A Map of Stress Responses

The Defence Cascade of Survival Instincts

The above image is a map of the “defence cascade” of stress responses/survival instincts, that I created based on, but tweaked and modified from, the excellent article:

“DISSOCIATION FOLLOWING TRAUMATIC STRESS: ETIOLOGY AND TREATMENT”.

I am particularly interested in tracking what happens to Dopamine. I will take us on a guided tour of this mapping, step by step, below. This work is in part a result of very many fruitful discussions on these topics with

Lilian Sjøberg

of

The HOPE shortcut

.

The defence cascade starts when our Nervous System detects a potential threat, or predicts danger based on past events and experiences. This could be a sound, something we see in peripheral vision, a smell, something touching us, losing our balance, the arrival of a specific person, etc. There are [at least] two potential starting points, depending on the initial proximity of the detected threat.

If the potential threat is not very proximate, such as a movement some way off in the forest, we start with a Orienting Response. This reflex response consists of stopping current activity, becoming still, and turning of the head towards the threat, in order to gather more sensory information, readying for action. Think of a deer hearing a distant noise, raising its head, turning its ears towards the sound, and standing very still. Dopamine is released due to the anticipation, and ready to be turned into Adrenaline if needed. Recall Dopamine is responsible for both “Go” [take action] and “No Go” [do nothing] responses, and, in this case, it is activating the initial “No Go” freeze type of response.

Once further sensory evidence has been gathered by the Orienting Response, the Nervous System assesses whether a threat is still predicted, comparing the current situation with past experiences. If danger is still predicted, the Dopamine is converted into Adrenaline for action [Fight or Flight]. Alternatively, if a false alarm is predicted, the Calm state is returned to via the release of Endocannabinoids, and the Dopamine spike is then degraded, e.g. by the MAO or COMT enzyme pathways.

If the initial threat detected is very nearby, or even touching, the starting point is the Startle Response, wherein the detected threat literally makes us jump. We have previously covered what the Startle Response in humans looks like, including videos of it in action:

The Startle Reflex in Humans

“…the main features seem to be: a wide open mouth, the arms coming up in front of the face, palms often facing outwards, with jerky motions a bit like a quickly damped tremor… The response also includes literally jumping off the ground, or ducking down, followed immediately by moving away from the source of surprise [flight], or moving towards it [fight]. If the source of surprise remains touching the person, they stay in an extended reflex response, until they have brushed it off or escaped the proximity.”

The Startle Response results in an immediate Adrenaline spike, using up baseline Dopamine, and moves directly into Fight or Flight response, until the potential threat is fought off, or escaped.

When Fight or Flight has been activated via either the Orienting or Startle responses, Calm is eventually returned to if the action is successful, i.e. the immediate threat has been escaped or fought off. The Adrenaline spike is then degraded, again via MAO and COMT enzymes and Endocannabinoid release. Dopamine may have fallen below baseline, because some of the Dopamine supplies were used up to produce the Adrenaline, which then slowly recovers back to baseline.

If Fight or Flight hasn’t been successful, and the threat has not been fought off or escaped, and especially if the threat is now proximate and predicted to be potentially lethal, the Nervous System tries its next line of defence. This is a type of freeze response that is known by different names by different researchers/communities. It is a stiff, rigid, “being like a statue” type of freeze known variously as Tonic Immobility, Playing Possum, Catatonia, Death Feigning, or Thanatosis.

Animals in Their Freeze Instincts

To enforce the rigid freeze, Dopamine and hence Adrenaline supplies are suddenly cut off. Both the Dorsal Vagus Nerve and the Habenula part of the brain are known to be able fast signal the sudden withdrawal in Dopamine.

The Role of Disappointment in Chronic Illness and Modern Society

Note that, although movement is suppressed in Tonic Immobility, awareness of what is happening still remains, and an emotion of great fear is experienced. However, it is possible, if an opportunity for escape arises, such as an attacker loosening its grip, or losing interest, to produce a sudden spike in Adrenaline, and instantly switch back to Fight or Flight for a brief period, e.g. to run away.

If the feigning death strategy is successful, and the threat loses interests or moves away, the Calm state can be once again returned to, often involving a process of tremoring in order to “reset” the system.

However, if a previous traumatic experience has occurred which escalated to this Tonic Immobility stage, and the current situation reminds the Nervous System of this previous event, the Fight or Flight stage may be bypassed. The Nervous System will go directly from the Orienting type response to the Tonic Immobility stage. The more traumas the Nervous System has experienced which escalated to this stage, the more the trauma bypass is likely to occur.

Hence, there is a vicious circle, by which the Nervous System becomes more and more used to this type of freeze response, and hence for it to become the default or “go to” response, bypassing Fight or Flight, whenever a major stressor occurs.

Indeed, in the extreme, it is possible for the Nervous System to become overly-sensitized, and begin to predict lethal levels of threats everywhere, and then to get stuck in the Tonic Immobility response. Idiopathic Parkinson’s is a manifestation of getting stuck in this type of freeze.

If the Tonic Immobility response is still not successful, especially if blood has been drawn, penetration by teeth or a knife has occurred, or the Tonic Immobility has been held for too long, then the last line of defence is triggered. This is to faint and flop, into so called Flaccid Immobility. Unlike Tonic Immobility, consciousness and awareness of the surroundings is lost in the Flaccid Immobility. Endogenous Opioids are released to numb any pain.

If, in the final stage, death is very likely, the release of endogenous psychedelics also occurs [in which one can speculate that residual Dopamine may have a role], resulting in “Out of Body” type experiences.

The purpose of the analgesics and psychedelics is not to have a “good death”, as neither the Nervous System nor evolution cares about whether death is painless. Both are optimized for survival. The purpose of these releases is, in the small chance of survival, a repair and resetting, or “reboot” of the Nervous system occurs, to prevent so much mental scarring due the massively traumatic experience that it would be damaging to survival in the future.

If the Flaccid Immobility strategy works, then eventually an unconscious but Calm state is returned to, followed by awakening. However, unlike Tonic Immobility, it takes a long time, many minutes, to come out of the faint. This process can once again involve tremoring.

Indeed, as an aside, such tremoring is seen in patients after general anesthesia [which seems to basically trigger the faint and flop stress response]. However doctors give other medicine to prevent the post-anesthesia tremoring, which they see as a bad thing. This is probably why general anesthesia can have long term detrimental effects, because the doctors are then preventing the natural completion of the Flaccid Immobility stress response they have induced, so the patient is partially stuck in it afterwards.

Once again, if a previous traumatic experience escalated to the Flaccid Immobility stage before, trauma bypass, in this case of both the Flight or Fight and the Tonic Immobility stages, may occur, so the Nervous System goes directly in the faint and flop. Again, there is a vicious circle of becoming more and more used to going into Flaccid Immobility, and this becoming the default stress response. In the extreme, it is possible to get stuck in this response. POTs and Chronic Fatigue types of conditions may be manifestations of getting stuck in this type of freeze response.

Thus ends our guided tour of my modified map of the defence cascade of stress response and survival instincts.

Learn much more about the Nervous System in my course, including lots of pragmatic tips for improved health. Now includes a major new module on everything you need to know about Dopamine.