From The Fugitive Psychiatrist: For More Info, Go Here…
Adrenal fatigue seems to be getting more and more common, funny enough, it’s often mentioned by people who will also claim that “chemical imbalances” are made up psychiatric myths. Remind me, what do your adrenal glands secrete?
Mainstream medicine has dismissed adrenal fatigue as a pseudoscientific health fad propagated by naturopaths and chiropractors and other disreputables (1). Fortunately for you hypoadrenics, mainstream medicine has it’s own branch of not real science: psychiatry. And it’s ok, we know. We believe you. Adrenal fatigue is real.
But we won’t be calling it adrenal fatigue, and we won’t let it just be an adrenal problem. No, that won’t do at all. We don’t need endocrinology getting a piece of this action, they had their chance.
For about 200 years or so psychiatry has had a diagnosis that we now call atypical depression, although it wasn’t always called that (1). It is characterized by chronic low mood, fatigue, sleeping in, laying around all day, moodiness, overeating, and being too god damn sensitive. It was believed to be caused by stress. In the 1800s it is was called neurasthenia, and later by something I’m sure I’ll never be allowed to say again, hysteroid dysphoria.
Now, what about adrenal fatigue? According to this aging pixie:
“You awaken feeling groggy and have difficulty dragging yourself out of bed [Oversleeping]. You can’t get going without that first cup or two of caffeinated coffee or tea [Fatigue]. You not only rely on sugary snacks and caffeine to get through the day but find you actually crave sweets, particularly in the late morning or afternoon [Hyperphagia] (Perhaps you’ve even been diagnosed with hypoglycemia.) [Don’t worry, when you’re 60 it will have turned into hyperglycemia]. Your thinking is foggy and you have memory problems [Have you tried vortioxetine yet?]. You suffer from recurrent infections, headaches and depression [Indeed]. At night, though exhausted, you have trouble falling asleep as the worries of the day replay in your head and you suffer from insomnia [Did you remember to take your temazepam?]. Ordinary stresses have an impact that is out of proportion to their importance [It’s almost like you’re… hyper… sensitive… to somethi– no no I didn’t mean it like that please stop yelling]. You wonder what happened to your interest in sex [You forgot it in your Oedipal phase]. If this description fits you, your adrenals may be running on empty, even if all your conventional medical tests are normal.”
Lucky for you, the SCID-I for DSM-IV isn’t a conventional medical test. Would you like your Vyvanse now, or after quetiapine doesn’t help?
“Just because the symptoms are similar doesn’t mean the biology is the same!”
Yeah, I know. Psychiatrists are the last group of people on Earth who need to be reminded of this. However…
Patients with atypical depression consistently show blunted activity of the HPA stress response (1, 2, 3, 4, 5, 6, 7, 8, 9). We can’t quite agree if the lesion is at the H the P or the A (fingers crossed for H, that makes it a brain disease), how to best measure it, or how to best define atypical depression, although none of this matters to us.
