A few years back, my dad was near end-of-life, my marriage was on the rocks, and I was training for the Boston Marathon. It was a lot to deal with – emotionally and physically. I ended up injured and never saw the start line. There’s a technical term for this: allostatic overload. (“Allostasis” refers to your body’s response to stressors; overload is just what it sounds like.) More and more evidence suggests that allostatic overload can harm our health – linking it to heart risks, high blood pressure, poor mental health, and early death. Consequences can be external too: College football players, for instance, are more likely to get injured during finals and midterms, research shows.
We all live in a perpetual state of allostatic load – the pileup of stress from a variety of sources. It’s just a question of how much load. Our bodies and minds are pretty resilient, but if one or more of those sources of stress gets over-amped, we enter a state of allostatic overload. When that happens for a prolonged period, part of your body may give out.
“Think of your body like a car,” said Natalie C. Dattilo, PhD, a Boston-based clinical psychologist. “As you use it and drive it over time, the wear and tear add up. If you’re not maintaining it, the car breaks down.”
Your body can break down from allostatic overload in many ways. For some people, it’s aches and pains, injuries, muscle tension in your back, stomach issues, and more frequent illness.
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Then there’s an emotional or psychological reaction to allostatic overload: You’re more cranky, you can’t sleep because your brain won’t turn off, and you fall into depressive or anxious states.
In some cases, you may have both mental and physical fallout from your stress overload.
How do you know if you’re in allostatic overload? It can be hard to tell, even for professionals. Psychologist Jennifer Dragonette, PsyD, points out that it’s not a DSM (Diagnostic and Statistical Manual of Mental Disorders) diagnosis, so it’s not something people necessarily recognize. “We don’t have a medication for it,” said Dragonette, a clinical services instructor at Newport Healthcare in California. “It often masquerades as anxiety or depression or is co-morbid with those conditions.”
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Allostatic overload doesn’t start with one specific, identifiable experience, either. “Part of treatment is figuring out what’s happening and why,” said Dragonette. “I often work backwards with my patients to parse out the causes.”
Best-case, you can recognize when you’re wading into dangerous territory and do something about it. But even if you miss your chance at prevention, you can find your way out from under overload. Here’s how.
Make a List and Decide Priorities
Everyone has unavoidable duties in life. Parents must take care of children; jobs need doing despite heavy workloads; friends need help. Some stressors are more universal – the pandemic, for instance, or periods of global upheaval.
The key: Some factors are within our control, and others aren’t.
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Dattilo likes to guide her patients in listing all their stressors and then helping them figure out what to take off their plates. “When we feel overwhelmed, we’re mentally disorganized and it all feels like too much to manage,” she said. “But when you take action by prioritizing what’s urgent and what’s not, you can help slay anxiety.”
Literally take a piece of paper and write down all the demands on your life and time, she suggested. Then cross off any that are out of your control. Federal workers might be worried about job security, for instance. That’s understandable, but it’s also by and large out of their control. They should try to scratch that from the list of worries.
“When you’re down to a list of demands that are within your control, prioritize them,” said Dattilo. “What’s urgent that you must take care of right now? What’s a demand that you can let slide?”
This whittles down the demands on your psyche so you can attend to the most important and timely priorities, she said. See if this helps you feel a bit more settled.
Exercise to Manage Stress
This one is tricky. Exercise can play a key role in managing allostatic overload. But if you’re not careful, it can also lead to injury. There are ways to find the middle ground when life is coming at you hard. “It’s challenging because overload doesn’t have a clear presentation like a rolled ankle,” said Gene Shirokobrod, DPT, a Maryland-based physical therapist. “More often it’s a long buildup and then a straw that breaks your back.”
“Overload doesn’t have a clear presentation like a rolled ankle. More often it’s a long buildup and then a straw that breaks your back.”
Gene Shirokobrod, DPT
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Consider back pain. If you’re in allostatic overload, you may have a long lead-up to injury from stress, strain, and energy use. Then one morning while putting on a sock, your back painfully “gives.”
Shirokobrod often begins with patients by asking about recent emotional and psychological stressors. “The body doesn’t care where it’s using energy, it just knows it has a limit,” he said.
If you suspect your stress levels are getting out of hand, try altering your exercise routine. In my case, ahem, maybe managing “sandwich generation” care of children and elderly parents while working full time might not be the ideal season to train for a marathon. “Your body has to work harder to sustain its energy when you’re in overload,” Shirokobrod said.
Still, moderate exercise is a good tool for keeping stress in check. And surprisingly, said Shirokobrod, short sessions of high-intensity interval training (HIIT) can work. “Performing eight to 12 minutes of HIIT or short sprints on an exercise bike, recovering, and then going again for several sets will help your nervous system recalibrate,” he says. “You won’t hurt your tissues with these short bursts, but if you’re in central nervous system fatigue, your body will respond better than going for long, steady aerobic sessions.”
Exercise isn’t enough: Sleeping and eating well are crucial in dealing with allostatic overload. “Are you changing your eating habits due to stress and a busy schedule?” asks Shirokobrod. “Make an additive change to your diet, instead, eating more veggies, drinking more water, and getting enough nutrients.”
There’s more, of course: Try meditation, breath work, therapy, or prayer – anything that you find helpful. No equipment or expense, and little time investment. All you need is belief in the tool you choose.
Returning to Normal
Most of us can get through allostatic overload for short periods of time. This is especially true if you keep all your tools at hand – exercise in particular, said Dattilo. “When we exercise every day, we create a physical and emotional reserve that can help sustain us through stress and strain,” she said.
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