Is Cortisol Hurting You or Helping You?

your breath starts to shake, might sort of feel like a predator is chasing you, except there

“is no predator, you're just late for work, you're just stuck in a traffic jam, okay?”

Now think about that experience, that very intense feeling that's washing over you, that is your cortisol at work, cortisol. That's a so-called stress hormone, maybe something that you've heard of, and if you go online, you'll see that it gets blamed for just about everything nowadays, weight gain, bad sleep, mood swings, hypertension, infertility, even diabetes. But how much of that is really true? Well today's guest is going to help me navigate the reality

of what may be one of the most misunderstood hormones, Dr. Robert Sapolsky. He's a neuroscientist, a biologist, he's a professor at Stanford University, he's also spent more than three

decades studying stress, he has lived with baboons in Africa, and he also runs a neuroscience lab.

He's author of why zebras don't get all sorts, such a great title for a book, it's pretty much the book to read on stress. Honestly, he's one of my favorite people to talk to, we've had them on the podcast before, and let me tell you, you're in for a real treat. I'm Dr. Sanjay Gupta, CNN's chief medical correspondent, and this is chasing life. But they didn't do anything.

Egal, it's just a failure. It's just a matter of how much we're doing. And when they then work, they'll be able to catch up. - That's right. - Safe, how much we're doing? - It's just a matter of how much we're doing. - Now, it's just a matter of how much we're doing.

- It's a hormone, what's a hormone? It's any chemical messenger that gets released into the bloodstream. That causes something or other to happen elsewhere in the body. We've all heard of estrogen, progesterone, and regions like testosterone. Everybody knows about adrenaline coming out of your adrenal gland.

Cortisol is the other main stress messenger coming out of the same place.

“So what happens in the body then when Cortisol actually kicks in during a threat?”

Or during a perceived threat? I'm going to say for now. - Well, if you're thinking like a normal vertebrate, everything it's doing is fantastic. It's ancient, ancient stuff dinosaurs when they were being stressed by a predator. We're secreting something close to Cortisol.

Fish have them birds, amphibians, reptiles, all the mammals. And what it does is it lets you survive a short-term physical crisis, like you're running for your life or you're running for a meal. Is it by releasing glucose into the bloodstream? Is that its primary mechanism of action?

- Well, that's kind of what it's most beloved for, mobilizing glucose from storage sites and handing it to your muscles that are good to save your life. They work in cooperation with adrenaline to increase your heart rate, and your blood pressure, they turn off all sorts of stuff in your body that you could do tonight if you survive a long enough.

You turn off growth, you turn off tissue repair, you turn off reproduction, you turn off aspects of your immune system,

everything that's not essential.

“- How do you think of it? Is it sort of a frenemy in this regard?”

- Well, it all depends on what kind of organism you are and what's stressing you. If somebody's trying to eat you and you're sprinting for your life, and you manage not to secrete this hormone, you're going to die. But then you get to us and we secrete Cortisol when we've got our own acute physical crises. But what we mostly do is we secrete it because of taxes and traffic jams

and unrequited whatever's for psychosocial reasons. And you get in trouble for two reasons. One is you now secrete it chronically at elevated levels. And the other is you shouldn't be secreeding it at all because everything it does here body is great for a five-minute emergency and is bad news if you've been doing chronically for months and years.

why is it such a poor mismatch for most of the things that, you know, worry us today?

“- Well, once again, I'm probably not being inaccurate that if it was 120 million years ago”

and a dinosaur was running for its life, it would have been secreeding glucocorticoids. It's been there that whole time it's how vertebrates survive all sorts of immediate emergencies. And what do we do? We turn it on and anticipating a blind date. We turn it on thinking about our hearts good to stop beating someday. We turn it on thinking about refugees on the other side of the planet.

We've come up with this bizarre thing that's unique to very smart social primates.

And a few other species, elephant citations, where you can go turn it on for all the reasons it didn't evolve for.

This would make no sense to any dinosaur. We've gotten sparned of that we are stressed by things that this system simply didn't evolve for, and do it chronically, it's got a hammer weight to your body.

“So is the only solution then to reframe how these things are actually being interpreted in our own brains?”

I mean, we're not going to change our cortisol system, right? We need to change how much we activate it. It sounds like how much we activated and for what reasons. You don't want to turn off the system when you want to react like a normal organism does, but you sure want to have it not activated when you're being a psychosocially smart human. And what you're left with is exactly you could come up with some wildly complicated system

that will shut down cortisol secretion only when you're being psychologically stressed and it's good the rest of the time. The alternative that's infinitely easier is to figure out how to be less psychologically stressed in your everyday life. There are these commercial at home tests now. People who are listening to this may be curious about their cortisol levels.

“Worth it, you think? Was this something you advocate?”

Uh, no, no because they're not necessarily particularly accurate ways of measuring the stuff.

They're not telling you the most important things, which is profiles over time.

Are you resting levels elevated when something stressful occurs? Do you turn on the stress response fast enough and big enough? Even born, importantly, when it's over with, do you recover from it quickly? And that's one of the vulnerable spots. So those are big problems. And the biggest problem is the basic mindset is this is a hormone that is your enemy. You know, it's interesting. Again, we're drawing these links between stress, cortisol, and then a whole host of things, including

hyperglycemia, sugar in your blood, infertility, high blood pressure, all these things. What about weight gain metabolism belly fat? That's sort of bucket of things. This is where cortisol comes screaming back with a whole new world of bad effects. cortisol, glucocorticoids, as we talked about, what does it do in mobile analysis, glucose from your stored sites because you're running for your life. And when the stressor is over with,

cortisol happens to stick around for a long time. And in primates, it's got a half life of about 90 minutes or so. What's it doing? Sticking around long afterward, cortisol not only mobilizes your energetic stress response, if then mediates your recovery from it. During the recovery phase, it promotes putting glucose back in your storage sites. It makes you hungry. It stimulates eating it. And what does it do? It tries to reverse all that. And if you're secreting a whole lot of it,

the net result is it's increasing fat deposition. You get a specially in trouble because there's two types of fat in the body. Broad dichotomy fat that winds up in your gut, tranquil fat, and fat that winds up in your rear end, gluteal fat. And what you see is fat in your gut is much more sensitive to glucocorticoids than is fat in your rear end. So not only your preferentially storing fat, if you're chronically being psychologically stressed, you're putting into the worst

place in your body right around all your organs there. That's where you don't want to be doing. At that promotes inflammation, that's another major downside of chronic stress. Because if you're chronically stressed, you're chronically good. It have to be going through the process of recovering from the stress response. And that's where a lot of the damage occurs.

cortisol. They need it, but in terms of the recovery, or the sustained effects of cortisol.

Is that? I mean, zebras don't get ulcers. That's the title of the book. So what are we to infer from that in terms of how zebras are different than humans then? Well, if you're zebra, and I've had the luxury, you've seen this many times, you're some zebra out in the Savannah, and you're eating some grass, and some lion appears, and you run for your life, and you get away from it. And as far as I can tell, 30 seconds after it's over with all the zebras thinking about

is, hmm, maybe I'll eat this piece of grass. Oh, though, that one looks good. It's gone. It's over with you take a primate, a babbling or us, and what it's thinking is how did I step into the wrong

“end of the field? Why wasn't I more tuned? Oh, my God, mortality, what could have happened to me?”

What could have happened to my loved ones? I don't know if a baboon is quite this sophisticated, but they sure are capable of being anxious. Zebras don't get anxious. Primates get anxious, which is you see threats that are not necessarily there. Coming up, practical tips if your cortisol is working overtime. That's after the break. This week on the assignment with me, Audie Cornish.

I have always believed about myself and told people that I don't have an addictive personality,

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Cortisol often gets blamed for sleepless nights. Difficulty sleeping is that a real connection between cortisol and sleep issues? Yeah, it's everything about that is bad. Stress by way of cortisol makes it hard to sleep. Disrupted sleep elevates your cortisol levels. No, we've got a vicious cycle. And when you look at the ways in which cortisol is disrupting sleep, it's particularly hitting the type of sleep deepwaves sleep where you're building energy

back up in your brain or restorative stuff. So separate of it, waking you up in the middle of the night because it sets off all sorts of alarms. Even if you stay asleep, you're doing a less efficient job at the building your energy storage. So you're getting in trouble in lots of ways there. And it's one of those stress disrupts normal function which triggers stress which disrupts normal function and off you go. What is the indication aside from measuring this through blood or

urine or saliva? However, how would you know that maybe you're an individual that's making too much cortisol? Well, rather than somebody taking your blood or making it you do unpleasant things with your urine or what, you know, how do you tell when you're stressed into a pathological range? You feel miserable. Your sleep is disrupted. You're exhausted all the time, even if you've gotten

“good sleep. Your sex life is thrown out of whack. You're getting a lot of colds. Your concentration”

is thrown out of that's like a pretty good assay rather than paint somebody to measure something in your bloodstream. Follows things are happening. That's a pretty good marker that either you're secreting too much cortisol or your body is listening to cortisol way too much. Things go wrong in this big global kind of way. Hyper tension, heart rate increase. If you've got diabetes, it suddenly becomes harder to keep it under control. Just everything

sureest sign. And at that point instead of seeing an endocrinologist, a doctor who does hormones,

“maybe seeing a psychologist would be better. Exactly. And that's where you run into, you know,”

every dead white male bias in the field, which is if there's a problem, fix it when it's already become a problem, rather than preventatively. And when you're fixing a problem after the fact, if you could do it when you got a lab coat on and you're using gazillion dollar machines versus trying to get somebody to shift their priorities in life, the bias of medicine is high tech after the fact interventions. When you come to this system overwhelmingly, the better solutions are

get less stressed in circumstances where it would make no sense at all to a zebra. Do people with higher cortisol do they? I want to phrase this question in a proper way, but

“are they more successful? Well, this puts us into tricky domain depends how you're defining”

more successful. Obviously, it depends on what exactly the excess cortisol is about. You're going to be

much more successful at remembering strings of digits backwards and stuff like that for the first

couple of days that you're super stressed. As we saw chronically, you begin to have downsides to all of it. That of course leads us to sort of industrial psychology type questions, so you look at big faceless corporations and who's got the elevated cortisol levels who gets the most stress-related diseases. The bias for ever was the people on top and it even had a term executive stress syndrome and it turned out the research studies that sort of broadcasts that to the world

“were done wrong in the late 1950s, but everybody learned, "Oh, those poor executives,”

sitting in that, you look at big corporations and it's middle management who gets the stress-related diseases." Why they've got the double whammy, they've got responsibility, but they don't have control. They don't have autonomy and that's a killer combination. Was that the White Hall experiment exactly? White Hall, which was showing British civil servants, every step you go down in the British civil service, Browning Point sort of scale, you're health is worse, your life expectancy is

worse, your more subject to stress-related diseases, and what was great was this was controlled, these were people at the bottom of the ladder who were not in poverty. They were just poorly paid civil servants, these were people who all got vaccinations, these were people none of them were getting malaria. So lots of controls in there, wonderful work by this guy, Sir Michael Marmett showing this, showing that you're placing that hierarchy is hugely influential. So the people who

are sort of middle management, they were worse off than people who may have been lower down the ladder as well as people who are higher on the ladder. Well, no, there you get the comparison of middle with top, and that big lesson was middle management, it's more stressed. Look at the people down at the bottom, they're doing the worst of all. So the big surprise was middle management versus executives, but go down the hierarchy there and as seen and every westernized country doesn't

matter if you've got socialized medicine or you've got the American nightmare system and also to different cultures, you go down the socioeconomic ladder and every step going down on the average, health is worse, life expectancy is shorter and it's not due to obvious stuff. Oh, poor people can't afford to go to a doctor. They go to doctors and places with socialized medicine. Oh, poor people as is known are more likely to drink or smoke to exit control for that is because you were being

psychologically pummeled all the time with being a very low ranking primate and that's the pricey bay. If you're thinking about this now, listening to this podcast is one of the objectives when thinking about stress and cortisol, would the goal be more to become more resilient to it

or try and reduce your stress in the first place? Obviously, you'd like to do both, but where would

you focus your attention? Resilience is how you were responding to an environmental kick in the

life so that there's fewer of those challenges and how resilience is probably the way to go. If you can get a less stressful job, if you can get a boss who's not a jerk, if you can figure out your abusive relationship, any of these things, that's great decreasing the legitimate psychosocial stressors going on in the world around you, resilience, perceptual changes are

“probably stronger and that is not to sit there and say to somebody, "Oh, all you have to do is just”

get the right attitude about appallingly unpredictable unempowered life." This is mostly for dealing with middle-class neuroses. I don't want to be polyanish about this at all because I think for a lot of people, they think so much of this is out of my control. There are people who live in places

with incredible socioeconomic disparities. That's just their reality. A few months ago now,

we had two headlines in the news at the same time. One was about the world's first potential trillionaire and one was about the fact that 600,000 people, 400,000 of whom are children may die as a result of cuts to USAID. That was in the same week and I remember thinking what the blank is happening here. Those types of disparities are toxic and it seems like they're toxic no matter

“where you lie in the socioeconomic spectrum, have or have not or wherever you may be. That's just”

stressful, it seems. Absolutely. What you see is when you look closely and wonderfully subtle work by all sorts of health psychologists, what you see is being poor is a pretty good way to elevate stress hormone levels and it's a pretty good way to be more at risk for stress related disease, being poor amid plenty. That's the route in equality being surrounded by having your nose rubbed in it over and over each day. Oh, a baboon gets trounced by a higher ranking guy. He's reminded

that he's low ranking, drive down the freeway and somebody in some expensive Tesla blasts past you.

You never even see that primate's face and you have been subordinated in the hierarchy there.

What surprises people the most is exactly what you mentioned. Everybody suffers with increased inequality. The poor because they have less psychological control and they're dumped on and all this stuff, the wealthy get less healthy as well. Why? Because they have to put more resources into keeping all the stressful stuff outside the gates of the mansion. Private schools, security stuff, bottle water because who knows what's in the real water supply?

What you see is ironically for the privileged, it could be very stressful to try to make a life

in which something stressful never occurs. My guess is because of who you are and your

“notoriety in this field, you must have a lot of people, including students and young clinicians”

and people coming to you who feel overwhelmed by the systemic stressors, the system, things that they can't directly control. What do you say to them to try and help them? Well, in terms of the psychological things that go into coping, don't try to control things you really have no control over. Don't try to predict stuff. We're knowing it in advance. It's just going to make stuff worse. Don't look for outlets where you're doing so makes everybody

around you more miserable. Don't mistake superficial relationships that are club on Friday night for a real support of social relationship. It's a very narrow range in which the psychological manipulations work. You don't want to make somebody feel like they had more control when the outcome was a disaster. You want to make them feel that way when the outcome was pretty good. Thank God I had some control. Look how much worse it could have been. As opposed to

look how much better it could have been. I've been on a band where again in recent years about how when you look closely, we really have no free will. There's no such thing as free will. We're biological machines. That's all I've been obsessing over. And that gives me a whole lot of people really upset. If you're on the bottom of a hierarchy and you were living in a culture which has system justification telling you over and over, it's your own damn fault. You could have been

other anybody could want to be that first trillionaire. All you're doing is telling somebody,

you have no control over your bad luck in life, all doing that. This is prove liberating.

“That's wonderful news. I read your book and I decided I wanted to be more like a zebra.”

I always learned so much from you. I really appreciate it. And whenever I get a little stressed,

I imagine being at Professor Robert's Polesby's house, walking out his front door, taking a few steps to the right. Not even that far in suddenly being in the middle of just that

“unbelievable sort of splash of nature. It was just so gorgeous. I mean, to say what you want,”

anybody who's listening. And I don't, again, I'm very careful not to sound too polyanish. But be

outside for 15 minutes in nature. And it does a pretty good job of regulating many of the things we've just talked about. And probably the most impactful way that it does that is, if it's beautiful enough

“out there, you get a sense of awe. And if you get a sense of awe, you get a sense of gratitude.”

And you get a sense that your problems are pretty small potatoes compared to how big the

sky is. Yeah. Well, that was my conversation with Neuroscientist Dr. Robert Sapolsky. Thanks for listening. I'm CNN Tech reporter Claire Duffy. This week on the podcast "Terms of Service." There's a growing category of products aimed specifically at addressing women's unique health needs. These tools and services are sometimes known as femtac. And they could provide big opportunities and benefits, but they can also come with some risks. To walk us through all of this,

I spoke with Bethany Corbin. Bethany is an attorney and CEO of fem innovation, where she advises startups, clinicians, and health care organizations. In my opinion, what it really does is gives us a collective language to talk about women's health care innovation and the tools that are out there so that we can take control of our health care experiences and know how to advocate for ourselves and a system that's probably not been designed to advocate for us. Listen to CNN's terms of

service wherever you get your podcasts.