WESTBOROUGH, MA November 30, 2024 – Stress affects all aspects of how we feel. There is no cure for human stress we must learn to modulate its impact. What affects one person may not impact another in a stressful manner. I have had a series of posts on the Human Behavior blog recently and since beginning this blog in 2014. If you are seeing this blog, you have access to my other posts and hopefully the research cited in the musings I espouse here. This post is about how some people are impacted by the work they choose and may experience serious physical and emotional problems directly associated with it. The example here is a tow truck operator who is suffering with the consequence of being exposed to motor vehicle accidents while towing for state police or other agencies who regularly call upon towing companies to haul away the wrecked cars and trucks driven by a host of young drivers who may not be on their best behavior. But I have regularly wondered how young EMT’s, funeral home operators, medical examiner recovery teams, and tow truck operators deal with the things they see. In addition to the lowest paid these personnel tend to be the youngest and most inexperienced and least trained setting up an unhealthy risk for long-term traumatic stress.

Recently, I began seeing a man who was referred because he had sustained a serious stroke. The man was only 59 years of age and needed quite a bit of help from his wife. He was referred by the speech pathologist here at Whittier who had a stong instinct the man had a psychological component to his condition. She was correct. I learned in our first visit that the man worked as a tow truck operator for over 10 years in a private towing company. Many police agencies use private companies to haul away cars involved in motor vehicle crashes or subsequent to an arrest. It is common practice here in Massachusetts. I strongly suspected that the man is experiencing the chronic symptoms of stress and it is highly likely he has full blown post-traumatic stress disorder from years as a tow truck operator. His body was so injured by the stress of his job that it created the perfect storm for both physical and emotional injury. He was at high risk for hypertension, heart disease, cardiovascular disease, obesity, and depression. Nothing is for certain, but he has the hallmark triad of PTSD (avoidance, hypervigilance, and triggering) in addition to the full blown stroke syndrome that left him disabled.

Before you say “does everybody have PTSD?” let us understand that exposure to traumatic events (beyond normal experience) can cause an acute stress reaction that in some cases evolves into PTSD over time. Human beings can adjust to traumatic stress if they have time to process what they experience. Sometimes they require professional crisis intervention or debriefing such as post incident review.

Our bodies are equipped with a built-in defense system—a complex army of infection-fighting cells and proteins that warn other cells of invaders, fight them off when they arrive, and heal any damage the resulting conflict produces. Stress is the number one cause of silent and malignant conditions like hypertension, stroke, heart disease, obesity, and autoimmune disorders like chronic fatigue, lupus, Type I diabetes, and others. Even multiple sclerosis and inflammatory bowel disease are linked to autoimmune disorders. These all have a known link to stress. The Washington Post published a story about human “weathering” a term first coined by Arline T. Geronimus, a professor and population health equity researcher at the University of Michigan. The fact of stress weathering our bodies from the “inside out” is a point not lost on many of us who previously worked in public service as police officers. And here in the United States, life expectancy levels have decreased for 2 straight years – the first time in decades. Chronic stress and its associated disease states is a likely culprit.

Blood pressure remains high. Inflammation turns chronic. In the arteries, plaque forms, causing the linings of blood vessels to thicken and stiffen. That forces the heart to work harder. It doesn’t stop there. Other organs begin to fail. Washington Post by Akilah Johnson and Charlotte Gomez in 2023. “Too much exposure to cortisol can reset the neurological system’s fight-or-flight response, essentially causing the brain’s stress switch to go haywire.” Relentless stress is associated with changes in our body’s chromosomes and shortens the life of our cells resulting in premature death to those who are vulnerable to its environmental biopsychosocial confluence.

Within the past month, Harvard Medical School has published a helpful booklet on the inflammatory response and the impact of chronic inflammation, edited by Mallika Marshall, MD (2024). The inflammatory response is regulated by the body’s immune system to promote quick healing. When this becomes chronic, like when we are under constant threat from environmental stress, the body begins to change and can not return to a state of equilibrium.

Our bodies are equipped with a built-in defense system—a complex army of infection-fighting cells and proteins that warn other cells of invaders, fight them off when they arrive, and heal any damage the resulting conflict produces.  Inflammation is the body’s response to threats that reach our insides. Inflammation is necessary whenever we are injured or infected. The only true way of heading off the impact of stress is taking direct action to lower the elevated fight-flight response involved in the stress response, lower physical tension and other signs, and minimize unrealistic expectations. The body has been accostomed to respond to threats every since our species evolved. Part of this evolution is to react quickly to threats (that saved us from being eaten) and to just as quickly return to our normal resting state. The constant elevation of the threat arousal system is not realistic nor sustainable. It is important in early adulthood to keep in mind there are specific behaviors that may be learned to mitigate the negative impact from chronic stress before it has negative impact on our health.

The other day I was so wound up with some much stress and tension, I almost cut my 12-hour day short. Things settled down but not after an 8:30 AM crisis call from a patient living on Cape Cod. All at once, my day was diverted to needing to find a hospital bed for a client with a boat load of unrealistic anger and now suicidal ideation. Not easy. I can honestly say that stress impacts me more now than it did early in my career but that said, I am mindful about managing the stress more purposefully. This post is not about me or my work habits. Although I read these posts and many others in order to make myself a better psychologist and to understand the importance of managing stress before it can cause irreparable damage to one’s mind and body. The connection has never been better understood by medical and psychological providers. So in order avoid weathering from the inside out, start taking control of things in your life that you can control and apply mindfullness strategies to your routine. You will feel better.