a life changing condition, being made to feel inadequate by a parent or teacher, losing a parent in a supermarket when a toddler, being bullied at school, having a horrible boss, fighting in a war and experiencing the loss of friends, and so on.
What I hope that you can see is that a lot of those listed above are very common and a number of them are not commonly associated with being a trauma. A toddler getting lost in a supermarket is almost an everyday occurrence, but not to the toddler who will be feeling lost, alone, and potentially abandoned. All pretty serious emotions. Imagine now that that toddler gets stuck in the fight, flight, freeze or faint response from this experience as when they are found by their parent they are told off rather than comforted, thus reinforcing the feeling of being abandoned, add in now the lack of trust they may develop because if they can't trust their parent to be there for them who can they trust and suddenly that individual may be left mistrusting and feeling alone for a long time.
My point is that even something that can seem small to one person can be a huge event to someone else (or even your adult self), and so everything needs to be considered when thinking of emotional traumas and the impact that they can have on us, and arguably the earlier that we experience them the larger the potential effect they will have on us.
Hopefully this short article has highlighted a few important points: firstly that stress is completely normal, perhaps it has explained why you or friends or family react to certain situations in a particular way. We have also presented a short simplistic model that hopefully goes some way to explaining how stress work and that it can have a cumulative effect on the system and how this can be physically (as well as emotionally and mentally) detrimental if you are in this state for a long time.
In part 2 we will be looking at how to process and treat emotional traumas to help people move from a Stressed or Anxious System towards a Normal System.