Trucker MD
Fight or flight
Why constant stress puts truckers at risk for chronic disease

By John McElligott, MD

Back in the day when we ate what we could kill and were constantly defending ourselves from predators, humans had a secret weapon. We developed a protective mechanism to enable us to run super fast when we needed to escape danger and be super strong when we needed to fight back.

Our adrenal glands and how they perform are chiefly responsible for this mechanism.

Modern times has changed the way we live, and of course the stressors have changed as well, although our days are still full of stressful events – especially in the world of trucking. The protective mechanism that the bodies of our ancient forefathers possessed has not changed, however, and still kicks in when we have to fight or flee.

Fight or flight is a response to real or perceived danger or stress. For instance, your adrenal glands excrete adrenaline and cortisol (stress hormones). A signal is sent from the brain telling this very small gland to get busy. It says, “Help me fight this battle that I am facing or help me get away from it fast.” In modern times, the critical event is occasionally physical, but most of the time it’s mental.

Let’s take physical danger/stress first. Adrenaline is released when a danger presents itself and one reacts. Adrenaline makes you react faster by increasing your blood pressure and heart rate, dilating your pupils, shutting down urine flow/sweating, and making one stronger.

Cortisol is released and your sugar levels are increased. Systems such as your gastrointestinal tract, immune and reproductive systems shut down, saving that energy and funneling it to the immediate event at hand. This temporary shutdown also allows the brain to make use of the extra sugar for its command and control functions. 

Perceived danger/stress is a different matter and has more long-term effects. It’s real in the mind’s eye, so the response from the adrenal glands are the same as above. The difference is that perceived danger/stress can be (and often is) recurrent. The constant repetition of stress hormone excretion takes its toll on the body, which is seen in truckers at an alarming rate. Most of these diseases and conditions seen in truckers can be the explanation of why we doctors cannot get control of diseases that plague the profession.

The diseases seen as a result of repetitive fight-or-flight hormone release are as follows:

  • Uncontrolled diabetes
  • Uncontrolled  high blood pressure
  • Unable to lose weight or continued weight gain
  • Depression
  • Memory loss
  • Sleep disturbances and sleep apnea
  • Skin conditions that are not fungal or bacterial

My own theory: Steroid (cortisol) psychosis seen in rare cases of post-traumatic stress disorder (PTSD).

So how do you control cortisol levels in your body?
When you’ve had one or more fight-or-flight events in your day, you need to get rid of the cortisol by physical exercise or by involving yourself in a relaxing activity. Heads up, truckers: Don’t overdo the physical exercise as some studies have shown that exercising for more than an hour can actually cause cortisol levels to go up, not down.

For controlling the cortisol levels in your body on a daily basis, here’s my personal prescription: Don’t rush and make plenty of time for rest and relaxation. Start your day by first getting the task done that you hate the most. Then, to quote a friend, “the rest of the day is a breeze.” Plan your day in advance and leave plenty of time for finishing up unpleasant tasks before relaxing.

Control anger, since this is the big releaser of stress hormones. When possible, sleep on a problem and you’ll do a better job of solving it. LL