The stress response

The COVID-19 pandemic presents dangers that many of us have never before experienced. Until now, it’s been easy when hearing about epidemics or potential epidemics on the news to cast it off and think, ‘Oh, that’ll never happen here.’ However, it is now happening here. It is happening most everywhere, given the worldwide dimensions of the COVID-19 pandemic. Even when communities come to control an outbreak, it comes back when those same communities loosen restrictions and open up. It’s hard to identify any society or country for which it hasn't resurged after a community comes to control the initial surge and loosens up the restrictions. As such, we’ve come to experience a low level dread that it’s only a matter of time before COVID-19 comes for us, if we haven’t had it already. Thus, the potential for serious illness and death to ourselves, our family and friends, and our wider communities heightens our awareness and places us in a persistent state of alarm.

Potential or actual job loss and financial stress that has accompanied the COVID-19 pandemic also raises our guard. Economies across the globe
are experiencing significant recessions, even to the point of some economists wondering about another great depression (Lacurci, 2020) with unemployment levels at about 20%. Job- and financial-related insecurities have thus put life as we know it in danger.

The human response to danger is called the stress response. We evolved this capacity to respond to danger because it helped our ancestors to survive acute threats to life and limb, such as being attacked by predators larger than ourselves.

From the microscopic to the macroscopic, the stress response involves cognitive, emotional, systemic, behavioral and social responses to threat or danger. All of these different aspects of the stress response occur largely simultaneously, interacting with each other. So, in the presence of danger:

• cognitively, we recognize it as dangerous or threatening, vigilantly focus our attention on it, and begin problem-solving for it; we also tend to learn quickly in these instances and will be able to remember it into the future
• emotionally, we are in a heightened state of alarm, having fear-based or aggressive feelings and sensations, such as tension, guardedness, gut reactions, rapid heart rate, increased blood pressure, increased perspiration, and flushed
• systemically, three bodily systems of the nervous system, hormonal system, and immune system work together to produce adrenaline, norepinephrine, and cortisol, leading to the above-described high-energy arousal and an inflammatory response which will have an initial beneficial role in healing from injury or illness
• behaviorally, we tend to aggressively take on the threat and fight it, or flee and avoid the threat
• socially, we tend to join together with others along some common lines of us against the threat; we also tend to offer help and tend to the needs of others

All of these aspects of the stress response interact with each other and lead to increased odds of survival when threatened.

We might imagine our distant ancestors in this heightened state of arousal and alarm, fleeing to climb the highest tree if alone in the jungle and caught off guard by a threatening animal, or banding together if in a group to fight a common threat. From the microscopic to the macroscopic, the stress response aids in our survival.

The stress response is like a sprinter, not a marathon runner

The stress response tends to work best when the danger is a distinct event, with a beginning, middle and an end. When zebras get chased by lions, their stress response provides them with a heightened burst of attention, arousal and alarm, leading them to be able to evade the lion by running away at great speeds. Once successfully free from danger, everything about the zebras calm down and they go about eating, resting and socializing in whatever ways zebras do. In this way, the danger and the resultant stress response have beginning and end points.

The same would be true if two territorial stray cats bumped into each other. They’d be apt to fight until one of them gets the upper hand and the other flees. The whole event wouldn’t last for hours, let alone days or months. Rather, it would be a matter of minutes, with largely distinct beginning and end points. Upon getting away and the fight resolving, both cats would calm down and go about their daily cat-like affairs.

At the time when the stress response was evolving, our human ancestors would have faced similar types of threats. It was dangerous back then, to be sure, but the dangers would come and then go. As such, the stress response adapted to be highly effective against distinct threats with a beginning and an end, measured in minutes, not days or months or years.

We can thus think of the stress response as a sprinter, coming out of the gait with a burst of attention, arousal and alarm, and effectively managing an event that’ll be over in a matter of minutes.

However, sprinters don’t tend to be good marathon runners.

Our current dangers associated with COVID-19 have no immediate end in sight.

The COVID-19 pandemic presents us with dangers to life and livelihood for each of us individually and for those with whom we join in these common threats. Just as it is supposed to be, our stress responses are kicking in to keep us safe. These dangers lead us to engage in the following:

• cognitively, they capture our attention and we engage in persistent problem-solving; as a result we might find ourselves watching our news feeds often, looking up do-it-yourself face masks or other COVID-related tasks
• emotionally, they lead us to be in a heightened state of alarm, with varying levels of anxiety and irritability, muscle tension and agitation
• systemically, our nervous, hormonal, and immune systems are working together to produce adrenaline, norepinephrine, and cortisol, leading to arousal and a widespread inflammatory response
• behaviorally, the dangers lead us to physically distance from each other, wear masks, shelter-in-place or engage in ways to respond to the pandemic through the institutions of healthcare, government, business and non-profits
• socially, lead us to engage in acts of compassion towards one another in our united fight against the virus; we may also tend to splinter into competing groups that differ on how best to respond to the pandemic and thus come to fight against each other

Based on what we know about how the stress response functions, these aspects are predictable and in fact describe the actual aspects of our individual and communal lives.

Notice too that some of these aspects of the stress response are leading to unhelpful responses when they continue indefinitely.

The stress response initially heightens our focus and attention on the danger, but over time they become impaired. The heightened attention of the stress response is like a sprinter being asked to run a marathon after the runner has already left the starting line in a full-blown sprint. The sprinter just can’t keep it going. Similarly, our initial heightened focus on danger becomes exhausted when asked to maintain it over time and as a result we become attentionally sloppy. Our attention spills out over anything and everything, and we become distractible.

Distractibility leads to aimlessness. Tasks and goals for the day are thwarted by other demands and they all become in partial states of completion. By the end of the day, it can seem like nothing got done and yet you’re exhausted.

Aimlessness is fatiguing. A persistent state of arousal associated with the stress response takes a lot of energy to maintain. It’s like an engine idling at too high of a rate. It uses up all the gas without ever really going anywhere. Similarly, when the stress response remains engaged for too long, the resultant distractibility and aimlessness is exhausting.

Sleep can become an avoidance strategy. While it may initially prove helpful, sleep as an avoidance strategy can outlive its usefulness, just as the attentional aspects of the stress response are outliving their usefulness. Avoidance sleep is rarely refreshing when done on a repetitive basis.

This odd combination of distractible over-activity coupled with pockets of inactivity and rest leads to a persistent boredom. It can feel like you have too much to do and not enough to do at the same time. In addition to sleep, other avoidance strategies such as binge watching TV or stress eating can provide temporary relief but they lose their luster in time. As a result, we come to have a vague sense of futility through our days called boredom.

In this boredom, we have little to hold our attention but for the threats associated with COVID-19 and a tanking economy.

The stress response thus leads to boredom and boredom leads back to stress in this age of COVID-19.

References

Lacurci, G. (2020, July 21). A second great depression? Unemployment crisis hits big cities hard. CNBC. 

https://www.cnbc.com/2020/07/21/some-big-cities-are-hitting-great-depression-unemployment-levels.html

Date of publication: July 27, 2020

Date of last modification: July 27, 2020

About the author: Dr. Murray J. McAllister is the publisher and editor at the Institute for Chronic Pain (ICP). The ICP is an educational and public policy think tank. Our mission is to lead the field in making pain management more empirically supported and to make that empirically-supported pain management more publicly acessible. To achieve these ends, the ICP provides scientifically accurate information on pain that is approachable to patients and their families.