Speaker 1: Welcome back. Today. We're heading into the endocrine system and
this one's going to be an interesting chapter. We'll read
endocrine systems till we get to pharmaceuticals. So let's see
what's going on here. The endocrine system contains the HPA
access which links the brain and the body's stress response
from threat perception to cortisol release. And remember, threat perception
doesn't have to be physical. It could also be psychological,
like having to speak in public and threaten and make
us vulnerable. So what about cortisols. Look at some of
the chemicals. Cortisol affects memory, immune function, and mood. Chronic
elevation impairs the hippocampus. Thyroid hormones regulate energy, metabolism and
mood hype. Both thyroidism mimics depression. We'll get more into
that a little bit later on. So sex hormones, they
influence emotional regulation, sexual behavior, and mood disorders. Oxytocin, which
supports bonding, social trusts, and attachment. Low levels may relate
to social drawl. Allostatic load refers to the commulative wear.
It's the total wear and tear of chronic stress on
the body and the brain. Remember the brain is different
than the mind reminds the abstract component the brain is
all the actual structures, the hippocampus, tomig less, so forth.
Chronic stress alters immune function, increasing risk for depression, anxiety,
and physical illness to body starts wearing down the endocrine system.
What it does is it kind of speaks quietly. Its
messages move slower than neurons and as fast as neurotransmission,
but they also last longer. That's a difference. Instead of milliseconds,
it's impact unfolds over minutes, hours, or even years. The
difference between this and the nervous system is the nervous
system delivers point to point signals. The endocrine system floods
the blood stream with hormones. That's it's what method of
travel is the blood stream and not neurons, So chemical
messengers that travel through the body shaping behavior, mood, and cognition.
That is what you can think of hormones as this
is where psychology meets physiology. Understanding this system allows you
to see how a thought, fear, single memory can go
all over your body and affect every organ. You'll see
an example now with the HPA axis and the stress response.
The xphpa axis, as you remember, is the hypothalmus, peturitary
gland and adrenal glands. The hypothalmus de text the threat,
whether real or imagined, and releases CRH cortico trope and
releasing hormone. Then cr signals to pituitary gland to release
adrenal corticotropic hormone or ACT and then finally ACTCH travels
to the adrenal cortex, which releases cortisol into the blood stream.
This cascade takes just a few seconds. However are the effects,
But as I mentioned before, it can last for hours
and this can lead to alertness, energy, or attention. You
see what critical does. It mobilizes glucose and it suppresses
non essential functions like digestion and reproduction. This is the
sympathetics nervous system being activated. Remember, the sympathetic nervous system
is your fight or flight system. The parasympathetic nervous system
is to calm you down, so it's a survival tool.
When stress is acute, just what happened recently, the system
is adaptive. When stress is chronic continues to happen, it
becomes toxic. Cortisol doesn't just help you respond though it
actually can't even rewire you. So high levels of quarters
all over time can shrink the hippocampus, impairing learning and memory.
So again, it can shrink the hippocampus, impairing memory and learning.
I know some of you're saying, well, once the stress
is over, do you recover the hippocampus growth. It varies
depending on the frequency of the stress, the intensity of
the stress, the person's personal background support system. If they
have all these things and less severe intensity, less severe
frequency of one time occurrence, and have a strong support system,
there are studies that show the hippocampus can recover fully.
If not, it can partially recover. All that depends again
on the type of stress and you and the love
of other factors. This matter clinically because patients with PTSD,
chronic depression, or burnout are often shown hippocampal volume reduction.
But again this is a cross sectional study that was
done to look at one point in time they can repair.
Most of the time, it does if you overcome the stress,
whether it goes away the PTSD or you've overcome the
chronic depression or the burnout. The biologies mark by trauma
as clearly as their thoughts. The concept of allostatic load
captures us wear and tear, and it's the cost of
repeated activation of the stress response. Elevated blood pressure, insulin resistance,
immune suppression, and emotional dysregulation are not just signs of stress.
They are the physical evidence of prolonged strain. Cortisol and
psychological function. Cortisol is the main body's main stress hormone.
It does more than gets you out of danger. It
influences memory. With acute cortisol boosts Acute cortisol boosts memory consolidation,
especially emotional memories. Chronic exposure impairs hippocampal dependent memory, especially
episodic and declarative. So I repeat that chronic exposure to
stress or cortisol impairs hippocampal dependent memory, such as episodic
and declarative memories. A lot of our emotional memories are
linked into the amignalo the emotions. Elevated cortisol is associated
with anxiety, irritability, and depression. Just regulated cortisol rhythms blunted
in the morning elevated at night are common in mood
disorders sleep. For instance, high night time cortisol interferes with
deep sleep compounding stress and reducing cognitive function, so deep sleep,
if I remember correctly, it could also affect your rem sleep.
Immune function control suppresses inflammation and immunity short term, however,
but when it's chronic, you can't suppress your immunity system
for that long and as well increases inflammation and leads
the higher risk of illness and delayed healing. Clients with
major depressive and sort of often show hyperactivity of the HPA,
including with anxiety that can present just hypervigilance, fatigue, insomnia,
and concentration problems similar to the same symptoms you have
with anxiety or PTSD. Now to go to thyroid hormones
and mood. Thyroid gland locating the neck produces hormones that
regular metabolism. The ones you should know are T three
and T four. T three is trio dithyronine and T
four is thyroxine. T three and T four also the
influence energy levels, cognitive function, mood regulation. These are really
good to know because when you're working with clients a hypothyroid,
you'll see it quite I've seen it probably about five
or ten percent of the time. It has solved my
client's issues because they have low thyroid to why because
low thyroid hormone presents with low energy, slow thinking, weight gain,
and a depressed mood. And it really does mimic depression.
So most of the time of psychiatric evaluations that you
have a thyroid panel. So if you miss this, you
may misdiagnose the mistreat. I always ask my clients in
the furry first visit, the initial visit, when's the last
time you see a medical doctor. Did you get a
thyroid panel, especially if I notice symptoms of depression. Right,
So this is the case formulation when you start developing
your case about your client and you're trying to get
all the information you can h burn. Thyroidism, in contrast,
can cause restlessness, anxiety, insomnia, and irritability. They can look
like generalize anxiety or panic disorder. Thyroid imbalance may not
cause a psychological condition, but it can amplify symptoms or
complicate treatment. Let me go back for a second. When
we talked about hippocampus and it say that it can
impair hypocampus or reduce the side of it. Always make
sure you follow up on that. Can it come back?
Can it reheal up? This is going to be important.
Same thing here, somebody says low thyroid, think of it
the opposite too. What does high thyroid do? Because you
need to have a balance. This is what you'll know.
You'll learn in biology, the major religions, but everything about
life really should be in a balance. You've heard the
phrase too much of a good thing. Now, speaking of
that would go to sex hormones Estrogen, progesterone, and testosterone,
so they govern reproduction, but they also shape the brain.
Estrogen has a neuroprotective effect. It modulates serotonin, enhances mood stability,
and improves verbal memory. Estigen levels fluctuate during the menstrual cycle, pregnancy,
and menopause, explaining mood shifts and increased vulnerability to depression
in women, especially doing postpartum and perimenopause. Progesterone promotes calm
and sedation. Low levels are associated with anxiety and irritability.
Testosterone influences dominant sexual behavior and aggression. Low testosterone tystosterone
may contribute to depression, fatigue, and low motivation in men.
So this is the same thing. You look for thyroid
in your thyroid panel and for men. If you started
noticing unexpected depression and there's no trigger nothing associated with it.
I would definitely send them in for blood work. Sex
hormones interact with neuro transmitter systems like dopamine and GABBA,
meaning hormonal shifts can directly affect what well. Dopamine and
GABBA are associated with motivation, reward sensitivity, and regulation. If
you remember back then GABA is the primary brake system.
It's this function is tied to anxiety. Dopamine influences reward movement,
and psychosis, so it can interfere in different ways with
these things. Oxytocin we talked about before, We'll bring it back.
It's the bonding hormone. Is often called the love hormone,
but that's only half the story. It's released during childbirth,
rest feeding, especially touch, even if you're to adults, sex,
and social connection. It enhances trust, empathy, and pair bonding
and therapy. Oxytocin may play a role in therapeutic alliance,
the client's ability to feel safe and connected with the clinician.
It's also linked to reduced anxiety and social stress buffering.
Disruptions in oxytocin systems are being studied in autism, spectrum disorder,
and social anxiety. When bonding where bonding and social cognition
are impaired. Low oxytocin may contribute to emotional detachment, blunted
affect and difficulty with intimacy. And this is what they want.
They're studying it in regards to autism, spectrum disorder, and
social anxiety. Last, but not least, is chronic stress, immune function,
and psychoaneuramineology. Psychoneuroimmunology is the study of how psychic psychology
influences immune health. So cortisol suppresses T cell activity, making
the body less responsive to infection. T cells are part
of one of your immune cells. It reduces the production
of cytokinds, delaying muscle I mean delaying tissue repair. Chronic
stress can also cause what they call low grade inflammation,
contributing to cardiovascular disease, autoimmune disorders, and chronic fatigue. It's
basically like running your car in high RPMs for a long,
extended period of time. You're going to worry down that engine.
A lot of times. You'll see elevated levels of pro
inflammatory cytokinds. With people who have depression, it's sort of
a measurable thing. Their bodies are fighting battles that they
can't name. When the immune system is over activated by stress.
Overactivated by stress, it feeds back into the brain, disrupting neurotransmission,
sleep and emotion regulation. So what this means clinically is
that persistent fatigue, pain and illness, and anxious or depressed
patients may not be somatic symptoms alone. They may be
biological signs of chronic emotional strain. So when you sit
with the client who's anxious, are exhausted, or emotionally flat,
you're not just seeing a mood state. You're witnessing a
system and overload. And this is where, of course, the
case formulation is gonna come in handy, Right, You're going
to have to look at everything that's going on. You
don't want to just think that this just this does
caused by stress. There's a lot of other disorders that
could be associated with those behaviors. That's it for now,