Image by Kayla Johnson / Stocksy

Have you ever paused long enough to ask yourself what you really want? I mean blocking off time just for you, getting really quiet, and allowing yourself the time to ponder on what it is your heart truly desires.

Because often, what we think we want and what we actually want are not actually the same thing.

Why we’re so disconnected from our desires

We all have unique and personal dreams hidden away in our hearts. But more often than not, those desires get buried beneath a lifetime of external pressures, from parents or society. Obligations masquerade as goals that we think we “should” aim for, instead of what we truly want. 

For many of us, our goals are not our goals; they were handed down to us from others. Our dreams aren’t necessarily our dreams; they were passed down from the generation above, and their dreams for us became our dreams.

All the key milestones have been set out for us. Go to college, find love, begin your career, get married, buy a house, have 2.5 kids, climb the corporate ladder. We set out to check the boxes one by one until at some point (sometimes earlier on the journey, sometimes later) something doesn’t feel right. 

At some point we think, Wait, what if there’s more?

That thought is the first sign that it’s time to reconnect to our own inner voice. Taking time to listen attentively within ourselves can provide us with invaluable insight into our genuine aspirations.

3 thought patterns getting in the way of knowing what you want

Unlocking our inner wisdom can be intimidating at first. We’ve been used to making decisions based on society’s expectations. It takes courage and dedication to rekindle our trust in ourselves—but it’s worth every bit of effort for a deeper connection with your true self.

In my work with women seeking to better understand themselves, we spend a lot of time peeling back the layers of the onion. One of the ways I recommend doing this is by ensuring we’re not spinning our wheels answering any of the questions below, which often get in the way of truly getting to the heart of what we want.

Wrong question No. 1: What is available to me?

A friend of mine was extremely unhappy with her job and had been for a while. She began searching for new jobs by looking at LinkedIn postings and other listings in her industry. As she began half-heartedly sending in applications, I asked her, what do you want from your next job? Turns out, she hadn’t actually taken the time to articulate it! All she knew was that she wanted out of where she was.

We limit ourselves when we don’t allow what we want to drive the end result and instead just choose what is right in front of us. As I say to my clients all the time, order off the menu! There is so much more available to us once we define what it is that we want.

Wrong question No. 2: What should I want?

Many of us have been raised on a cacophony of “shoulds.”

I was raised on the east coast of Canada by first generation immigrants from India. In my community, the “shoulds” sounded like, “You should be a doctor, a lawyer, or engineer.” If you rebelliously wanted to do anything outside of that, it was assumed you just weren’t smart enough to pursue the three “best options.”

“Shoulds” can follow us all the way through our careers. I recently coached the president of a retail company who had just stepped down from her role. Her big “should” included joining company boards. She dragged her feet to interviews for board positions and ultimately wasn’t selected anyway. Her “should” led to a lot of wasted time and energy.

Make sure that as you explore what you truly desire, it doesn’t include a list of “shoulds.”

Wrong question No. 3: What do I think I can have?

This is a big one. When you try to answer the question What do I really want?, are you allowing yourself to dream big? Are you allowing your imagination to fly and to consider what it is that would light you up and make you come alive? Or are you limiting your wants to what you think you can have? If it’s the latter, you’re selling yourself short. Notice when your limiting beliefs are holding you back from what it is that would make your heart sing.

How to actually figure out what you want

I want to challenge you to set aside time just for you. Go to a coffee shop or a park or a favorite, quiet corner of your home. Grab your notebook and pen and ask yourself, What do I want? Write down what comes up for you.

Then run your answers through the questions above. Are the desires you wrote down a true reflection of what you want? Or are they what is most obviously available to you, or what you think you should want, or what you think you can have? If your answer is yes to any of these three questions, go deeper.

What you really want is on the other side of the limitations you’ve placed on what is available to you.


Image by Good Vibrations Images / Stocksy

When happiness is experienced in the here and now, it is a subjective human emotion within a current human experience.

For example, you play competitive soccer, and your team wins its match; you (and your teammates) are happy in the current moment. You don’t win every match, and when you lose, you feel something other than happiness. Overall, though, you feel happy because you have friends to play with (relationships and community), you are physically fit (movement), and you maintain balance in your life (stress and emotional control). Happiness in the broader sense of time becomes a subjective evaluation of life satisfaction or quality of life.

The keyword is subjective. Happiness depends on innumerable factors and is unique to each individual. What makes me happy may not make you happy, and vice versa. But how do you define happiness? The concepts of happiness and well-being have been debated since the days of ancient Greek philosophers who argued that the secret to a better and more harmonious life and thus, a better, more harmonious society, relied upon both virtuous character and eudaimonia.

OK, so what the heck is eudaimonia, Dr. V?

Eudaimonia is a Greek word that commonly translates as “happiness” yet more likely approximates “human flourishing or prosperity” and “blessedness.”

Even from the ancient philosophical perspective, eudaimonia definitions differ. According to Aristotle, virtue and exercising virtue are central to eudaimonia, but also there is consideration given to external goods such as health, beauty, and wealth. Conversely (and for comparison), the Stoics did not believe external goods were necessary; for them, virtue was sufficient and necessary.

Aristotle believed that human beings gain eudaimonia when they develop their highest human functioning—rational thought and reason—and complement these with rational actions. That’s my super-condensed interpretation of Aristotle’s meaning of eudaimonia. If you’re interested in delving into the ancient origins of happiness and well-being, Aristotle’s Nicomachean Ethics and Eudemian Ethics are a good place to begin.

In my mind and for me personally, eudaimonia would be something like I could have all the medical knowledge (reason), medical ability, and empathy for patients in the world, but if I don’t put those qualities into action (work) by helping people, then I could not achieve true happiness.

Put another way, when I fully participate in intellectually stimulating and fulfilling work for the benefit of others, then I have found my purpose, my happiness, and my success as a human being.

Eudaimonia, sometimes referred to as eudaimonic happiness, has a yin/yang counterpart, or an “evil twin” depending on how you look at it, called hedonia or hedonic happiness. Hedonia is the sense of happiness induced by momentary pleasure or satisfaction and immediate self-gratification.

In my case, for example, hedonia could be the accolades of a colleague, a pay raise, or a new car (purchased because of the pay raise), all of which bring a sense of short-term happiness. No doubt that life brings a mix of hedonic and eudaimonic happiness, but what helps us achieve our purpose in life is the lasting happiness resulting from long-term goals and actions.

Thus, the ideal human quest to achieve well-being is accomplished when we strive for meaning and a noble purpose and go beyond self-gratification.

Eudamonia in the 21st century

Since the days of Aristotle, there has been a resurgence of interest in the concept of happiness, not by philosophers but by psychologists seeking to understand the effects on health.

Most notably, Barbara L. Frederickson, Ph.D., a professor of psychology in the College of Arts and Sciences at the University of North Carolina at Chapel Hill, has put forth the ideas that (1) not all happiness is created equal; (2) that the human body recognizes this and responds differently; (3) eudaimonic happiness may provide health benefits at the cellular level; and (4) hedonic happiness may produce negative health effects at the cellular level.

Wow, that’s big! It means that two events seemingly equal in terms of eliciting a sense of happiness could, in fact, be experienced differently at the cellular level.

The epigenetic root of happiness

Frederickson’s team collaborated with the team of Steven W. Cole, Ph.D., a professor of medicine, psychiatry, and behavioral sciences at the University of California at Los Angeles to examine how eudaimonic and hedonic well-being (happiness) influenced gene expression within human immune cells.

The premise was that when immune cells are under extended periods of stress or adversity, there is a shift in the normal gene expression; the fight-or-flight response activates something called the conserved transcriptional response to adversity (CTRA), which upregulates pro-inflammatory genes and downregulates genes involved in defending against viruses.

Fifty-three genes were observed with respect to CTRA, including inflammation (19 genes), interferon response (31 genes), and antibody synthesis (3 genes). Although the participants as a whole reported feelings of well-being, those with high levels of hedonic well-being experienced a small increase in stress-related CTRA, and those with high levels of eudaimonic well-being experienced significant decreases in stress-related CTRA.

Experiencing a greater amount of hedonic well-being is like consuming “empty calories.”

Fredrickson suggested that experiencing a greater amount of hedonic well-being is like consuming “empty calories.” While simple pleasures may provide short-term gratification, they may cause long-term negative health effects. In other words, if you eat a whole pint of ice cream, you may feel good temporarily, but eating a pint every day will likely cause you to gain weight and could potentially lead to other poor health outcomes down the road. Cole states that eudaimonic well-being elicited a downregulation of the pro-inflammatory genes’ expression and an upregulation of the pro-immunity genes’ expression. Put simply, having a strong sense of purpose will lower inflammation and increase immunity.

As such, try to make eudaimonic happiness a priority in your life—your cells will reward you with good health, better performance, and greater health span. And with better health, performance, and health span, you’ll have the power to continue sharing your talents and gifts with others who need them…and need you.


  • Cortisol, most commonly known as the stress hormone, is a popular conversation point in the wellness space.
  • Experts agree that while too much or too little cortisol provides specific problems, the term “cortisol imbalance” is not a legitimate medical term.
  • To test cortisol levels, individuals should seek advice from a healthcare professional with hormonal expertise.

A new wellness topic is trending on social media: cortisol levels and how individuals can balance those levels for the sake of bettering their health.

Cortisol, most commonly known as the stress hormone, is a delicate conversation. It makes sense why people would debate “the perfect balance” of this hormone, but medical professionals are hesitant to lean into the social media world’s terminology.

Cortisol is a complex hormone that is difficult for doctors to assess and manage, “it seems highly unlikely that influencers would have the experience and knowledge to provide sound advice,” Lawrence Kirschner, MD, PhD, an endocrinologist at The Ohio State University Wexner Medical Center, told Health.

Dr. Kirschner explained that many times if a person doesn’t feel well, they want validation that their symptoms have a clear medical explanation. 

“Something like ‘cortisol imbalance’ is a term that sounds like something from a medical textbook. However, it isn’t a term that has a real meaning in a medical sense,” he noted. “Thus, any discussion of ‘cortisol imbalance’ as a medical condition is based on a piece of medical misinformation.” 

Since cortisol imbalance is not a valid medical diagnosis, he noted that reports describing a “treatment” are also a form of misinformation.

Still, cortisol levels can be too high or too low—but determining this is more complex than influencers may lead many to believe. Here’s everything you need to know about this hormone—and how to separate the facts from the fiction you see online.

What Is Cortisol?

Cortisol is a stress hormone that can appropriately raise sugar in the bloodstream, help convert glucose to energy, and assist in fight-or-flight situations. Cortisol is produced and regulated in adrenal glands located near the top of the kidneys. These glands affect both the central nervous system and the endocrine system.

“It is important to understand that cortisol acts in just about all tissues in the body, although these actions can be very different in different tissues in the body,” Dr. Kirschner explained. 

Cortisol can affect the following organ systems:

  • Nervous
  • Immune
  • Cardiovascular
  • Respiratory
  • Reproductive
  • Musculoskeletal
  • Integumentary

According to Dr. Kirschner, many factors regulate cortisol secretion, including time of day, stress (including physical, social, and emotional stress), medical conditions, medication use, and alcohol and other drug use.

Medical Conditions and High Cortisol

When cortisol isn’t regulated properly, it can lead to too much cortisol in the body, and in some cases excess disorders, such as Cushing’s syndrome.

“If you have too much cortisol, like in Cushing’s syndrome, it raises blood pressure, causes weight gain in your trunk and face, causes muscle weakness, easy bruising, thinning skin, irregular periods in women, acne, hair loss,” Caroline Messer, MD, an endocrinologist at Northwell Health, told Health

The most common cause of Cushing’s syndrome is the long-term term use of medications used to treat conditions like asthma, rheumatoid arthritis, and lupus. However, in some cases, an individual’s body may make too much cortisol due to tumors.

“We’re finding out more and more that for a lot of these patients, it tends to be a small adrenal mass that is over-secreting cortisol and it can really easily be overlooked for somebody’s whole life,” explained Dr. Messer.

If a tumor is determined to be the cause of excess cortisol, it is removed surgically.

“Because tumors that produce cortisol excess cause the normal system to ‘shut down,’ people are often given replacement steroids after tumor removal until their own system wakes up, a process which can take a few months up to two years, or sometimes longer,” noted Dr. Kirschner.

For those who can’t undergo surgery or if surgery doesn’t cure the excess cortisol, Dr. Kirschner explained that other options include medications that block the production or action of cortisol, and radiation (or rarely chemotherapy) to try to kill any remaining tumor. In rare cases, the adrenal glands are removed.

What Does It Mean to Have Low Cortisol?

When the body doesn’t make enough cortisol, this could be due to conditions like Addison’s disease. Fatigue, muscle weakness, loss of appetite, weight loss, and abdominal pain are symptoms of low cortisol.

“When there’s too little cortisol, which is a condition called adrenal insufficiency, you can’t maintain normal blood pressure, so you start having really low blood pressure, vomiting, lose appetite, sodium starts to drop,” explained Dr. Messer. 

Treatment for low cortisol is medication like hydrocortisone, which replaces the cortisol.

Lifestyle Habits That Affect Cortisol Levels

People who are under high stress, have inflammation, are overweight, or have diabetes or alcoholism may have mildly elevated cortisol levels that are not caused by medical conditions like Cushing’s disease, Dr. Messer noted.

When higher levels of cortisol are present but not pathological, doctors refer to this as pseudo-Cushing’s.

“In these cases, we try to treat the underlying cause—help you lose weight, lower blood sugar, decrease inflammation, decrease stress, help you drink less, etc.,” Dr. Messer continued.

While there isn’t medication to bring down cortisol levels, if there were, she noted that it wouldn’t change the underlying causes that raised it in the first place.

Pseudo-Cushing’s might be what is driving most of the social media attention around “balancing” cortisol, suggested Dr. Kirschner.

“Since cortisol is rarely out of ‘balance,’ restoring ‘balance’ isn’t something that most medical professionals will consider,” he said. “Much of the ‘cortisol imbalance’ talk really relates to people who don’t feel well, whether that is energy, stress, weight gain, anxiety, and so on.”

For these people, once serious medical conditions are ruled out, the best way to improve their health is often through general wellness activities like regular exercise, a healthy diet, time with family and friends, and quality sleep, added Dr. Kirschner. 

Testing Cortisol Levels

Telling the difference between “normal” and “abnormal” cortisol levels can be challenging, often requiring complex testing best handled by a healthcare professional experienced in hormone health.

According to Dr. Kirschner, cortisol levels are typically tested in the blood, saliva, or urine, although levels can also be measured in tissues like hair. Because hormone levels vary throughout the day and are highest in the morning, the timing of the testing is important for proper diagnosis.

For instance, when checking for high levels of cortisol, doctors recommend testing when cortisol levels are the lowest, which is between 11 p.m. and midnight. However, labs are not open during these hours to draw blood, so Dr. Messer recommends giving patients saliva tests that they can do at home during those hours.

Using more than one method to test is also crucial, she reiterated, because many medications (like birth control) can lead to elevation of the protein that is analyzed to evaluate cortisol levels, leading to false positives.

Giving a steroid late at night and checking cortisol levels the next morning is another way of testing, Dr. Messer added.

“The idea behind that is if we’re giving you a steroid then your body doesn’t need to produce cortisol, so cortisol should be suppressed the next morning, but if it doesn’t get suppressed the next morning then there’s an issue and we have to evaluate further,” she explained.

If cortisol levels are determined to be pathologically high, then imaging of the pituitary or adrenal glands might be conducted.

“The most important thing is not to be terrified if your cortisol comes back slightly elevated,” encouraged Dr. Messer. “It’s very likely that it’s not Crushing’s disease and with proper testing, we can tell [what caused it] and help you lower it naturally.”


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