I see a lot of dark under-eye circles on the faces of patients in my practice — and I’m not a cosmetic surgeon. I’m a functional-medicine practitioner.
My patients typically come in because they have a host of niggling symptoms that don’t make sense: They can’t lose weight, they feel chronically anxious, or they have eczema that won’t go away. About 25 percent have hypothyroidism; almost 50 percent report sleep issues.
But what is clear right away is that they all feel tired, overwhelmed, and unable to get to the bottom of their to-do lists.
These patients are in a state of chronic stress, and their bodies are showing the signs. This condition is technically called “allostatic load,” and it occurs after their stress response has been activated for too long.
Our bodies are beautifully designed to handle short-term threats — the stress response makes us alert, energized, and able to withstand physical injury — but we’re not designed to stay in this hypervigilant state all the time. It wears us out.
We can’t eliminate all the high-pressure aspects of our lives, nor would we want to. We all need some stimulation to be healthy. Still, we can learn to recognize the signs that our bodies are stuck in fight-or-flight mode.
We can also start to choose from the various stress responses that our bodies are designed to deploy — ones that shift our systems away from chaos and toward rest and recovery.
Signs of Adrenal Overdrive
Getting stuck in survival mode leads to two conditions I see routinely:
- Adrenal overdrive: When you can’t turn off the stress response, and you feel wired and tired.
- Adrenal overdrive with exhaustion: When you can’t turn on the stress response and you’re so exhausted you can’t get moving.
These types of adrenal malfunction show how the positive aspects of the survival system can become liabilities. For example, the energy from a big rush of blood sugar saves you when you need to battle or flee, but when blood sugar stays elevated for too long, it can lead to insulin resistance and type 2 diabetes.
Likewise, adrenaline does a terrific job of raising your heart rate and constricting your blood vessels. But when this process goes on too long, hypertension can develop.
The first step to escaping survival mode is knowing how to identify it: In adrenal overdrive, you feel anxious, hyperalert, and tense. You may notice that you’re wired and tired at night.
In adrenal overdrive with exhaustion, you might feel wiped out when you wake up in the morning, tired all day long, and then wide awake with worry when you finally turn out the light at night. Because you can’t shut the vigilance off, you never really rest.
We often have no idea that these symptoms mean anything. We may think we’re “just tired,” or that anxious thoughts reflect a genuinely threatening reality (and sometimes they do).
We might completely dismiss the idea of stress because we believe we have it better than other people — even though the difficulties of homeschooling a wily teenager or meeting the demands of our jobs are intense.
In an achievement-oriented culture, we often feel ashamed if we can’t handle exorbitant amounts of pressure, because it seems like everyone else can. We think there must be some problem with us, and we keep quiet about it.
To a degree, these kinds of stress are part of being alive. But most of us never get — or take — a break.
Even before we were forced to contend with a global pandemic, we were always on. Checking our smartphones is often the first and last act of the day. We’re triggered by emails, headlines, and text messages right up until we go to bed — some of us even sleep with the TV on.
Our schedules override the normal circadian rhythms that would have us going to sleep when it gets dark and waking up when it’s light.
Day in and day out, a range of stimuli we might never suspect are triggering our nervous systems, causing unrelenting stress that can do real damage to our health over time.
Yet when we learn to appreciate how our bodies are meant to respond to stress, and to identify when we’re stuck in the fight-or-flight response, easing into modes that rebuild and restore our health can become second nature. After all, our bodies are designed to support us. We just need to give them the chance.