Abstract
McEwen and Stellar propose allostasis — achieving stability through change — and allostatic load: wear on regulatory systems from repeated stress adaptation.
McEwen, B. S., & Stellar, E. (1993). Archives of Internal Medicine, 153(18), 2093–2101. DOI
Key findings
- Allostasis defined — Stability is maintained by adjusting set points — not freezing one state.
- Load over time — Allostatic load accumulates when demands outrun recovery cycles.
- Wear not spike — Chronic wear differs from acute fight-or-flight — duration matters.
- Individual vulnerability — Genetics, history, and behaviour shape who loads faster.
Limits
1993 conceptual clinical review — biomarker detail evolved in later McEwen work.
Application
When stress is just how life is for years — repeated adaptation can accumulate wear, not only one bad week. See Energy switch.