Is Your Nervous System Stuck in Fight or Flight?
- Dr. Mindy Pelz
- 2 days ago
- 20 min read
EP327 with Dr. Mindy Pelz
You're tired all day, but your brain won't shut off at night. Small stressors feel bigger than they used to. Your patience is thinner. Your sleep is lighter. And you can't quite explain why.. sounding familiar?
In this episode, I break down something I’m seeing everywhere right now: nervous system dysregulation and HPA axis dysfunction. We talk about why so many women are living with their stress response stuck in the “on” position and how modern life keeps the gas pedal pressed down.
Your body was designed to handle short bursts of stress, not chronic activation. And when cortisol stays elevated for too long, it shows up as fatigue, anxiety, belly fat, mood swings, and that wired-but-tired feeling.
You’ll learn how trauma, hormones, gut health, toxins, and chronic stress all layer together to dysregulate your system — and what you can actually do to reset it.
Your nervous system was never meant to run at full speed all day long.
-Dr. Mindy Pelz
So many women right now are feeling overwhelmed, reactive, and exhausted. Not because they’re failing — but because their stress response hasn’t had a chance to turn off.
In This Episode, You’ll Learn:
What HPA axis dysfunction actually is
The six most common causes of nervous system dysregulation
Why cortisol contributes to belly fat and burnout
Five signs your system may be stuck in fight or flight
How menopause amplifies stress sensitivity
Seven science-backed ways to regulate your nervous system naturally
This episode is a reminder that sometimes it’s not your life that’s chaotic. It’s your nervous system asking for support.
TRANSCRIPT
Dr. Mindy here, and I want to talk to those of you that are really affected by fatigue, depression, anxiety, insomnia, or challenges handling stress. This is not that uncommon, especially in this day and age. But what is important to know is that you actually have more control than you've been taught on how to overcome these symptoms. And it all falls under the category of nervous system dysregulation. I know that sounds like some kind of fancy term, but I want to break this down for you because really the technical term for this level of dysfunction that's contributing to these symptoms is called HPA axis dysfunction. There's a 2025 review in the American Journal of Medicine that really published this amazing review on an integrative approach to HPA axis dysfunction. How do you go from recognizing it to recovery? That's what we're going to unpack in this video so that you can start to feel better. Deal? Here we go.
First, I think we have to take a closer look not only at this study, but we have to really look at what nervous system dysregulation is. I think it's a really important conversation, especially in this day and age, because if you understand when you're dysregulated and you understand when you're regulated, you also understand how to boost your energy, boost your moods, and sleep better. That's how important this concept is. So, let's start off with what is nervous system dysregulation. It all comes to this part of your endocrine system called your HPA axis. H stands for the hypothalamus, P stands for pituitary, and A stands for adrenals. This HPA axis's job is to identify if there is a threat. So, let's go back to our primal days. I've been teaching you all about the primal days for years now, but the HPA axis back in the hunter-gatherer days was meant to kick in when we had a threat. If a tiger was coming after us, a lion was going to eat us, we had the signal from within to get up and move. That signal is actually called cortisol. A lot of you are working to bring your cortisol levels down.
So, what happens when this HPA axis gets triggered is you see a threat, and your brain registers it as a threat, and then it sends chemical messengers down to your adrenal glands and says, "Make cortisol. We've got to move". Now, remember that cortisol is the hormone that is meant to make you move, which is why it's so damaging. To my belly fat people out there, I've been teaching you over and over again how to see that belly fat can often be cortisol that is left unused. When cortisol comes on the scene, we're supposed to move; we're supposed to move away from the threat. But what happens with HPA axis dysfunction is that this system, this alarm bell within our body, is on all the time. It's very much like I used to teach my patients all the time: it would be like you're driving in your car and somebody has duct-taped your gas pedal to the floor. You are just going as fast as you can, and you keep trying to slam the brake, but the gas pedal is duct-taped to the floor, and you can't undo the gas pedal. That's what's happening with the HPA axis. Somewhere, and we're going to talk about six things that cause your nervous system to become dysregulated. Somewhere, this HPA axis thinks it is still in fight or flight. The stressor is still there. The damaging thing about nervous system dysregulation is that you can actually feel it. You can feel the inner rumblings of it just sitting on the couch if you are stuck in this dysregulated place.
So, let's talk about the six most common causes of nervous system dysregulation, and hopefully, you'll see yourself in this. The 2025 review said that these six things, when they are repeated over and over and over again, put you in HPA axis dysregulation. The first one is chronic stress. I just want to say that chronic stress is like one of those things that everybody is like, "Yeah, I've got chronic stress". But what happens with HPA dysregulation is that your nervous system forgets to turn off the fight-or-flight reaction. Let's use this day and age right now. It's a tough moment in human history. We've got a lot of intense news being thrown at us every single day. I think most people right now are stuck in some form of nervous system dysregulation. What's happening is that you get a wave of stress, and then you wake up the next morning, you get another wave of stress. So, all day long, your nervous system says, "We're going to stay in fight or flight because safety is not around". And all you're doing is going to your phone and picking up your phone and looking at the news and reagitating this nervous system. The first thing to understand is that you can be stuck like the gas pedal on the floor in a state of fight or flight, even though you're sitting comfy-cozy on your couch in your living room, because it's what your brain is taking in. If you are continually stressed for a really long time, whether it's work or relationships or some other problem—you know, right now it's world problems—that part of your HPA axis will start to weaken, and it never shuts off. All your body is doing is making cortisol 24/7. Chronic stress, chronic bad news, chronic obsession over the next thing you've got to, the next mountain you've got to climb, or the next work problem you've got to fix, that keeps you in a dysregulated place.
The second thing, and this one's really big, is childhood trauma. The crazy thing about childhood trauma is something could have happened to you at five and six years old, and it's still got that gas pedal of the nervous system slammed to the floor. Because once your body has a signal that there is a trauma to run away from, you actually have to train it how to move out of that state. In the back half of this video, I'll be talking about how you untrain it to start to see regulation and safety. This is an important part of this conversation. Now, with trauma, I just want to use myself as an example. I think we've all had lots of trauma in our life, but I really experienced this recently when I was in Pacific Palisades where the LA fires were. I rushed out—a lot of you have followed me through that journey; a lot of you have read Age Like a Girl, where I explained that journey in the intro—but I rushed out the morning of January 7th so quickly from this neighborhood I was living in, this neighborhood that I grew up in, and I never went back. For months, my brain was caught in some kind of feedback loop where it felt like it needed to keep running. It thought I was still running from fire for months. I literally had to go back to the Palisades two months after that event so that my brain could see that the fire was over and that the town had been completely decimated so that my brain could start to move on. The same thing happens with childhood trauma. I know we've all had a lot of different childhood traumas. A lot of it, especially the women listening, I just want to honor that a lot of you have had sexual abuse trauma. It's very common for women. Not everybody had the greatest adults growing up. We can still be stuck in fight or flight because your body thinks it's still running from that event that maybe hit you 20, 30 years ago. That's how strong the memory of the body is. We're going to keep talking about this as I walk through this.
Number three, a common cause of nervous system dysregulation is poor diet. This one is a really important one. Remember how we used to always say that certain people couldn't go and get Chinese food because it had monosodium glutamate in it, and some people would have an anaphylactic shock if they ate Chinese food. What we now know is certain synthetic versions of monosodium glutamate are actually a neurotoxin. These toxins actually rev up your nervous system and move you out of a regulated nervous system and into a dysregulated nervous system. Which is why it's really important that when we are under times of extreme stress, the time we want to eat the worst food is actually the time we should eat the best food. Because if I'm under work stress, if the world is falling apart, if my relationships are falling apart, and then I go to ultra-processed foods, there are so many chemicals in those foods that are neurotoxins, and it'll just rev up this HPA axis and put you deeper into a state of dysregulation. The 2025 review said that a diet high in sugar and fat—this is bad fat; this is canola oil, cottonseed oils—can exacerbate a stress response and contribute to HPA axis dysregulation. Chronic consumption of these diets has been shown to alter key stress hormones, leading to a sustained activation of the HPA axis. Now, the study did go on, and I will backfill in with some of my own expertise: there are some deficiencies that these foods cause that actually keep you stuck in fight or flight even more, and you can supplement in with these deficiencies. Three of the most important deficiencies that happen when food neurotoxins, let's just say, enter our nervous system, is it depletes you in omega-3s, magnesium, and B vitamins. So, making sure you backfill in with those supplements can be really helpful. I'll put in the notes my favorite; sometimes we have discount codes, and if that feels like something you want to access, you can go there.
Okay, number four, your gut microbiome. I've been saying this for a really long time, but this study showed that dysbiosis, an imbalanced gut bacteria, can activate the HPA axis, leading it to be in an altered stress response. It continues and says, "Conversely, chronic activation of the HPA axis can negatively impact your gut microbiome". Basically, what the review is saying is that if I don't have a good, healthy gut microbiome, I can have a poor stress response. And when I have a poor stress response, I get too much cortisol into the system, and then too much cortisol gives me a worse gut microbiome. So, it's a feedback loop. This is why, and again, we're going to go through the solutions here, but this is one of the reasons that I'm such a fan of you all eating more plants, more fiber, more fermented products. I wrote about those things in both Fast Like a Girl and in Eat Like a Girl; I have lists and recipes there if you want to dive into those. Put it in the comments: do we ever think, "God, I'm just exaggerating. I have these exaggerated stress responses, or I'm walking around with depression and anxiety. It must be my microbiome"? I just think this is one we don't talk enough about. If you want to learn more about it, put it in the comments, and I'll make sure to do more videos on it because it's really critical.
Okay, the fifth reason you can get stuck in this dysregulated place is hormones. I talked about this in Age Like a Girl. When estrogen and progesterone go down, you start to see a massive swing in neurotransmitters. In Age Like a Girl, I call it "estrogen's girl gang". We have to understand that those hormones and neurotransmitters were like a buffer for stress responses. But if you put this all together—if you're a 48-year-old woman right now that's looking at the news, trying to navigate the news, you've already had some kind of childhood trauma, you've had chronic stress, your microbiome's off from years of birth control use and antibiotic use and stress, and now your hormones are going down because you're going into menopause—this moment may feel like you can't even take it. If you're one of those women, put it in the comments, because we are here to help you and to support you in supporting yourself through this process. That's what menopause does: it pulls those hormones down, and then you feel a little raw, and then stress hits you more acutely.
Okay, number six, and this is one I did in my clinic all the time, is we detoxed people because toxins can also keep you locked in a state of dysregulation. Some of the worst toxins for nervous system dysregulation are alcohol, smoking, and recreational drugs. Those are biggies. But we detoxed so many heavy metals in my practice. I will tell you that heavy metals like mercury are an agitator. So, mercury fillings, mercury in fish (if you're eating a lot of fish), and mercury used to be in flu shots. If you're getting a flu shot, make sure it's thyosol free, which is the fancy name for mercury. When mercury's in the system, our nervous system is just a little more agitated. If you add that to the list of things, now you can see why handling stress is a little difficult and why it might not be your fault. It might be that these six things are out of balance; let's help to put them back in balance.
Now, a lot of you might be listening to this and thinking, "Okay, well, how do I know?". I've gone through this myself a lot of times; I've been like, "Is my stress response overly exaggerated right now, or is this situation actually that bad?". Here are five signs you would know you have a dysregulated nervous system. The first is impaired stress resilience. This is when even the littlest thing hits you, and you have a major flare-up. I really believe that this is a lot of the perimenopausal journey that we are going through, this massive neurochemical shift. The little things are going to make us really have a strong reaction, and that is okay. Again, I want to help you figure out how to balance that, but I want you to be aware of it first.
Okay, the second thing is mood disturbances: depression, anxiety, sudden irritability. How many times have you had an irritable moment and you think it's your husband's fault, or you think it's your work's fault, or you're blaming it on the news, but actually, there's an HPA axis, a nervous system that got stuck, and it's like a record that just keeps repeating itself? Sometimes we need to look at those behaviors, those mood disturbances, not as things in my life aren't going well or the world is falling apart. We need to look at them more as, "How did my nervous system get stuck, and how can I get it regulated again?". I just did a beautiful podcast with my dear friend Dr. Sarah Sazal, who is a Harvard-educated OB, and we talked about this moment in wellness. Many of you know the Epstein Files came out, and Peter Attia was on the Epstein Files, and it shook the wellness world. One of the things that we talked about in that podcast—I'll leave a link here—is how to spot a dysregulated person. One of the things Sarah said is she could tell he was dysregulated because he was easy to agitate. He would get irritable on interviews, and he would try to control, and he would try to talk over people. He would try to give you absolutes, like "you have to do this or don't do that". That is a dysregulated mind. It was a really interesting conversation if you want to dive into that. Mood disturbances aren't always a problem of the moment; they could be an internal system that's locked in this dysregulated place.
Okay, the third thing you would know if you are stuck in a dysregulated nervous system is that you would have chronic fatigue. Your brain uses a lot of energy, and it's exhausting to be on high alert all the time. The result is you can be exhausted from just trying to manage everything that's coming at you. The fourth thing is your immune system. You start catching colds a lot because chronic stress can really suppress your immune system. And then poor sleep, especially if you're waking up at 2:00 to 3:00 in the morning. Those are five pretty telltale signs that you're locked in this dysregulated place.
Okay, what do we do about it? Here we go. I'm going to give you seven ways you can balance your nervous system and get yourself back into a regulated place. I just want to put this out right now: I think this is the best thing we can all do in this incredibly horrific moment in history. I think we need to commit ourselves to these seven things so we can regulate ourselves because what the world needs right now is regulated humans. It's massively important.
So, first is sleep. Now, it's kind of a juxtaposition because I just said if you're dysregulated, you can't sleep, and then I said to regulate yourself, you've got to sleep. So, what does this look like? I think the first thing is prioritizing it. This is one that I'm recently coming off of because of the trauma that I went through over the last year. The last thing to get back on track has been my sleep. So, prioritizing sleep to me means going to bed at the same time and waking up at the same time. I've really shut down my social scene and my traveling. So that's what prioritized sleep looks like to me: I'm going to bed at the same time, and I'm waking up at the same time. Those of you that are menopausal, just know there's a whole chapter in Age Like a Girl on sleep that's really, really good. So, you have resources there if you're having trouble sleeping. A couple of things I want to say, because if you are stuck in a dysregulated nervous system and the cortisol is just pouring into your system all the time, sleep can be really hard. You want to make sure that the hours leading up to sleep, you're not watching any agitating news or shows so that that nervous system doesn't get reminded that it can't relax. What you do going into sleep really matters. Try to create some sleep habits and a sleep environment that tells your body—think of it from your body's angle—tells your body that you can start to relax.
Okay, the second thing you can do, and this has been really helpful for me, is you can do adaptogens. I did a whole video here on ashwagandha, and you all loved it. There's some incredible science behind how ashwagandha can bring cortisol down. I'm finding it very helpful for sleep as well. The science says that you want to do 125 to 500 milligrams twice daily of ashwagandha, and Rhodiola rosea is the other adaptogen that science is saying can really bring down cortisol levels, and you want to do 200 to 600 milligrams a day. Again, we will put some of our favorite tried-and-true products in the notes so you can go find it there.
The third thing that could be helpful to pull you out of this dysregulated nervous system is magnesium and omega-3s. Again, poor diet and chronic stress start to deplete you of these nutrients. When you're depleted of these nutrients, you start to be stuck in a fight or flight. This is not good. So, it's a self-fulfilling prophecy. The research says that a good starting amount of magnesium is 400 milligrams a day. The type of magnesium that will support a healthy nervous system is magnesium glycinate. So, 400 milligrams a day. I like to take my magnesium at night. This review that I keep coming back to also recommends omega-3s for being able to get your nervous system regulated again. The reason they say this is that the integrity of the membrane that surrounds your brain cells needs omega-3s. If we've been eating a diet high in omega-6s, which is the ultra-processed diet, then we need even more omega-3s. These are like your fish oils, or I've done some videos on sardines—that was really popular. So, even some of your healthy sardines and fatty fish. I try, for example, when I go out to eat, I always look for wild-caught cod on the menu because it has a ton of omega-3s. Or I'll look for wild-caught salmon so that I can try to get it in through my diet. The study said that people taking omega-3s daily for eight to 10 weeks helped regulate the stress response better than people who didn't take that level. So, consistency matters, and it can be a really helpful way, and you can get it through fish or you can get it in a supplement.
Okay, the fourth thing is exercise. I think this one's really another self-fulfilling prophecy because we're like, "I'm exhausted. I'm depressed. I have no motivation, and now you're telling me to exercise". Well, it doesn't have to be; you don't have to hire a fitness trainer and start a whole new exercise program. What the research shows is that you aim for 150 minutes of exercise a week, and that's about 20 minutes a day. It seems to be a sweet spot for the nervous system. What's interesting for those of us who have been dedicated to fitness our whole life is some of us are actually putting ourselves into a dysregulated nervous system because we're working out too much and too hard. If you're going to use exercise to calm your nervous system, 150 minutes a week, 20 minutes a day, that could be a walk. A walk in nature. Now you're stacking habits. You're bringing cortisol down even lower. Some of you who have been fasting a lot, you've been doing everything right. I know I was that person; I'm often that person, and like, "Tell me, I want to do everything right". We have to remember that the need to be perfect or the need to not mess up also locks the nervous system into this dysregulated state. So, let's be playful about it. One hundred and fifty? Maybe you do 20 one day, maybe you do 15 the next, maybe you do 40 the next. Let's just get into a pattern of, "I'm going to go out to walk. I'm going out". You all know I love surfing. "I'm going to go out and surf. I'm going to go to the gym. Whatever it is to regulate my nervous system. I'm going to go do yoga to regulate my nervous system". That is a very different approach to exercise than just saying, "I'm going to go to the gym to lose weight," or "I'm going to go to the gym to stay in shape". So, remember the intention behind your movement activities really matters. Some of you need to do less, and you need to focus on regulation and how to regulate the nervous system through a less aggressive workout.
Okay, the fifth thing we can do. We talked about how diet put you in a dysregulated place. Well, you can use diet to regulate yourself. This study notes that there is this vicious cycle, like everything else, where poor diet leads to more agitation of the nervous system. But over time, poor diet can also start to change your microbiome. It can balance your nervous system quite a bit. Here are the big things you want to do with diet. You want to avoid the ultra-processed foods, especially right now in this moment. Avoid sugar, refined carbs, and the bad oils like canola oil and vegetable oil. I mapped them all out in Eat Like a Girl. Think of food as having energy. You want to add in some of the live food, which is really plants. Try to get as many different greens as possible. Try to reach for an apple instead of a potato chip when you're under chronic stress so that you're putting an energy into your system. An energy that's going to heal and help and balance you. Nature heals, and it heals when we look at it; it heals when we listen to it; and it heals when we eat it. We are so blessed to have nature around us all the time. It's there for us not to conquer or even just sit and enjoy; it's there to help us regulate our nervous system. That is the purpose of nature. So, make sure that you're looking at it from not only a lens of going out into nature to calm the nervous system, but eating nature, so you calm the nervous system.
Okay, the sixth thing is meditation. Of course, we know this, as somebody who struggles to meditate, but I'm committed to it every morning. Fifteen to 20 minutes. I meditate every morning. Sometimes it is excruciating; sometimes it is easy. But what this study said is that meditation has a really positive effect on reducing cortisol levels. Just like I showed you it can be a series of things that lock you into a state of fight or flight, you might have to use a series of things to unlock you. You might need to start eating better; you might need to start moving a little bit differently; you might need to start prioritizing sleep; you might need to take some time in the morning to meditate. I do think I can tell you for myself, as somebody who's committed to regulation, that I often, when I feel like I can't handle stress, I go back to these basics I'm giving you right now. Sometimes it's like, I just need to go back to slow, be more intentional with my eating, my moving, and how much I engage in thoughts that get me all wound up. Meditation isn't always about the moment; it's also about learning how to calm your mind so that when you get to a stressful moment, you have access to that tool set.
The last one is social support. I think this is a really important one right now as we all navigate this really difficult moment in history. We need to lean into each other. Community is incredibly important. There is so much evidence that the happiest people are the ones that have the most positive relationships. This doesn't mean you have to have a romantic relationship; it can be a friend relationship. Studies are showing that really healthy social support offers what they call "social buffering," which can really help mitigate how stress comes into your body. I can tell you for myself, this week, as I'm doing this video, I did this podcast with Sarah Sazal on the Peter Attia situation, which made me have to go into the Epstein files and read some of the things I never thought I would read. Out of that has come a lot of conversations with friends, especially friends who have been sexually abused. It feels good just to talk about it. I learned this from Julie Gottman, one of the premier world marriage experts, that shame only persists in silence. So, if you're being triggered by the news of the day, find that good friend you can talk it out with. A lot of the girlfriends I've been talking to this week are like, "I don't know what to do with how I'm feeling right now". I even had a friend call me and said she was sexually abused as a young child repetitively, and she said, "I couldn't even take in all of the information that was being thrown out about the Epstein files, and so I ended up going to a bottle of wine". She said, "I'm really mad at myself for doing that". I just said to her, "Let's stay close, let's stay connected as we all try to navigate the stress of the world right now". When we look at dysregulation of a nervous system to regulation of a nervous system, it's really important that we understand the nervous system was never meant for the gas pedal to be down all the time. This is where the disease, the mental health challenges, and the relationships fall apart: when we haven't learned how to regulate ourselves. My hope is in this particular episode, you are learning what the difference between dysregulated and regulated is, and you're getting some a glimmer of how you can regulate yourself. Now, if you want a further discussion on this, come find me on Substack. I'm over there really diving deep into this. Leave questions, comments, and stories here, and understand that I strongly feel like we are a community. We can do this together, but it's really important to understand yourself so that you can understand other people. As always, I hope that helps.
Resources Mentioned
Science Direct: An Integrative Approach to HPA Axis Dysfunction: From Recognition to Recovery
More on Dr. Mindy
Books
Reset Academy
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