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A Very Low Threshold For Stress Tolerance

Question:

I find that I have a very low threshold for stress tolerance. I don’t have a problem with any particular individual task, but when I feel I’m juggling things or "multitasking," or if I have a huge (or even mildly large) list of work to get done, I get overwhelmed and just shut down. Depending on the situation, I may give up, get angry or irritable, attempt to escape the situation, start crying, or occasionally even lay down and sleep (not exactly fainting, but not a normal nap either).

Come to think of it, I feel the same way about interpersonal conflict and even audio and visual things (can’t stand a lot of noise, can’t stand a cluttered place or images where there’s "too much going on," have trouble talking to more than one person at once).

I have difficulty doing things that others take for granted; I do not own a vehicle because I feel driving stresses me out in this manner. I often avoid visiting friends and family or scheduling doctor and dentist visits or signing up for college classes or any other extracurricular activity because of the potential for stress. I am having difficulty getting things done at work because I feel extremely overwhelmed (I work in a call center and should probably find a simpler line of work, but it’s hard to find something simple that will pay the bills.) I have trouble cooking a meal or performing certain grooming things (I am very clean, but I cannot for the life of me get it together with hair, makeup, jewelery, or other typically complicated feminine stuff). I get absolutely overwhelmed if anything outside of the normal routine happens (schedule change at work, bus schedule changes, remodeling the house, someone taking my food from the fridge, etc).

In today’s fast-paced world this peculiar problem is really holding me back; I am intelligent enough, I just can’t focus on more than one thing at once, and it creates an emotional reaction when the rest of the world tries to fit this square peg (me) into that round hole (modern life).

Now that you understand my problem, here are my questions. Is my current state a mental illness in and of itself, or could it be a symptom of a known mental illness, or is there an option I’m not thinking of? Am I making a mountain out of a molehill? Is it just that some people are not cut out for the fast-paced modern American lifestyle? I don’t come from a slower time or simpler way of life — I am 23, have always been around fast-paced computers, city life and multitasking, and have always had problems with it.

Perhaps you should know that mental illness runs in my family, so that’s why I’m guessing it might be an inherited illness rather than just something being wrong with me personally.

Any advice would be greatly, greatly appreciated. I’m about to go see a mental health professional anyway but I have done a little bit of studying in psychology and I haven’t seen a case like this, or a name for it.

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Answer:

I think you’ve done a very excellent job outlining how your particular issue affects your life. The world definitely makes enormous demands on people, and people vary considerably in terms of how many demands they can deal with at once. Some people thrive in a multitasking environment, while others cannot function well under such conditions. What would seem to be a simple difficulty handling multiple demands on your attention and time is not so simple for you however, given how pervasively modern society requires people to multitask. When faced with competing demands on your attention, you end up feeling overwhelmed and become paralyzed in a significant way. This is to say, you get stressed out and anxious. Naturally, you want to avoid the rather awful feeling of being stressed, and so you avoid situations that have stressed you in the past. This ends up constricting the range of things you are able to do with your life. The situation you’re in is not unlike having been painted into a corner. You are observant and smart enough to recognize that something is wrong, but not sure what that something is or how to address it.

There isn’t any single clear diagnostic category that is leaping out at me when I read over what you’ve submitted. A few ideas do some to mind though. The obvious part of your issue is the anxiety and overwhelm part, but there is something causing that overwhelm, which would appear to be some sort of sensory or attentional issue. Your problem appears when you are required to split your attention across competing demands, and when you are confronted with the unfamiliar. You could be having a problem with shifting your attention from focus to focus. You could be having a problem such as is seen in obsessive compulsive spectrum issues or sometimes with autism or aspergers disorder where the act of doing something familiar in a repetitive manner is comforting or tension relieving, and any challenge to routine behavior patterns becomes threatening. It could be that routine things feel more comfortable because you have difficulty with attentional gating and habituation, which could also suggest a difficulty with selective attention.

That last phrase is a mouthful, so I’ll explain. In order to make sense out of the cacophony of the world, our brains have developed the ability to pay selective attention to one thing in the midst of many things that could be attended to. The "cocktail effect", which occurs when you are talking with someone at a party and then hear your name in an adjacent conversation and find yourself suddenly and automatically reorienting to listen to that adjacent conversation illustrates how this works. Most people don’t have to make too much of an effort to focus on the one primary conversation they are part of. Most people don’t have any choice but to reorient their attention to the adjacent conversation when they hear their name there. In each case, the other conversation is filtered out of attention at an early stage so that it becomes the background, and the attended-to conversation becomes the figure (e.g., that thing attended to). The filtering function that characterizes normal attention is accomplished inside the brain via neural circuits inside the brain that function like little gates to literally dampen down the possibility of attending to one conversation while the other is being attended to. If there is, for some reason, a problem with how those neural circuit gates function, then you will not be able to blot out the background because there will be no background; everything will be the foreground, and that will be enough to make anyone uncomfortable.

If I’m on the right track here (and I’m not sure that I am so take this for the informed but certainly not authoritative speculation that it is), you might profitably consult with a neuropsychologist, and a psychiatrist or neuropsychiatrist (which would be a psychiatrist who has specialized in neuroscience as well as conventional psychiatric pharmacology). The neuropsychologist would be able to offer you tests which could establish how your attentional functioning compares to the normal population. The psychiatrist could, if he or she thought it useful and indicated, potentially offer you medication which could help adjust how your attention functions. Going the medication route could prove helpful, but any help it brings you will come with several price tags (e.g., insurance companies will note that you are on psychiatric medications and may deny you coverage in the future on this basis, there may be unpleasant side effects, etc.). I’m bringing them up not because it is the right thing for you to do, but rather because you are looking for ideas.

I’m not aware of any non-medical intervention that might be useful for helping to strengthen an attentional problem of the type that might be happening here. There are many non-medical interventions that can help you relax, better manage stress, avoid situations less, and/or learn to accept and tolerate your circumstance better than you presently do (which will help take some of the pressure off you). You can explore such interventions with the aid of a therapist. As you are distressed by your issue, this would be a good idea to pursue in any event.

Regular vigorous physical exercise is something that you can likely take up without any outside assistance which may help you feel less anxious and depressed in general. It will not treat an attention problem, but it can help you to feel better, and is generally a good thing for your physical and mental health (provided you don’t overdo it), so I’ll mention it as well.

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Comments
  • Student

    Dr. Dombeck,

    I believe I have a similar problem as mentioned in the article 'A very low threshold for stress tolerance'

    I have always topped in my schooling. I also topped my undergrads. But I have never been able to do many things at a time . I am a very successful programmer. Very good at logic. But I feel overwhelmed if there are 3 or more tasks that I have to do. If I have some work, I find it difficult to check emails, I find myself to be unable to call up my friends and spare time to keep in touch with the family.

    I am doing my MBA right now. I am 27 years old. I may call myself professionally successful. I am good communicator, good listener, I consider myself to be above average intelligence and logic. But I get completely blank and helpless while simplest multitasking or time-stressed tasks.

    You may reveal my writing , however I would request you to keep my name and email id confidential.

    If there were similar patterns of responses and if you would like to get more information from me, please feel free to email me. I would be glad and thankful if you could help solve this problem, whether it is real or psychological.

    Wish you a great day.

  • I C

    Dear Dr. Dombeck,

    I agree that the writer on low-stress tolerance did a great job describing her predicament and its impact on her life. She presents familiar dilemmas that can be hard for outsiders to grasp or offer help with. Here's my modest offering on the topic:

    Apart from pharmaceutical intervention, perhaps another idea to boost or reinforce attentional abilities is cognitive remediation. I stumbled across this option when a neuropsych eval revealed that adult-acquired MS had further amplified my pre-existing attentional weaknesses that have challenged me since childhood--likely due to ADHD. (Curiously, my neuropsych strengths had also been amplified.) While cognitive remediation can be a longer-term committment and it is a somewhat involved learning process, I believe that it may be a less-invasive and effective option, especially when pharmaceutical intervention can present less desireable risks and complications. --ic

    PS: Thanks to you and writers here for helpful efforts. Keep up the good work.

  • Jessica

    I am so glad to hear that I am not the only one that has these feelings, the one thing that is different for me is the fact that i am a working mother of 2, married, and have a household to keep up with and no help from anyone. I have just started to feel overwhelmed in the past 3 years, since the birth of my last child, and unfortunately I tend to have a few cocktails everynight to help me stay focused on getting one job completed. I have not even been able to completely clean my house in one day like I used to, and that bothers me, I am taking Zoloft, more for anxiety than depression, but sometimes I feel like I just want to run far away and leave everything behind, life becomes so overwhelming.

  • Tracy

    wow!Glad to have found this. Come from a family, both sets of grandparents alcholics or parents who deny reality because they can't cope. Now in middle age, I find myself drinking to fall asleep and handle stress. Seems exercise is not enough to sleep thru the night. I feel my gene pool has betrayed me. My husband has minor anxiety, but is strong and rational overall.

  • Joseph

    Isnt it true that when the mind has a low stress tolerance, easy activity wears out the melatonin, seronin and dopamine inside of your brain from being overwhelmed? it could possibly be a chemical imbalance in the brain caused pretty averagely in 10% and more frequently in a lower percentile. i am 19 year old male living at home with heavy car payments and high standards. I'm running into a similar problem, but there are alot of days where i can be perfectly fine, confident, healthy, aware, and others where im down the drain and can't function entirely as if my brain shuts down and cant remember the simplest things. It's like i never had any socialization skills in the first place. As a child i actually noticed a slow decrease in my interests, muscle growth, healing speed, focus, and whit. And recently I've found out that being extremely sad is the only way my mind can actually release stress. Major bummer. Can't hold a job for more than a couple weeks, and i feel like the weight of my family and girlfriend relies on me and I haven't been myself.

  • David Joseph

        Well how do doctors make their living?  On diagnosing or prescribing or treating or curing?   Good medicane has no baselines, that is truth, because neither does our own body.  Everybody has stress, and we all bring it on ourselves.  Do what you can and simply feel good about it when you accomplish any task.  Not everybody is a multi-tasker - period.  Mind over Matter with alot less chatter!  Doctors have stress too, maybe some more than others, how do they deal with it?  If your stressed about normal living such as providing like the generation before us.....then stop stressing.  Provide what you can with what you have, that's it!  Keep it simple.  It does no good to place demands on yourself that exceed your abilities.  Supportive relationships, and meeting goals that you can will bring you to the point where you feel good about handling responsibility, probablly better than any medication a doctor would prescribe.  Why won't Insurance companies validate these prognosis? 

    From NUKEY

  • Zoloft Prescription Medication

    My name is Stephen Long and i would like to show you my personal experience with Zoloft.

    I am 40 years old. Have been on Zoloft for 2 years now. Zoloft certainly got rid of my depression and anxiety. It also helped me with sleeping and I did not gain any weight like others have. However I was younger when I tried this so perhaps my metabolism worked differently then. It was impossible to reach orgasm on this drug so I would sometimes delay taking my drug to give my body a mini wash out period and this helped. However, if I waited too long to take the tablet, I endured severe headaches and had to lie down. Fortunately, this was reversible as soon as I took the drug again. I eventually tapered off this drug thanks to my doctor's plan which worked perfectly. The main reason I gave up Zoloft is because at the time there were reports saying that long term use of it was dangerous.

    I have experienced some of these side effects -

    Sweatiness, loss of libido, EXTREME headaches if forget to take drug.

    I hope this information will be useful to others,

    Stephen Long

    Zoloft Prescription Medication

  • Anonymous-1

    I can handle a great deal of stress, but in some situations that others would find not stressful I sometimes will ‘freak out’. These situation I can’t seem to deal with are for example (1) “going to a fast food restaurant and waiting in line” (2) being in any city where there are crowds of people (3) Being in a crowd of people is not tolerable to me at all. (4) Living in a subdivision with neighbors. (5) I do not like to fly on airplanes because there are so many people in there and they always take me to a densely populated city. I realize I have engineered my life to avoid all of these things too. It works pretty well for me too. I live in the National Forest, there are no neighbors for miles. I am 50 miles from any fast food restaurant, theater or anything that could be even called a ‘city’ by most. I never go anywhere there will be a crowd and if I go somewhere and there is a crowd there I simply leave at once regardless of what I came for or how far. If I must go into a city, I plan my trip carefully so that I can get in and out as quickly as possible. The ironic fact is I am a psychologist myself. And to be straight about it a rather effective one too, though I do only specialize in one area of treatment. My patients come from many parts of the world to my remote facility in the National Forest where I live. I had some horrific experience during the war, does it really matter which one? But I am not a youngster by any means. I have been diagnosed with PTSD. But that was hardly a surprise to me of course. I must admit that I was borderline suicidal and suffered from severe depression for a time after I got back. And later even when I was being very successful and even internationally recognized in my field of work I was severely depressed and could not understand why really. But I did not deny my depression but I detrmined to recognize it and Iwanted to actively deal with it and effectively. I abused alcohol at that time too, I was a classic case of "self-medicating". But I never really got roaring drunk or drove while intoxicated. my father was a great and a tremndious father who died of alcoholism. I never onmce saw him truly drunk though.Ultimately my doctor suggested SSRI’s. The first I took was Celexa, this was a real nightmare for me in every way. It had horrible effects on me. He said the drug might improve my memory it did only I did not want to remember thee things I did. As in having ‘wake-up in a cold shaking sweat horror show nightmares’ of combat. I even moved to another bedroom for several nights for fear I might be of some danger with a possible PTSD episode that might endanger my wife. Of course I never took the Celexa again. The next try was Paxil. It was effective to some extent but the side effect were unacceptable, no sex drive and it made me much too passive. As I said I am not young but I am still somewhat sexually active still and I keep myself in decent physical shape and at a healthy weight.. Next was Welbutrin, not an SSRI. Eventually, after trial and error, we managed the dosage levels of Welbutrin with an almost subclinical dose of Paxil, which worked well for me to this very Even with my academic background I find it almost “eerie” that my brain chemistry can be modified in this way to relive my symptoms as it does. At present I have lost hundreds of thousands of dollars in the last year, the IRS is after me for non-existent back taxes they say I owe, they have slapped lien on my ranch and facility. I am in the worst financial shape I have been in for many, many years. Yet, I am somehow very happy still. My knowledge of human biochemistry is significant, especially brain chemistry. But even so I almost wonder if I don’t feel “too good” given the circumstances I am in right, now money wise. It makes me wonder if all our emotions and feelings, psychopathologies etc, are just unbalanced biochemistry and sometimes partly the result of genetics? I 'know' for example that I can with statistical significance (even though the actual sample space is rather limited here) identify a sociopath, and more particularly a certain category of ‘narcissistic, sociopathic serial murderers’ by simply examining their MRI and a blood sample. Now it is true that these guys are all in prison for being serial killers and they have been convicted of same from whom I was provided the copies of the MRI’s to study . Hence, one can rightfully challenge the ‘experimental design’ here and I certainly acknowledge that. But my ‘gut’ tells me the evidence is pretty clear here too. What I wonder is who has done some good research on if cognitive or “talk therapy” can effect a change in brain chemistry. I can imagine agencies of biochemistry that might allow this really. But this is just speculation on my part too. In any case the lesson I learned here was that one has to get the right combination and dosages of SSRI’s and other pharmaceuticals by essentially 'trial and error'. But perhaps it is worth doing just that under an experienced physicians’ direction. It has worked for me.

  • ned

    Here is the problem that creates all of those anxiety issues. It's called COMPUTER (INTERNET). I'm quite sure this is the main culprit in all of those issues. I lived in times when computer was not so mainstream and there was stress, but not even close to what is it now. Also, computer and internet are killing our social skills and what happens is that when we are faced with high social situantion, we don't have a keyboard to respond, and we can't hide any more behind computer screen. Trust me on this.

  • a simple one

    another option is you could be someone who is just "highly sensitive." so far that's what i've gone with and try to function accordingly. there are 3 or 4 books and websites and more stuff on the internet than needs to be about it. hope this helps.

  • Anonymous-2

    Consider checking out information on (HSP) Highly Sensitive Person .

  • Gem

    This post is a bit old so you may not read this but hopefully someone will find it useful if they relate to you...

    The symptoms you describe sound like those similar to 'Pyroluria'

    Pyroluria is somewhat new on the medical scene, it has slowly become more recognised in the last ten years and I (I work in Mental Health Services) have definitely noticed more recognition of it.

    In a nutshel: Pyroluria is a blood disorder. A person with prroluria creates excess "kryptopyrroles" (a by product of haemaglobin synthesis), and these kryptopyrrols bind to zinc and Vitamin B6 and are then excreted during urination. This results in a deficiency in zinc and B6. Zinc and B6 are needed for neurotransmitters GABA and serotonin (which help us to be happy and calm) to fire, therefore leaving the person biochemically predisposed to depression and anxiety.

    Diagnosis is via a urine test.

    Treatment is with higher than your average dose of Zinc, B6 and other minerals that may be depleted due to the high stress anxiety and depresson can place on the body.

    I would recommend further investigation into pyroluria if you have any ofthe symptoms mentioned in the query.

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