Hypertension - This Didn’t Come Out of Nowhere

“He heals the brokenhearted, and binds up their wounds.” Psalms  147:3

I’m sharing this because high blood pressure is often treated as something that appears suddenly, as if it arrives because someone is careless, unhealthy, or unable to cope. That assumption is not only wrong in my case — it erases the real cause.

What my body is showing now is the end point of prolonged exposure. It is not a momentary spike, not a bad day, and not a failure of resilience.

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This was built over time

My blood pressure did not rise because of one stressful event. It rose because my body was held in a state of continuous threat for years, with no meaningful relief, no real safety, and no ability to stand down.

When a human nervous system is forced to remain on high alert long-term, blood vessels stay constricted, recovery never fully completes, and the body gradually stops trusting that rest is safe. That process is not psychological weakness. It is biological adaptation.

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What the 24-hour monitor showed (14 February 2019)

In the early stages of what I now understand to be unmanaged psychosocial hazards at work, I wore a 24-hour ambulatory blood pressure monitor on what was recorded as a “normal” workday.

The results were not borderline.

Across the full 24 hours, my average blood pressure was 146/100 mmHg. During working hours, it averaged 151/103 mmHg. Even overnight — when the nervous system is meant to stand down and recover — it remained 130/92 mmHg. My maximum recorded reading reached 185/123 mmHg.

Ninety-six percent of my diastolic readings over the 24-hour period were above the normal threshold. During the day, 79% of systolic readings and 79% of diastolic readings were elevated. Even at night, 100% of diastolic readings were above the accepted limit.

This was not a single spike. It was sustained hypertension across an entire “ordinary” day and night.

This pattern is clinically consistent with autonomic dysregulation.

When the sympathetic (“fight-or-flight”) system remains chronically activated, blood vessels stay constricted and baseline vascular tone remains elevated. The body does not fully transition into parasympathetic recovery, even during sleep. The result is sustained diastolic hypertension, exaggerated daytime peaks, and inadequate restorative dipping.

In plain terms, my cardiovascular system was behaving as though it was under continuous threat — because it was.

This was not a brief emotional reaction. It was sustained physiological activation across a full 24-hour cycle.

I was formally diagnosed with hypertension and commenced medication as a result.

This is what prolonged workplace threat and unmanaged psychosocial hazard exposure can look like in the body.

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What this is called

There is a name for this pattern.

Neurogenic hypertension refers to high blood pressure driven or amplified by the nervous system, particularly the sympathetic — or “fight-or-flight” — system.

In plain language, it means the brain and nervous system are continuously signalling “danger,” and the cardiovascular system is being forced to stay in a high-alert state.

Normally, the body alternates between sympathetic activation (alert, mobilised) and parasympathetic recovery (rest, repair). In neurogenic hypertension, that balance is lost. The parasympathetic system struggles to regain control. Blood pressure can remain elevated even at rest or during sleep. Small stressors can trigger disproportionate spikes.

This is not imagined. It is measurable.

Autonomic dysregulation leads to persistent physiological arousal, exaggerated responses to small stressors, and a failure to return to baseline even in safe conditions.

Importantly, this is reflexive, not voluntary. You cannot “think” your way out of it.

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The number that made me stop

When my blood pressure recently measured in the 170s over 100s, with one reading at 173/112, I didn’t see a random medical problem. I saw evidence.

That number is not the beginning of the story. It is the receipt for what my body has been carrying.

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What is actually happening in my body

In my case, the pattern reflects something very specific. My fight-or-flight system has been overpowering my baseline blood-pressure control. This is not “just anxiety.” It is sustained physiological stress load.

When the nervous system is held in threat mode for too long, it does not switch off simply because someone lies down, rests, or appears calm on the outside. People in this state can have markedly elevated blood pressure, particularly the lower number, while their pulse looks relatively normal. They can experience significant blood-pressure spikes even while at rest.

It can look like feeling wired but exhausted. Hypervigilance. Startle responses. Internal agitation. Difficulty relaxing even when tired. Sleep that is broken or non-restorative. Early morning waking with an adrenaline surge. Appetite disruption. Nausea during stress. Irritability without wanting to be. Emotional flattening or overwhelm.

These are downstream effects, not the cause.

That combination is not random. It makes sense once the cause is understood.

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Why clinicians sometimes miss it

Blood pressure guidelines focus heavily on kidneys, salt, vascular stiffness, and age. Trauma physiology is still poorly integrated into cardiology. Symptoms are often dismissed as “anxiety,” particularly in women, who are disproportionately under-recognised.

That does not make the condition less real.

It simply means the framework is incomplete.

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The cost of endurance

I endured because I had to. I kept showing up, complying, documenting, asking properly, escalating through the correct channels, and waiting for systems that were meant to protect me to intervene.

Instead, the threat persisted.

Silence, procedural obstruction, power imbalance, and prolonged uncertainty are not neutral experiences. They are physiological stressors. The body does not experience injustice as an abstract concept; it experiences it as danger.

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Why duration matters more than intensity

Short stress passes. Acute stress resolves. What damages the nervous system is inescapable stress — situations with no clear end point, no effective protection, no restoration of agency, and repeated re-exposure.

Over time, the nervous system learns one rule: stay alert or you won’t survive. Once that happens, the body stops switching off.

Duration and inescapability matter more than intensity. This is why resilient people can still develop autonomic dysregulation.

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This is what happens when safety never arrives

People sometimes ask why I didn’t “just rest.” The answer is simple: rest requires safety.

When the threat is ongoing — professionally, financially, or institutionally — the body does not interpret stillness as safe. It interprets it as exposure. So the system remains braced, day after day, year after year.

Eventually, that state shows up in the body in measurable ways, including sustained high blood pressure that places strain on the heart, brain, kidneys, and blood vessels. This happens quietly, without drama, and without collapse — until the body can no longer absorb the load.

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What causes autonomic dysregulation

Common precipitating factors include prolonged threat or coercive environments, chronic trauma or unresolved danger, medical or institutional harm, long-term injustice without agency, repeated silencing, and illness combined with lack of safety.

These are not abstract conditions. They are lived environments.

And the body adapts to them.

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This didn’t come from weakness

People like me often end up here after prolonged trauma or ongoing threat. It is common in those who have lived through workplace bullying or coercive control, years of unresolved injustice, being silenced or disbelieved, or navigating systems that cause harm instead of stopping it. It also appears in people who have lived in a state of constant vigilance without safety.

This is not about personality.

It happens to people who are otherwise capable, rational, disciplined, and resilient — people who keep going because they have to.

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This is not about stress management

I am not talking about being “stressed.” I am talking about prolonged autonomic overload caused by sustained power imbalance, lack of procedural justice, silencing, uncertainty without resolution, and harm without accountability.

No amount of mindfulness fixes an environment that never allows the nervous system to stand down.

Medication alone rarely fixes this if the threat persists.

Nervous system regulation is not about platitudes. It requires actual safety, reduction of ongoing threat exposure, trauma-informed care, and time — not willpower.

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What recovery actually requires

Recovery is not one thing, and it is not quick. It requires protecting the body medically while it is under strain, reducing ongoing harm and restoring some agency, and allowing the nervous system real time to relearn safety.

Autonomic dysregulation will not resolve while the nervous system still perceives ongoing injustice, unresolved danger, powerlessness, or forced silence. This does not mean everything must be fixed overnight, but it does mean restoring agency, reducing active exposure to harm, and being believed.

This is why purely psychological approaches often fail — the threat is real.

Recalibration is slow and biological. It happens through repeated experiences of actual safety, predictability, non-retaliatory environments, and time without fresh shocks.

Instead of “feeling calm,” real progress looks like blood-pressure spikes becoming less extreme, diastolic pressure trending down, faster recovery after triggers, slightly more restorative sleep, and the body standing down without effort.

These are biological wins, not mindset achievements.

Recovery is slow, layered, and conditional on safety.

This process is measured in months, sometimes longer. That is not failure. It is biology.

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The truth I need people to understand

This did not come from nowhere. It did not happen overnight. And it did not happen because I couldn’t cope.

It happened because I was forced to survive without safety for too long.

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Final word

If you want to understand my blood pressure, don’t look only at the numbers. Look at the years that led to them.

My body has been doing its job in an environment that hasn’t allowed it to rest.

That’s the truth of it.

Source: Cardiology report - 14-15 February 2019.

Further reading - scientific research on CVD risk from unmanaged psychosocial hazards in workplaces appears to be in the early stages. 

Romero Starke, K., Hegewald, J., Schulz, A.…(et. al). (2020). ‘Cardiovascular health outcomes of mobbing at work: results of the population- based, five-year follow-up of the Gutenberg health study.’ Journal of Occupational Medicine and Toxicology. 15(15). [Open access]: https://doi.org/10.1186/s12995-020-00266-z

Xu, T., Magnusson Hanson, L.L., Lange, T., Starkopf, L., Westerlund, H., Madsen, I.E.H, et. al. (2019). ‘Workplace bullying and workplace violence as risk factors for cardiovascular disease: a multi-cohort study.’ European Heart Journal. 40(14). 1124–1134. [Online - Institutional access required] : https://doi.org/10.1093/eurheartj/ehy683

Herrmann-Lingen, C. (2018). ‘Victimization in the workplace: A new target for cardiovascular prevention?’ European Heart Journal. 40(14). 1135–1137. [Online - Institutional access required] : https://doi.org/10.1093/eurheartj/ehy728

Rodriguez-Munos, A., Notelaers, G., and Moreno-Jiménez, B. (2011). ‘Workplace bullying and sleep quality: The mediating role of worry and need for recovery September.’ Behavioral Psychology / Psicología Conductual, 19(2) 453-468 [Online OA version] : https://www.researchgate.net/publication/236606535_Workplace_bullying_and_sleep_quality_The_mediating_role_of_worry_and_need_for_recovery 

Once we repaired things — Part 2

I need to say this clearly. I am extremely vulnerable now, but I was not when this happened. What I experienced didn’t come from fragility. It contributed to creating it.

After the first date, I sent Paul a message that was honest and open. I said I’d had too many bad experiences with too many so-so’s. It was context — me telling the truth about my history so I didn’t have to pretend I arrived unscathed by it.

He replied with reassurance. He said he was authentic and not another so-so. He said he wanted to get to know everything about me.

I let myself believe him. That wasn’t naïve. It was a reasonable response to what I was being shown — and to the care I thought I was sensing.

Things were going well until the end of one date, when something shifted. I felt it immediately. Passive aggression. Subtle, but sharp enough to register in my body before I could explain it to myself. A small internal tightening that said, something just changed.

Earlier that evening, almost casually, I’d said: “There are a lot of jerks out there.”

He disagreed with me.

I remember feeling quietly dismissed. It’s easy to disagree when you haven’t lived the accumulation behind a sentence like that. Women don’t arrive at conclusions like that lightly. They arrive there after years of being treated as disposable, misread, or expected to absorb poor behaviour politely.

I didn’t know then what was coming.

That weekend, I found myself unsettled. Alert in a way that felt deeply familiar. That old sensation of walking on eggshells — of scanning for signs, wondering if I’d done something wrong without knowing what it was. Not because I was weak, but because my nervous system recognised a pattern I’ve spent much of my life navigating: managing someone else’s mood without explanation.

By Sunday afternoon, I worked up the courage to ask what was going on. That took more out of me than it should have, because part of me already sensed the answer might not be safe.

What followed caught me completely off guard.

One moment I was asking a genuine question — what’s going on? — and the next I was being met with anger that felt sudden and disproportionate. The tone shifted so fast I struggled to keep up. Accusations came without explanation, stacking one on top of another, as though a private narrative had already been decided and I had been cast in it without my knowledge.

I remember trying to orient myself in the middle of it — trying to understand what I was supposedly being accused of, trying to remember things I was said to have said, trying to find a way into the conversation. I couldn’t. There was no space.

When he compared me to someone from his past, something in me went cold. I hadn’t consented to being placed into someone else’s story. I hadn’t been known long enough to be spoken to that way. I felt myself shrinking internally, not because I believed what was being said, but because I suddenly understood I wasn’t being seen at all.

My heart was racing. My hands were shaking. I could feel my body going into shock as I tried to stay calm and listen, hoping there might be a pause where I could finally speak. That pause never came.

Then he hung up.

The call ended abruptly, without resolution, without care, without even the most basic acknowledgment of how destabilising that moment was. I sat there staring at my phone, shaking, my chest tight, trying to steady my breathing and make sense of what had just happened.

I felt frightened — not in an abstract way, but in my body. The kind of fear that comes when emotional safety is pulled away without warning. I had done nothing to deserve that treatment, yet I was left alone to carry the shock of it.

Was he willing to listen?

No.

And that moment landed heavily.

Because this mattered to me. I had allowed myself, carefully and consciously, to feel safe and at peace — something I do not do lightly. I believed I was dealing with someone who meant what he said about being authentic and wanting to know me.

Realising that sense of safety wasn’t real was deeply destabilising. False safety hurts more than no safety at all.

I didn’t know what to do. It felt like my last hope had been smashed by the very thing I was promised it wouldn’t be. I didn’t know whether to try to respond, because how do you speak when someone has already decided a story about you and refuses to hear anything else?

I was frightened.

I was alone in a misunderstanding I had no voice in.

So I did the only thing I could.

I prayed.

I didn’t know what to do.

What continues to trouble me is how familiar this pattern is for women. No matter how kind, reasonable, or accommodating we are, the responsibility somehow shifts back onto us — to explain better, be calmer, try harder, or absorb more.

I’ve been told all of it:

• You’re not bitchy enough.

• You’re trying too hard.

• You’re not trying hard enough.

There’s even a book — The Rules — filled with instructions for women on how to manage themselves so men might finally “step up.”

Why is the burden always here?

Why can’t men step up simply because they are with a good woman?

Why is male anger so often excused or normalised, while women are expected to carry the emotional consequences quietly?

I was not okay with being compared to someone from his past in that angry call. I was not okay with being accused and then silenced. I was not okay with being left shaking, afraid, and unheard.

I am my own person.

Authenticity requires listening. Getting to know someone requires patience, curiosity, and emotional regulation. What happened that Sunday did not reflect those things.

I am angry — and my anger is valid.

In the days that followed, the impact didn’t fade — it settled. I replayed the call over and over, trying to locate the moment where things went wrong, wondering how a simple question could have led to such hostility. I felt raw and unsettled, my body still holding the shock. Sleep was shallow. Ordinary things felt harder. My thoughts kept circling back to the same questions, because I had been left without any answers. I carried a quiet ache — the grief of something that had felt promising, and the deeper grief of recognising yet another moment where my voice hadn’t mattered.

My fear and anger came from being harmed, not from being flawed. That was the truth I was forced to suppress. Getting to know someone requires communication. Where was my voice? Silenced, again. 

I can’t be silent anymore. Because this matters to me. 

To be continued…

See also : http://mystory-myvoice.blogspot.com/2025/10/interlude-mrs-harris-goes-to-paris.html

Frightened, alone, misunderstood, shamed, silenced, harmed. 

I Asked for Boundaries - The Code Calls That Courage

I was not trying to be brave.

I was burnt out.

I asked for role clarity.

I asked for a realistic workload.

I asked for reasonable boundaries.

I asked for a safe and sustainable work environment.

That was all.

Under the Staff Code of Conduct, Courage is defined as “acting ethically and professionally in spite of known fears, risks and uncertainty.”  

What the Code does not say — but lived experience reveals — is that sometimes the act requiring courage is not whistleblowing or dramatic disclosure.

Sometimes it is simply saying:

“This workload is not safe.”

“This role is unclear.”

“This behaviour is harming me.”

I knew the culture. I feared retaliation, not because I was doing anything wrong — but because I had seen what happened to those who challenged dysfunction.

When a local Associate Director acted incompetently and without consultation, I was thrust into escalating instability. Decisions were made that affected my work, my reputation, and my wellbeing — without transparency or procedural fairness.

I did what any reasonable employee is told to do:

I followed the proper channels.

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Acting Despite Fear

The Courage section requires staff to act ethically and professionally despite fear and uncertainty.  

I did not disengage.

I did not behave unprofessionally.

I did not bypass process.

I documented concerns.

I sought clarification.

That is what facing challenges and difficult issues looks like in practice.  

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Raising Concerns Responsibly

Courage includes “having the strength to raise potential unethical behaviours” and to report concerns appropriately.  

Excessive workload.

Role ambiguity.

Instability created without consultation.

These are not personal weaknesses. They are recognised psychosocial hazards.

Asking for a realistic workload is not defiance.

Requesting boundaries is not misconduct.

Seeking clarity is not insubordination.

It is professional responsibility.

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The Obligation on Leadership

The Code makes clear that Courage also requires those in authority to:

• be open to receiving information

• take reasonable steps to respond appropriately

• make well-considered and justifiable decisions

• ensure fairness and dignity, especially where adverse effects may result  

These are obligations.

Instead of openness, there was defensiveness. Instead of proportionate response, there was obstruction. Instead of safeguarding health, there was escalation of harm.

When raising workload and safety concerns results in reputational framing or increased instability, the Courage obligations have not been met.

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WHS Context: Realistic Workload Is a Safety Issue

Under the Work Health and Safety Act 2011 (NSW), employers have a primary duty to ensure, so far as reasonably practicable, the health and safety of workers — including psychological health.

Psychosocial hazards include:

• excessive or unrealistic workload

• role ambiguity

• lack of consultation

• poor organisational justice

• misuse of positional power

A realistic workload is not a luxury. It is a safety control.

When an employee identifies workload as unsustainable, the appropriate response is risk assessment and mitigation — not silence, obstruction, or adverse treatment.

Fear of retaliation following safety concerns is itself a red flag in any WHS-compliant system.

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What More Could I Have Done?

The Code required me to:

• act ethically

• raise concerns appropriately

• face challenges professionally

• attempt resolution 

I did.

The Code required leadership to:

• respond openly

• exercise positional power properly

• treat staff with dignity

• make justifiable decisions where impacts were foreseeable  

That did not occur.

The question “What more could I have done?” is often what conscientious workers ask when systems fail them.

But the Code does not require silence in the face of harm.

WHS law does not require workers to absorb unsafe workload or psychological risk to protect hierarchy.

At some point, responsibility shifts:

Not to the exhausted employee asking for realistic workload and boundaries — but to those entrusted with authority.

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Courage, Properly Understood

My courage was not dramatic.

It was:

• asking for a realistic workload despite fear

• requesting boundaries in a toxic culture

• following process while under strain

• remaining professional while instability escalated

That conduct aligns with the Courage section of the Staff Code of Conduct.  

The response I received did not. 

And that is where the real divergence lies.

Video

NOTE: Incivility can be covert, not only overt. 

Why being respectful to your coworkers is good for business by Christine Porath