The call comes out of the blue, from the Emergency Room of a foreign country. They speak French, connecting me to a young woman who was brought to them with sky-high blood pressure, 190/130, and an excruciating headache. They are doing a full neurological work-up to rule out bleeding into her brain, maybe a ruptured brain aneurysm.
Gaby comes to the phone, “It happened so suddenly. I was at a work meeting, talking to my colleagues in a friendly, tranquil atmosphere. I stopped in the middle of a sentence; the pain was unbearable. They called an ambulance.”
The same day, as if by a strange alignment of the stars, another hospital in New York calls for Lauren. “Your patient is here. She had an LOC (loss of consciousness) episode while at work. Her blood pressure is extremely low, 90/60. We are giving her fluids, a saline solution.”
Lauren was writing a speech at her computer, working remotely, when that episode occurred that afternoon. Seemingly, there was no external pressure.
Both women are successful professionals in the humanitarian field. They often travel to foreign countries, the “hot spots” that have become so numerous on the planet, where populations are in crisis due to wars, famine, or climate events. It’s always a heart-wrenching experience coming from a developed country and seeing with your own eyes how the other 90% live, often feeling powerless in providing adequate help for their needs. But it’s a part of a job they have chosen for love, and they think they have adjusted well, going through that challenge multiple times. If you ask both Gaby and Lauren, they do not report being stressed out. They are immersed in their “normal” routine.
Stress: we recognize it better when it’s acute, like the loss of a loved one or a job, or a sudden change in a person’s life that may even be a positive one, like a promotion that entails increased responsibilities. We may then experience a fight-or-flight reaction caused by a surge of catecholamines, adrenaline, and noradrenaline.
But there is another kind of stress, more subtle and ominous, as it does not immediately meet the eye and finds you defenseless against it. It is subliminal; it’s chronic stress.
A stay-at-home mom is overwhelmed by the burden of raising children without help after giving up a career. She suffers day to day, thinking that her efforts are “normal,” are what’s expected of her. An employee is going to work every day not knowing what kind of mood she is going to find her boss in. She is subject to their sudden whims, unfair requests, and derogatory comments. It’s hard at times to write that off as psychological abuse. An elderly husband is living next to his spouse who’s cognitively deteriorating, requiring more and more of his attention and supervision. It’s a little bit worse every day without the hope of a breakthrough in sight.
These are all examples of “chronic stress,” situations that strike you as emotionally demanding from the outside but are often perceived as “normal” life predicaments by the person who is in the midst of them. They have in many ways adjusted until a signal, at times a dire physical one, stops them in their tracks.
“Chronic stress is an unrelenting circumstance that offers little chance for a return to normalcy. That’s what makes it more toxic,” says Greg J. Norman, Associate Professor of Psychology at the University of Chicago, as reported in an article in this month’s National Geographic, “The New Science on Stress.”
“A 2023 national survey by the American Psychological Association (APA) found that, since the start of the pandemic, stress has taken a serious toll, with the incidence of chronic illnesses and mental health problems going up significantly.”
The physiology of stress studies have indicated that the neurotransmitters (catecholamines) and hormones (cortisol) produced in stressful situations may have serious effects on the cardiovascular system (tachycardia, changes in blood pressure) and may depress the immunological system, making us more susceptible to a variety of pathologies from infectious diseases to cancer.
Both Gaby and Lauren were luckily discharged with no specific diagnosis other than a stress-related medical condition.
