I think stress needs a rebrand. After all, it is what gets us out of bed in the morning and keeps us alive. Without cortisol, we would not be here. What matters most is not simply the presence of stress, but how we think about it. Large studies have shown that our perception of stress can influence its impact on health and longevity. The more convinced we are that stress is harming us, the more harmful it appears to become.
It’s strange to think of emotions and thoughts as biochemical cascades, but that is exactly what they are. The stories we tell ourselves shape how our neuroendocrine biology unfolds over time. Without being reductive, we can say that our thoughts help sculpt our physiology.
What fascinates me most about being human is our capacity for nuance. Pain and pleasure, anxiety and excitement, often share the same biological architecture. In consensual BDSM, painful sensations can be experienced as pleasurable when there is trust, control, and safety. Remove those elements and the same sensations are processed as threat and distress. Context changes biology.
This principle extends beyond sexuality. Many of our most cherished and most aversive experiences arise from overlapping physiological systems. The difference often lies less in the chemistry itself and more in our appraisal, meaning-making, and sense of control.
Part of the challenge is that stress is inherently subjective. What overwhelms one person may barely register for another. There is no universally agreed definition of what constitutes a stressor because each of us interprets the world through a unique biological and psychological lens.
What does seem universal is the need for rhythm. Every system in the body requires accelerators and brakes, periods of activation and recovery. Yet modern culture often celebrates exhaustion as a marker of success. Being stretched, oversubscribed, and burnt out has become a badge of honour. Rest, meanwhile, is treated as something that must be earned.
What nonsense. Rest is built into every natural rhythm. All living creatures are governed by cycles of activity and recovery. We are designed to rise and rest in equal measure.
Zebras demonstrate this beautifully. When a predator appears, they mobilise instantly into fight-or-flight. Once the danger passes, they return to grazing. Their stress response is powerful, but it is also flexible. In wild mammals, a robust stress response is often a sign of fitness, not fragility. What becomes toxic is not the activation itself, but the inability to switch it off.
The difficulty for humans is that our physiology cannot distinguish between a lion emerging from long grass and an email from a toxic boss. The same systems activate. The same hormones surge. Often, however, there is nowhere for that mobilised energy to go.
This is where modern life becomes complicated. We often define comfort in physical terms, but the nervous system also responds to predictability, control, social connection, and status. A warm home and a full fridge do not necessarily translate into physiological safety if life feels uncertain, isolating, or relentlessly evaluative.
Cortisol illustrates this tension. It has become the villain of modern wellness culture, yet it is simply one component of an extraordinarily adaptive system. While chronically elevated cortisol is associated with poorer health outcomes, there is no universally agreed threshold at which someone becomes “too stressed.” Cortisol behaves more like blood pressure than a toxin: a useful physiological signal that becomes problematic mainly when extremes are sustained.
This is why chasing cortisol measurements in blood, saliva, or hair is rarely as helpful as people hope. Outside of true endocrine disorders, subjective experience often tells us more. How are you sleeping? Do you feel rested? Do you have an appetite for food, joy, connection, movement, and intimacy? These questions may reveal more about your stress burden than any biomarker.
"Stress is not a single lab value. It is a story told through events, perceptions, and physiology. Our task is to recognise when adaptive strain has tipped into harmful overload and to create opportunities for recovery."
We can do that by intentionally activating our rest-and-digest pathways: sleeping well, spending time away from devices, moving our bodies, being in nature, and connecting meaningfully with others. Sometimes anxiety, burnout, or low mood may be asking us to pay attention to lives that no longer fit. If you find yourself feeling exhausted, anxious, or blunted, perhaps the next step is not to suppress those feelings, but to make enough quiet space to listen to what they are trying to tell you.
ABOUT THE AUTHOR
Dr Skye Scott is a family GP, and co-owner of Health with Heart - a holistic wellness solution that includes a warm-hearted practice in Sandton; bespoke corporate wellness programmes; unique retreats and medical travel experiences; an educational podcast and portal; and a community outreach initiative. For more information or to get in touch, follow @health_w_heart or @drskyescott on Instagram or @HealthwithHeartDoctors on Facebook, or visit www.healthwithheart.co.za.
