Hormonal shift number one is dysregulated cortisol production. Let’s start with the hormone everyone talks about: cortisol. But what most people do not understand is that it’s not just about having high cortisol. Narcissistic abuse creates a dysregulated cortisol pattern that is far more complex and damaging than simple elevation. Under normal circumstances, cortisol follows a predictable daily rhythm. It should be highest in the morning to help you wake up, gradually declining throughout the day and reaching its lowest point at night to promote sleep. This natural rhythm is controlled by your hypothalamic-pituitary-adrenal (HPA) axis.
Narcissistic abuse completely shatters this pattern. The constant hypervigilance, unpredictable narcissistic rage, and chronic stress of walking on eggshells create cortisol dysregulation. Sometimes your cortisol spikes at inappropriate times, like 3:00 a.m. when you should be sleeping. Other times, it flatlines when you desperately need energy. This dysregulation shows up in three patterns:
- Hypercortisol Phase: With chronically elevated levels, you experience anxiety, insomnia, weight gain around the midsection, and a feeling of being wired but tired.
- Hypocortisol Phase: Your cortisol production crashes. You feel exhausted, struggle to get out of bed, and cannot handle any stress.
- Erratic Swings: Your cortisol bounces wildly between high and low throughout the day.
Doctors often miss this because standard cortisol tests only measure a single point in time, usually morning levels. They are not looking at the entire daily pattern or understanding the context of narcissistic abuse.
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