I am a Behavioral Medicine Clinical Psychologist and Registered Nurse and have been practicing with Meier Clinics for 28 years. While working with anxiety and stress in the arena of mental health is commonplace in my clinical practice, helping people cope with the fear, anxiety and stress related to COVID and its collateral impact on society is an all-new dynamic. The focus of this article is on the effect COVID has on cortisol levels and things we can do to help decrease its negative effects.
Cortisol is the hormone secreted by the adrenal glands when one experiences stress, fear, or threat of survival. Cortisol is the primary player in the “fight, flight, or freeze” response. The fight-or-flight mechanism is part of the general adaptation syndrome defined in 1936 by biochemist Hans Selye of McGill University. Once cortisol is triggered, your body immediately mobilizes and prepares to act. For instance, if you were sitting in your backyard and a mountain lion jumped over the fence and darted for your dog, you would be stimulated by cortisol to either” fight”, i.e., try to help protect your dog, or to “flee” (flight), i.e., run for safety in your home. What is essential at that point is that there is a physical release of the neurochemical followed by the “fight or flight” response. If this response does not occur, the cortisol builds up in your system and wreaks havoc on you physically and emotionally.
While “fight or flight” is the most common response to cortisol, there is another possible response where one may “freeze” (an elevated level of cortisol with no release). Except for the vaccine, the COVID virus is not something that we can “fight”, and with the global impact of the virus, not something that we can “flee” or “flight” from. Therefore, many people are dealing with the emotionally immobilizing impact of the “freeze” response to the threat.
Chronically elevated levels of cortisol affect us both mentally and physically. Mentally, this condition is associated with anxiety, depression, irritability, fatigue and mood swings. It interferes with learning by negatively affecting short term and long-term memory, concentration and motivation. Furthermore, cortisol is also associated with poor sleep, nightmares, loss of sociability and the avoidance of interactions with others.
Physically, chronically elevated cortisol is associated with several problems such as a lower immune function, weight gain, increased blood pressure, cholesterol and heart disease, type 2 diabetes, osteoporosis, and other chronic diseases. With no outlet for the cortisol response, the “fight, flight or freeze” response is destructive.
While this seems daunting, there are several powerful things we can do to mitigate the destructive effects of chronically elevated levels of cortisol.
- Spiritual Health and Power of Prayer: Prayer heals. Prayer generates peace, power and health, a guard against anxiety and disease. Many studies show that prayer helps to lower inflammation, raise immunity, increase longevity, reinforce good habits, and puts one in touch with their true purpose. Prayer helps strengthen defenses against stressors and the corresponding rise in hormones such as cortisol
- Regular Physical Activity: Hiking, biking, jogging, walking, swimming, elliptical training, or any aerobic activity is incredibly helpful in reducing cortisol.
- Breathing: With elevated cortisol we tend to “pant” or breathe out of the top third of our lungs. This breathing increases our anxiety. I encourage “diaphragmatic breathing”, or belly breathing, where you take deep breaths all the way to the bottom of your lungs….so deep that it causes your belly to expand. A good habit to consider is just as we are encouraged to drink plenty of water and to take sips of water every 15 minutes, I encourage using this marker as the time to also take 6 deep diaphragmatic breaths.
- Cognitive Acceptance: Cognitively embracing the uncertainty rather than fighting the uncertainty. There are many areas in our world right now related to COVID that we are completely powerless over. Embracing your powerlessness over these things leaves room to deal in the reality that we do not have all the answers yet. One needs to be able to differentiate where they have influence (vaccinations, social distancing, hand washing and using protective gear) and where they are powerless (knowing when this will end). Making room for, and embracing the anxiety helps keep you from fighting the cortisol response, which only makes the anxiety worse.
- Practice Being Present: Anxiety and fear associated with COVID is primarily future focused regarding the threat of illness and the impact it is going to have on our society. It is helpful to shift your focus. If possible, focus on being present in your current circumstances and practicing compassion for self and others. Engaging in activities that are currently happening such as meals with your family, organizing your home, listening to your favorite music, or doing an online exercise program promotes being present in the moment.
- Meditation and Mindfulness: Fear increases cortisol. Practicing mindfulness and meditation helps to decrease fear by increasing confidence and resilience. The deep breathing involved in these practices stimulates the Vagus nerve which helps your system to lower blood pressure, lower heart rate and decrease cortisol. It is not necessary that you be an expert and it does not need to be anything “woo-woo”. It can be as simple as 10-15 minutes a day of taking long deep breaths. On the inhale gently saying or thinking “calm” and on the exhale “ease”. Mindfulness and Meditation can be done anywhere and at any time.
- Maintaining Social Connection: Social isolation has been shown to be related to increases in cortisol, especially in teens. Close personal relationships, whether friends, family or romantic partners are integral components of our physical and mental wellbeing. Again, research shows that connection with others and physical touch stimulates the Vagal nerve to calm the parasympathetic nervous system. Oxytocin is increased and cortisol is decreased with connection to others. While social distancing has created a challenge in doing this, with Proper protective gear, Zoom, Facetime and other online platforms some level of connection can be achieved. Prioritize spending “real” time with those that you can.
- Lean in and Lean on: Lean into your experience and into the experience of others. Acknowledge that everyone copes in their own way. As you and others bounce between the “fight, flight and freeze” try to meet people where they are without judgement or criticism, without blaming or shaming. It is vital that as many people lean on you, that you too have people to lean on. It’s important to have people who you can talk to, process with, and navigate the challenging circumstances experienced daily.
- Laughter and Fun: Research has shown that laughter lowers stress hormones. Try to find ways in your daily life to enjoy, to laugh and to keep a sense of humor! For instance, in our town of Hailey, Idaho, we have the 8 pm “howling” tradition that sparks many to chuckle!!
With threats to our survival, and with limited ability to predict and control our outside circumstances, our cortisol goes up. By practicing several if not all the above we can make a huge impact on how we experience this enormous challenge.
Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus. (Philippians 4:6-7)