Introduction
In the previous article on this topic,
The Overlaps Between Stress and Parkinson's Disease, Part 1
I showed that the effects of stress on the body actually also describe very well many of the symptoms associated with Parkinson's Disease, revealing that PD is not just "brain damage" but is actually a problem with the entire nervous system. In this sequel, I show that there is also a direct correspondence between the severities of fight-flight-freeze stress response and PD symptom progression, by comparing how the body behaves in short term acutely applied, but increasingly heightened, stressful situations to the onset and subsequent evolution of the symptoms of PD over time.
This article was motivated by the Fajardo Method of Holistic Biomechanics, in which the fight-flight-freeze response is expanded into a seven-stage framework. Here, we briefly go through these seven stages, as the body undergoes increasingly acute stressful situations, and, at each stage, consider the parallel evolution of worsening symptoms of a person with PD (PwP) - if the disease is allowed to progress. My purpose is to add considerable weight to the perspective that PwP are stuck in the freeze stress response. This is important, because it helps us to underline that when the disease is allowed to progress unchecked, a PwP will move through the stages and end up stuck in increasingly serious modes of stress.
Seven Stages of Stress
Stage 1: Startle
"...heightened alertness and investigation of potential for danger... nervous system takes in sensory information about surroundings to determine if a fight or flight situation exists... few physiological and anatomical changes... eye sockets narrow... and stress hormones (adrenalin, cortisol, and glucocorticoids) begin to be produced... triggers hundreds times a day as the body investigates novel sensory information... brighter light, unexpected shout, temperature changes... but should quickly return to the parasympathetic [relax and repair] nervous system state if no immediate physical danger exists."
In talking to a very large network of PwP all over the world about their lives leading up to diagnosis, I have found a large subset who have a common "Parkinson's Personality" type, including myself. In particular, many PwP are hyper-vigilant in someway, as if our "startle" response is on more of a hair trigger than standard. Our nervous systems are thus more easily spooked, but are also sensitized, taking longer to calm down too. Hyper-vigilance in Pwp prior to diagnosis may manifest as anxieties, obsessional-compulsive behaviors, worrying more than normal about welfare of loved ones, holding oneself to unrealistically high standards.
Stage 2: Fight
"Blood flow increases to the muscles in the arms and legs to provide energy for vigorous movement. Water flows out of the arms and legs toward the center of the body..."
We have also found that the same subset of PwP, prior to diagnosis, were "warriors for a cause", with a propensity to put ourselves in positions of protecting or standing up for others, but also holding ourselves to very high moral standards resulting is us being extremely argumentive and stubborn.
Stage 3: Flight
"...body starts to twist and side shift, following instinct to run away... may not be uniform in direction... shoulders may twist to the right while hips twist to the left... spinal twists and side shifts..."
By the time of diagnosis, PwPs bodies already show significant semi-permanent postural imbalances just as described above. For definite examples, I have included photographic evidence of my own body below. The type of postural asymmetries shown are extremely common, first appearing in early stage PD. Such postural imbalances affect the whole kinetic chain, causing serious issues with walking, for example.
Stage 4: Freeze
"The pelvis and the shoulder girdle (collarbone and shoulder blades) begins the process of curling into a ball..."
As PD progesses, PwP start to exhibit the classic "Parkinson's Stance" (illustrated below) in which the body appears to be indeed increasingly curling up this way.
Stages 5 and 6: Collapse I & II
"Chest cavity decreases ... head and pelvic cavities continue to curl toward each other. Organ motility decreases as the body begins to shut down internal processes such as digestion... Changes in the first collapse stage become more extreme. The body cavities have all been decreasing in size... organs begin to swell... body no longer provided with normal internal pressure..."
Left unchecked, the Parkinson's Stance gets worse over time and the PwP becomes more and more stooped and permentantly fixed in an increasingly curled up state. Breathing becomes increasingly shallow as the chest cavity barely expands. Digestive issues, especially constipation and malabsorption of nutrients become increasingly serious issues.
Stage 7: Rigor
"... muscles increase to their highest tension... are dehydrated... making movement extremely slow and difficult, and sometimes spastic... an extreme fight or flight response."
Bradykinesia (muscle rigidity, stiffness) and/or tremors become increasingly serious as PD progresses. The ability to move dissappears.
Conclusions
Although the seven stage framework has been developed to describe acutely applied short duration stress, without any reference to PD, the very same framework also describes well the declining state of a PwPs body over time - if the disease is allowed to progress. Therefore, we believe that not only are PwPs permanently stuck in such stress response states, the degree of the stress that we are stuck in also moves through the stages as our situation is allowed to degenerated.
Recommendations
Understanding, addressing and interrupting the ingrained stress response of PD is clearly a priority area for any health care intervention. Mental health support such as counselling and cognitive behaviour therapy, anti-inflammatory nutritional regimes which avoid the body being startled into a high internal alert mode, and practicing stress interruption methods and techniques, such as those tried and tested in the Fajardo Method, must now be regarded as just as important, if not more so, as drug therapies. There is an urgent and serious requirement for these measures to be put in place, and applied as soon as possible to catch the problem in the earliest stage, in order to prevent Parkinson's Disease symptoms becoming increasingly and rapidly worse.
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