How Do Elevated Cortisol Levels Impact Mental Health?

What is Cortisol?

Cortisol is a steroid hormone that is naturally produced by the body’s adrenal glands sitting atop of the kidneys, playing many pivotal roles in a healthy person, namely with regards to the body’s stress response. If produced in the proper amounts, the body uses cortisol in a healthy manner. At its baseline, cortisol is used to help “your body respond to stress or danger, increase the body’s metabolism of glucose, control blood pressure, and reduce inflammation” (HealthDirect, 2019). Additionally, cortisol plays a role in the fight or flight response, helping the body spring into action in times of need. According to the book, The Impact of Inequality, “Cortisol is the most important endocrine hormone involved in preparing the body for sustained physical activity in meeting a threat. To make energy available, it raises blood sugar levels by counteracting the effects of insulin, releasing fatty acids from the body’s fat deposits into the bloodstream” (Wilkinson, 2005). As a result of all of these pathway's cortisol is involved in, it is very important in maintaining a healthy individual.

So, what is the problem?

Problems begin to arise when cortisol is overproduced by the body. This can be the result of a variety of factors, including genetics, chronic stress, medications, and more. Chronic stress is one of the primary drivers for the overproduction of cortisol, as this hormone works to bring the body back to normal. As mentioned above, cortisol works by shutting down the body’s stress response, restoring the metabolic energy level back to normal, and suppressing the immune system. When stress remains high, the adrenal glands continue to produce this hormone and prevents the body from returning to normal. This is what creates some of the side effects of this condition, including weight gain, fatigue, muscle weakness, thinning of the skin, and more.

Cortisol’s impact on mental health:

“When considering the physical and emotional toll of increased stress, nearly half of adults (49%) report their behavior has been negatively affected. Most commonly, they report increased tension in their bodies (21%), “snapping” or getting angry very quickly (20%), unexpected mood swings (20%), or screaming or yelling at a loved one (17%)” (American Psychological Association, 2023). These statistics directly highlight the impact that stress can have on one’s daily living, negatively impacting several aspects of it. When these feelings of tension, anger, etc. persist for long periods of time, this can be physically and emotionally draining for an individual. From a physiological standpoint, high cortisol levels impact the body through disturbing the normal actions of the amygdala. “High levels of cortisol have been associated prolonged activation of the amygdala, a deregulation which may lead to reduced abilities to regulate emotion. Along with this, individuals showing higher cortisol reactivity to stress are at greater risk for experiencing subsequent depressive symptoms and insecure attachment styles – a risk factor for developing social anxiety disorder – have been associated with larger cortisol responses to stress” (Pulopulos et al., 2020). The proper maintenance and function of these pathways in the body is essential to maintaining balance, so when disturbed, the body may become negatively impacted.

Another important factor that has a relationship with mental health disorders and is impacted by chronic stress is sleep. Chronic stress can disrupt sleep patterns leading to insomnia or poor sleep patterns. If prolonged, the lack of sleep can lead to a wide range of other health conditions, including immune system malfunction.

Conclusion:

Cortisol plays a vital role in the body’s response to stress and inflammation. When expressed in the correct amount, this hormone is beneficial. The problem arises when cortisol is over-expressed by the body, leading to a wide range of health complications. Prolonged exposure to cortisol can lead to an increase in anger, anxiety, depression, and other mental health disorders which can drastically impact all areas of a person’s life. With many around the globe dealing with high stress, it is important to be aware of the complications related to elevated cortisol levels, taking the appropriate steps to promote proper mental and physical health.

References:

American Psychological Association. (2023). Stress in America^TM 2020: A National Mental Health Crisis. Apa.org. https://www.apa.org/news/press/releases/stress/2020/report-october#:~:text=When%20considering%20the%20physical%20and%20emotional%20toll%20of

HealthDirect. (2019, February 11). The Role of Cortisol in the Body. Healthdirect.gov.au; Healthdirect Australia. https://www.healthdirect.gov.au/the-role-of-cortisol-in-the-body

Pulopulos, M. M., Baeken, C., & De Raedt, R. (2020). Cortisol response to stress: The role of expectancy and anticipatory stress regulation. Hormones and Behavior, 117, 104587. https://doi.org/10.1016/j.yhbeh.2019.104587

Wilkinson, Richard G. The Impact of Inequality: How to Make Sick Societies Healthier. New York: The New Press, 2005.

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