There are many considerations for behavioral and lifestyle modifications when it comes to addressing HPA dysfunction:
■Reducing perceived stress
■Controlling light exposure
■Optimizing sleep hygiene, sleep duration, and sleep nutrition
■Optimizing physical activity
■Spending time outdoors both to connect with nature and natural light exposure
■Making time for regular play and pleasure
Taking steps to reduce stress, and to mitigate the stress that we can’t avoid, is essential to reversing HPA axis dysfunction. You cannot supplement your way out of this condition!
The following behavior and lifestyle strategies will dramatically improve your chances of recovery.
REDUCING THE AMOUNT OF STRESS EXPERIENCED
■Learn to say “no”
■Avoid people who stress you out
■Go on a news fast
■Give up pointless arguments
■Limit your to-do list
■Stop internet debating
STRATEGIES FOR DECREASING STRESS
■Reframe the situation
■Lower your expectations
■Practice acceptance
■Be grateful
■Cultivate empathy
■Manage your time
GENERAL TIPS FOR STRESS MANAGEMENT
■Start small
■Make it a priority
■Be gentle with yourself
■Choose a mix of practices
STRESS MANAGEMENT PRACTICES
■Mindfulness practices (Mindfulness-Based Stress Reduction, MBSR)
■Meditation
■Yoga
■Tai chi
■Qi gong
■Biofeedback
CONTROLLING LIGHT EXPOSURE
■Two main issues: too little exposure to natural light during the day and too much exposure to screens (i.e., blue light) at night
■Minimize computer, tablet, and phone use two to three hours before bedtime
○Tools to minimize:
- lux,
- orange tinted glasses,
- dim/cover/remove any lights in bedroom,
- blackout shades, eye mask
■Increase light exposure during the day: get 15 to 30 minutes of bright light exposure daily. Consider a walk outdoors earlier in the day or using a bright light therapy machine
SHIFT WORK
■Rotating shifts are the most detrimental to health and well being; if you are currently working rotating shifts, speak to your boss about switching to regular shifts. If this is not possible, and your health is a priority, you may need to consider a career change.
TRAVEL WITH CHANGING TIME ZONES
■Low dose melatonin (e.g., 250 mcg–1 mg) may help decrease jet lag
■Shifting mealtimes a few days before can ease the transition
SLEEP
■Most people should aim for at least eight hours a night
SLEEP HYGIENE
■Use your bedroom only for sleep and sex
■Avoid working and using electronic media in bedroom
■Don’t bring your phone into the bedroom
■Be careful with addictive books before bed
■Keep room temperature cool and comfortable
■Avoid emotionally upsetting conversations or activities
■Reduce noise levels
SLEEP NUTRITION
■People with digestive issues often do better with light dinners
■People with hypoglycemia do best with late snacks
■Low-fat and low-carb diets can cause insomnia; experiment with macronutrients when insomnia is a problem
■Avoid stimulants after noon or earlier, depending on individual sensitivity
PHYSICAL ACTIVITY
■Beneficial effects for both mental and physical health
■Avoid overtraining
○Signs include insomnia, anxiety, muscle soreness, waking up tired, poor exercise tolerance or recovery, decline in performance, and brain fog
○General rule: you should feel better and more energized after exercise and the next day