27 Oct 2015
October 27, 2015

Stress and Failure: Which Comes First?

9nong via Getty Images

9nong via Getty Images

I’ve often wondered the answer to that age-old question: Which comes first? I’m not referring to the chicken and the egg but rather stress and failure. Is it overwhelming stress that causes one to fail in one’s professional and personal life, or is it the failures that one is experiencing that causes stress?

We do know some stress can be a good thing, and I have even blogged about this point in the past.

What I’m talking about here is a level of stress that seems to prevent one from pivoting to the next phase of life. After all, why do some people seem to effortlessly manage change and succeed in life, yet others continually stall and get stuck in bad personal or professional situations?

Research over the past decade has clearly demonstrated the impact chronic stress has on the brain. For instance, stress can reduce the size of our brains as well as affect how different parts of the brain communicate with one another.

Studies have recently shown that if young adults are exposed to chronic stress early in life, they often have more mental health issues later in life.

And we now know more about the devastating impact of post-traumatic stress disorder on one’s ability to succeed at work and at home.

At the same time, chronic depression can cause one to isolate oneself socially and professionally which can lead to failure, which then can cause stress. It’s also no surprise that repeatedly being passed for promotion or staying in an unhealthy relationship can cause stress levels to increase dramatically.

So, I’m not sure if it is the stress that comes first and then causes problems, or there are underlying mental health and emotional issues first that then cause stress. I’m interested in what others think on this topic.

But I do know there are some tests that might help you and your doctor understand if there are some biochemical reasons that are causing your inability to pivot to your next chapter of life:

1. Salivary testing for cortisol.
This test looks in the saliva for any biochemical imbalance of hormones from the adrenal glands that could be causing problems. This test is significant progress from the test I had to do on patients in medical school, which required being connected to an IV and given different injections over an entire day. Since normal cortisol levels vary during the day, you will have to spit in a test tube several times throughout the day but it’s a good measure to see if there’s a problem. I’m not a big fan of a simple cortisol level that some doctors measure because of the changes in cortisol levels that occur throughout the day. It’s hard to determine with just one level what exactly is going on.

2. Insulin-like growth factor, IGF-1. You might have heard about this relating to bodybuilders trying to use it to get bigger. The reason your doctor might be interested in it is a condition called adult growth hormone deficiency. It would be rare, but not impossible, to manifest this condition past puberty ,but it does happen. Often there is a history of short stature, as well as fatigue, muscle weakness and cloudy thinking. I admit it is rare but it does occur.

3. Sex hormones. For women, early menopause can cause problems with mental acuity and stress which could be preventing one from attaining one’s goals. The good news is the early menopause can be easily diagnosed with LH, FSH, and estradiol levels. The problem is that the thought of menopause for some women in their late 30s or early 40s is not something they are emotionally prepared for. And unless you are thinking about it, you’re unlikely to talk to you doctor about it.

4. Thyroid function tests. Usually once or twice a year, I see someone with previously undiagnosed thyroid disease. The symptoms are usually subtle but thyroid disease (both hyper (overactive) and hypo (underactive) can present with trouble mentally focusing and paying attention. There usually are other symptoms but these tests might be worthwhile to order if you just haven’t felt like yourself for months or years.

So which comes first — stress or failure? We need more research to know for sure, but if you have been feeling “stuck” in your personal and/or professional life, and you just can’t seem to pivot to the next phase, talk to your doctor about these tests. They just might uncover the reason.

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