The Andarta Way

The Cognitive Cost of Staying Switched On

Prolonged stress doesn’t just wear on the body — it reshapes the brain. The prefrontal cortex, which governs focus, memory, and decision-making, is particularly vulnerable. Stress hormones and inflammation interfere with its wiring, reducing the very functions high performers rely on most (Girotti et al., 2018).

I know this personally. During my own period of burnout, I found myself unable to concentrate, forgetting things I would normally hold with ease, and stuck in a kind of mental fog that seemed endless. For me it was a painful illustration that stress doesn’t just leave you tired. It changes how the mind works.

The evidence backs this up. In one large cohort, study people who reported higher stress in midlife showed significantly greater declines in IQ and memory nearly 30 years later, even after adjusting for their early-life ability and background (Christensen et al., 2023).

And the effects accelerate with age. Chronic stress appears to promote low-grade brain inflammation, reducing the brain’s flexibility to adapt and form new connections, and shrinks memory centres — changes that accumulate over decades and become harder to reverse (Girotti et al., 2024). In practical terms: it appears that the longer stress stays switched on, the steeper the slide in cognitive capacity.

The Cardiovascular and Metabolic Price of Chronic Stress

The toll isn’t confined to the brain. Over time, the cardiovascular and metabolic consequences become just as clear.

People reporting higher levels of stress face a significantly greater risk of developing coronary heart disease, even after accounting for traditional risk factors (Richardson et al., 2012). Work-related stress is also a recognised driver of metabolic syndrome: the combination of high blood pressure, weight gain around the abdomen, impaired glucose control, and abnormal cholesterol that lays the groundwork for diabetes and heart disease (Chandola et al., 2006).

I’ve seen it firsthand. One client pushed so hard to get their start-up through a Series B raise that they developed type 2 diabetes. Another business owner arrived with significant heart disease. Both still outwardly performing, but already paying the price physiologically. With the right interventions we caught and managed both, but these were preventable. The body does indeed keep score, even when performance seems intact.

Mechanistic research helps explain why. Prolonged stress keeps blood pressure high, stiffens blood vessels, disrupts glucose metabolism, and fuels inflammation — a perfect storm for both heart disease and metabolic dysfunction (Hjemdahl et al., 2002; Osborne et al., 2020). More recent work links perceived stress directly with inflammatory biomarkers, which correlate with higher rates of metabolic syndrome (Jurgens et al., 2023). Other studies show that stress predicts the onset of hypertension over time (Munir et al., 2024).

The short-term signs, fatigue, subtle blood pressure changes, weight gain — are often dismissed, as mine were. But over the long term, they become the foundation of disease.

Read Time: 5 mins

Author:
Dr Jonathan Clark-McKellar

Recovery as Adaptability

So, our aim is simple. Reduce unnecessary activation of those primary mediators, switching them off when they are no longer needed, while maintaining the ability to respond when it matters. Done well, recovery doesn’t weaken performance. It preserves adaptability: The ability to learn from stress, grow through it, and switch fully on when required — and off when the task is done.

What Comes Next

Understanding why recovery matters is the foundation. But principles are only useful if they can be turned into practice. In the next article, I’ll focus on the smallest and simplest levers we use with high performers: Micro-recoveries. These are short, deliberate breaks built into the working day. I’ll cover the evidence, the theory, and the practical tools we use with clients to reduce fatigue, sustain focus, and keep the stress response from running unchecked.

References & Further Reading

• McEwen BS, Gianaros PJ. Stress- and allostasis-induced brain plasticity. Annual Review of Medicine, 2011.

• Girotti M, Adler SM, et al. Prefrontal cortex executive processes affected by stress in health and disease. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 2018.

• Christensen DS, Mortensen EL, Flensborg-Madsen T. Midlife perceived stress and cognitive decline: a longitudinal study of Danish men. BMC Geriatrics, 2023.

• Girotti M, et al. Effects of chronic stress on cognitive function: from mechanisms to relevance for mental health. Neuroscience & Biobehavioral Reviews, 2024.

• Richardson S, et al. Meta-analysis of perceived stress and incident coronary heart disease. American Journal of Cardiology, 2012.

• Chandola T, Brunner E, Marmot M. Chronic stress at work and the metabolic syndrome: prospective study. BMJ, 2006.

• Hjemdahl P, Rosengren A, Steptoe A. Stress and cardiovascular disease. Circulation, 2002.

• Osborne MT, et al. Disentangling the links between psychosocial stress and cardiovascular disease. Circulation: Cardiovascular Imaging, 2020.

• Jurgens S, et al. Inflammatory biomarkers link perceived stress with metabolic syndrome. Brain, Behavior, & Immunity – Health, 2023.

• Munir M, et al. Impact of chronic psychological stress on the development of hypertension: a prospective cohort study. High Blood Pressure & Cardiovascular Prevention, 2024.

In my last article, I made the point that recovery is not the opposite of performance. It’s an integral part of it. The process that makes sustained output, and the preservation of health and happiness, possible.

In elite sport, recovery is programmed. In special operations, it’s often sacrificed. In the corporate, artistic, and entrepreneurial worlds, and many other high-performance arenas, it’s almost entirely absent.

Think of recovery this way: every challenge we rise to requires that we activate our stress response — the chemical and hormonal drivers that help us meet the task. In a healthy cycle, the challenge is met, the system switches off, and the body and mind return to baseline. Supported by sleep, nutrition, social connection, and reflection, this is how we adapt: we grow stronger and more capable the next time a challenge appears.

But modern life rarely allows that cycle. The next deadline arrives, a social event cuts into sleep. The school calls because your child is unwell. A meeting is rescheduled, an invoice needs chasing. On their own, these in-the-moment challenges would be enough to tax us. However; the human mind is also remarkably good at dwelling on past problems or anticipating future ones, and the body responds as if they were happening now. Unless we find a way to switch off, the stress response stays on, often far longer than it needs to.

And remember, the stress response isn’t always predictable, or universal. What triggers it in one person might feel like a quiet morning to someone else. I’ve seen Special Forces operators at their most composed in extraordinarily hostile environments, and medics at their calmest treating critically injured patients in total isolation. Yet I’ve watched those same incredibly capable people wilt at a wall of unanswered emails, or the chaos of the school run.

It’s not about the event itself. It’s about how the mind perceives it, which signals the body to mobilise resources. And when stress is triggered, the body’s reaction is predictable. Without recovery, we see raised blood pressure, disrupted metabolism, weight gain, mood changes, burnout. Without recovery, recurrent stressors don’t lead to adaptation. They wear us down.

Neuroscientist Dr Bruce McEwen called the accumulated strain of this state allostatic load — the wear and tear that builds when stress systems are never allowed to reset. He described three levels.