What does it mean when the brain gets stuck in a fight-or-flight loop?” 🚨
It doesn’t mean the person is consciously scared.
That is the first misunderstanding.
A patient may say, quite accurately: “I’m not anxious. I’m not afraid.”
And they may be right.
But arousal dysfunction is not always conscious fear.
At a brain-body level, sustained illness ( mediated by multiple biological mechanisms ) can create allostatic load repeated attempts by the body to maintain stability under stress.
Over time, the system shifts into a new allostatic state: higher baseline arousal, altered autonomic tone, disrupted sleep, interoceptive noise, inflammatory signalling, vascular changes, and reduced confidence in bodily prediction.
The last part is important .
So the brain’s state has shifted to
“I cannot predict this body reliably.”
That uncertainty itself drives arousal.
When internal signals become unpredictable : dizziness, tachycardia, fatigue, PEM, pain, breathlessness, weakness : the brain has to keep monitoring.
That’s interoception
That is metabolically expensive.
The prefrontal cortex, which normally helps with flexible thinking, planning, inhibition and contextualising threat, becomes less efficient under sustained arousal.
Noradrenergic systems, particularly alpha-1 mediated arousal under high stress states, can shift the brain away from flexible prefrontal regulation towards more reflexive, rigid, defensive action.
So the brain selects the lowest-cost action under uncertainty.
In predictive processing terms, the loop is this:
1/ The body produces noisy or threatening interoceptive signals.
2/ The brain predicts high cost or danger.
3/ Attention narrows onto the body.
4/ Arousal increases.
5/ Prefrontal flexibility reduces.
6/ Action becomes avoidance, rest, guarding or withdrawal.
7/ Short-term prediction error reduces.
8/ The brain learns: this was the safest policy.
9/ automatised over time
That is the loop.
Not “pseudoscience”.
A brain-body system under allostatic load can become organised around threat minimisation and cost reduction.
A disturbing story of systemic failure to recognise iatrogenic harm in the mental health system.
Shows how attempts to claim it is just a few badly informed prescribers doesn’t cut it.
Patients are dismissed every step of the way.
Notice how one of the clinicians then projects their own failure to deal with situation back onto the patient by labelling them ‘difficult’.
We are denying young women the right to make truly informed choices about psychiatric drugs.
Most of us receive little to no information about what starting SSRIs and other psych meds might mean for having children one day.
For some people, coming off these drugs safely can take years, yet many young women start them without anyone discussing the long-term planning that may be required.
Far too many pregnant women find themselves faced with an impossible decision: stop their medications abruptly and risk serious withdrawal symptoms, or stay on their meds and increase the risk of adverse birth and health outcomes for themselves and their babies.
It should be a non-negotiable: girls and women deserve to know all of this prior to starting psychiatric medications.
@mikhailafuller
I support State sanctioned execution of mohels and anyone who defends them. Intruding into a child’s penis and amputating the foreskin is a penalty worthy of death.
@cartersteinhoff This is wild
I’m circusized and suffer from pfs and PSSD - god knows
But the gamut of symptoms resembles fight or flight/ chronic stress
Long-term use of antidepressants: little evidence of benefit and growing evidence of risks, including sexual dysfunction, emotional numbing, cognitive impairment, weight gain and increased risk of physical health problems in older adults.
The news articles that say finasteride or SSRIs "may" cause or increase the risk of sexual dysfunction and depression are such a minimization of what these drugs can actually cause: anhedonia, emotional blunting, cognitive dysfunction, bone-related issues, muscle wasting, physical changes, and much more. And to not emphasize that these changes can be permanent is a serious slap in the face to those suffering.
I can't believe we're still at this stage of highlighting the absolute bare minimum of this harm.
Good time for this standard reminder: If someone is clearly negative on you - cut immediately.
The effort required to turn them is never. NEVER. Worth it.
There is a 50/50 shot of someone liking you in the first place (look at the president). Move on.