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PIVOT, DON'T PANIC: The pathophysiology of Fear & Stress

Updated: Apr 8, 2020

(8min read approximately)

FEAR is a stress response.

What happens when we get stressed? Better yet, What IS stress?

By definition, stress is “A threat (either real or perceived), to the balance of homeostasis.”. Originating from “allostasis”, the body constantly attempts to balance around mental, physical, and emotional variables.

Stress is actually helpful to the body until it doesn’t cease, which is when it becomes damaging. Think to the Window of Tolerance that each of us has. We consistently fluctuate between these two horizontal lines, one being “Rest” and the other being “maximum capacity”. We regularly need to seek rest from the stress in order to prevent reaching or exceeding our maximum capacity, which usually presents as “crashing” or burning out.

Stress is something we FEEL, not THINK. It’s important to learn to compartmentalize this thought. Our IQ (thinking) is very different from our EQ (feeling). When we are feeling stressed, it’s because we are thinking of everything that is overwhelming us (to do lists, life experiences, etc.). Stress then is a very real feeling of everything that has overstimulated us, without ceasing, and preventing us from getting back to rest.


Fear originates in the brain structure called the Amygdala. There are actually 2 in the human brain, one in either hemisphere, and each amygdala is approximately the size of an almond, hence where it’s name comes from.

Stress responses are received in the Hypothalamus structure of the brain. The hypothalamus secretes corticotropin-releasing hormone (CRH), sending information through the sympathetic pathways, connecting with the adrenals which secretes catecholamines (epinephrine and nor-epinephrine). This will present as a sympathetic nervous response (elevation of cardiac output, vasomotor changes, lipolysis, glycogenolysis, insulin suppression, increased respiration, enhanced blood coagulation). The stress response of body tissues (gluconeogenisis, protein catabolism, inhibition of glucose uptake, suppression of protein synthesis, stabilization of vascular reactivity, immune response suppression)is also mediated by the glucocorticosteroids. This is caused by the stimulation of the anterior pituitary gland to release adrenocorticotropic hormone (ACTH), causing the outer portion of the adrenal gland to release substantial amounts of glucocorticosteroids, specifically cortisol and aldosterone. This is called the Hypothalamic-pituitary-adrenal (HPA) axis.


What can we do to break the cycle of fear that we get stuck in?

SEAL TEAM 6 is our favourite example! Here are the strategies and steps they use to break the cycle of fear:

GOAL SETTING: Visualize the end game! Where do you want to be/go? What are the goals? MENTAL REHEARSAL: How to I get where I am going? What does it look like between my current situation and my end game? What do I have to do in the next minute, month, year, to get where I want to be? SELF TALK: Self talk changes your mindset. You must have a growth mindset (success mindset) in order to reach your end game. Use the 400 words/minute that you speak to yourself (or 576,000 words/day) to intentionally change your mindset. AROUSAL CONTROL: when something happens, how do you deal with it? How do you keep yourself in check/ accountable? Can you control your breathing? Your heart beat? Do you have the necessary skills and tools to be able to control the situation? Where can you seek help? GRATITUDE: Instead of saying “I’m afraid of___”, replace each fear with a gratitude statement …”I am grateful for _____”. HOPE: Hope is a beautiful combination of the first 3 steps. Knowing that there is a goal that you know how to reach, and are able to be in control, gives hope for the end game. This also is a driving factor for passion.

We’re inviting you to start becoming more aware of the things that are stressors around you, and how your mind and body respond to those stressors. Allow yourself to become more conscious of the things happening in your body and you may start learning some fascinating things about yourself!

In this time of uncertainty, fear and stress, allow yourself to PIVOT in a new direction instead of PANICKING!


Lee-Ellen Copstead | Jacqueline Banasik, Pathophysiology, 5th edition.

Unit 1:Pathophysiological Processes. Chapter 2: Homeostasis and Adaptive Responses (Stress as a concept), pages 13-16.

figure: Lee-Ellen Copstead | Jacqueline Banasik, Pathophysiology, 5th edition.

Unit 1:Pathophysiological Processes. Chapter 2: Homeostasis and Adaptive Responses (Stress as a concept), page 15.

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