Most people think stress is psychological. It’s not. Stress is a metabolic lock-in state, one that traps the nervous system and mitochondria in perpetual defense mode. In this episode of The Empowering Neurologist, I’m joined by Dr. Scott Sherr to unpack what he calls the Sympathetic Spiral of Doom, and, more importantly, how to get out of it.
The spiral begins when psychological stress, trauma, infection, toxins, or mitochondrial injury push the body into survival physiology. From there, the autonomic nervous system and mitochondria amplify each other’s perception of danger. Mitochondria abandon efficient oxidative phosphorylation and shift into glycolytic “wartime” metabolism, even when oxygen is available.
The nervous system mirrors this with chronic sympathetic activation and a metabolic state that favors a shift of our brain’s immune cells (microglia) away from being supportive and towards a more destructive cell type as we cover in Brain Defenders. The downstream effects are familiar: fragmented sleep, hormonal disruption, rising inflammation, poor exercise recovery, and declining cognitive resilience. Whether the spiral starts top-down (stress and hypervigilance) or bottom-up (redox dysfunction, toxins, infections), the endpoint is the same, energy collapse and impaired adaptation.
Dr. Sherr’s work lives at the intersection of biochemistry, neurology, and behavior. He emphasizes that escaping the spiral requires both immediate interruption and long-term recalibration. On the immediate side, we explore intelligent GABAergic modulation, not by adding oral GABA, which doesn’t cross the blood–brain barrier, but by targeting GABA-A receptor function to restore inhibitory tone. This is the real brake pedal of the nervous system, allowing parasympathetic recovery to come back online.
We also discuss mitochondrial recoupling through redox repair, including tools like methylene blue, which can restore electron flow through the electron transport chain and reduce danger signaling. Hyperbaric oxygen therapy plays a critical role as well, orcing oxygen into tissues, improving mitochondrial efficiency, lowering inflammation, and accelerating neural repair. But interruption isn’t enough.
Long-term resilience comes from health optimization: rebuilding mitochondrial capacity, restoring redox balance, recalibrating the gut–immune axis, optimizing hormones, and addressing the psychosocial and emotional wiring that keeps stress patterns locked in place. In some cases, psychedelic-assisted therapies can serve as powerful pattern interrupters, reopening neuroplasticity and allowing stress physiology to reorganize. The takeaway is simple but profound: peak performance isn’t about pushing harder, it’s about recovering faster.
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Dr. Scott Sherr is a Board Certified Internal Medicine Physician Certified to Practice Health Optimization Medicine (HOMe) and a Hyperbaric Oxygen Therapy (HBOT) specialist. His formal titles include:
- COO of Troscriptions, a line of physician formulated, pharmaceutical grade, and precision dosed buccal troches containing novel ingredients like methylene blue, again, and others in formulas for energy, focus, sleep, stress, immune support, and more.
- VP of Health Optimization Medicine and Practice (HOMe/HOPe), the nonprofit arm of Troscriptions, which trains practitioners on optimizing health rather than treating disease.
- Chief Medical Officer of OneBase Health, a company building software and hardware to power integrative technology, including hyperbaric chambers, lights, sauna, and more. His clinical practice is built on HOMe as its foundation, complemented by an integrative approach to hyperbaric oxygen therapy that incorporates cutting-edge and dynamic HBOT protocols, comprehensive laboratory testing (utilizing the HOMe framework), targeted supplementation, personalized practices, synergistic technologies (both new and ancient), and more.
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