Body Stress Systems
Everybody has them to protect their body when challenged or threatened.
When these systems are disrupted, functional symptoms can arise.
Up until now we have been talking about functional symptoms, and how they affected the life of one patient of mine. But what are functional symptoms and what causes them?
Below are some of the symptoms that people with functional conditions suffer. It is not unusual to have more than one symptom. Fatigue is a common functional condition but less understood in regard to which system to attribute it to.
I have been observing these symptoms for years in my patients, but when I was introduced to the brilliant research done by Professor Kasia Kozlowska at the Body Mind Unit at Westmead Hospital in Sydney, a systematic understanding of the symptoms and their causation became clear.
She has helped relate the vast array of symptoms to one or more the seven body stress response systems, according to their physiological activation. More details will be found in my book, ‘What the Hell is Wrong with Me?’
So, what are body stress systems and how do they affect your body?
Whenever your body is challenged by a change in its environment, one or more of your seven body stress systems get activated. For example, if you suddenly find yourself in a very cold environment, your body has to respond to protect you. It turns on the defensive mode (more on this later) which activates a stress response in your autonomic nervous system and straight away your blood is shunted away from your skin to keep your core warm, and it activates your skeleto-motor system to cause tiny muscles in your skin to pull up your body hair into goosebumps to hold a layer of warm air next to your body. This and many other automatic responses occur without you thinking about it.
Your brain system may alert you to the cold and take intelligent action to get you warm again by finding a source of heat, etc.
The important point is most stress responses are automatic and occur without us noticing. All good so far.
The diagram below shows the sequence of events in activating a stress response:
What happens when your protective systems go awry?
But when your body has been more severely affected, either by a potent stressor, such as an operation or illness, or a series of fairly normal life events, without there being time for your system to recuperate, your body stress systems can be disrupted. The usual protective measures of your body stress systems are no longer serving to help you. Instead, you are subjected to an array of unhelpful and even disabling symptoms.
As a junior doctor, I was doing shift work in an intensive care unit and eating hospital food, when I started to have abdominal pain. It resolved when I stopped that type of work and returned to healthier eating.
This was a classic functional condition: a chaotic circadian rhythm and work demands, along with an unhealthy diet, disrupted my body stress systems and triggered the symptom, through my circadian rhythm, autonomic nervous and microbiome-gut-brain body stress systems.
There is still a lot to learn about the cause of functional conditions and it is likely that genetic and epigenetic factors have a role: other doctors doing the same work didn’t develop these symptoms.
If you had asked me at the time whether I was stressed, I would have said no. While the 15 hour shifts, the Code Blues and the epic life-and-death Intensive Care experiences were demanding, I enjoyed it, but my body stress systems didn’t.
This is one reason why people fail to recognize the cause of their symptoms: it seems improbable that their life choices could be contributing to their symptoms, especially if they enjoy the demands.
I explore these seven body stress systems in more detail in my book.
The third part of my book focusses on the various types of treatments that have been found to be effective. I will talk more about this in the next newsletter, but it is important to mention that, for some people, we simply cannot find any cause. Treatment can still be given, nevertheless.
Summarising so far:
Everyone has body stress systems and so everyone gets functional symptoms
When your body stress systems are disrupted, your symptoms can persist