The Physiology of Trauma and Lifestyle

Trauma is something that happens to the body/mind/heart in which the nervous system can not process and digest. Trauma is unique and individual and two people can experience similar situations while one person will experience trauma symptoms and the other may not. Yet that same person may experience something else that will result in trauma. Trauma can be an isolated experience or something that happens chronically over an extended period of time. What I have learned through years of living, teaching, studying and practicing Yoga Therapy is that every single person has been traumatized, it is “just a matter of degree,” as my teacher says.  

When a trauma occurs the body releases cortisol, among many other hormones. Cortisol is the natural hormonal response to regulating stress. When trauma gets stuck in the body there can be elevated levels of cortisol for extended periods of time because the body is continually responding to stress. 

Ideally, around 6am the adrenals start to secrete cortisol, which helps us wake up in the morning, and cortisol continues to be active throughout the day. This hormone regulates the body so you can stay alert and energized, controls metabolism and digestion so you can easily and effectively digest your meals, suppresses inflammation, regulates blood pressure and blood sugar and supports the sleep-wake cycle.

After a trauma the body/mind/heart may continue to be stressed by triggers. These may include driving past an intersection where a collision happened or seeing a person who resembles someone who harmed you. With chronic trauma the triggers may be more pervasive. Cortisol may secrete before each meal if meal times were a place of trauma or someone knocking on the door to deliver a package may ignite a sense of danger. Depending on the trauma(s) and the individual responses the body can get stuck in a fight/flight or freeze response, which can keep the cortisol at moderately to extremely high levels because it is constantly trying to regulate the stress response that has gone into overdrive.

Why does this matter? When cortisol levels are high the body can lose some of its immunity protection, inflammation increases because the immune system is overtaxed, digestion can become impaired and sleep and menstrual cycles can be disrupted. There can be increased hypervigilance, or always being on alert, while blood pressure and blood sugar can also be high.

When cortisol is chronically elevated melatonin can also be impacted. In the evening, around 6pm, the pineal gland typically begins to secrete melatonin. Melatonin is a hormone that has the opposite effect on the body than cortisol. It manages the sleep-wake cycle in preparing the body to wind down and rest, detoxifies and rejuvenates the body. It maintains the circadian rhythm of the body while also regulating menstrual cycles in female-bodied people. 

Ideally cortisol is active during the day when we need those functions of energy, digestion and managing stress while melatonin is active during the night so the body can rejuvenate, replenish and detoxify. When the cortisol and melatonin cycles are in alignment we can wake up feeling refreshed, have energy, sleep soundly, easily digest our food and have symptom free menstrual cycles.

When cortisol levels are high this can lead to lower levels of melatonin, which has been researched in people diagnosed with PTSD. Low melatonin can cause some of the same challenges as high cortisol including: disrupted sleep and menstrual cycles as well as high blood pressure. As cortisol levels rise the adrenals go into overdrive to continue secreting cortisol to maintain the body and nervous system’s ability to run or fight off threats. This can lead to inflammation in the body and the buildup of free radicals, which are unstable molecules that damage cells and are associated with disease and aging. With low levels of melatonin the body can not adequately detoxify and fight these free radicals during sleep.

When the hormones are not in alignment with the body’s natural rhythms is there any hope? Absolutely! 

If cortisol is overactive we can focus on supporting the body accessing the natural melatonin cycle. Cortisol is active during the day and when we eat. If we stay awake during the daytime hours and we eat only during daytime hours that in itself can support cortisol levels returning to their natural rhythm. Melatonin is active during the night when we are ideally resting or sleeping. If we sleep during the nighttime hours only and do not eat after 6pm that can shift our body/mind/heart into more alignment with the body’s natural healing processes and physiology. 

As you move towards aligning with the body’s natural circadian rhythms many notice a decrease in PTSD symptoms. People have reported sleeping better, less pain, less anxiety and depression and more energy. When the body is functioning more optimally specific treatments that target PTSD symptoms can be more effective. 

In this approach our life becomes our medicine and eating and sleeping become a form of trauma treatment. We start from the basics and work from the inside out. From the inside we address balancing our hormones and aligning ourselves with nature. Wild animals do not experience PTSD and there are many reasons for this. One of them may be because their hormones are firing optimally so the cortisol can support them effectively to run, fight or freeze in the face of predators and melatonin can help them detoxify and rejuvenate from any hardships in their day while getting sufficient and adequate rest. Animals generally follow a routine, and this routine can be one of the reasons they don’t experience PTSD symptoms as well, even after going through life-threatening events on a regular basis. 

How does one begin to balance the cortisol and melatonin cycles?

  1. Create a routine and stick with it at least 80% of the time.
  2. Sleep at the same time every day. The ideal time to sleep for melatonin production is before 10pm.
  3. Wake at the same time every day. The ideal time to wake for cortisol production is before 6am. 
  4. Do not sleep during the day as this will activate melatonin production during the ideal time cortisol is being released. 
  5. Eat at the same time every day. 
  6. Do not eat after 6:30pm as cortisol is activated in digestion and after 6 is when cortisol is ideally reducing while melatonin is beginning to be released. 
  7. Do not snack throughout the day as that leads to more cortisol production. 
  8. Remove or drastically reduce sugar from your diet as it is inflammatory in nature. 

This is the inside out approach to balancing the internal landscape of the body, which will then support the work to address the specific triggers in PTSD. When the cortisol and melatonin are more balanced it is easier to work with the triggers that happen in daily life because your hormones are working with you instead of against you. Of course there are many ways to work with PTSD, and this is just one way. What I have found in my Yoga Therapy practice is when people can follow a routine the work and healing happen much faster and more efficiently. 

When I bring this up to clients in my practice there is commonly a feeling of overwhelm or uncertainty if this is possible. How does one start this process if their lifestyle is far from the recommendations?

  1. Ease in. Don’t try to do everything all at once because that will not be sustainable. I love the 10% rule. Try making a 10% change every couple weeks so it isn’t overwhelming to your system, which can backfire and cause even more cortisol to flood the system. This can also lead to a yo yo effect where you do it for a week or two and then give up, which is more stressful on the body than small, incremental changes that the body can integrate. What feels possible? Start there and add from there. 
  2. Begin with one thing. Focus on sleep first, and focus on one end of your sleep cycle. Go back to #1 and ease in. If you are currently sleeping from 12-8 go to bed at 11:45 for a few days to slowly acclimate your body to a different bed time. Do yoga nidra before bed as a way to settle your system and prepare for sleep instead of looking at screens. 
  3. Practice the recommendations fully for 3 months. Then you will be able to see the results of balancing your cycles, you will understand your baseline, and if you go through a bout of sleeping and eating irregularly you will know how to return to your baseline. 
  4. Find the balance of not beating yourself up but also not letting yourself off the hook. There will be times where you sleep in or you eat later than intended. Some of the common symptoms of trauma can be black and white thinking, impatience and being overly critical of the self. These are attempted survival skills that can be useful (through quick thinking or blaming ourselves because it was safer to internalize anger or rage than externalize it), but also can cause harm (through impulsivity, rebelliousness, self-sabotage and self-hatred). Ideally, if you follow this rhythm 80% of the time the melatonin and cortisol can bounce back because they aren’t chronically overtaxed. 
  5. Have an accountability partner. For many people it is easier to get to the gym if they have a friend waiting for them. Who is someone who will celebrate your wins and encourage you when it is hard? 
  6. Work with the triggers around eating and sleeping. For many people these times of the day came with traumatic experiences, which makes changing these patterns more difficult. Yoga Therapy or other forms of therapy can be beneficial to help you ease into the recommendations in a way that can feel more tolerable to your system. 

The physiology of the body is incredible and is always working to support and protect you. Even when the cortisol is high it is reacting to a stimulus of danger so it keeps firing to keep us alive, alert and ready to fight, run or freeze. Even if our logical brain knows there is no inherent danger in going to the grocery store or seeing a dog in a fenced yard the emotional and reptilian brain may be wired to potentially see those things as threats. When we can work directly with our physiology we can become attuned to our natural cycles, the rhythms of nature and have the ability to rewire our brains and our nervous systems to become more resilient, adaptable and able to process the happenings of life (beautiful, painful and everything in between) with more ease.