The Stress We Carry
In today’s world many of us wear our stress as a badge of honor. We are overworked, constantly productive (often tying our self-worth to what we can achieve), overstimulated, under-slept and often under-nourished (even in a state of caloric surplus). We multi-task, we wear many hats, we try to juggle it all… but what happens when we can no longer keep up with our busy, stressed-out lives? Many patients I see have experienced some type of crash— and this shows up differently for different people. Peri-menopausal symptoms or hormone “imbalance”, extreme fatigue, getting sick more frequently, auto-immune symptoms, an early joint replacement, a cancer diagnosis. Often something happens that forces the slow-down.
There are many terms thrown out on the internet that may not be medically accurate, one of those terms is “adrenal fatigue”. This essentially describes what is happening from a chronically stressed and depleted system but it is not a medical term that is recognized. So what is really going on?
Allostasis and allostatic load
In medicine we describe the amount of combined stress a body can take as “allostatic load”. Similar to homeostasis where the body’s physiology seeks harmony and balance, allostasis is an understanding of physiologic balance that goes deeper, describing how the body is constantly responding to change and how the body always seeks the most efficient regulatory mechanism in the moment. This means basically that our bodies are always responding and adapting to change with the best response for the organism in the moment. But the problem is that our bodies live only in the present moment and cannot plan for the future. SO, it may be advantageous for example to raise your blood pressure to meet the demand in a stressful situation, but if you are chronically in that stressful environment and your body is chronically adapting by raising your blood pressure, over time this is no longer beneficial. Then multiply this by all the chronic stressors someone is exposed to (or carries in their body in the form of previous trauma or toxic exposures) and this is called allostatic load. Simply put, allostasis is your body’s ability to maintain stability through change. And everyone has a different set point because everyone has different stressors that “add up” to create different allostatic loads.
How stress changes your stress response
It is now well known through studies looking at adverse childhood events (ACE scores looking at childhood trauma) that exposure to early life stressors such as trauma and abuse impact our stress responses later in life . This can cause different patterns in hypothalamic-pituitary-adrenal axis alterations (often a blunted reactivity or lower cortisol response than is normal or a flattened cortisol curve), autonomic shifts such as lower vagus nerve tone or increased sympathetic (fight or flight) tone, pro-inflammatory biology, and epigenetic changes in stress-related regulatory genes. The effects vary by type (such as threat exposure vs deprivation), timing, and of course individual responses. All this to say, a nervous system that is exposed to chronic stress early in life (and this does not have to be big T trauma but can also be little “micro-traumas”) is impacted in how it responds to stressors later in life.
Signs and symptoms of high allostatic load
The truth is everyone is an individual and will respond to high allostatic loads differently. Everyone has a different “tipping point” when the stress bucket becomes full and your body starts to experience symptoms. Symptoms of high allostatic load can be anything! Fatigue (especially fatigue that doesn’t resolve when you rest), poor recovery from work-outs, frequent illnesses— catching every cold or flu that comes around, brain fog, memory issues, struggling with blood sugar balance and cravings, high blood pressure, weight gain that is difficult to lose, mood shifts (depression, anxiety, irritability), aches and pains that are worse can all be symptoms of high allostatic load and are just some examples of what can show up!
So what can we do?
Allostatic load is a useful concept because it helps understand why two individuals may have very different responses to the same stressor. Stress gets a bad rap— with good reason as many of us are living in highly stressed and dysregulated states— but it is important to understand that the stressor itself is not bad. We need stress and stress hormones to survive! And interestingly, too little stress also causes problems. It is the way we respond to stress that can cause problems. If you are struggling with any of the symptoms above, the best thing to do is work with a qualified health provider to dig into the underlying root cause of your symptoms. BUT there are some general things you can do to support your body to increase your stress resilience!
Nervous system regulation practices— I love to talk about this, there are so many things you can do to support balance! Breathwork, meditation, yoga, time in nature, grounding, just placing a hand on your heart, taking a deep breath and finding center again.
Sleep— restorative sleep is the best tool we have for health and healing. Of course, sometimes life steps in (I am a mom with small kids too), but do the vest you can to get restorative, regular sleep! If you suffer from poor sleep, come in for a visit and we can get to the bottom of it.
A balanced diet and balanced blood sugar— regular balanced meals with plenty of protein and fiber will help keep your blood sugar steady which sends your system a signal of safety.
Movement— movement is a great way to burn off stress! Find something you love to do and move your body! When in doubt go for a walk.
Processing emotions— learning to actually feel our feelings is a skill most of us haven’t learned. Unprocessed emotions contribute significantly to our stress, resilience, and ability to cope. Journal, talk to a trusted friend or find a therapist you jive with!
Connection— humans are meant to live in community. We are wired for community and connection and strong social connections help buffer stress
Osteopathic manipulative medicine— my number one tool for supporting nervous system regulation and helping the body increase stress resilience!
Functional medicine testing— sometimes hidden stressors can be significant triggers like heavy metal toxicity, toxic load burden, or nutrient deficiencies. This is something we can dig into both with history, lifestyle, and functional medicine testing if you’re ready to take your health and healing to the next level!
Final thoughts
Stress is a natural part of life. and stress is not inherently bad! We can have some control over the response thought learning nervous system regulation tools and supporting our system so that we have better stress resilience. Stress is not just an emotional experience—it’s a whole-body event. By learning to recognize the signs and investing in practices that restore balance, we can protect long-term health, energy, and vitality.
Instead of asking “How much stress can I handle?” the better question might be:
“How can I support my body so stress doesn’t become my story?”
If you want to learn more, check out Dr. Aviva Romm’s Podcast and blog on the topic linked here.
References:
Ramsay DS, Woods SC. Clarifying the roles of homeostasis and allostasis in physiological regulation. Psychol Rev. 2014;121(2):225-247. doi:10.1037/a0035942
Bunea IM, Szentágotai-Tătar A, Miu AC. Early-life adversity and cortisol response to social stress: a meta-analysis. Transl Psychiatry. 2017;7(12):1274. Published 2017 Dec 11. doi:10.1038/s41398-017-0032-3
Niu L, Gao Q, Xie M, et al. Association of childhood adversity with HPA axis activity in children and adolescents: A systematic review and meta-analysis. Neurosci Biobehav Rev. 2025;172:106124. doi:10.1016/j.neubiorev.2025.106124
Wesarg C, Van den Akker AL, Oei NYL, et al. Childhood adversity and vagal regulation: A systematic review and meta-analysis. Neurosci Biobehav Rev. 2022;143:104920. doi:10.1016/j.neubiorev.2022.104920
