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Stress Management Skills Are Key To Daily Cortisol Rhythm

Publication date: 04 April 2016

In my last couple of blog posts I've looked at the value of cortisol testing for stress assessment. Cortisol is a major stress hormone, which is produced in the adrenal glands and helps us cope better with stress by giving us more energy. One form that adrenal dysregulation can take is a loss of the daily cortisol rhythm. The healthy pattern is that cortisol should be high in the morning when we wake, then drop steadily over the course of the day. A not-uncommon finding in stress and anxiety cases is that the cortisol is flat - maybe even rising towards bed time (which is likely to disrupt sleep onset). What's the significance of this flat pattern of cortisol and what can you do about it?

Research shows that the flat cortisol pattern correlates with poor stress tolerance and other poor health markers. Conversely good stress resilience skills correlate with a clear drop in cortisol over the course of the day.

Professor Richard Davidson, in his book 'The Emotional Life of Your Brain', tells us something about the brain basis of good stress resilience. The two key brain centres are the amygdala and the prefrontal cortex (PFC). The amygdala is like the stress trip-wire in the brain: it monitors experience and when it detects a threat, real or emotional, it signals the body to react - for example by engaging the "fight or flight" response. The PFC acts like an executive controller for this circuit - it can dampen down the amygdala's response, once it's had time to come to a more measured assessment of the current situation. In people with good stress resilience, or emotional resilience, the PFC (or a particular part of it) is able to activate strongly, and suppress amygdala activation well.

In the video below, Prof. Davidson tells us about a study where they tracked this brain basis of resilience, and also measured the same subjects daily cortisol rhythm (based on taking several saliva samples over the course of a day). (Remember saliva cortisol is active cortisol as opposed to bound or stored cortisol.) The study found that good prefrontal suppression of the amygdala correlates to prominent daily cortisol rhythm (large drops from morning to evening).

What can we conclude from this result? How can we best help people showing a flat cortisol rhythm? Well, we have to be a little bit careful because studies that show a correlation don't necessarily prove causation. But we know that the adrenals are basically dumb glands - they do what they're told to, ultimately by the brain. It's likely that the flat cortisol rhythm is the result of poor brain regulation rather than the cause. We're probably better to focus on the brain rather than trying to fix the adrenals.

One really good way to improve brain regulation is with training. Stress resilience is a skill that can be trained, just like many other things, and thanks to neuroplasticity we can expect to see the effects of training in terms of brain changes. Biofeedback and mindfulness are two excellent training tools.

I think the whole of Professor Davidson's talk is interesting but the part that's relevant to this article is from 8 minutes to 14 minutes 40 seconds.

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