The implications of excess cortisol in the body
What is cortisol? Cortisol is one of the key hormones produced in our 'fight–flight–freeze' response. It's a glucocorticoid that is produced within the adrenal glands (these sit atop the kidneys, one on each side). One of three layers that form the adrenal cortex (like the 'bark' of the adrenal gland), the zona fasciculata, creates cortisol. What is its action within the body? Upon encountering a perceived threat, your hypothalamus (a tiny region at the brain's base) sets off an alarm system in your body. Through a combination of nerve and hormonal signals, this system prompts your adrenal glands to release a surge of hormones, including adrenaline and cortisol.
Adrenaline increases your heart rate, elevates your blood pressure and boosts energy supplies. Cortisol, the primary stress hormone, increases sugars (glucose) in the bloodstream, enhances your brain's use of glucose and increases the availability of substances that repair tissues. This is all in an effort to ready the body to respond immediately to the threat. This can occur as a fight, flight or freeze response, which is mediated by the sympathetic nervous system. The cortisol communicates with parts of the brain that mediate mood, processing and fear. Ever found that you perspire excessively in a nervous moment such as right before an important meeting, prior to getting on a roller-coaster or when you are avoiding your boss because you haven't finished that report? All these situations, along with other modern-day stressors, can be associated with cortisol release. The action of cortisol also serves to dial down functions that are deemed detrimental in a fight or flight situation. Overall, these functions demand larger quantities of energy within the body, and include:
altered immune system responses
suppressed digestive system function
reproductive system function
growth processes
Cortisol levels within the blood stream are usually at their highest first thing in the morning and at their lowest around midnight. The HPA axis (hypothalamic–pituitary–adrenal axis, i.e. the chain of command of release) releases cortisol in a diurnal manner (on a daily basis) at regular intervals. One of these larger interval times is early in the morning. This is to prepare us for the day to spur us forward for daylight activities as a mammal. In modern society, this means:
getting up and getting ready for the day
morning exercise (a good reason why it is best at this time! AND it helps to manage this particular large burst in the morning IF you are an individual suffering with higher-than-normal cortisol levels)
caring for our children
going to work. (Morning meetings are great for capitalising on this larger cortisol release.)
Why chronic high cortisol levels are not ideal Usually, the stress-response system is self-limiting. Once the threat has passed, hormone levels return to normal. As adrenaline and cortisol levels drop, your heart rate and blood pressure return to baseline levels and other systems resume their regular activities. But when stressors are always present and you constantly feel under attack, that fight or flight reaction stays turned on. This can occur with a lack of stress management within our lives. While we no longer need to run from predators in the wilderness, many of us are multi-tasking and leading highly scheduled lives.
The kids need to be picked up after school and we're stuck in traffic on our way from work. If only we had left the meeting on time!
There are the different sporting activities to get the children to on the weekend as well as running to and from their various play dates.
We need to visit our mother in hospital and run errands for her.
We are juggling two or more jobs to pay the rent and ending our week exhausted.
Living our life in this activated state can have consequences. Though not perceivable 'threats' per se, the time constraint itself takes place as 'the threat'. We are chasing the clock trying to fit everything in. Long-term activation of this stress-response system, plus overexposure to cortisol and other stress hormones related to the process, equals disruption to almost all of your body's processes, putting you at an increased risk of many health problems, including:
anxiety
depression
digestive problems
tension and blood pressure related headaches
chronic muscular tension
bruxism (grinding teeth/clenching) issues
heart disease
sleep problems
weight gain
memory and concentration impairment
recurrent illness from lowered immune response
onset autoimmune disease. In genetically predisposed individuals, inherited genes for such conditions supplied opportunity for expression.
Which preventative behaviours can be implemented to help? Everywhere we look within the health industry today, we are advised why it's so important to learn healthy ways to cope with our stress levels. It has really become a mainstream idea of present; more and more of us are becoming mindful of our needs to limit the effect of stress in our lives. Is it changing? Are we listening? I think so. However, many of us are only doing so once we have tasted some of the consequences, playing Russian Roulette with what our bodies can tolerate—to quote Gabor Maté, 'When the body says NO'. In addition, it is good to remember there is what I deem to be a healthy level of stress and an unhealthy level of stress. A healthy level of stress can motivate us and drive us forward into action. It can even concurrently involve excitement, the thrill of the unknown and what awaits. However, an unhealthy level of stress can be considered to be that threshold that is unique to us all. (One size does not fit all!) It is when your thoughts are inundated with tasks to complete, involves more of an outlook that is less optimistic, your quality of sleep may be very poor and/or your energy levels are low. It is at this point that I would like to invite everyone to take responsibility. Take responsibility for yourself as if you were your own best friend, child or partner. These will all be different people to each of us but they are all nonetheless people we care for deeply. We should attempt every day to show that same care and responsibility to ourselves. Osteopaths can help to provide direction with some of the above presentations, as well as an objective and holistic plan forward towards your goals. Here are some of the best ways to address the root cause:
Take time to journal. Allow all that you are feeling to pour out onto the page, without structure or sequence. Read it later on. Here you might find clues to your sources of stress to direct management going forward.
Write down your daily schedule. Sit back and just take in what is there. Is there opportunity for better time management? Is there too much scheduled into your day where more time is necessary? Take stock and where possible overhaul your schedule to allow for time to recalibrate.
Consult with a psychologist. A professional can sit and truly listen to what is going on for you at this time. They offer a safe place for you to divulge your feelings and the difficulties with which you are struggling and may help you with direction and appropriate strategies to assist you.
Take responsibility for your self-care. Pick one behaviour you are aware of that is detrimental to your cortisol levels (e.g. saying 'Yes' to staying back at work every day after your scheduled finish time). Change this behaviour to one which serves your needs (i.e. saying 'No' to staying back when you have completed your tasks for the day; allotting time the next day to follow up tasks rather than staying behind).
Exercise! Adopting regular exercise into your schedule can assist with the release of endorphins, which aid cortisol reduction in your body.
Osteopathic treatment. Osteopathic techniques can be applied which serve to reduce the sympathetic response within the body. Techniques include soft tissue massage, muscle energy technique and craniosacral technique. Your osteopath can also provide direction on breathwork exercises, which have been scientifically linked to reduction in blood pressure and heart rate to assist reduction in the sympathetic response in the body.
Take each day to assess changes you would like to make to benefit yourself and seek professional intervention if you're having trouble. Your osteopath can certainly assist in referral where necessary. Take care everyone, Lenore
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