Cognitive behavioural therapy may help resolve chronic adrenal (cortisol/glucocorticoid) and exaggerated stress response problems

Hi all. I've been posting at times recently about how exaggerated stress responses and/or chronic stress and consequent chronically elevated cortisol (which often progresses to adrenal fatigue/exhaustion) may lead to chronic fatigue, auto immune issues, blood sugar regulation problems and thyroid disease - and the results of my seemingly promising attempts to improve my own situation in this regard by reprogramming the HPA using supplements (adaptogens) like phosphorylated serine (Seriphos) and rhodiola rosea .

I tripped over this paper this morning in an entirely different context: biologicalpsychiatryjournal... - it sheds some interesting light on the topic.

Basically it says that patients with post traumatic stress problems show characteristic changes to the expression of a gene that modulates (adjusts) our response to glucocorticoids (stress hormone - particularly cortisol), and also reduced volume in relevant parts of the brain - and that both these changes and patient PTS symptoms reverse/improve significantly with cognitive behavioural therapy.

That's presumably with e.g. bio feedback training to recognise bodily responses/triggers of stress and to manage the resulting mental responses to minimise their effect. It'd be great to hear from anybody with experience of working with techniques like these...

It seems to confirm that chronic/long term/post traumatic stress has the potential not just to make us ill, but also to cause physical changes which may keep us ill long after the original problem has been eliminated. Not only that, but that these changes mess with our adrenal responses, which in turn it seems can (we know from other sources) often progress into the adrenal, immune, diabetic/blood sugar regulatory, thryoid problems and chronic fatigue. (the classic metabolic disease of modern times)

The message has to be that it behoves us to act if we find ourselves in unacceptably stressful situations (wrong job, relationship, bad lifestyle, bad mental habits whatever) to get rid of the causes of the stress pronto. Before lasting harm is done….

It's a bit sobering. The resulting physical changes seemingly don't automatically reverse when the stress is removed, and may predispose us to ongoing exaggerated stress responses (?) even though our life situation may subsequently have become much more relaxed. (my situation I believe - i run chronically elevated cortisol levels even when relaxed judging by the Genova adrenal stress test)

It's encouraging in that it suggests that there scope to at least make a start on reversing these effects via cognitive behavioural therapy/mind training.

This wiki page defines what a glucocorticoid (the chemical name for a family of hormones including cortisol) is - and even hints at how messing with this system may risk the onset of the previously mentioned metabolic conditions (inflammatory, blood sugar, fatigue, thyroid problems etc) by pointing out that these hormones play an important role in regulating some of these systems.

A related item that also popped up this morning which may be of interest. Clymer Health (a naturopathic practice in the US) have long history of working on chronic stress and consequent adrenal problems as the underlying cause of chronic fatigue. (i've linked their manual several times before)

It seems that one of their guys is running a phone seminar on 12th Dec at 3.00pm EST (US eastern seaboard time - 5hrs behind GMT/UK time) on adrenal dysfunction and the blood sugar control (among other) problems it can lead to: campaign.r20.constantcontac...


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  • Thanks for posting. xx

  • :) No prob Louise, ta for that.

    Stuff like this has a way of popping up in lumps.

    This piece published by the journal Nature surfaced after posting the above:

    Very relevant to the same general topic. It's a review of research that pretty clearly shows that not just stress but more broadly the absence of a sense of purpose and well being in our lives causes clear physcial changes in our bodies and brain - including alterations to immune function - that may contribute to many of the sorts of health problems mentioned above.

    It really really emphasises the big issue. That sorting these health problems is not just a case of popping the pills and waiting for the miracle. That the scenario is incedibly holistic - that life is very much set up in a manner where we're required to take ownership of of our mind state and of our life path and sort them out if we want to feel good and be healthy - to find that which we're supposed to be doing.

    Conversely that there's no brownie points for wallowing in misery/suffering/guilt/penance/staying stuck in what we know in our heart is the wrong xyz (whatever bugs us) etc - all of the negative mindset based stuff that so much traditional religious and societal conditioning tends to point us towards. (mostly i suspect to keep us down, and those in authority in power)

    Another way of saying it might be that we (via all sorts of linkages known and unknown) manifest in our lives what we 'dream' into existence - and that ultimately we have the choice to create in whatever direction we choose….


  • Thanks Ian for this. Definitely stress has an awful lot to answer for! Much to read so will need to break it down into small pieces.

    How are you doing?

  • HI CG. Chronic stress does seem to very arguably be at the root of so much metabolic illness.

    The trouble is that chronic stress in the widest sense is probably not the result of a narrow/limited life situation (short term stress often is, but when the situation changes that normally evaporates), but of underlying and much more fundamental lifestyle/life situation problems.

    That's stuff that bothers us at the existential level, that disturbs our fundamental state of being. We may even consider it normal, or not really notice it…..

    Resolution as above requires our taking ownership of ourselves and our mind. It can require considerable mind/self work to gain enough insight to see what's really going on (we so easily get sucked into chasing after stuff we think we need/matters, but which in the end delivers no well being/genuine happiness) and to see how we might start to act to manoeuvre free. Wisely of course - that's without doing even more harm to ourselves and others.

    The one basic (as above) seems to be that while we're free to refuse to take responsibility for ourselves, that failure to act (at whatever level is possible for us) ensures sliding deeper into the mess.

    It's by this measure no accident that finding ourselves trapped working in controlling bureaucracies the culture of which conflicts with our own truths is one the worst and most frequent causes of stress these days.

    It's quite new agey, but whether it's just down to our perceiving stuff differently these days or a genuine change it seems like we're at every level (from environmental to macro economic to national/political to social to personal life) increasingly finding that just passively being along for the ride isn't good enough any more. That everything we think and do has effects...

    I've had very good results following the Clymer/naturoptahic methodology. That's using rest/avoidance of stress and adaptogens as posted about before to moderate exaggerated stress responses. (Seriphos, rhodiola rosea and ginseng - with low timed dose melatonin at night to reset my messed up sleep cycle)

    It's (to the surprise of my endo) helped enough that my dose of beta blocker (which was causing problems with fatigue/muscle aches) is halved, and at the same time my blood pressure is normal for the first time in many years. I'm losing weight slowly (10kg so far), and look and feel much better too. Whether it's to do with the extra T3 started some months ago as well I don't know - but my total dose of thyroid is up by 50mcg of T4 daily for similar TSH and i seem unlike previously to have been able to use the extra T4.

    The million $ question remains whether or not the reportedly possible (in suitable cases) HPA (hypothalamic/pituitary/adrenal axis) re-programming will eventually take. I'm 4 months in, and still need the blood pressure meds and the adaptogens. Reducing the dose maintains control for several days, but the effect fades.

    Hence the interest in cognitive behavioural therapy, since it seems that whether it's learned or partially hard wired from birth there's something odd about the exaggerated responses to (apparently) moderate stress i have developed in adult life.

    None of what i've written in this thread can amount to advice, but on the positive side the above does seem tentatively to have shown that (at least in my own case) in addition to acting directly to help control my blood pressure that it's possible to chase the high cortisol period around the clock, which may suggest there's something pretty plastic/programmable in play.....


  • Ian, good to hear of your progress, remember, it took quite awhile to get out of balance so it will probably take some time to get back in balance. We all tend to want the fix right now and rarely is it that simple. You definitely seem to be on the right track. PR

  • Ta PR. It's i hope at least part of the scenario.

    I should perhaps say as well that while the effect is somewhat moderated these days that i still seem to produce episodes of 'reactive' high blood pressure. There seem to be two definite triggers - eating the wrong food, or getting stressed (especially mentally) as a result of situations that have previously proven difficult.

    The food triggers seem to be sugar/too much carbohydrate/a wide range of processed foods, but it's not clear what the mechanism is. There's possiby a widely used additive or something like that that triggers an inflammatory resonse, but gluten, wheat and the like seem to be problematical too.

    There's also the little matter that i only found out a few weeks ago that i had a borderline glucose challenge test (a slightly raised result, but not enough for a diagnosis) for type 2 diabetes/glucose intolerance while in hospital back in 2005 - so this could also be a factor.

    It seems that adrenal dysfunction/poor control of cortisol levels and problems with control of blood sugar levels tend to be linked, so this isn't surprising. (see the final paragraph of the first post above which links a telephone seminar by Clymer Health in the US on 12th Dec on this topic)

    The stress that causes problems seems to be the result of especially situations where my response has become a bit habitual - hence the interest above in cognitive behavioural stuff. Physical stress if severe eventually has some effect, but it's in comparison moderate…


  • Here's some more links to papers from this morning setting out how mind state/cognitive/life events/inherited/gut function/dietary factors directly to alter our stress response (HPA axis programming etc), and vice versa.

    There's a few papers under the first link that discusss accuracy of and factors influencing the results obtained with the salivary cortisol/stress test too.

    I can't draw conclusions, or order the links in a way that helps much - but what's dead interesting is that there's now solid research out there to show that mind state (in one discussed case enabled by mindfulness and/or compassion meditation) for example directly impacts and changes gene expression to produce physical change, that life events and experience directly influence the wiring of the stress regulating parts of the brain, that diet/gut flora impacts the wiring of the brain, that conditioned responses to threats are inherited not just through genetics or socialisation but directly at the cellular level etc etc.

    The bottom line is that it's becoming pretty clear that the traditional perspective that suggests that our health is determined by external 'nature (inherited characteristics) or nurture (socialisation)', and that the rest is about bucking up and pulling ourselves together and doing our best with the pretty much fixed 'machine' (physical body) we inherited isn't even remotely a realistic picture.

    That in fact mind and mind state (most especially subconsciously held attitudes and beliefs) act through an incredibly wide range of mechanisms to not just control but actually (if not create) significantly alter what seemed to be hard wired/unchanging systems in the physical body on a day to day and ongoing basis. Not necessarily even just in a given life, but from generation to generation.

    The old Buddhist saying 'with our minds we make the world' starts to sound like it might be more and more literally true - that the objectively existing reality and its independent observers so beloved of traditional 'science' doesn't exist. The spiritual and philosophical traditions have long known this to be the case anyway:

    The last link to the journal 'Psychneuroendocrinology' is a real gold mine for papers in this general territory.

    Feel free to comment or add insight or information...


  • Ian, that is going to take a little while to work thru but thanks for all the links. The very first one is of particular interest. "The link between childhood trauma and depression: Insights from HPA axis studies in humans" Dr. Derry was one of the only who has written about childhood abuse, terror or fright, or bullying also seems to produce similar results, and the maladaptation of the biochemistry of the individual including thyroid hormone resistance. I have not researched this extensively, I'm still following up on the problems with the TFT's, but most studies seem to focus on the HPA axis and have not realized the thyroid part. I need another pair of eyes and another 24 hours in the day. PR

  • Ian, don't know if there will be any new useful info for you but this is an article on Kresser's website about food and blood pressure, might be a tidbit or two. PR

  • Ta PR. Good stuff. Funnily eough they are all foods I've found myself drawn to….


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