The HPA Axis, Cortisol and Chronic Stress

We have a stress-response system in our body called the HPA axis (the Hypothalamic-Pituitary-Adrenal Axis is the proper name).

This is a brilliant system, designed to stimulate the body at the appropriate time to respond to stressors; it combines the central nervous system with the endocrine system so all the right parts are in working order when we face an emergency situation that needs our physical and mental resources.

When a stressor occurs, the HPA axis responds by releasing corticotropin releasing factor (a hormone) which stimulates the anterior pituitary to secrete adrenocorticotropic hormone, and this causes the adrenal cortex to secrete cortisol.

Cortisol, a hormone, has many roles to perform in the body. In its role against stress, it assists in shutting down systems that we may not need so we can deal with an emergency – like our digestive system, immune system and reproductive system. It increases our blood pressure, heart rate and blood sugar so our body can use those resources. When the emergency passes, or when the body has enough cortisol to handle the situation, a signal is sent back to the hypothalamus which tells it to stop releasing the corticotropin releasing factor and the pituitary also gets the message to cease and desist releasing the adrenocorticotrophic hormone. The offline systems come back online and the body returns to homeostasis.

At least that’s how it's designed to work.

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But what if the stressor is ongoing?

What if the “turn off” signal doesn’t occur?

This is what happens in situations of chronic stress. The HPA system stays activated, and it doesn’t get a chance to return to homeostasis. The blood pressure may stay elevated, the heart rate may often feel too quick, the blood sugar becomes unstable and this creates a cascade of physical and mental health problems that, in turn, incite us to make poor choices in how we treat our body.

Because our system is in constant overdrive, we may feel exhausted; we may not even have enough energy to put ourselves into a deep sleep state at night. We may find ourselves reaching for stimulants like caffeine and sugar to cope with the demands of the day. This brings additional imbalance to our body and we may feel moody, dysregulated, gain excess weight, and begin to suffer from anxiety and depression.

In a woman’s body, the needs of the adrenal glands to continue pumping out cortisol may begin to borrow from the progesterone stores, which further puts the hormones and body systems in disharmony. Eventually the thyroid may also have to contribute more output, which brings a new level of exhaustion if it is overworked. We may suffer from brain fog, low libido and poor overall immunity. All aspects of life seem difficult and there just isn’t enough energy to sustain us.

This is where I will insert my plug for finding a lifestyle that works for you – everyone needs built-in time for self-care, so that we can cope with the daily demands and give our body and mind cues of safety that allows the HPA axis to get the “all is well signal”. This is part of what Ayurveda calls our dinacharya (daily routine) or ritucharya (seasonal routine). Those are daily and seasonal practices that help us stay grounded and supported.

But, being a human being, I realize there are certain phases in life where it just seems impossible to engage in the daily self-care because of the trauma or intense stress of the situation. The astrological system of Jyotish can help us make sense of the timings of these phases, so when we are in the thick-of-it, at least we know that’s where we are karmically supposed to be and we can work with remedies on that level. When we are in a position to do more, we do more. Energy always shifts to some degree in some way.

But what if you’ve been suffering from chronic stress or the effects of trauma and you need to rebuild your system and regulate your HPA axis before you can begin to find healthier daily routines?  I would encourage building the awareness that it takes time to rebuild your system to re-nourish your body and mind, and tell you to be patient with the process. I would also say that it takes consistent action. That is the most important thing. The consistency becomes a gift you give to yourself so you can move about the world as the best version of yourself that you were meant to be.

A way to begin this process is to find out what helps you reduce stress. Āyurveda and yoga teach us that a great way to induce calm in the body is to reduce sensory impressions. Consider ways you could do this – is there a quiet place in nature that you can sit for a few minutes (and not look at your cell phone)? Perhaps in the trees or by the water, where you can just sit, focus on your breath, feel your physical tissues and let your system slow down. Can you soak in a bath of warm water by candlelight with an essential oil that is supportive to your nervous system (and not look at your phone!)? Are there certain aromas that help you feel grounded and prompt you to breathe deeply, that you could pull out of your pocket, close your eyes and smell several times a day? Or, maybe you want to close the door, curl up under a blanket and sit still for a couple hours while you read a novel.  Perhaps taking a break from all electronics, turning off the phone and doing some baking works for you. Or maybe it’s playing a game of golf, or swimming. It is important to discover what works for you as an individual – and then make the time to do it, regularly.

Working with prānāyāma, asana and meditation can also be highly supportive as they naturally stimulate the parasympathetic nervous system to send cues of safety to the body (assuming we are doing slow, balanced hatha yoga). There are certain poses and specific breathing practices that signal the body to reduce the need for cortisol and a relax a stimulated HPA system.  

It is also imperative to examine our sleep cycles and rebalance our circadian rhythm if necessary. Sleep is one of the most regenerating processes our body has to detox and support the brain and nervous system.

Of course, eating a balanced diet of whole foods (and eliminating things like alcohol, processed sugar and excess caffeine) can give our body and mind proper nourishment. In addition, there are certain foods and herbs that can help support the body and mind to build ojas, the subtle immune system of the body that we want to protect and replenish. Having good quality ojas is an important buffer to deal with the challenges life brings.

What foods, yoga poses, herbs, prānāyāma styles, etc. that are most helpful might be a little different for each person depending on his or her unique physiology. It is important to tailor the medicine (which I believe all of these things are) to the person, also taking into account the season and environment the person is in. That is part of what makes Āyurveda so powerful – that it is tailored for an individual and it teaches us how to determine what we need at a given time.

It is also important to go slow. Making too many changes at once can be overwhelming and leads to a low success rate of sticking to it. But figuring out what would be the most beneficial change at a particular moment to make – and then following through – begins a process of deep healing. It will affect all systems of the body and lead you back toward harmony.

Working with these ideas in your counseling process can be very supportive to the health of your entire organism, and can begin to heal an overstimulated HPA axis. If you are someone who has been dealing with long-term stress, or trauma, and you feel like you haven’t been able to move past the effects, these ideas may hold power for you, and I encourage you to learn more about them.