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Disclaimer – The information in this article is meant for entertainment only and is in no way meant as a replacement for professional medical or psychological support. Please seek the appropriate professional advice from a healthcare professional should you feel it necessary.

One of the most significant services I offer, which has been steadily increasing ever since the first lockdown, is delivering resilience and mental toughness workshops to corporate clients.

As part of that training, I teach delegates about stress and how to manage it effectively, and I start by explaining how the autonomic nervous system works – including:

• The flight, fight, freeze stress response
• How to recognise that the stress response has been triggered
• Tools for quickly and effectively managing stress
• Recognising the symptoms of prolonged stress

During workshops, delegates are often surprised to learn that some of their ongoing, long-term physical symptoms could result from chronic, ongoing stress. 

The Stress Response

As I’ve written in many previous articles, understanding how stress initially manifests is critical to avoid long-term physical and mental health problems. As I’ve said repeatedly, we can’t change what we aren’t aware of. 

If we pay attention to what’s happening in our bodies, we can recognise and deal with stress, anxiety and overwhelm BEFORE it becomes chronic.

Initial Stress Symptoms

If you’re unaware of how stress initially manifests in you (i.e. when your stress response has been triggered), the most common initial symptoms are:

• Uncomfortable feeling in the chest or stomach (feeling anxious/butterflies)
• Heart palpitations
• A sudden need to go to the toilet
• Fuzzy head/headache
• Feeling sick
• Lump in the throat

However, many of us have been dealing with stress for such a long time that it’s become our regular ‘state’ – we call this ‘survival mode’. When we experience prolonged stress, it can have a significant impact on both our physical and mental health.

Following are three often surprising symptoms of chronic stress that we don’t often hear about:

1. Unexplained Aches/Pains/Illnesses

Stiff, Painful Hips/Lower Back 

The psoas muscle (as illustrated in the article artwork above) connects our lumbar spine to our inner thighs. It is known as the fight/flight muscle, as it gets triggered during the activation of the stress response (fight, flight, freeze). This muscle is necessary for running and kicking (critical attributes for fighting or running away from sabre tooth tigers!).   

If you suffer from prolonged stress, the psoas can become incredibly tight, especially if your job entails sitting for long periods. A tight psoas can result in lower back pain as well as pain in the hips when standing up, walking or running.

For most of my life, although I’ve been incredibly active, I’ve always had difficulty running because of the pain it generated in my hips. Over the years, I’ve seen numerous consultants and had multiple scans and other investigations. However, tests always came up clear, leaving the doctors baffled. I’ve also had significant bouts of lower back pain. Again, after medical investigation, no underlying cause has been found.

My chronic hip pain

I recently listened to a world-renowned endurance athlete, David Goggins, being interviewed on the Joe Rogan podcast. He was talking about how important it is to take care of his psoas. Because of his excessive stress throughout his life. He said that his performance is affected if he doesn’t release it regularly.

The psoas is a difficult muscle to get to, as it can’t easily get released through regular massage or stretching. However, David and Joe discussed the Pso-Rite, a tool for alleviating tight psoas (cheaper options are available on Amazon). I ordered one immediately! 

After just a few days of working that muscle, yesterday, for the first time in my life, I ran (albeit a short distance) without any hip pain, and my nagging lower back pain (usually a constant low hum) has completely gone.

Other physical symptoms

Other ways stress can manifest are unexplained aches and pains, psoriasis, eczema (and other skin conditions), headaches that don’t go away even with painkillers—continual coughs, colds, chest infections that don’t clear up, even with antibiotics, etc.

Of course, you must seek professional medical advice for any pain or physical ailment, especially if it’s ongoing.  However, if no underlying cause can be found, it may be worth considering that it might be psychosomatic.

2. Impaired decision-making/Inability to think critically

When we trigger our stress response, our amygdala, the part of the brain responsible for spontaneous action, kicks in and shuts off the thinking part of our brain, the pre-frontal cortex.

The amygdala is one of the oldest parts of our brain, which we share will all other mammals. It’s an inbuilt safety mechanism that alerts us to real and perceived danger, which never shuts off.

It is responsible for identifying potential threats and triggering our flight, fight, freeze response, shutting down our pre-frontal cortex and preparing us for immediate physical action. 

Why we can’t think straight

This process is the precise reason why we can’t think straight and often make poor decisions when we’re stressed. An excellent way to explain what happens is that our critical thinking goes ‘offline’ so that our more primitive ‘spontaneous action’ response can take over. 

To bring your pre-frontal cortex back online quickly, as soon as you recognise that you’ve been triggered (see the ‘initial symptoms’ above), grab a pen and paper or use your phone to write down the answers to these questions:

• What am I thinking right now?
• Are these thoughts true? What evidence do I have for these thoughts?
• What’s a better/more realistic thought?
• What positive action can I take right now?

3. Dissociation (sometimes referred to as Disassociation)

Dissociation is an adaptive tool most often learnt as a defence mechanism in childhood but can also develop later in life in response to traumatic experiences. People who experience dissociation either do so following one significant traumatic event or many episodes over an extended period.

Adults who can’t remember large parts of their childhood may have been suffering from dissociation. In adulthood, whenever they experience high-stress situations, the brain will likely return to what is familiar and often induce the same pattern of behaviour.

Lights on/no one’s home

I describe dissociation as ‘the lights are on but no one’s home’; it’s like looking at everything through a net curtain or like someone put a lid on the world.

People interacting with someone dissociated may not even know that they are – in fact, the person themselves may not even recognise it if they’ve been doing it most of their lives. 

Ways to identify if you’re dissociated:  

• All the colour seems to have drained out of the world
• Everything feels hopeless
• You can’t think straight or critically
• You struggle to look past the immediate future 
• Everything looks fuzzy, distorted or just ‘off’ 
• Sounds, including voices, may seem distorted
• You feel like you’re underwater or floating
• Everything feels a bit surreal
• You can interact with people and even have full-blown conversations, but afterwards, the details may be sketchy, or you may not be able to remember it at all.

Dissociation is disorientating and debilitating. If you recognise that this happens to you or a loved one, I strongly urge you to speak to a healthcare professional about it. Many successful treatments are available, and it’s far more common than you might imagine.

In summary, learning to identify when you’ve triggered your stress response and taking immediate action to bring your nervous system back to baseline, as well as introducing stress management practises into your everyday life, is critical for your overall physical and mental wellbeing.