VP#3 The Cortisol Trap: Stress to Burnout - final
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[00:00:00] Welcome to Functional Medicine with Dr. Var. This podcast is to help you explore the underlying root causes of your chronic symptoms and health challenges. Reset your health and reclaim your life.
VARSHA: ~ Picture this, your alarm goes off, you grab your phone, you look at the endless emails, notifications, the messages, and before you've even left the bed, your brain is already off to the races. Next thing you know. An hour has passed by and your late for work. You're already behind and the stress already, and the stress only piles on as you go through traffic meetings and endless to-dos.~
~And when you get home and you're finally ready to crawl into bed, your body is drained, but your brain just won't shut off. Sound familiar?~
~Picture this, your alarm goes off. I don't, that's okay. Picture this. Your alarm goes off.~
~Picture this, your alarm goes off. You grab your phone, you look at the endless emails, notifications, and messages,~
~and before you even left the bed, your brain is already off to the races and before you know it. An hour has gone by because you've just been on your phone answering all these messages. Now you're stressed because you're late for work and you feel like you're already behind and you feel defeated for the day.~
~You get to work and. You endure even more stress. The endless meetings, the endless to-dos, the meetings, the endless to-dos. And when you get home at night and you're finally ready to go to bed, your body is drained, but your mind will not shut off. Does that sound familiar? Sound familiar. Okay, one more time.~
Picture this. Your alarm goes off, you grab your phone, you're looking at emails, notifications, and messages, and before you even left the bed, your brain is already off to the races. Next thing you know, . ~Next thing you know. ~An hour has passed by and you're late for work and you feel already behind the stress only piles on from there, though going through traffic meeting, endless to-dos, and when you finally crawl into bed at night, your body is drained, but your brain won't shut off and you can't sleep.
~Sound familiar? ~Sound familiar? If so, you're not alone. You're living in what I call the cortisol trap. Today I'm gonna talk about stress, cortisol, [00:01:00] and burnout. We'll cover what cortisol is, why it becomes dysregulated. The signs your stress response is out of balance, the phases of burnout and how they affect your health.
~And most importantly, strategies that you can incorporate to reverse the cycle so you can reset your health and reclaim your life. Hi, I'm so you can.~
And practical strategies to reverse the cycle so you can reclaim your energy, focus, and resilience.
~Oh, that's right. I was gonna put it as a graphic, so I don't need to say that.~
~Okay.~
What's really happening inside your body when you feel this wired, tired way? To understand that we need to take a journey, through time . Picture this scene from 50,000 years ago. You're walking across the African savanna scanning for food when suddenly.
You hear a noise and grass, and it's a lion crouched, muscles coiled
ready to strike at you. But here's what's incredible. In the next 200 milliseconds, your body performs what might be the most sophisticated emergency response in all of nature. Your amygdala. Which is like your brain smoke detector instantly recognizes threat.
That signal [00:02:00] races like lightning to your hypothalamus, your brain's command center, which immediately sends an urgent message to your pituitary gland ~code red your. ~The pituitary then shouts to the adrenal glands, which sits on top of your kidneys. Deploy everything we got now and within seconds, your body becomes a survival machine.
Cortisol and adrenaline flood your bloodstream, your heart pounds like a drum pushing blood flow into your legs. Your liver dumped glucose into your blood . Your muscles tense up, ready to leap into action,
and ~even your blood clotting factors, ~even your blood clotting factors increase because if you're injured, you need to stop the bleeding fast. ~Meanwhile, your digestion shuts down. ~Meanwhile, your digestion shuts down. Your immune system dials back because you don't need to fight off a cold when you might be fighting for your life.
This is the hypothalamic pituitary adrenal axis, and it's absolutely brilliant. In 10 seconds, you go from being a potential prey [00:03:00] to survival machine who's capable of running faster, jumping higher, and thinking clearer than you thought possible. And the best part is after you escape that adrenaline and the cortisol returns back to baseline because the threat is gone.
The system resets and you're back to gathering berries and making tools. But here's what happens. In the modern world, your 50,000 year old brain doesn't know the difference between that lion and your email inbox. ~Your brain is still operating. As it should have been 200 years ago.~
~Your 50-year-old brain doesn't know the difference now from the lion. Okay?~
~But in our modern world today, we have so much stress that our brains can no longer tell the difference between running away from a lion. Versus the stress from managing our email inbox.~
~So all of these things that we deal with, your overflowing todo list, list the traffic, ~so all these things that we deal with now, your overflowing to-do list, the traffic jam, your demanding boss, all of these in our brain are being looked at as predators that we have to run away from and it shoots out the stress hormones.
Chronically. So the same system that saved your ancestors' lives is now being triggered 50-100 to 200 times a day by things that aren't actually trying to kill you.~ To kill you. I don't need to say that. I don't know why.~
~Okay. ~[00:04:00] Instead of those short bursts of stress hormones, , we're now living in this chronic activation mode. It's like flooring the gas pedal on your car ~and never, ~and never letting go. The engine screams, the temperature rises, and eventually something breaks.
And that's when people start noticing they're not just stressed. They're ~exp ~experiencing real measurable changes in their bodies. Let me show you what that looks like.
Now, before we dive into what's wrong, let me clear up a huge misconception. Cortisol is not a villain. In fact. ~Like I mentioned, you literally cannot. ~You literally cannot live without it. Cortisol is what wakes you up in the morning with energy and alertness. It's what maintains your blood pressure and your blood sugar.
Without cortisol, you would be dead. ~In fact, there are some people that have an autoimmune disease called Addisons. ~In fact, there are some people who have autoimmune disease called Addisons where they don't make cortisol, and if they don't get treated quickly, it is life threatening.
But the majority of us just have [00:05:00] chronic. Stress, which leads to some chronic cortisol signaling. Normally, your cortisol is supposed to be higher in the morning to help you get up, and then it slowly tapers off through the day so that it can relax and help you sleep. Cortisol is inversely proportional to melatonin, so when cortisol is low, melatonin is high, and you want that at night.
So that you naturally feel sleepy. ~However, when you inco incorporate, oh, sorry. ~However, when you encounter stress during the day, ~whether it's a deadline, pressure, pressure, ~whether it's a deadline pressure, an argument with your husband near miss traffic accident, ~sorry, there's a little gnat that's really bothering me.~
~Um, ~you know, the cortisol spikes quickly to help you handle it, and it's supposed to return to baseline.
And you actually have two stress hormones. You have adrenaline that gets secreted first, and then cortisol slowly follows behind, and then adrenaline is outta your system. But cortisol is a little bit more like a marathon runner providing sustained energy, and then it tapers off.
Now when you're under chronic stress. This HPA Axis signaling is [00:06:00] off and the normal cortisol pattern or rhythm then becomes disrupted,
So there are three stages of dysfunction. There's stage one where you're starting to have problems where you are under a lot of stress and you're not managing it well. So your cortisol pattern tends to be high even later in the day when it's supposed to start tapering off.
So it's just chronically high. ~And this is stage one and. Yeah, ~this is where you're just always on. You're checking your phone all the time. You have constant deadlines. Your nervous system just never gets a chance to rest, and it never gets the clear, all clear signal. ~It's, ~there's still information that's saying that you're still in danger.
And so it's still keeping you on fight or flight ~so that you can fight or flight. Right? So. So you can fight or run,~
~you know, ~compared to our ancestors, we are just drowning in so much information and we have so many things to do. ~I mean, ~technology is wonderful, but it's also made us more accessible. So there's a lot [00:07:00] more demand than there was even 20 or 30 years ago. ~I mean, I can't believe I didn't have a cell phone when I was in.~
~Medical school. I got one when I was in residency and I'm like, how did I survive? You know? But I did, and I was probably less stressed, to be honest. But anyways,~
~then ~ when you're in that stage one for a while, ~then. ~ You may end up going to stage two where the pattern flips. Your cortisol is high at night, so you can't sleep or you fall asleep, but you wake up at like two or three in the morning and then it doesn't rise like it's supposed to in the morning, and it's harder for you to get up because you don't have that cortisol awakening response.
So you might be sluggish and foggy because ~it, ~cortisol might be even lower mid-morning, and then towards the evening it starts to hike back up again, so then you can't sleep.
Then the third pattern is where it's just flat line. ~You're so. ~You've been through so much chronic stress, and this is where we would actually call burnout, where anything seems like such a chore, like you just can't function. Even with minor things that aren't even stressful. You may have trouble getting outta [00:08:00] bed.
You may feel exhausted all the time, and you just feel like you're constantly running on empty. You may feel emotionally numbed, checked out.
And you may feel like you don't even wanna talk to anybody, ~and this is the phase where it can be. Dangerous because this is where, not already there, and so ~sometimes it can feel very debilitating and you may think, well, what's wrong with me?
Why can't I manage it? And there's nothing wrong with you, it's just your HPA axis is dysregulated ~and.~
You may find yourself drinking more caffeine or energy drinks just to try to function,
When you get into severe burnout, you may even have just an emotional exhaustion where you feel depleted, used up. You may have depersonalization where you feel detached from your work and people around you, and you may feel like you have a reduced sense of accomplishment. Feeling like nothing you do matters.
But here's what most people don't understand. Burnout isn't a character flaw. It's not a weakness. It's your stress system finally saying, I can't do this anymore. I quit.
And to get to [00:09:00] burnout, it may be months to years, you might start out in stage one where. You feel always on. You're running on your stress hormones, so you're still able to be ~product ~productive. You're still energetic and you feel like, Hey, I'm a high performer. I can handle it all. I work better under pressure.
But you're slowly depleting your reserves while you're system fights to maintain performance. So then you move to stage two where the cracks start to appear. Your erratic cortisol creates erratic emotions and energy You find like you're just kind of up and down. ~You become I, ~you become irritable or small things snapping at the kids road rage.
You get sick more often. Your sleeping issues worsen. Anxiety creeps in. ~You have Sunday scaries where you're like, I don't wanna go to work. You're like, ~you have the Sunday scaries where you're like, oh my God, I just don't wanna go to work the next day. ~You find yourself hard, you find it, ~and you're finding it harder to make decisions.
You get decision paralysis. And you know, in this stage you might be blaming external [00:10:00] factors. Oh, work is crazy. Kids are going through a phase. But you don't realize that it's actually your stress system that is failing. It's not the external things. 'cause those external things are always there.
And then you move on eventually to stage three where you just burn out
Everything I just described is reversible. Your nervous system is incredibly adaptable. The same biology that got you stuck into chronic stress can learn to heal, regulate, ~and become ~and become more resilient than it was before. The key is knowing. How to work with your biology instead of against it.
And that's exactly what we're gonna explore next.
~So how do you recover if you are in one of these stages, and especially stage three I?~
We need to really reset your nervous system. Think of your nervous system like a smoke alarm that's become hypersensitive right now. Recovery means recalibrating that alarm. So it only sounds when there is actual fire. And this process takes intention, consistency, and the right tools,
step number one is [00:11:00] you want to do things that regulate the nervous system. This is probably the most important step. You need to teach your nervous system to downshift. ~'cause ~currently it's just.
Stuck in overdrive. So it's constantly scanning for threats. It's constantly on high alert. You need to teach it to just slow down. One of the best things you can do is breath work.
There are many different patterns ~in my integrative medicine fellowship that I'm in. ~4 7, 8 breathing, which I think is so effective. So what you wanna do is you want to pick sometimes during your day, and even if that's overwhelming, just do it before bed because it does help with sleep, is you wanna inhale for four.
So you inhale 1, 2, 3, 4. You hold for seven. And then you exhale for eight. But doing this will activate your anti-stress system called your ~parasympathetic, ~parasympathetic nervous system, and by activating that, you are helping to reset. That HPA axis, because that's what we call your sympathetic nervous system.
you wanna practice it [00:12:00] ideally around the same time to start and then add it throughout the day. Just do it every day, and over time you'll be resetting your nervous system.
Now, if you are in burnout too, you may wanna ~act.~
Also, do something that is a little more stimulating. So you can do some things like splashing cold water on your face every morning or at the end of the shower. Just let your shower go to cold and let it stimulate your body for about 10 seconds. So try some different things and see what's best for you.
~Now sometimes breath work because. Um, now~
And then there are other things like mindfulness, ~but I think, you know, ~if you're really in that burnout stage, that might be too much for you. But if you're in stage one or two, you may wanna look into mindfulness where you not only do the breath work, but you're actually focused on your breath and doing something called a body scan, which checks how you're feeling in each part of your body.
~And it's just. ~The goal is just to observe without judgment, but that's very powerful for ~help, ~helping to reset your, ~your, uh, ~nervous system to go more towards parasympathetic [00:13:00] versus sympathetic. Step number two is rebuilding your sleep. ~Sleep rhythms, you know, ugh. Our bodies are complex, so there's a lot of different things.~
Sleep is where your body repairs the damage from chronic stress. So if you're not sleeping, you're not getting the repair and you're gonna continue to feel tired and wired. You're also gonna continue to feel inflamed, as I spoke about in my other podcast. So you wanna have the same bedtime and wake time, even on weekends.
It would be even ideal for your circadian rhythm if you go to bed by 10:30 PM your time zone. Because that seems to help balance your HPA access ~to your HPA access. And if you go to, I mean, I know for myself, if I go to bed, pass a certain time, it's like the point of no return. I feel like I've gone past the point of no return.~
~You know, like I might be,~
~and then. ~You wanna have some sort of bedroom bedtime routine to help you ~kind of ~reduce your stress before you go to bed. You wanna stay away from blue lights and you also wanna ~like ~avoid eating two hours before bedtime because digestion can be stimulating.
Step number three is you wanna balance your blood sugar. Now sometimes with in the world of intermittent fasting and time restricted feeding. ~Uh, ~we feel like we have to go through [00:14:00] periods of time of not eating ~and. ~It is challenging 'cause a lot of people who have cortisol issues also have insulin issues because cortisol can affect insulin.
But if you're really in those second or third stages, you may actually do better by just keeping your blood sugar balance. Because what happens is if you are fasting and you are very stressed and you have this cortisol secretion, your cortisol. Senses that your body is sensing that you're fasting, it's going to even produce more because cortisol's job is to take blood sugar from your muscles, put it in the bloodstream so you have fuel to keep going.
So if you're fasting and your body senses that there's no fuel. Or less fuel, then your cortisol is gonna go up. It is known that fasting can increase cortisol and most time that's a short term effect, and that's good. But if you are in this chronic stress state, you don't wanna do any major fast, it's actually better for you to [00:15:00] eat protein, a healthy amount of fiber, and a healthy fat. ~So, you ~and that you wanna do every three to four hours to keep your blood sugar stable.
And then you should, ~you know, ~reduce your caffeine intake. So one cup of caffeine is okay ~and it, ~I recommend if you're chronically stressed. ~M, ~maybe just one beverage under 200 milligrams. The recommended allowance in general is under 400 milligrams a day, but you may need to limit it, but I understand that if you're.
Have this chronic stress and chronic fatigue. As a result, you may need a little kick in the morning, ~so, you know, ~try to find some good caffeine sources. ~You know, ~find a good healthy coffee. ~You know, ~organic coffee is not always the best because those can be contaminated with mold since they don't use pesticides.
So you wanna make sure that you get a coffee that has been mold tested or drink some green tea,
step four is you wanna move wisely. ~So when you are in the stress state, ~doing high intensity workouts can actually be more detrimental [00:16:00] because again, it raises more cortisol. ~Um, you know, and then if you're in that, now, if you're in that severe state. So step four is move wisely. ~If you're in that severe state, a little bit of exercise can be more stimulating and that might actually help you.
But if it makes you feel more exhausted then you wanna stop ~now, ~I would recommend though, in general, to do more low to moderate intensity because you don't wanna add more stress on your body. And if you're doing a super high intense workout like every day. Or even three or four times a week and you find that you're exhausted from your workouts, then you should definitely scale back.
Just be mindful the exercise ~and, ~and the real lesson is just to listen to your body If you're doing something that feels good.
Then stay with it. If you're doing something and you're just still feeling exhausted and you're not sleeping, then it's time to scale back and it's just temporary until you get things reset. So it's not like you can't go back to that later on.
~I. ~And you might even wanna consider walking in nature because walking in nature has been shown to really significantly reduce your stress and reset your nervous system. Yoga is also a great one, and yoga's great [00:17:00] for strength training too. And then if you're really, really stressed, Tai Chi might be a great option for you.
So just pay attention to. How you're feeling.
Step five is setting boundaries and having some sort of rituals. So you wanna protect your recovery time. Your nervous system sends clear ~sys ~signals about when work ends and rest begins. So without boundaries, you're always on. ~So if you get home and you're still working after hours, then you know you're not.~
~You know, ~if it's once in a while, it's okay, but ~you know, ~you definitely need your rest and recovery and brain relaxation time. What I would recommend is just even turning off work notifications if you're not in like a place where you have to be on call ~or, um, you know, and that's not just physicians and healthcare providers like.~
~Our IT person told me he was on call and I was like, wow, it looked like engineers, you know? But anyways, um, ~and then just have an end of day ritual. Sometimes journaling is best because you can just brain dump everything so that it's out on paper, or if you wanna type it on a computer, speak it in a voice memo, you've gotten it out.
So those are some simple things that you can do. Then also just practice gratitude. They found the people that. Keep a gratitude journal, [00:18:00] really feel a lot ~hap ~happier, and it can just be three things, three simple senses about what you're grateful for. I'm grateful for my health. I'm grateful for my family.
~I'm grateful for my, you know, garden, so ~I'm grateful for my garden. So just. ~You know ~anything and whatever you're grateful for, and it can be something small or something big, . And number six is social connection. This is a powerful stress buffer when you connect with people, when you feel like someone understands you and you feel like you have support.
~You know, ~it makes your life so much easier. We humans are wired for connection. So when you isolate yourself or if you feel isolated, that amplifies everything and amplifies the stress response. And it doesn't even have to be like you have to have 10 friends because it's not the quantity, but it's the quality.
Having even one good quality friend that you can have a deep conversation with. Beats having five friends that you may kind of know. So ~you know, ~you wanna find [00:19:00] somebody that you can just share something with. And sometimes it's not your spouse. ~I mean, you know, I sometimes. ~You ~have to, you ~might feel sad because you feel like you can't share things with your spouse or your spouse doesn't understand, but that's okay.
~He or she is just, you know, ~everybody has different ways of thinking and different needs, so it's okay to have other friends that you might be able to be more vulnerable with or share something with.
~And you know, ~if you have trouble finding a way to make connections, sometimes joining a class or a group, ~that you have a hobby that you, ~that you have a shared interest in. That way ~you also, ~you're meeting people that have similar interests. You could volunteer for a cause that you care about because most people that volunteer are.
~Usually a good quality ~usually are very caring people, right?
~You know? ~And even sometimes just having minor. Connections. ~You know, ~just doing a quick chat with the cashier at the grocery store or your neighbor that you don't really know that well. ~You know, ~just small little interactions also are important too. ~Also ~makes us feel connected, even if they aren't people that we see on a regular basis.
step [00:20:00] seven is certain nutrients. ~So ~ you need some extra help to be able to do these other things and need a supplement. And when they're related to stress, we call them adaptogens. And there are many different ones.
Probably the most popular one is ashwagandha. Now, ashwagandha, you have to be careful because. It does actually lower your cortisol. So if you're in that third phase, you don't wanna use ashwagandha ~but, um, you know, ~if you're just in the beginning stages, it might be something that might help you, but ~you know, ~work with your healthcare provider.
I recommend my patients to take a break from Ashwagandha after about eight to 12 weeks because otherwise. ~Then, you know, ~your cortisol might get too low. ~I had an experience after my cat had passed away, I had a lot of anxiety and I was taking ashwagandha and suddenly I was like, why am I so super anxious?~
~And my heart rate was really low and I realized it was because I was still taking the ashwagandha. Um, I had been taking it for, I think it was like three months, and then I stopped it and I was totally fine. ~Supplements should be used cautiously.
There also is Rhodiola, which is a little more stimulating, so that might be a better one if you are in stage three, ~you know, ~I would take it in the morning. Just be careful with it. ~Um, and ~again, just work with your healthcare provider for the right dose and. ~Uh, ~how long you should take it. ~Uh, ~my favorite one is holy basil.
'cause Holy basil it just keeps you kind of stable and just gives you that little support that you need. You can also find it in tea 'cause holy [00:21:00] basil. It's also called tul.
There's, ~um, you know, ~other nutrients like magnesium, magnesium glycinate, and magnesium L threonate are especially great for these conditions. ~Uh, ~glycinate form tends to relax you and make you less anxious. L threonate form can cross the blood brainin barrier where it can actually help with your focus and also helps with your sleep.
B complex is important for energy and also for, ~you know, ~stress deplete your B vitamins rapidly. So you wanna make sure you're getting enough of that. ~Um, and ~then omega threes, 'cause those are just very, ~they're just ~anti-inflammatory and such a great nutrient and ~just ~helps with, ~um, ~brain health and cardiovascular health also.
So I gave you some different strategies. ~You ~just work with your healthcare provider to choose a couple that resonate with you and try to commit to them for several weeks and see how you feel. And then slowly add the other ones.
Because you didn't get there overnight. That's has been building for years, whether you realize it or not. And so it does take time. I mean, don't be disappointed if [00:22:00] after two to three weeks you still feel bad because your body has to reset itself. So just give your body the gift of ~just ~patience and continue to do things and move forward and eventually you will feel better.
~So I hope this was helpful. I hope this was helpful for you.~
~And I hope this was helpful. ~If you like this video, please share and ~please follow, ~subscribe so that you don't miss out on future episodes. ~You may even wanna turn on notifications because apparently now social media's not pushing videos up to your followers anymore, but anyways, anyways. Okay.~
If you wanna watch the video version, you can check out my YouTube channel Functional Medicine with Dr. Var, where those will be posted in video format. ~And then don't forget that I have a daily three to five minute wellness tip, and I have a challenge for you to try that day.~
~And leave in the, and in. Okay. Lemme start over. Okay learn stuff even from patients, so I don't know everything. So, you know, I, I told a patient the other day, I said, I don't know every single thing. That would be impossible, but you know. Because she was kind of, she was, you know, I had this new patient the other day who was a little reluctant to share something with me because she didn't wanna like step on my toes, but I was like, no, I welcome information.~
~I couldn't possibly know every single thing. I learn stuff every day and sometimes I do learn from my patients because they, uh, are very savvy, especially my functional medicine patients. So anyways, ~Thanks for listening or watching and have a fantastic day!
