It’s Just Stress, Doc!

Adrenal fatigue seems to be the diagnosis du jour.  Almost everyone is suffering, at least to some degree, from Adrenal Fatigue, which by the way is currently not a medical diagnosis.

Dr. James Wilson, has popularised the diagnosis of Adrenal Fatigue in his excellent book of the same name.1  However, disruption of how the body deals with stress was described at least as far back as 1976.2

Our bodies have a finely tuned system that responds to perceived threats.  This system is called the Hypothalamic – Pituitary – Adrenal (HPA) axis.  It evolved over millennia to give us the best chance of surviving.  However, we are now told that stress is not only making us sick,3 but that it could be shortening our lives.4-5  So is the HPA axis broken?

A short physiology session

THE HPA axis consists of the hypothalamus, pituitary and adrenals.  The hypothalamus and pituitary are located in the brain and the adrenals are little glands situated on top of your kidneys.  If you put your hands on your hips so that you thumbs touch the bottom edge of your ribcage just before they disappear under a thick muscle sheath, you will locate your adrenals.  Tenderness in this area is used by some practitioners to help diagnose adrenal fatigue

The hypothalamus can be seen as the “general” in the army.  It receives signals and sends messages to and from the rest of the body. The hypothalamus sends messages to the rest of the body by secreting a chemical that activates certain pathways in the pituitary (“sergeant”).  The pituitary barks orders in the form of another chemical, which activates the adrenals (aka the “corporal”).  The adrenals then release the real fighters (“privates”) to go and quench the threat.  These privates are the hormones:  cortisol, DHEA, adrenalin, nor-adrenalin. This allows you to fight or flight. Once the threat is dealt with the “privates” relay back to “sergeant” and the “general” that all is well and the hypothalamus stops sending orders. Generally the body is back to a “steady state” after 30-45 minutes.

This is all well and good if you are running away from a lion.  However stress is very different today, and seldom do we go back to a neutral state in 30 minutes. With continuing messages from the hypothalamus to fight or flight, we exposed to continual high levels of cortisol and pro-inflammatory chemicals.⁷  This is what is making us sick.

 Types of stress

We all know about psychological and emotional stress – work stress, relationship stress, getting the kids to school on time etc. etc.

What we often don’t recognise as stress but have a stressful effect on the body are:

• sugar, refined food and alcohol
• electromagnetic radiation – we are exposed to more EMR in one day than our great-grandparents were exposed to in their whole lifetime⁸
• pollution
• noise
• respiratory infections
• genetic predisposition (whether born this way or if genes have been “turned on or off” due to our environment)

Signals to the hypothalamus

How does the hypothalamus, which developed millions of years ago, know that getting the kids to school is stressful?  It is the signals that our conscious brain sends to the hypothalamus.  When our conscious brain perceives (whether real of imagined) stress, it alerts the hypothalamus.  So, in effect, it is our perception of stress that continually activates the HPA axis, leading to poor health.⁹

Just Stress

There is almost no medical condition that does not have stress as a component.  Stress is not something that we just have to put up with. We may not be able to change our exposure to pollution or noise.  We do have to go to work, even if it is unpleasant.  What we can do is change our perception.  As the serenity prayer goes:

Grant me the serenity to accept the things I cannot change, The courage to change the things I can And the Wisdom to know the difference

– the serenity prayer

Adrenal Fatigue

Yes, we are all to some degree adrenally fatigued.  And if we are well down this path, heading to exhaustion, we may need to seek expert help.  So, to stave off this destruction, lets change our perception and infuse our lives with positive experiences.  The more positive experiences we have, the more our brains are likely to view situations as positive,¹⁰ thereby preventing the cascade of stress chemicals. This is turn, means we are more likely to have positive experiences.¹⁰ Isn’t that just a fantastic mechanism that we have to make our lives peaceful?

Our goal is not to change the world or even ourselves.
Our goal is to change our perceptions about the world and about ourselves.

– Paul Ferrini

References

Wilson JL. Adrenal Fatigue The 21st Century Stress Syndrome. Petaluma: Smart Publications; 2001.
Carroll, Curtis GC, Mendels J. Neuroendocrine regulation in depression. I. Limbic system-adrenocortical dysfunction. Arch Gen Psychiatry 1976; 33(9): 1039-44.
Loerbroks A, Gadinger MC, Bosch JA, Stürmer T, Amelang M. Work-related stress, inability to relax after work and risk of adult asthma: a population-based cohort study. Allergy 2010; 9999(9999).
Drury SS, Theall K, Gleason MM, et al. Telomere length and early severe social deprivation: linking early adversity and cellular aging. Mol Psychiatry 2011.
Tobiasz-Adamczyk B, Brzyski P, Florek M, Brzyska M. Job stress and mortality in older age. International journal of occupational medicine and environmental health 2013; 26(3): 349-62.
Wikipedia. Released under CC-BY-SA; http://creativecommons.org/licenses/by-sa/3.0/.
Stephens MA, Wand G. Stress and the HPA axis: role of glucocorticoids in alcohol dependence. Alcohol research : current reviews 2012; 34(4): 468-83.
Hywood A. HPA Axis. ACNEM STP: Thyroid and Adrenals; 2009; 2009.
Maldonado EF, Fernandez FJ, Trianes MV, et al. Cognitive performance and morning levels of salivary cortisol and alpha-amylase in children reporting high vs. low daily stress perception. The Spanish journal of psychology 2008; 11(1): 3-15.
Hanson RM, Richard. Buddha’s Brain: New Harbinger Publications, Inc.; 2009.