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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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