Walking Dead: Chronic Stress Injury.

"The physiological response to stress is normal, expected, and helps us cope with threats. Our brain has the ability to store memories of events (images, smells, sensations) that can be triggers for ongoing stress responses. When we are unable to turn off the normal stress response we can become physically impacted from the constant state of arousal.” — NOLS Wilderness Medicine Handbook

Once you learn the signs and symptoms (S/Sx) of chronic stress injury, you see it in people, cultures, and environments everywhere you go. 

Viewing the impact of chronic stress as a personal injury is a frame that would change most people's lives.

It's obvious someone is injured when their wrist is in a cast, they have a rash on their face, or are presenting symptoms of the flu.

It is just as obvious that someone is suffering from chronic stress injury once you know what to look for.

A key concept in First Response is ‘early changing’ and ‘late changing’ vital signs. Indicators that something bad is happening. Some signs appear early, while others show up later.

• Early-changing vitals include heart rate, respiratory rate, and skin colour.
• Late-changing vitals include pupil responsiveness, blood pressure, and core body temperature.

If someone’s pupils are fixed, dilated, and unresponsive to light… you’re late in the game and a crisis is already happening. If someone’s lips are turning blue (cyanosis), something bad is happening but you’re not in full-blown meltdown... yet. 

Cyanotic skin is an early-changing vital sign. Unresponsive pupils are a late-changing vital sign.

There are early-changing and late-changing signs of chronic stress injury.

Early Changing S/Sx:

• Loss of vitality/creativity.
• Dreading work.
• Short fuse. "Everyone's a problem, everything is too much work."
• Lack of motivation.
• Physical fatigue.

Late Changing S/Sx:

• Sleep disturbances.
• Substance use/abuse.
• Persistent anxiety.
• Isolation.
• Inability to feel pleasure (anhedonia).
• Hopelessness.

It's easy and tempting to shrug this off, "These are normal for me, and everyone I know feels most of them. It's not that bad."

That is true.

But you won't like the reason why...

Our society is sick.

Chronic stress injury is a reality for the majority of people you walk past on the street. That doesn't make it normal. Absolutely not healthy.

It means that we have come to accept profound dysfunction and illness as 'normal'.

If you notice the S/Sx of chronic stress injury, you should start treatment (Tx) for it.

The longer this goes unresolved and unprocessed, the more insult is added to injury, the worse things get, and the harder it becomes to resolve later on.

Tx Principles for Chronic Stress Injury:

• Take a real break.
• Disconnect from technology/social media.
• Do things that bring you joy.
• Body-based decompression: yoga, walks in nature, massage, breathwork, meditation, exercise, and sunlight.
• Get the basics right: sleep, diet, exercise, meditation, home, hygiene.
• Resolve the sources of stress (have the uncomfortable conversation, change your job, get out of debt, stop doomscrolling).
• Seek professional help (therapy, psychiatry, doctor's office).
• Build more structure for energy management into your daily routine.
• Scream into a pillow.
• Shake and dance it out.
• Cry.

One thing NOLS doesn't address head-on, but I believe is important to share:

Chronic psychological-emotional stress injury will eventually metastasize and manifest as physical conditions and illness.

• Yes, there is a direct connection between your gut issues and your toxic relationship.
• Yes, your inferiority complex from childhood is now manifesting as an obscure and untreatable rash on your back.
• Yes, you get sick every 3 months because your immune system is trashed, because your body is never in a rest/repair parasympathetic state from workaholism.

If you are under chronic stress and your body is dumping adrenaline and other biochemical cocktails into your system beyond reasonable levels, paired with poor recovery from broken sleep and a myriad of minor issues, this will set off physical cascades that eventually become major problems.

Acute stress will grow into chronic injury. Stay injured long enough, and it becomes debilitating and life-threatening physical and psychological problems.

Fortunately, all you need to do is manage your stress. Be kind to yourself. Practice self-care like a sacred ritual. Slow down. Deep breath.

Take good care,
EB.