Understanding Prolonged Activation State
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Why symptoms can continue long after the original trigger has passed.
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Many people recovering from Long Covid, ME/CFS, chronic fatigue, persistent pain, anxiety or burnout ask the same question:
“If the original trigger has passed… why do I still feel this way?”
Prolonged Activation State (PAS) offers a different way of understanding why symptoms may continue long after the body has entered an ongoing state of activation.
Rather than focusing only on what has gone wrong, PAS explores what may still be keeping the body activated—and how that activation can begin to change.
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Your body is continually responding to life.
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Through out every day, your body is responding to the life you are living.
It senses what is happening around you and within you, often long before your conscious mind has interpreted the situation.
This response is completely natural.
It helps us adapt, communicate, protect ourselves and engage fully with life.
Most of the time, these responses are brief.
The body senses.
It responds.
The situation changes.
The activation settles.
Life moves on.
But sometimes that process doesn’t fully complete.
Instead of returning to balance, the body can remain activated for much longer than intended.
This is what we describe as a Prolonged Activation State (PAS).
Prolonged Activation State (PAS)Â is our term for an ongoing state of body activation that continues long after the original trigger has passed.
When activation doesn’t switch off...
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Most body responses are designed to be temporary.
The body senses what is happening.
It prepares you to respond.
Once that response has happened, the activation naturally settles.
But if the body continues waiting for a response…
the activation remains.
It is a little like sitting in a parked car with your foot resting gently on the accelerator.
The car isn’t travelling anywhere.
But the engine continues working.
Fuel continues being used.
Over time, unnecessary wear begins to occur in the engine.
A Prolonged Activation State is the same.
The body continues using energy long after the original situation has passed.
The problem isn’t that the body activates.
The problem is when that activation continues far longer than it was ever designed to.
How prolonged activation affects the body
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A Prolonged Activation State doesn’t usually affect just one part of the body.
Because activation influences multiple body systems, people may experience a wide variety of symptoms that can appear unrelated but arise from the same underlying state of prolonged activation
Nervous System
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Possible experiences include:
• Fatigue
• Brain fog
• Poor concentration
• Dizziness
• Headaches
• Light sensitivity
• Noise sensitivity
• Poor sleep
• Anxiety
• Feeling constantly “on”
Endocrine System
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Possible experiences include:
• Reduced resilience to stress
• Hormonal fluctuations
• Temperature regulation changes
• Energy highs and crashes
• Altered appetite
• Reduced recovery
Immune System
Possible experiences include:
• Increased sensitivity after viral illness
• Persistent inflammation
• Allergy-type symptoms
• MCAS-type presentations
• Recurrent infections
• Slower recovery from infections
These systems do not operate independently.
The nervous, endocrine and immune systems communicate continuously with one another.
Within the PAS model, the hypothalamus is considered an important coordinating centre linking the nervous, endocrine and immune systems. When activation becomes prolonged, changes may be observed across all three.
How does activation begin to settle?
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Within the PAS model, the body is continually responding to the life we are living.
When those responses are recognised and appropriately acted upon, activation naturally begins to reduce.
This isn’t about trying to eliminate symptoms.
It’s about learning to recognise what the body may be communicating through them.
Over time, many people discover that as they respond differently to these signals, the body no longer needs to remain in a prolonged state of activation.
Mickel Therapy® explores how the body’s signals can be recognised and responded to in everyday life.
Frequently Asked Questions
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The PAS model doesn’t replace everything we already know about the body.
Instead, it offers a different perspective on why symptoms may persist and how they may begin to change.
Below are some of the questions people ask most often.
How is PAS different from other explanations?
How does PAS relate to Long Covid and ME/CFS?
Does PAS mean the physical changes aren’t real?
Can prolonged activation change?
Watch: What is Prolonged Activation State?
If you’d prefer to watch rather than read, this short video introduces the concept of Prolonged Activation State (PAS) and explains why symptoms continue long after the original trigger has passed.
Continue the conversation:
Featured on Raelan Agle’s Recovery Channel
If you’d like to explore these ideas in conversation, Dr Mickel recently joined Raelan Agle for an in-depth discussion about Prolonged Activation State, Long Covid, ME/CFS and recovery.
Watch interview with Raelan Agle