Vitality Are You Addicted to Stress? How to tell and what to do about it By Sara Gottfried, M.D. This is an excerpt from Wanderlust: A Modern Yogi’s Guide to Discovering Your Best Self, a curation of ideas and practices from master yogis, provocative thinkers, mind-body experts, cutting-edge artists and innovative business leaders. Order your copy at wanderlust.com/wanderlust-book-discover-your-best-self/. ••• Are you addicted to high stress? Your health and longevity hang in the balance of your honest response. What I’ve noticed in my 20 years as a specialist in integrative medicine is that cortisol has become the new crack: highly addictive yet flying below the radar of awareness. Chronic stress, and its hormonal indicator, cortisol, can make you fat, cranky, and inflamed, or at minimum, age faster than necessary. Mastering stress as a form of energy, rather than being bullied by it into addictive patterns, is the key to health prosperity, longer life, and happier days. My mission is to offer novel ways to rehab your rhythm with stress so that there’s a playful, hip-hop vibe to it, not the grim march through your 20s, 30s, and 40s of racing from one task to the next. Cortisol is the “fight or flight” hormone and it has a simple job: to get you out of a jam. If a tiger is about to charge you, cortisol raises your blood sugar, heart rate, blood pressure, sending fresh blood to your muscles so you can either pick up a club and fight the tiger or run like crazy up the nearest tree. But now many of us live our lives in near constant state of fight or flight? More than 90 percent of the people who begin their work with me online tell me that cortisol is running the show, and notice the telltale signs of wear and tear—the to-do list that’s a mile long, the second wind at night and lack of sleep, the dependence on coffee, the feeling that they are tired but wired. Even worse, when unaware of the ravages of stress, many wear the business like a badge of honor. Our bodies are not set up to tolerate such a high level of unremitting stress. Ultimately, it can become addictive, as high cortisol establishes a new set point in your body, around which you organize the rest of your life. Put another way, cortisol used to be on our team, and now it’s working against us. Not convinced? Here are a few stats to illustrate the role of cortisol as bully: Got moodiness? Half of people with depression have high cortisol from chronic stress—not surprisingly, high cortisol is associated with low serotonin, the feel-good brain chemical in charge of mood, appetite, and sleep. Got memory or intense emotions? High cortisol shrinks the hippocampus, the part of your brain where yo consolidate memory and regulate your emotions. Got muffintop? High cortisol preferentially makes you store fat at your waistline and causes blood sugar to rise. Got addictions? The most common ways to crank up cortisol are coffee and alcohol, our favorite psychoactive and addictive drugs. Just as you can be addicted to meth or heroin, you can be addicted to high cortisol, thereby enabling the bully. The signs of addiction are often more subtle than track marks: perhaps you have workaholism, or just feel chronically depleted from working so hard or giving so much, or you are experiencing wandering attention. Maybe you have the usual response to your addiction to cortisol: you’re in denial. You’re thinking, “Yeah, yeah, but I don’t have a problem with stress.” Think again. Cortisol is insidious in how it gets into your body, wreaks havoc and creates collateral damage. Beyond feeling tired but wired or getting a second wind at night, here are a few questions to gauge your addiction to cortisol: Do you have drama in your life, such as your relationship with your partner or your mother or work colleagues? If you have a period of smooth sailing, do you feel bored? Do you need to exercise to self regulate? Do you feel out of sorts when you don’t get your gym time in? If you have a day where you are completely unscheduled, do you feel uneasy, maybe anxious—and rush to fill it in? How’s your sex drive? Would you rather get work done than revel in carnal pleasures? What I learned in my mid-30s is that I had to rehabilitate cortisol. I needed to step up to the fact that high cortisol was acting like a mean girl in my body, and to own my part in the various ways, conscious and unconscious, I was feeding my addiction to high-stress living. Unfortunately, when I went to my doctor for help, I was stunned by his lack of insight. I was the woman sitting in the exam room shivering in the pathetic exam gown, explaining to my doctor about how, at 35 years of age, I couldn’t lose weight, had no sex drive, and was irritable most the time, especially the week before my period. He suggested an anti-depressant, a birth control pill, and told me to exercise more, eat less, and reduce stress. I had a hunch that my doctor’s suggestions were completely wrong, and I decided to look for real solutions. My hypothesis was that my problems were hormonal. After all, I’m a gynecologist and think about hormones all day. Here’s the shocking part: When I measured my level of cortisol, the hormone secreted by the adrenal glands, I was stunned to find it was triple what it was supposed to be. I was addicted to cortisol, and it took me four weeks to kick the habit. I didn’t need an antidepressant—I needed the secret sauce of the cortisol rehab. I was a runner, which raises cortisol, and I needed to run differently. I needed adaptive exercise, like yoga and Pilates. I started taking natural supplements to help lower cortisol, like phosphatidylserine. I hit the pause button, and it worked. If you’re addicted to cortisol and need rehab, you can too. It starts with looking at the most important points of leverage in breaking the addiction to cortisol, which involve the way you eat, drink, move, and supplement. Here are my top five ways to rehab cortisol and get re-centered, with cortisol in its sweet spot of not-too-high and not-too-low. Start with an easy win: Take phosphatidylserine 400 mg per day. Will power is strongest in the morning: Institute a morning practice of at least seven minutes duration and perform diaphragmatic breathing—used in yoga, meditation, and tai chi, and involving the deep inhale of air into your upper and lower lungs while allowing the belly to expand. It’s been shown to lower stress and cortisol, and raise melatonin, another important hormone of the body’s inner clock. My favorites are listed at thehormonecurebook.com/destress. Cut back on the cortisol-raising drinks: caffeine and alcohol. The greatest health benefits come from moderate consumption of green tea (but avoid caffeine if you have sleep issues), and drinking three servings or less of alcohol each week. The irony of caffeine is that it only has short term benefit; long term, it will make you more tired and addicted to cortisol. Master your sleep. When you’re off of caffeine, you may sleep an extra hour or two per night, which you need to perform the adrenal repair of high-stress living. Wear a tracker, such as the Up or Fitbit, to track your deep sleep and improve it over time. Enlist your besties. Make a public proclamation to your best friends that you need to be help accountable to your cortisol recovery. No more offers of sugary treats, no more girls night out for sweet cocktails, no more late nights. Get them on your side to amplify your recovery. There’s a large gap between what conventional medicine offers people who are stressed out and addicted to cortisol, and what they most want and need. Start by getting cortisol into its rightful place—what I call the Goldilocks position of just-right-for-you. High cortisol disrupts your other hormones, including the delicate estrogen/progesterone balance, slows down your thyroid and testosterone production. Once you get cortisol under control—and it doesn’t take too long—then start working with the sexier hormones, like thyroid and testosterone. Don’t let cortisol run your show. Unlock your greatness by mastering your navigation of the main stress hormone. Photo by Flickr user Benjamin Watson. — Sara Gottfried, M.D. teaches women how to balance their hormones naturally so they can rock their mission. For the past 20 years, Dr. Gottfried has been dedicated to practicing and helping women feel at home in their bodies. She is a Harvard-educated physician, keynote speaker and author of The Hormone Cure: Reclaim Balance, Sleep, Sex Drive and Vitality Naturally with The Gottfried Protocol (Scribner/Simon & Schuster, 2013). She is board-certified in Obstetrics and Gynecology, and is regularly featured in magazines such as O Magazine, Glamour, and Yoga Journal, and TV including The Ricki Lake Show and 20/20. She is the leading medical expert featured in the award-winning film, YogaWoman. For more information, check out her website, Facebook, and Twitter.