damaging effects of allostatic load occur when allostatic systems are either overworked , fail to shut off after the stressor is gone , or respond inadequately to the challenge . Allostatic load can lead to long-term health issues if not properly managed .
Importance of Managing Allostatic Load and Building Stress Resilience
An understanding of the management of stress and allostatic load is crucial for health and quality of life , especially in the context of aging . Prolonged or repeated activation of the HPA and the SAM system along with disruptions of the endocrine system caused by toxic stress ( or allostatic overload ) can interfere with the body ’ s ability to regulate core physiological processes , including antiinflammatory and immune responses , blood clotting , metabolism and gluconeogenesis .
Chronic stress leading to allostatic overload also creates neuroplastic changes in brain areas such as the amgydala . These effects on the amgydala then contribute to affective and anxiety disorders which perpetuate stress .( 7 ) Structural and functional changes in the amgydala also affect breathing , producing hyperventilation , another factor which perpetuates stress and anxiety .( 8 ) Disruptions in the regulatory functions of the autonomic nervous system and catecholamines resulting from toxic levels of stress have multiple negative effects on homeostasis in body systems , including the cardiovascular , pulmonary , hepatic , skeletal muscle and immune systems , resulting in increased risk for physical and psychological disease .( 9 )
When allostatic load overwhelms the body ’ s coping capacity it can result in persistent activation of the stress response or a state of depletion , with low corticotropin-releasing hormone ( CRH ) and subsequent lack of activation of the stress response . Low CRH is central to conditions such as seasonal affective disorder ( SAD ), postpartum depression , and , in some patients , chronic fatigue syndrome and fibromyalgia ( 10 ).
Stress also affects core processes of energy production and body regulation through its effect on mitochondria .( 3 ) At the deepest sub-cellular level of health , chronic or excessive ( toxic ) stress is a source of allostatic load that affects the structure and function of mitochondria ( 11 ). Mitochondrial defects affect the brain , endocrine , reproductive and immune systems . They also play a role in psychosomatic disease , transducing psychosocial experiences and emotional responses to biological and physiological changes that underpin disease .( 3 )
Chronic stress increases the risk of developing cardiovascular disease , immune dysfunction , certain types of cancer , obesity , respiratory and neurodegenerative disease , and gastrointestinal issues .( 9 , 12 ) In disrupting the function of diverse organ systems it often creates physiological changes that perpetuate stress . The gut microbiome is one example : stress disrupts the micobiome , and this disruption lead to brain changes that increase a person ’ s susceptibility to stressrelated disorders .( 13 )
Hyperventilation is another example . Stress leads to hyperventilation and low levels of carbon dioxide or chronic hypocapnia . The hypocapnia and the body ’ s attempts to create compensations leads to disruptions of homeostasis which in severe cases affect the brain and nervous system in ways that perpetuate both physiological and psychological stress .( 14 )
In my experience as a health practitioner , the accumulation of chronic stress is one of the most significant predictors of treatment resistance in patients with chronic illness . It ’ s also the driver of many functional conditions , unexplained by pathology .
Finding Ways to Manage Stress and Allostatic Load
In conditions that are perpetuated by stress the following steps are necessary to improve both physical and mental health :
1 . Identify and reduce physiological and psychological stressors
2 . Improve the function of the stress response system
3 . Improve resilience and tolerance to stress
Identify and reduce stressors
Stressors are any factors that require activation of the body ’ s stress response factors to maintain homeostasis . To effectively reduce allostatic load in a person whose stress response system is dysregulated , it is crucial to identify both the psychological and physiological drivers of stress . Psychological drivers include emotions , trauma and cognitions such as rumination and worry . These contribute to chronic stress by creating and sustaining
136 | vol30 | no3 | JATMS