When Rest Isn’t Enough: How Chronic Stress Quietly Drains Your Energy
Going from someone who used to work multiple 12 hour shifts running a pharmacy by herself to somebody who blinks too hard and gets tired is wild. Many other women, I’m sure, feel this way as well. And it’s not about age.
Do you feel deeply fatigued even after rest? Struggling with stubborn belly fat, increased irritability, brain fog and a racing mind at night even when your body is depleted?
You might think it’s stress. Maybe anxiety. Or just getting older. And It can definitely be the culmination of these things, but it typically points to something deeper. There is a very real physiological reason why your body feels like it's working against you.
It's called HPA-axis dysfunction. And once you understand it, much of what you've been feeling will make sense.
WHAT IS THE HPA AXIS?
Think of your HPA-axis as your body's internal alarm system. An intimate three-way conversation happening between your brain and body at any given time.
The three players are:
The Hypothalamus- the command center in your brain that senses danger
The Pituitary Gland- the messenger that receives and carries the alarm signal forward
The Adrenal Glands- the responders sitting on top of your kidneys that release your stress hormones
When you encounter something stressful like a difficult conversation, an approaching deadline or threatening situation, your hypothalamus releases a hormone that alerts the pituitary gland, which then signals your adrenal glands to release cortisol, our primary stress hormone.
In a healthy system, once enough cortisol is circulating, it signals the hypothalamus to stand and stop the stress response. Then the body returns to baseline. This is called a negative feedback loop, and when it works, it's beautiful.
The problem is chronic stress and unresolved trauma can break that switch.
WHEN THE ALARM WON'T GO OFF
Imagine a fire alarm in your house that goes off every day. Sometimes for actual fires. Sometimes for burnt toast. Sometimes for absolutely no reason.
Eventually, you'd either be completely overwhelmed or you'd tune it out and stop hearing it altogether. That's essentially what happens to your nervous system under chronic stress.
Some studies show that prolonged stress reduces the sensitivity of the receptors that are supposed to receive cortisol's "stand down" cue. The feedback loop weakens over time and the body loses its ability to self-correct. And each stressful experience makes the system less resilient to the next one, which is part of why stress can feel like it intensifies with time.
For women who've experienced childhood stress, instability, or trauma, this pattern tends to run even deeper. Early stress can cause changes at the genetic level, altering how your stress-response genes express themselves in ways that carry into adulthood. Your nervous system learned how to survive in an environment that felt unsafe. So it did exactly what it was designed to do. The work now is gently teaching the body that it is safe to rest.
THE PHYSICAL TOLL
Too many women are living with symptoms they've been told are "just anxiety" or "just hormones" or "just part of getting older," when there's actually a deeper physiological story behind what’s happening.
When the HPA axis stays dysregulated over time, the body becomes caught in a state of chronic, low-grade inflammation. This systemic dysregulation affects multiple body systems at the same time. The brain, the musculoskeletal system, the gastrointestinal tract, the cardiovascular system, even the skin.
Here's what that can look like day to day:
Inflammation & Immune Issues
Frequent illness, autoimmune flares, mysterious pain, slow healing. HPA dysfunction has also been linked to conditions including lupus, rheumatoid arthritis, and multiple sclerosis. Your immune system isn't overreacting for no reason. It is simply responding to a system under sustained pressure.
Sleep Disturbances
Cortisol should be highest in the morning and lowest at night. In HPA dysfunction, this rhythm gets switched and cortisol rises in the evening, making it hard to fall asleep, stay asleep, or ever feel truly rested. Then poor sleep drives more cortisol dysregulation the next day. The cycle feeds itself.
Weight, Metabolism & Blood Sugar
Stubborn belly weight, sugar cravings, blood sugar, wings, and metabolism that is sluggish are all tied to cortisol. Cortisol is deeply involved in how your body stores fat and manages blood sugar so when it's dysregulated, your metabolism feels like it's working against you no matter what you eat.
Heart & Cardiovascular Strain
Elevated cortisol over time puts sustained pressure on your heart and blood vessels, contributing to high blood pressure and increased cardiovascular risk that often can go unnoticed or get dismissed in women.
Chronic Tension & Pain
Chronic tension, fibromyalgia-like symptoms, joint inflammation are all common physical manifestations of long-term HPA-axis dysfunction.
MENTAL AND EMOTIONAL TOLL
The mental and emotional symptoms of HPA dysfunction are the ones most likely to be dismissed or mislabeled as something being wrong with you rather than something happening to you.
Prolonged cortisol dysregulation causes real, measurable changes in the brain including shrinkage of the hippocampus which is the region responsible for memory, learning, and emotional regulation.
What this looks like in real life:
Brain fog and memory lapses- losing your train of thought, forgetting names, struggling to focus
Emotional reactivity- small things feel huge because your threat-detection system is stuck on high alert
Anxiety and depression- chronic stress leads to suppressed hormone synthesis, sustained neuroinflammation, and disrupted neurotransmitter balance contributing to lasting behavioral and physiological changes
Anhedonia- difficulty feeling joy or pleasure, even when your life looks good on paper
Wired but exhausted- that particular hell of feeling depleted and unable to rest at the same time
If any of this sounds familiar, you are not falling apart. I spiraled for quite some time thinking my body was broken. But our biology is just doing exactly what chronic stress teaches it to do.
THE GOOD PART
A 2025 review in The American Journal of Medicine confirms what integrative health practitioners have understood for years. The symptoms of HPA axis dysfunction such as fatigue, insomnia, mood disturbances, and poor stress tolerance can be meaningfully addressed. Not masked. Actually addressed, through targeted changes to lifestyle, nutrition, and nervous system regulation.
And from this certified integrative nutrition health coach, your body is not broken. It adapted.
And when you stop blaming yourself and start supporting yourself with nervous system regulation practices, nourishment, rest and safe connection, that feedback loop can be gently restored and strengthened again.
READY TO GO DEEPER?
If this resonated with you, I want you to know there's a roadmap.
My book, Healing Beyond the Physical walks you through evidence-informed steps you can take to start restoring your nervous system, your hormones, and your energy.
Because you deserve more than surviving. You deserve to live.
References
Chourpiliadis C, Aeddula NR. Physiology, Glucocorticoids (https://www.ncbi.nlm.nih.gov/books/NBK560897/). 2023 Jul 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. Accessed 4/12/2024.
Dunlavey CJ. Introduction to the Hypothalamic-Pituitary-Adrenal Axis: Healthy and Dysregulated Stress Responses, Developmental Stress and Neurodegeneration (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6057754/). J Undergrad Neurosci Educ. 2018 Jun;16(2):R59-R60. Accessed 4/12/2024.
Leistner C, Menke A. Hypothalamic-pituitary-adrenal axis and stress (https://pubmed.ncbi.nlm.nih.gov/33008543/). Handb Clin Neurol. 2020;175:55-64. Accessed 4/12/2024.