The HPA Axis

The HPA Axis stands for the Hypothalamic pituitary adrenal axis. Don’t worry too much about the name, just know that your HPA axis is your bodies stress response’s central hub. Your hypothalamus, which regulates hormones and body temperature, is the first piece of this process. Let us say you are stressed by some event like a person insulting you. The insult is the “trigger”, and your brain sends a message to your hypothalamus saying, “I have been upset by something, get ready to fight, flee, or freeze.” It is important to note that our brains work on such ancient circuitry that it is not easy for them to react much differently from a person using harsh words towards us versus our ancestors thinking they saw a giant snake slithering towards them in a tree. The hypothalamus sends a message to your pituitary gland, think of that gland as hormone central. The pituitary gland sends out a chemical messenger called CRF (corticotropin-releasing factor).

Again, the name isn’t as important as the function. CRF travels in your bloodstream to your adrenal glands on the tops of your kidneys. CRF tells the kidneys your body needs cortisol and adrenaline, stress hormones, to be released so you can best deal with this perceived threat. Cortisol and adrenaline are good for what they evolved to do. They get us in the right physical and mental state to keep us safe. Unfortunately, our body cannot differentiate a threat to our ego or feelings to a threat of our personal safety all that clearly. So now, you have been insulted and your body is filled with cortisol and adrenaline. So, what happens?

Being Triggered

The heightened arousal state that cortisol and adrenaline put us in cause the signs of being “triggered” we are familiar with. Racing heart, tense muscles, feeling the need to cry or yell, emotional imbalance, even feelings of panic. This can go on for hours and the reason for this is our HPA axis is not a simple on and off switch type of system. Once it is activated, it takes time for the hypothalamus to receive the information that enough cortisol has been released into our body so it will then stop asking the pituitary gland and adrenal glands to do their job. By then we have suffered from this “triggered” reaction and feel absolutely worn out and afraid of it happening again. Again, this is an unfortunate side effect of a evolutionary essential process in our bodies. If your HPA axis did not work at all, you wouldn’t be able to react quickly and effectively to real physical threats. In fact, your HPA axis has a big part to play in simply waking you up in the morning! So, we have a biological system that is necessary, but has a byproduct effect that is intensely difficult to manage. What can we do?

Where a Counselor can Help

There are no drugs that manage your HPA access, at least not in a way that is sustainable and healthy. But there are therapeutic interventions that help a person regulate this system better. Some of these include:
• Stress reduction methods like mindfulness
• Exposure therapy to perceived threats
• Assertiveness Training
• Conflict resolution skill building

Stress reduction methods like mindfulness help us send messages to our brain that a perceived threat is either manageable, or not a threat at all. Breathing exercises, mindful awareness of being in the moment, and meditation causes our HPA axis to learn that most things it is overreacting to as major threats are minor inconveniences that do not require a major stress reaction. Exposure therapy can do this as well. If a person is triggered by things like elevators or cramped spaces, a controlled and gradual exposure to these triggers retrains the HPA axis to react to them in more modest ways. Exposure therapy sometimes gets pushed to extremes but when done by a well-trained counselor it is a very effective and powerful process.

Assertiveness training is less about training your HPA axis to react to threats, and more about creating an identity that is more likely to see threats as challenges instead of dangers. Think of it as bolstering one’s mind so that the HPA axis isn’t rallied but in the direst circumstances. Of course, many triggers come from conflict with others. Arguments, insults, disagreements, all can trigger people with overactive HPA axes. Conflict resolution skills that are built through counseling can reduce the amount of conflict that rise to a level that activate the HPA axis. Combined with assertiveness training, conflict resolution creates a more capable person to handle the common issues we have with one another that can be triggering if we lack the mental resources to navigate them.

Is Being Triggered Bad for You?

On one hand, even the intense emotions of being triggered have some beneficial value. They show us areas where we may need to work on controlling our reactions, or areas where we have issues to work on in counseling. They also can be seen as a sign that our mind and body is in sync with keeping us safe, although they may be overreacting. However, consistently being triggered and having stress reactions of this intensity has consequences. Turning back to biology for a moment, research has shown that cortisol has negative impacts on our brains when we are chronically exposed to it. The areas of our brain involved in memory seem particularly vulnerable to excess cortisol exposure.

The HPA axis itself also has a vulnerability to too much cortisol. At first, excess action of the HPA axis leads to a feedback loop where the cycle kind of gets stuck in “on” mode. This leads to chronic anxiety. As time passes though, the HPA axis sort of burns out and things like depression or adrenal fatigue can set it off. It is important to get help from counseling and therapy before this occurs. While it may take years, chronic activation of the HPA axis through triggers can lead to long term physical and emotional problems.

If you struggling with triggers that cause you excessive stress and wish to learn to work through these issues, please contact Life Enhancement Counseling Services today at 407-443-8862 to schedule an appointment with one of our experienced Orlando mental health counselors.


Tom Daniele