General Adaptation Syndrome: When Stress Takes Over

By James Wilson, DC, ND, PhD

Stress can be a real killer. How do we learn to deal with it in a healthy way? To answer that, first let us look at general adaptation syndrome and the role the adrenal glands and their hormones play in activating it. General adaptation syndrome is the pattern of physiological adjustments the body makes in response to environment (including the emotional environment). It has three phases: alarm, resistance and exhaustion. Understanding these phases will help you to help patients understand why their bodies respond the way they do to stress, as well as how to help minimize its harmful effects.

The Alarm Phase (AKA The “Fight-or-Flight” Response)

The initial response to stress is the alarm reaction, better known as the “fight-or-flight” response. This reaction is a complex chain of physical and biochemical changes brought about by the interaction of your brain, the nervous system and a variety of different hormones. Your body goes on full alert, responding to the stress chemicals released into the blood stream (such as adrenaline) by increasing blood pressure, heart rate, oxygen intake, and blood flow to the muscles.

The alarm stage is usually short lived. Typically the increased adrenaline lasts a few minutes to a few hours and is followed by a drop in adrenaline, cortisol and other adrenal hormones that lasts a few hours to a few days, depending upon the magnitude of the stress. After the alarm reaction is over, your body goes through a temporary recovery phase that typically lasts 24-48 hours. During this time there is less cortisol secreted, your body is less able to respond to stress, and the mechanisms overstimulated in the initial alarm phase become resistant to more stimulation. In this let recovery phase you feel more tired and listlessness, and have a desire to rest.

The Resistance Phase

After the recovery phase, if there is additional stress or a series of stressors your body goes into “the phase of resistance.” Entering this phase lets your body keep fighting a stressor long after the effects of the fight-or-flight response have worn off. Cortisol is largely responsible for this stage, which stimulates the conversion of proteins, fats and carbohydrates to energy through a process called gluconeogenesis. This process ensures your body has a large supply of energy long after glucose stores in the liver and muscles have been exhausted. Cortisol also promotes the retention of sodium to keep your blood pressure elevated and your heart contracting strongly. The resistance reaction provides you with the necessary energy and circulatory changes you need to deal effectively with stress.

Cortisol is a powerful anti-inflammatory hormone that, in small quantities, speeds tissue repair, but in larger quantities depresses the body’s immune defense system. A prolonged resistance reaction increases the risk of significant disease (including high blood pressure, diabetes, and cancer) because the continual presence of elevated levels of cortisol overstimulates the individual cells and they begin to break down. Your body goes on trying to adapt under increasing strain and pressure. If this phase goes on too long your body systems weaken, leading to exhaustion (the third stage). The resistance reaction phase can continue for years, but because each of us has a different physiology and life experience the amount of time one can remain in this phase is unpredictable.

The Exhaustion Phase

Some people never experience the exhaustion phase; others visit it several times in their life. In the exhaustion stage there may be a total collapse of body function, or a collapse of specific organs or systems. During this phase, lower levels of cortisol and aldosterone are secreted, leading to decreased gluconeogenesis, rapid hypoglycemia, sodium loss and potassium retention. Body cells function less effectively in this condition as they rely heavily on a proper amount of blood glucose and the ratio of sodium to potassium. As a result, your body becomes weak. This means that during the exhaustion phase your body lacks the very things that would make you feel good and able to perform well.

When adrenal corticosteroid hormones are depleted, blood sugar levels drop because low cortisol levels lead to decreased gluconeogenesis. This means that your body is less able to produce its own blood glucose from stored fats, proteins, and carbohydrates, leaving you more dependent on food intake. Simultaneously, insulin levels are still high. The combination of low cortisol and high insulin levels leads to a slowing of glucose production and a speeding of glucose absorption into the cells. Hypoglycemia results because the body cells do not get the glucose and other nutrients they require. When energy and electrolytes once again become available and the cellular stress decreases, the damaged cell must be repaired or replaced.

The reactivation of normal cell functions is an energy consuming series of events that uses up a greater amount of energy than is normally required. Yet this has to take place in a situation in which your body is struggling just to produce enough energy to maintain some semblance of homeostasis! Uninterrupted, excessive stress eventually exhausts your adrenal glands. They become unable to produce adequate cortisol or aldosterone. This combined effect on your kidneys of too little aldosterone can lead to collapse, and in some extreme cases even death. Anyone in this phase should seek immediate medical assistance.

Original blog by Dr. James Wilson can be found here.


Dr James Wilson

James L. Wilson, DC, ND, PhD, received his Ph.D. in Human Nutrition from the University of Arizona, with minors in Immunology, Microbiology, Pharmacology and Toxicology, and research in Cellular Immunology. His doctorates in Chiropractic Medicine and Naturopathic Medicine are from the Canadian Memorial Chiropractic College and the Ontario College of Naturopathic Medicine (CCNM).

As one of the 14 founding members of CCNM, now the largest Naturopathic College in the world, Dr. Wilson has long been on the forefront of alternative medicine. For over twenty-five years, he was in private practice in Canada and the United States. In 1998, Dr. Wilson coined the term ‘adrenal fatigue’ to identify below optimal adrenal function resulting from stress and distinguish it from Addison’s disease.

With a researcher’s grasp of science and a clinician’s understanding of its human impact, Dr. Wilson has helped many physicians understand the physiology behind and treatment of various health conditions. He is acknowledged as an expert on alternative medicine, especially in the area of stress and adrenal function. Dr. Wilson is a respected and sought after lecturer and consultant in the medical and alternative healthcare communities in the United States and abroad.