Anxiety, depression and the Adrenal glands

Hello

Reaching out for thoughts and experiences of the role our adrenals play in the establishment and maintenance of anxiety and depression. I am early in my investigations into this area but suspect that my adrenals are at the root of my current illness. After a very stressful event in May 2013 i began to feel nauseous especially during the morning. This eased for 2 months but then reappeared and the nausea has been with me every day to this day. I continued to work which was difficult until I finally gave in to the inevitable in August 2014. Back in January 2014 my GP originally prescribed lanzaprozole which provided some relief. With no progress she eventually arranged for tests and scans which all returned ok. This news resulted in my symptoms increasing and having fever, brain fog and fatigue suddenly appearing. This is when I stopped work. A friend then visited who suggested I consider that I have an anxiety based illness. I jumped at this idea, visited my GP who prescribed sertraline. To cut a very long story short covering the last 9 months, I have tried many AD meds which has resulted in my low mood turning to depression as I dropped failed meds like Trazadone. I now take Mirtazapine and have just started Pregablin in an effort to overcome the nausea and growing anxiety. Recently I have decided that I must take some proactive action as my symptoms are not improving. I have read about the adrenals and possible insufficiency or fatigue with the symptoms similar to mine and I suspect many others active on this forum. Fatigue, low mood, nausea, aches and pains, addiction to caffeine. The adrenals over time can stop working optimally due to virus or simply over work and stress. The body needs cortisol to function and is vital for humans to get up and approach the day and deal with daily stresses . When the adrenals are asked to produce cortisol and are not able to produce or not enough then the body tries to compensate by producing adrenaline leading to anxiety and stress symptoms including nausea as the body is then left with a large quantity of adrenaline with no way to use it resulting in anxiety and stress. Looking to take the cortisol saliva test but do not expect any support from my GP. I have a mental illness, deal with it and take your drugs.....next! Any views or experiences of this area would be greatly appreciated.

I'm glad you've created this thread because I would be interested too.

I get the impression from reading online that adrenal fatigue isn't really recognised as of yet by the medical profession in the UK.

Due to issues I have with my medication I am experiencing cycles of fatigue and additional adrenaline and I am concerned about how to balance this. I've managed it with my mood with Omega 3 after reading threads on here and doing my own research but would like to do the same with this if possible.

My GP is the same. In and out in 10 minutes and thats a double appointment for the complex stuff! What a joke. He is also pretty ignorant about antidepressants so I'm loathed to have this discussion until I need to because I know he will only say to switch and thats not necessarily the way and its not like he will have to go through the hell of side effects, months of experimentation and the many months it will add on for recovery as well as all the work I could lose on my current recovery.

Do you believe there could be a cortisol link too?

Another possibility I have been considering if liver health which has a lot of the fatigue & mood issues involved and supplementation & diet for that is perhaps more openly available as its more recognisable to the medical profession as an issue.

Hello Terry

Part of me is asking why I am exploring other physical conditions when I am being encouraged to accept my condition. Why should I!? I sometimes feel that a diagnosis of anxiety and / or depression is a convenient diagnosis for the GP as they can then stop looking for a source issue and prescribe drugs with no assurance of success. I feel that I have been cast adrift due to my diagnosis so need to take control myself. There are many references to adrenal fatigue online but many seemingly respected medical institutions or individuals who disregard this condition. They work or they do not work optimally nothing in between apart from complete acute adrenal failure which is a medical emergency. Who am I to disagree? Any stories or experience of this condition and outcome would be great to hear. There is an accepted condition called adrenal insufficiency which is where then adrenal glands are working but are not working optimally and are not able to secrete enough cortisol on demand. This is what I am looking at and through a nutritionalist am considering having a 24 hour adrenal test which takes 4 samples of cortisol through key points in the day. £79 fee is putting me off as is the concern of yet another clear result. I have had my cortisol measured through a blood test which was normal but have since found that this is almost worthless as it does not show the peaks and troughs through the day. There is also a blood test for adrenals where the cortisol level is tested before and after a trigger substance called ACTH is injected which should result in cortisol being created and pumped into the bloodstream by the adrenals. If the response is poor then adrenal problems can be diagnosed. The extreme conditions of adrenal health are Addison's disease (low cortisol level) and Cushing's syndrome (high cortisol level). As for liver health then I am told that my blood results would show something but all elements are 'within range'. Took some supplements to help my liver produce bile but no improvement in nausea symptom. Think it is worthwhile raising awareness of the adrenal glands as it seems to me that they are the conductor (and orchestra?) for the entire body and mind

Very interested to see how this goes for you and I hope you find an answer. I am in a similar situation in that I know I have some underlying anxiety but feel I have some concious control over it most of the time but am still plagued with physical symptoms. Mainly head pressure, along with fatigue and generally always feeling unwell.

I would guess there is probably a different cause to mine but I will eagerly watch how things go with your search to get better. I am currently on my own search. It is so hard and expensive without the help of the GP though.

Hi Hipha,

Yeah, cortisol changes so it would need to be a test like that. Its supposed to be highest in the morning and is why we wake up. Something about the last couple of hours in the sleep cycle where it is produced but I think it has to be post 5 hours sleep when it starts. Something like that anyway.

Workout for over an hour and the cortisol starts getting high as well.

I can imagine your concern about paying for these tests, they are a bit of a punt. Its difficult to say isn't it when these kinds of symptoms overlap into so many other conditions. I know what you mean about your GP making assumption too as mine does this and I've learned to question his diagnosis thesedays given he has made a couple of mistakes I later found out about.

My take on acceptance has always been that it has its place in recovery but not at the cost of other changeable factors. Otherwise it literally is like suffering a physical illness where there is medication available to treat it. Anxiety works a certain way and the neuroscience is all the same as well as the process for causing it and recovering from it. But thats purely at a chemical level. How it is triggered and how we work our way out of it can be different for people but it doesn't matter as long as the same changes are created via neuroplasticity. But if you have something real underlying that, its never going to be a full recovery, you simply avoid "secondary pain" as they call it. The "primary pain" remains.

So, I believe in investigating things and not having HA, I have no issues in researching because I don't have that bias towards the catastrophic.

I hope you get somewhere with it.

Thanks for your replies. I see my GP on Monday and will ask her to support me in this new line of investigation. If not I am on my own and will need to invest a lot of time, courage and money into investigations. Challenge will be that for some reason adrenal health and it's connection to mental health seems to be viewed with scepticism by the primary medical community. I do not understand this attitude as it seems clear to me that the adrenal glands are a critical part of our mental and physical health. My GP has never mentioned this to me let alone suggested any tests. I do have a mental health issue today there is no doubt. But it is strange that I did not have any anxiety or depression symptoms before taking AD meds only nausea. If my adrenal glands are unable to produce cortisol on demand and now, then the body must compensate. I have read that the body does this by triggering the production of Adrenaline but not sure about this. Looking back over the last 20 years I can see a pattern of me dealing with work stress and a few traumatic events (death and serious illness in family) and my increasing difficulty in waking up and need for caffeine in the morning alongside lower mood and confidence and general negativity towards life. Then a final traumatic event in May 2013 where my son was sick for the entire 9 hour flight to Florida; I felt completely helpless and very stressed (the captain considered diverting the flight). The next day my symptoms appeared whilst driving and the nausea has been with me ever since. There is a chart of the different levels of adrenal health and the symptoms and consequences on the web which I could relate to. I will try and find it and post a link. Hoping that forum members will offer up their own views and would encourage anybody with evidence that challenges the view that the adrenal glands are not a critical element of the brain body axis and contribute greatly to mental health.

I haven't read this all completely but I skimmed through. Just thought I would put in my two cents :) I went to a nutritional doctor and he told me flat out that I had adrenal fatigue and it is such a vicious cycle with anxiety. He explained the process and it was so clear. Traditional doctors typically don't acknowledge it, which is frustrating. I wish I could explain how he did but I'm so frazzled with anxiety right now :(

There is some information on it here:

https://www.adrenalfatigue.org/what-...drenal-fatigue

I wonder about this myself. Since going on Duloxetine I am sure I have been more tired a lot. I have noticed this more in the last 2 years and when Winter came I could struggle for months with extra fatigue. I feel drowsy a lot, lack motivation, feel like I can't start things easily or commit to things, etc.

For some time I have been monitoring what seems to be a cycle in my anxiety. Currently about every 7 days I will have 3-4 days where my anxiety raises substantially. On several occassions it has been more noticable that it is adrenaline as I have been clenching a lot and felt aggression as well we the agitation. After that it will just drop off and I can have a couple of days of fatigue or just be tired in general between cycles.

For the last 2 years I have also found that because my slleep cycle has slipped so badly, I am going to bed in daylight. I find myself waking up closer to this bedtime and I've wondered whether it was connected to how my medication works with adrenaline and serotonin along with my circadian rhythm being so out of tune.

I just find it very strange that I have this on/off cycle permanently and it is stopping me moving forward as nothing seems to have an effect on it, I just have to grit my teeth and put up with it until it goes off. Inbetween these periods I find that I can take steps to work on my anxiety.

Originally it could be 3 weeks of anxiety vs. 1 not so bad week. So, by reducing it I wonder whether I have worked on my anxiety a lot but can't shift this other issue because it is medically induced?

Yes the timing and rhythm of sleep and waking are linked to adrenal stress. I have read that jet lag and challenging work shift patterns can impact upon the rhythm and operation of the adrenals. My issue started after a very stressful flight and then the adjustment to the time zone - 5 hours which I recall knocked me physically before the nausea started. In other news....my GP has referred me to an endocrinologist for adrenal investigations (on my suggestion). Not expecting much as it seems that adrenal health is black and white. They are working or they are not (producing too much cortisol is Cushing's syndrome, producing too little is Addison's disease). A friend who is a GP told me he us sure it is not my adrenals as my salt and blood sugar levels are ok as is my blood pressure. Just seems that so many of my symptoms are associated with adrenal health. Will let you know how I get on

I know this post is old but wondered if anything ever came of your investigations into this. I’m currently waiting for the blood test you mentioned where they inject you with the synthetic substance to encourage cortisol production, I’m hoping to have it in the next few days. I’ve been suffering strange cycles of general unwellness mixed with anxiety and gastro problems which come in flares. Like I’ll be not too bad for a week then have a bad week or so etc and can’t find the trigger/reason. I pushed my doctor for the early morning cortisol test and she agreed but was sure it would be normal, but it wasn’t, my cortisol levels were very low

I, too, am coming to this thread several years after it began, but find it very interesting. I, too, have been on the fence about whether "adrenal fatigue" is a real thing or not. My GP says no, my nutritionist said yes, and told me my adrenals were shot and had me on a supplement for months. Did it help? Not sure. My anxiety DID get better for a while but was it the supplement for the adrenals or all the other changes I was making to my diet? Or all the other supplements? After three months, I found my anxiety was right back up to where it was when I started, and all the supplements I was ingesting, plus the weekly visits and the expense was getting to be too much, so I stopped seeing him, at least for a while.

I, too, have always seen cycles in my health and mood. I seem to get "ill" about every two weeks. Just for a day or two, and not enough to keep me in bed, but enough to make me wonder what's going on. And since I often can't tell the difference between physical illness versus anxiety symptoms, who knows if it's a physical illness cycle or a mental illness cycle.

Just tagging along in case this thread comes back to life.
Sue