Why Allostatic Load Matters

A conversation with a client a few days ago and then a conversation I had on a podcast gave me the idea to write about allostatic load. And in writing about allostatic load, we’re going to talk a lot about stress. Because when it comes to our health, stress is what most often underlies chronic disease and a slew of other symptoms.

Stress is a good thing. It’s actually what allows our bodies to adapt and survive. But it’s supposed to be acute. To be short lived. And then we recover from the stressor and get back to baseline. But when we are exposed to repeated stressors again and again, that’s when our acute stress response becomes maladaptive and our bodies lose homeostasis. We don’t make it back to baseline, and therefore, our bodies lose the ability to function how they were designed. Because of our body’s incredible ability to respond to acute stressors in a productive way, it’s important that we take a step back and look at the big picture in our lives, not just the immediate situation.

What exactly is allostatic load?

Think of allostatic load as the cumulative wear and tear we put on our bodies when we are exposed to repeated stress over and over again. Instead of stressors being acute, they’re chronic. Our normal bodily responses designed to get us out of acutely stressful situations don’t get turned off like they should and instead these bodily responses are elicited too frequently creating a big, hot, stressful mess. You’ve reached your allostatic load. But sometimes life gets crazy and we go through stressful seasons and perhaps we do reach our body’s stress threshold. That’s okay. Sometimes that happens. But if we can become aware, catch it and learn to recover, we will know how to take much better care of ourselves. But if we don’t, it’s this long term exposure to allostatic load that leads to our bodily systems going haywire.

It’s important to know that stressors can be “good” and “bad” things – I like to categorize them as productive and unproductive stressors. A new job, getting the flu, arguing with your partner, planning a wedding, studying for finals, not getting enough sleep, buying your first house, traveling, injury, caring for a loved one, getting a new diagnosis, graduating college, moving, experiencing grief, having a baby, a loved one passing away, infertility, adopting a new baby or child, sitting in traffic, ignoring hunger cues, repeatedly ignoring fullness cues, high intensity physical activity, your favorite sport’s team losing, going to college, being in an unfamiliar social situation, spilling coffee on your shirt, running late for work, etc. The list goes on and on.

Here’s an analogy that I hope helps you understand allostatic load.

The Water Bucket

Pretend you are sitting with a big water bucket in your lap. In your right hand is a hose. Every time you are exposed to a stressor you squirt the hose into your bucket. You keep squirting with each stressor. Every time you recover from a stressor (with self care – whatever that looks like given the stressor) you get to dump a bit of water out of your bucket. If your squirts are more than your dumps, you will fill up your allostatic load bucket all the way to the top and reach your stress threshold. This is when you reach burn out, have an emotional breakdown, experience physical symptoms you didn’t have before, etc.

In order for our bodies to function optimally – both physically and mentally – we have to make sure our squirts are counteracted with dumps. What is also really important is that everybody has a different bucket size. Everyone perceives stress differently. Take two people. Both of them are in graduate school, volunteer weekly, are in long distance relationships and they both just found out their parents are getting divorced. One person might be able to cope with all these heavy things healthily, while the other person finds herself having an emotional breakdown, understandably, with the weight of everything on her plate. We all have a different stress capacity based on genetic and environmental factors.

It’s easy to compare yourself to the next person. Why can that person do x and y and still maintain z? We have no idea everything going on in a person’s life. Lack of sleep alone is a huge stressor which makes coping with other stressors in life very difficult. I know when I haven’t gotten enough sleep, seemingly trivial things become almost catastrophic.

When I was studying for my NP boards, working part time, living in Manhattan and planning a wedding, the subway being late or going slow had the capacity to send me into hyperventilating tears. I had zero emotional margin in that season of life. It sucked. That example can seem silly since all those stressors are choices and incredible privileges, but it was my own experience. For others, even with a lot of stressors in their bucket, the subway being late doesn’t send them over the edge. We could compare our stressors and our ability to cope with stress to other people all day long. That’s not helpful. What is helpful is to own your story, cultivate awareness around the size of your bucket, know when you’ve reached the top and then learn how to dump the water out.

It’s a process. We are all continually learning more about ourselves. And as seasons of life change, we will learn new things and re-learn old things about ourselves. When we moved from New York to Boston, I learned that I really enjoy urban living…Manhattan is just a whole other level of urban living. Making that moved dumped a whole lot of water out of my metaphorical bucket which left a lot of room for me to healthily cope with other stressors.

Remember you never arrive. Life will continually present challenges. And I’m learning and growing just like you.