Stress and cortisol have been linked ever since early stress research identified cortisol as the main mediator of stress – that is, the main hormone the body releases when stressed. So, as the so-called “stress hormone,” managing cortisol levels may seem like the key to managing stress. Unfortunately, it isn’t that simple.

As a researcher, I’ve long been interested in how the body responds to stress. And, while cortisol does play a role in stress, our understanding of stress has broadened to extend far beyond cortisol. Still, many people have questions about how cortisol impacts the body.

To answer some of those questions, I will briefly explain the relationship between stress and cortisol and share some practical ways to cope with the stressors in our lives.

Cortisol helps the body respond to stress 

Cortisol is the main hormone involved in glucose energy metabolism, the process that helps the body produce and use its main energy source: glucose.

When we get stressed, the body activates two systems. First, the autonomic nervous system immediately activates the sympathetic nervous system, or its ‘fight-or-flight' response. Next, part of the endocrine system called the hypothalamic-pituitary-adrenal (HPA) axis releases a variety of hormones, including cortisol, to fuel the body as it continues its stress response. Cortisol helps our organs shut down the body's immediate stress response. It also helps to restore the body’s normal energy metabolism — which is mainly based on glucose — after the stress response.

The idea is that we cope with short-term stress mainly with the help of the autonomic nervous system. If we can’t cope with our stress, or are facing a stressful situation long-term, our bodies use the HAP axis and cortisol to help us cope. 

Cortisol levels change throughout the day 

Cortisol isn’t only present in the body when we are stressed, however. Cortisol is always present in your body. 

Cortisol provides our bodies with the energy we need to complete our daily tasks. Our cortisol levels naturally peak 30 minutes after we wake up and slowly decrease throughout the day. They reach their lowest levels overnight, which allows the body to relax and restore its energy.

Cortisol can cause symptoms — but it’s usually beneficial

Our bodies are made to work in many situations, including stressful ones. But our bodies aren’t designed to withstand stress forever. When our bodies operate outside of their “normal” for a while, their physiological systems can be overwhelmed. This is called chronic allostasis overload. 

If the body’s cortisol response goes on for too long, we may have symptoms. These symptoms mainly affect the immune system. They include:

• Decreased immune response
• Increased inflammatory response
• Hypertension  
• Fatigue
• Major Depressive Disorder

Cortisol levels aren’t tested in standard lab panels. In most cases, a doctor won’t test cortisol levels unless they suspect specific health concerns such as hypercortisolism or an adrenal tumor. These conditions can be diagnosed with a blood test. 

However, cortisol is normally beneficial. Most of cortisol’s effects consist of deactivating the acute response system which has been mobilized to deal with a situation we can't control.  

Coping mechanisms can reduce stress

If this story only focused on cortisol and stress, we’d be missing an important part of the equation: ourselves! How we perceive and respond to a stressful situation influences what happens in our bodies. 

The best way to combat stress is by developing efficient coping mechanisms. Depending on our personality and the problems we are facing, we tend to engage in two main coping styles. They are:

• Active coping, or trying to stay in control of the problem 
• Passive coping, or avoiding the problem

These coping styles may be helpful or harmful depending on the situation. For example, trying to stay in control of a situation that we can’t change is not a good idea. Conversely, it’s also not ideal to remain passive in a situation when there is something we could do to solve it.  

The best solution? Try to be flexible and adapt your strategy to the circumstances rather than being rigid in how you react.  

It is also important to learn how to relax rather than constantly thinking about the problem.

Here are some free and low-cost relaxation methods you can try at home and in the workplace:

• Breathing exercises
• Meditation
• Yoga
• Physical Activity
• Engaging with our support system, such as family and friends
• Participating in workplace wellness programs 

It’s also important for us to identify why we are stressed. This might look like taking a moment to identify the exact reasons you are having trouble coping with a situation. It can also help to name the emotions – such as frustration, anger or deceit – you are experiencing. Stress is a symptom, not an explanation.  

If you are still struggling to cope with stress on your own, ask for help. Therapists, psychologists, psychiatrists and social work counselors can provide additional resources for managing stress.  

Additionally, MD Anderson offers resources designed for managing stress during cancer treatment. Your doctor can also refer you to see a psychiatrist or get support from specialists focused on specific stressors such as pain management, fatigue and survivorship.

Request an appointment at MD Anderson online or call 1-877-632-6789.