Allostatic load and chronic stress

Allostatic load and chronic stress

Reading Time: 5 minutes

Stress — the physical or mental response to something our brain perceives as challenging or threatening — isn’t always a bad thing. We feel “good stress” when we’re excited or take on a tough but interesting project, and your body’s short-term (acute) stress response could save your life if it helps you get out of the way of a driver running a red light. So you could say that stress is normal, even healthy in certain “doses” or under certain conditions.

But I don’t have to tell you that too much stress is more than just too much of a good thing. Too much stress is simply not good. It doesn’t feel good, and it’s not good for your health.

I’m talking about the chronic, unrelenting stress that develops in response to a long-term stressor or a succession of acute stressors without adequate recovery time in between. If you feel powerless over these stressors, you may even experience trauma. Some examples of this powerlessness include people who:

  • Are primary caregivers for a chronically ill partner or parent
  • Are in abusive relationships
  • Experience discrimination
  • Experience frequent microaggressions based on gender, weight, skin color, sexual orientation or other factors
  • Have internalized weight stigma
  • Are experiencing poverty or food insecurity
  • Have demanding jobs with little autonomy

The problem is that stress isn’t all in our heads. It’s in our bodies. Chronic stress — or one really big life stressor such as a death of a loved one — can contribute to assorted physical and mental health problems. These include high blood pressure, depression and anxiety.

When chronic stress creates allostatic load

On the physical front, when we experience stress, multiple systems in our bodies are activated. This includes the immune, cardiovascular, nervous and digestive systems, and our hormones and metabolism can get a little messed up, too.

Layered on top of that hot mess is the fact that when life hands us stressors that exceed our ability to cope in a “healthy” way, we’re likely to experience:

  • Poor sleep and disrupted circadian rhythms
  • A less-healthy diet due to emotional eating and/or reduced ability to plan, shop and cook
  • Decrease in physical activity
  • Increase in smoking, alcohol use, or drug use (if we already use these substances at all)

There’s a term, “allostatic load,” that’s primarily used in research and among healthcare providers who understand these impacts of excessive stress on their patients and clients. The term refers to the cost of chronic exposure to fluctuating or increased brain and hormonal responses resulting from chronic “environmental challenges” that someone responds to as being particularly stressful.

For example, lets imagine you have the world’s worst boss, and you have the ability to let their ineptitude or meanness roll off your back — either because of your innate psychological makeup, or because you’ve done personal work that allows you to cope effectively.

On the other hand, your teammate cringes when your boss walks over to your desks, feels each of their words and actions acutely, and talks about how they dread coming to work each day. You might not have an increased allostatic load, but they will. You both are having the same “environmental challenges,” but only one of you is responding to them as being particularly stressful.

Who’s carrying an allostatic load, and what happens?

A 2020 systematic review looked at research on allostatic load and found, not surprisingly, that you’re least likely to have a high allostatic load if you:

Of course, the potential to have so much stress that you can’t cope can potentially happen to anyone. The paper I mentioned found a lot of variables in the effects of work-related stress. Women who don’t have enough time to recover from work stress are more likely to have higher allostatic load. Regardless of who you are, and the source of the stress, the health consequences of a high allostatic load include increased risk of cardiovascular disease, pregnancy complications, lower bone mineral density, diabetes complications, and mood disorders.

As a registered dietitian who has lived through the two-plus years of pandemic-related stress, I’ve seen how that stress manifested as increased food and body concerns—including a higher rate of eating disorders, which can be fatal — among people of all ages and genders.

There are no easy solutions to relieving chronic stress. When you feel like you’re drowning in stress — or getting a little crispy around the edges — a bubble bath or a glass of wine isn’t going to cut it. (And relying on the latter could become a problem of its own.) That’s why I want to share a few books that have helped me and many of my clients.

Recommended reading

The first is Burnout: The Secret to Unlocking the Stress Cycle by sisters Emily and Amelia Nagoski. This engaging book explains the difference between stressors — both isolated and systemic — and stress itself, and what happens when you deal with the stressors but not with the stress. There are actionable tips for completing the stress cycle — in other words, moving your body out of a state where its stress responses are stuck in “activate” mode. This is the book I recommend to my female clients who are trying to do it all or have high-stress jobs. If you like podcasts, I recommend the author interviews on “Ten Percent Happier” and on Brené Brown’s “Unlocking Us.”

Next is Anchored: How to Befriend Your Nervous System Using Polyvagal Theory by Deb Dana. This is Dana’s first book that’s not written for therapists and other clinicians. The book starts by explaining our autonomic nervous system and how regulating our vagus nerve, the body’s main “information superhighway,” can help us return to feelings of safety after experiencing stressors. The book is rich with techniques you can use to understand your nervous system and shape its responses. Her interview on the “Insights at The Edge” podcast is a good listen.

Finally, Widen the Window: Training Your Brain and Body to Thrive During Stress and Recover from Traumaby Elizabeth A. Stanley takes its name from the concept of widening your “window of tolerance” to stress. If every little thing seems to send you into fight, flight or freeze mode, then your window of tolerance is likely very narrow. This book takes you on an exploration of the many faces of extreme stress and trauma — including how trauma is often dismissed or denied—then offers strategies for healing and widening your own window. For podcasts, I suggest her appearances on “Ten Percent Happier” and “Insights at the Edge.”

This post contains Amazon Affiliate links. As an Amazon Associate I earn from qualifying purchases.


Carrie Dennett, MPH, RDN, is a Pacific Northwest-based registered dietitian nutritionist, freelance writer, intuitive eating counselor, author, and speaker. Her superpowers include busting nutrition myths and empowering women to feel better in their bodies and make food choices that support pleasure, nutrition and health. This post is for informational purposes only and does not constitute individualized nutrition or medical advice.

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