#allostatic load

not with yes i’ve been there too and so many medical professions don’t understand pain it’s awful

but have you considered that the relief of drugs isn’t just chasing a high for many addicts but an equally legitimate physical or mental pain that has gone ignored and untreated?

There's this concept that we talk about a lot in medical school and particularly osteopathy called the allostatic load. It is basically all the things that are weighing on the patient and causing their dysfunction. For example, if someone has cancer, they've got something huge on their plate. But they also have to worry about finances, who's gonna watch their kids, worrying about their loved ones, and maybe they have a bunch of somatic dysfunction from lack of movement. In OMM, our goal is to reduce that allostatic load. Sure, it might not fix all their problems, but it'll take something off their plate so they don't have to worry quite as much or be quite as uncomfortable.

My allostatic load is pretty high right now with just this neuro exam and maybe soreness from training, but I'm healthy and I can handle it.

Until the school decided to swoop in and teach us venipunture next week. I'm terrified of needles. And they keep emailing us to make sure we prepare. While they know we're studying for neuro.

I knew I would have to face my fear this year. But I really thought they would wait until after neuro to dump that on us. I'm literally full-body trembling as I write this. I can barely keep myself from crying when I get an IV from a professional, let alone a first attempt.

Im freaking out.

But I'm really trying to only focus on neuro until Monday at least.

Those Who Matter Don't Complain (but suffer silently)

Since our human proverbs are half-truths, the common translation of the proverb "Those who matter don't complain" was unsatisfactory.

"Those who matter don't complain" sounds wise because it praises endurance. There is something admirable about the organism's ability to continue functioning despite difficulty. The body is indeed an extraordinary example of silent persistence. The heart beats without asking for praise. The immune system repairs damage without writing a report. The liver detoxifies without demanding recognition. Most of life happens without conscious supervision.

But the proverb creates a false hierarchy when it implies that what is silent is more valuable than what speaks. The body is silent because it has no other option. It does not possess a narrative voice that can say, "Something is wrong and I need help." Its language is physiology. It speaks through pain, fatigue, inflammation, changes in blood pressure, insomnia, and illness. A fever is not a complaint. It is a signal. Pain is not weakness. It is information. But we can assume that the temperature and pain are the body's complaints.

The brain's "complaining" is also not merely useless noise. It is one of the mechanisms through which an organism detects problems before irreversible damage occurs. Anxiety, dissatisfaction, frustration, and fear can become pathological when they are excessive, but in moderate forms they are protective systems. A creature that never experienced discomfort would not survive for long. And those who complain are not without right because it is an attempt to alleviate the problem with reality, especially with the body, before irreversible damage occurs, such as an illness.

This becomes especially clear with allostatic load. The body can tolerate stress because stress responses are adaptive. A burst of cortisol helps you escape danger. Increased heart rate prepares you for action. Suppressing hunger or exhaustion temporarily can help you survive a crisis. The problem appears when the emergency system remains active for too long. The body keeps paying the metabolic cost of a threat that is no longer physically present. In that sense, chronic psychological suffering is not the body complaining too much. It is the body carrying a burden that the whole organism has failed to resolve. So those who do not complain also die, suffer silently and die quickly.

The interesting paradox is that the brain complains because the body cannot complain in words. The conscious mind is partly an alarm system. It translates internal states into narratives. Sometimes it produces catastrophic stories and makes suffering worse. But sometimes it notices the smoke before the fire becomes irreversible. A person who says, "I cannot continue like this," may be expressing exactly the information needed to prevent collapse. A society that teaches people to never complain can accidentally train them to ignore important signals.

Perhaps the deeper version of the proverb would be that those who matter may not complain loudly, but they communicate.The body communicates through symptoms. The mind communicates through thoughts and emotions. Wisdom is not found in silencing either one. It is found in learning which signals are useful and which are false alarms.

Time, effort, and sacrifice are not abstract moral categories imposed upon the organism from culture or ideology. They are neurobiological commitments that require justification at the level of metabolism, prediction, and learning. The brain does not accept pain, delay, or sustained exertion by default. It tolerates them only when they are embedded within meaningful horizons that render present…

Look at that, it turns out there is a technical term for that mental fatigue you feel from being stuck in the house doing the social distance thing.

Allostatic Load.

I knew there had to be something to describe how awful this feels.  If there wasn’t a term for it before I figured someone smarter than I would be working on one.  Nope, it’s already out there.

Are you feeling it?  I am feeling it. …