Prolonged Adaptive Stress Syndrome (PASS)
©Arlene R. Taylor PhD www.arlenetaylor.org
Ignoring who you truly, authentically are can literally be killing you... Forcing yourself to be someone you are not or stuffing down who you really are...will tax you so much that it will shorten your life by years and years.
—Phillip C. McGraw PhD, from his book Self Matters
In the mid ‘70s after experiencing firsthand the exhaustion of burnout and mid-life crisis, Taylor became even more interested in the concept of energy. With increased awareness, she noticed others whose symptoms appeared to match hers. Taylor interviewed some of these individuals, several of whom had sought care due to suspected PTSD (Posttraumatic Stress Disorder). According to their respective physicians, however, the patients’ reported symptoms did not meet the classic definition for PTSD. While some symptoms mirrored PTSD, there were two notable exceptions:
- There was no identifiable incident that could have served to trigger the symptoms (e.g., rape, military service in a war zone, catastrophic illness / events)
- Flashbacks did not occur.
Over time, Taylor continued to interview individuals and identified a collection of symptoms that seemed to be exhibited fairly consistently, although the actual level of symptomatology varied based on the person’s own history. A common theme ran through their histories: they expressed disappointment and dissatisfaction with life as they had been living it for the past decade or so. The reasons for this dissatisfaction were, at times, nebulous, but life clearly wasn’t working for them, at least not in ways they had been led to believe life should or could work. Persistent fatigue was a key trigger for seeking consultation, a fatigue that couldn’t be tied to anything specific. None had been diagnosed with an illness, disease, or condition that would be associated typically with energy drain (e.g., Infectious Mononucleosis, CFIDS or Chronic Fatigue Immune Dysfunction Syndrome).
In their search for answers, many of these individuals reported having completed assessments such as Herrmann’s Brain Dominance Inventory, the Myers Briggs Temperament Inventory, Benziger Thinking Styles Assessment, Blitchington’s and Cruise’s Four Temperament Inventory, the Keirsey-Bates assessment or the Johnson-O’Conner aptitude testing. They were able to articulate examples of tasks during the performance of which they felt good and had plenty of energy. But when the opposite occurred, they felt drained and disappointed, uncomfortable and even exhausted. In general, the more time they had spent completing these types of energy-exhausting tasks, the more PASS symptoms they reported. This further reinforced Taylor’s perception that the reported energy drains were related to the types of tasks these individuals were asking their brains to complete.
For purposes of sharing her observations in a more formal manner, Taylor arrived at the acronym PASS, Prolonged Adaptive Stress Syndrome, to describe the eight commonly observed symptoms that may be present in varying degrees in individuals who have spent years living an energy-exhausting lifestyle.
The brain likely has to work much harder when trying to accomplish tasks that do not match its own energy advantage. The additional energy-expenditures can contribute to an increased need for sleep, interference with sleep, decreased dreaming, and a progressive fatigue that is not alleviated by sleep.
Living an energy-exhausting lifestyle can push the brain to activate a protective safety mechanism. The Reticular Activating System or RAS can push the individual into a state of protective alertness. This sense of hypervigilance can be exhibited as a startle reflex, an increased sense of generalized alarm, or as restless jitteriness.
3. Immune System Suppression
Stress can suppress immune system function (e.g., temporarily shrink the Thymus gland). Outcomes related to immune system suppression can include a slowed rate of healing, exacerbation of autoimmune diseases, an increased susceptibility to contagious illnesses, and/or an increased risk of developing diseases such as diabetes and cancer.
4. Reduced Function of the Frontal Lobes
Some individuals experience a decrease in artistic or creative competencies (e.g., writer’s block, difficulty brainstorming options, diminished problem-solving skills). Others evidence interference with their ability to make logical or rational decisions, exhibit a tendency toward increased injuries due to cognitive impairment, or notice slowed speed of thinking and/or reduced mental clarity.
5. Altered Neurochemistry
Interference with hypothalamus and pituitary function can affect hormonal balance (e.g., decreased growth hormone, insulin production irregularities, alteration in reproduction functions, and an increase in glucocorticoids that can prematurely age the Hippocampus). Reports from mice/rat studies suggest that altered neurochemistry due to extreme or prolonged stress may interfere with the permeability of the Blood Brain Barrier.
6. Memory Problems
Cortisol, released under stress, can interfere with memory functions. Dr. Robert Sapolsky of Stanford University and author of Why Zebras Don’t Get Ulcers outlined several consequences:
- Decreased utilization of blood sugar by the hippocampus can create an energy shortage, which interferes with an ability to lay down a memory, store data in long-term memory, or access and recall the memory at a later date.
- Diminished neurotransmitter function (think of this as “phone lines are down”), which can reduce effective communication among neurons, resulting in the mind becoming muddled, with negative effects on attention and concentration.
- Increased production of free radicals associated with stress, which can actually kill brain cells from within (to say nothing of contributing to other problems such as wrinkling of the skin). The brain’s search engine, the hippocampus, appears particularly susceptible to negative stress.
7. Discouragement or Depression
Conserve/Withdraw is a reaction form that the brain may use when an event or situation seems overwhelming and for which there seems no ready solution. Experienced over time, this can lead to discouragement and a sense of hopelessness, even exacerbating existing depression. Estimates are that 20 million people in the United States may be depressed at any given time, with approximately 15% of those being suicidal. No surprise, exhaustion can contribute to both discouragement and depression.
8. Self-Esteem Problems
A perceived lack of success in life, as well as the cumulative impact of PASS symptoms, can whack one’s sense of self-worth and/or exacerbate existing self-esteem problems. Behaviors may appear that mirror low self-esteem (victim mindset) and/or inflated self-esteem (offender mindset). An altered sense of self-worth can also impact the way in which an individual exhibits personal self-care.
Based on PET (Positron Emission Tomography) Scans, Dr. Richard Haier of San Diego has estimated that the brain may need to work 100 times harder second per second when an individual develops and uses skills outside of his/her area of energy advantage.
As Taylor and others have noticed, when the brain is forced to spend large amounts of time completing tasks that are energy-exhausting, the individual may experience chronic anxiety and eventually exhibit symptoms of PASS. The number and/or severity of PASS symptoms likely has to do with the length of time the person lived an energy-exhausting lifestyle.
The brain is the first body system to recognize a stressor and it reacts with split-second timing. It can stimulate the stress response for up to 72 hours after a traumatic event—real or imagined—longer, if you keep rehearsing the event in detail.
It has been said that stressors generally interact with the brain in a predictable 20:80 ratio. Sometimes referred to as the 20:80 Rule, it states that:
- 20% of the adverse effects to the brain and body is due to the stressor itself
- 80% of the adverse effects is related to one’s own perception of the stressor and the weight or value ascribed to it
It is possible that the adverse affects on the brain and body resulting from life situations that lead to PASS symptoms may exceed the typical 20%. This seems likely, given that this form of stress involves not only external and environmental triggers but also the rate at which the brain itself must work and the amount of energy that must be expended in order to accomplish the desired tasks.
By virtue of the increased energy expenditure, this type of adapting may be considered a major life stressor. Over time, it may also contribute to an increased risk of self-medicating through addictive behaviors in an attempt to alter one’s own brain chemistry and “feel better.” At least it is an area worth evaluating, especially if the individual recognizes several of the PASS symptoms.