The Role of Depression in the Development and Persistence of Adrenal Fatigue


The history of medicine is complete with examples of diseases and disorders that were ignored, neglected, even denied by the medical establishment. Although modern doctors are more open-minded about unknown or unclassified illnesses than they were in the past, many patients still face skepticism when they complain about conditions that do not fit neatly into any accepted category. In these instances, doctors sometimes surmise that the symptoms are affected by the patient's mental or emotional state. Such is the case with adrenal fatigue, a syndrome that has grown exponentially common in the US

What is adrenal fatigue?

About the size of your thumb, your adrenal glands sit atop your kidneys and produce hormones that help you deal with stress. Under normal circumstances, they secure small amounts of these regulatory substances. But when you are in danger, either real or perceived, they flood your body with adrenal hormones, particularly norepinephrine (adrenalin) and cortisol, that activate the fight-or-flight response. The purpose of this response is to prepare your body for battle by giving you greater strength, mental clarity, and energy.

Because stress is a fact of modern life, most us have norepinephrine and cortisol coursing through our bodies when we are in no real danger. As a result, our adrenal glands have to work overtime to keep up with the more or less constant demand. It is not surprising then that our adrenals can occasionally become overdrawn, forcing the body to deal with stress at a hormonal deficiency. This condition is known as adrenal fatigue.

Is it real or imagined?

Even though there are similar disorders that affect the adrenal glands in similar ways, adrenal fatigue is not an accepted medical condition. There are many reasons for this, most of which concern the different ways human bees process and handle stress. For example, we know that tests can measure cortisol levels in the blood as well as the saliva. They can even tell doctors if the adrenal glands are producing enough hormones to deal with daily stress. However, there is no consensus among medical professionals about what constituents low levels on these tests. Doctors also know that people have different numbers of cortisol receptors that help determine how well adrenal hormones work to reduce anxiety and stress. In fact, most researchers believe that adrenal fatigue is caused, at least in part, by the interactions between the brain and the adrenal glands.

One thing we can say for certain is the adrenal fatigue is a real condition with real symptoms that are caused by chronic stress. We do not know why it affects some people and not others or how it can be effectively treated on a long-term basis. Then again, it was only recently that disturbances in the central nervous system and neurotransmitters were identified by science and accepted by the medical establishment. In other words, we have much to learn before the condition is understood and accepted.

Signs and symptoms

While adrenal fatigue is not yet recognized as a legitimate disorder, adrenal insufficiency (Addison's disease) is. The main difference between the two is that adrenal insufficiency results in either complete adrenal failure or extremely low adrenal function called hypoadrenia. Adrenal fatigue is actually caused by the opposite disorder, hyperadrenia, which is an overactivity of the adrenal glands due to increased need. With that said, the two disorders result in similar complications in patients. They include the following symptoms, which can and often do vary from mild to extreme:

· Chronic tiredness

· Trouble thinking clearly or concentrating

· Inability to deal with daily stress

· Unexplained body aches and pains

· Low blood pressure

· Skin discoloration (hyperpigmentation)

· Uncontrollable food cravings

· Lightheadedness and / or dizziness

· Depression

· Sudden weight loss

· Trouble sleeping

· Loss of body hair

· Fatigue

Adrenal function and depression

The complex chemical systems that regulate biological processes like energy, sleep, appetite, and sex drive are disrupted when stress hormones are released into the body by the adrenal glands. In particular, the powerful stress hormone cortisol can reduce the levels of serotonin, dopamine, and other neurotransmitters in the brain. This reduction has been linked to depression, especially to clinical or major depression. Why?

As we know, the adrenal glands help us manage stress. They were not, however, designed to deal with prolonged periods of anxiety that last for days, weeks, even months on end. These major depressive episodes not only result in elevated stress levels, they may also be exacerbated by the continued release of cortisol and other stress hormones in response to the symptoms of depression, such as fatigue, poor sleep, anxiety, and mental exhaustion.

Recent findings

Although the link between depression and adrenal fatigue requires additional investigation, researchers have established that it does indeed exist. In one recent study, the mean adrenal gland volume was 70 percent higher while patients were depressed than it was after they were successfully treated for their illness. While testing for adrenal fatigue was not completed in that study, it stands to reason that adrenals that were working 70 percent harder to pump out stress hormones would be more likely to suffer from fatigue than those that were operating normally. It is not a large leap then to deduce that chronic stress can cause depression and later adrenal fatigue, which can wreck havoc on your life.


In the most serious cases, patients with adrenal fatigue have a hard time getting out of bed for more than a few hours each day. They may sleep and sleep and sleep, but since the problem is in their adrenal glands, slumber will not restore their diminished energy levels. And since adrenal hormones have a distinct effect on cognitive function, mood, and mental states, they may find it difficult to escape anxiety and depression. But how exactly do you treat a condition that is not acknowledged by medical professionals?

Even if they do not accept adrenal fatigue as the likely cause of a possible illness, doctors can complete tests that measure the hormonal output of the adrenal glands. But since they fluctuate wildly through the day, it is important to get multiple blood and / or saliva tests to establish a baseline for cortisol levels. It is also crucial for patients to try to limit stress while they take these tests, since increases in anxiety will result in false positives and negatives from yo-yoing cortisol levels. If adrenal insufficiency is the diagnosis, there are several ways to treat the disorder.


Because they know that stress forces the adrenal glands into overdrive and that the hormones they release can cause depression, doctors almost always turn to antidepressants to treat the symptoms of the underlying problem. Of course, that will not solve the problem, ie, that the adrenal glands are not working as they should. It is for this reason that many patients have turned to alternative medicine to treat this modern malady.


Adrenal fatigue occurs when your adrenal glands can not meet the demands of daily stress. In most cases, there is absolutely nothing wrong with the glands themselves, but rather with the amount of stress the person encounters on a regular basis. Therefore, the only way to treat adrenal fat is to find healthy, effective ways to cope with stress. Our prescription? Eat right, exercise, get a good nights' sleep, and take dietary supplements.

One group of supplements that may help reduce stress and support healthy adrenal function at the same time is adaptogens. These safe and effective herbal medicines have been used in both Hindu and Chinese traditional medicines to ease stress and anxiety for thousands of years. Natural supplements with no known drug interactions, adaptogens such as ashwagandha, ginseng, maca, licorice root, and rhodiola are available for sale on the internet. When using adaptogens to treat adrenal fatigue, be sure to follow the recommended dosage.


The debate over whether or not adrenal fatigue is an actual disease is illegally to end anytime soon. We can, however, all agree that rising levels of stress and strain have very real, often deleterious effects on our health. The link between chronic stress and depression is now accepted by members of the medical community. Adrenal fatigue is precipitated by these prolonged bouts of anxiety and depression that force the adrenal glands into overdrive and gradually wear them down. Those that suffer from this increasingly common disorder must find healthy and effective treatment options, such as adaptogens, to help them manage daily stress.

Brandon Kamins