Did you know that a prolonged excess of cortisol can seriously affect health? There is an important distinction, though: living under stress and having a confirmed pathological excess of cortisol are not the same thing.
I want to talk about this in human terms. About how our bodies and inner lives can become caught in a circle. And where an opening might begin to appear.
When all your energy goes into getting through the day
You struggle to concentrate. Your plans fall apart. Your memory lets you down, and in the morning you want to stay under the covers. Even washing the dishes becomes a project. In relationships, you give way again, stay silent again, leave too little room for yourself again.
Sound familiar?
These experiences deserve attention. But they cannot tell you your cortisol level. Fatigue, sleep problems, and changes in weight have many possible causes. An assessment helps establish what is happening, rather than confirm the first explanation that comes to mind.1
In Cushing’s syndrome, associated with prolonged cortisol excess, recognised signs include characteristic fat redistribution, a rounded face, muscle weakness, easy bruising, and wide purple stretch marks. Mood and memory problems, infections, and slow healing may also occur. This is a clinical picture requiring medical diagnosis, not a test for a “victim position”.2
What happens in the brain
We need cortisol. It helps mobilise energy and regulate inflammation. The concern is prolonged excess or disturbed functioning of the stress response system.1
Research describes how stress and glucocorticoids contribute to changes in neural connections and synaptic transmission. Dose, duration, and conditions matter. Much of the mechanistic evidence comes from animals; changes may reflect adaptation rather than neuronal death.3
There is human evidence too: in patients with Cushing’s disease, treatment and reduced cortisol were followed by increased volume of a previously smaller hippocampus, a brain region involved in memory. This concerns a particular patient group. It does not show that every exhausted person’s brain is “being destroyed”.4
Frightening? I also find room for hope here. We say “broken forever” too readily when the reality is much more complex.
Stress, inflammation, and that familiar circle
Cortisol normally helps restrain inflammation. Chronic stress research also considers reduced cellular sensitivity to glucocorticoids. In two experimental rhinovirus exposure studies, this reduced sensitivity was associated with cold risk and a stronger inflammatory response.5
So the formula “cortisol increases white blood cells, therefore the whole body is inflamed” is too simple. One blood test measurement cannot explain the whole story.
Stress and the body are studied in other ways too: in a small study, experimental skin wounds healed more slowly in people caring for relatives with dementia than in a comparison group. This does not establish that every slow-healing scratch you have is caused by cortisol.6
Nor does chronic stress mean cortisol is always high. A meta-analysis found varied results; the nature and duration of the stressful situation matter.7
In lived experience, the circle might feel like this: I sleep poorly, struggle to cope, criticise myself, become more tense, and cannot rest again. Here I am describing one possible experience, not a universal chain of laboratory results and chemical reactions.
Where familiar patterns come from
Now we reach the part that particularly interests me in my work.
Sometimes a person lives as though the right to closeness must be earned. Be easy to be around. Do not argue. Read the other person’s mood before listening to your own. Do not ask for too much.
Once, this may have helped preserve a bond with important people. Circumstances are different now, but the inner message remains: “If I choose myself, they will stop loving me.”
Early adversity is studied in relation to later health. For example, a longitudinal cohort study found an association between childhood maltreatment and elevated inflammatory markers in adulthood. An association is not an inevitable destiny, and it cannot establish the cause of an individual’s illness from their biography.8
Today, I would not say that every experience of survival is a “victim role” installed by parents. There may be genuinely difficult living conditions, illness, violence, a lack of money and support. Responsibility for violence belongs to the person who commits it.
Learned helplessness research helps us discuss the experience of lacking control. However, much of this research tradition relies on animal experiments. It is not a diagnosis of “victim”, nor proof that your thoughts caused excess cortisol.9
“Start a new life.” Where is the energy supposed to come from?
Sleep well. Meditate. Exercise. Eat better. Set boundaries.
Good words. But how does that list feel when you have no energy left? Sometimes it becomes another piece of evidence against you: “I cannot even look after myself properly.”
“Stop being a victim” can sound much the same. The person is already suffering, and now we ask them to feel ashamed of suffering too.
I prefer another question: what keeps you in this way of living, and what is it still trying to protect?
If you agree against your wishes, what are you afraid of losing? If you cannot ask, what response from the other person feels almost unbearable? If you are angry with yourself for being tired, whose voice do you hear in that demand?
These questions do not come with ready-made answers. They begin an exploration.
Deep work and reclaiming choice
In Process Work, I am particularly interested in the point where a person’s familiar way of being themselves becomes open to reconsideration. Space then appears for a new position in life, a new state, a new perspective.
We can notice what is still difficult to express: tension, an image, a movement, a quiet “no” barely audible beneath the habitual “yes”.
Without forcing ourselves to become someone else immediately. By getting to know a part of ourselves that has long had too little room.
Sometimes the first step is asking for time before answering. Sometimes it is acknowledging a desire without acting yet. Sometimes it is seeking help rather than facing real circumstances alone.
For me, the image of the Creator represents gradually participating in our own lives. It does not mean unlimited power. It means distinguishing what depends on me, where I need support, and what I cannot change right now.
Psychological work does not replace diagnosis or treatment of an endocrine condition. The studies cited do not establish that Process Work normalises cortisol. Discuss prescribed medicines with your treating clinician: seeking medical help is also a way to care for yourself.
But we can explore our familiar responses, listen to our needs, and seek support. Together, at your pace.
If you recognise yourself in this text, I invite you to an individual session. We can explore your circle and the place where the possibility of choice begins to emerge.
Marina Ivannikova Shvets. Personal development specialist working in the Process Work approach and creator of Talvira. Sessions by appointment.
Sources and notes
1. NIDDK / NIH. Cushing’s Syndrome. Clinical information on cortisol, signs, and diagnosis of Cushing’s syndrome.
2. Nieman L. K., 2015. Cushing’s Syndrome: Update on signs, symptoms and biochemical screening. Clinical review, European Journal of Endocrinology.
3. McEwen B. S. et al., 2015. Mechanisms of stress in the brain. Mechanistic review, Nature Neuroscience; authors include Rockefeller University researchers. DOI: 10.1038/nn.4086.
4. Starkman M. N. et al., 1999. Decrease in cortisol reverses human hippocampal atrophy following treatment of Cushing’s disease. Patient study, Biological Psychiatry. DOI: 10.1016/S0006-3223(99)00203-6.
5. Cohen S. et al., 2012. Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. Two viral exposure studies, PNAS. DOI: 10.1073/pnas.1118355109.
6. Kiecolt-Glaser J. K. et al., 1995. Slowing of wound healing by psychological stress. Experimental wound-healing study, The Lancet. DOI: 10.1016/S0140-6736(95)92899-5.
7. Miller G. E., Chen E., Zhou E. S., 2007. If it goes up, must it come down? Chronic stress and the hypothalamic-pituitary-adrenocortical axis in humans. Meta-analysis, Psychological Bulletin. DOI: 10.1037/0033-2909.133.1.25.
8. Danese A. et al., 2007. Childhood maltreatment predicts adult inflammation in a life-course study. Longitudinal cohort study, PNAS. DOI: 10.1073/pnas.0610362104.
9. Maier S. F., Seligman M. E. P., 2016. Learned helplessness at fifty: Insights from neuroscience. Review of learned helplessness research, Psychological Review.