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 have sleep problems. But what I realize right away is they 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 the 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 hyper-vigilant 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. And we can start to choose from the different stress responses that our bodies are also 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 in my practice: adrenal overdrive (when you can’t turn off the stress response) and adrenal overdrive with exhaustion (when you can’t turn it on). In the former, you feel wired and tired; in the latter, you’re so exhausted you can’t get moving.
These two 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 leads 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 moving out of survival mode is knowing how to identify that you’re in it: You feel anxious, hyper-alert, and tense. You may notice that you’re “wired and tired” at night.
If you’re in adrenal overdrive with exhaustion, you might feel wiped out when you wake up in the morning, tired all day long, 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 are symptoms of anything. We may think we’re “just tired,” or that anxious thoughts reflect a genuinely threatening reality. We might completely dismiss the idea of stress because we believe the circumstances shouldn’t be as challenging as they are — even though the difficulties of raising a wily teenager or meeting the demands of your job 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 a part of being alive. But most of us never get — or take — a break.
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 serious damage to our health over time.
When we learn to appreciate how intelligently our bodies are meant to behave in response to stress, and to identify when we’re stuck in the fight-or-flight response, easing into modes that rebuild and restore our health will become second nature. After all, our bodies are designed to support us. We just need to give them the chance.