Withdrawal syndrome vs adrenal fatigue

Adrenal fatigue and psychiatric drug withdrawal — by Alto Strata

In many ways, withdrawal syndrome is the opposite of adrenal fatigue.

In withdrawal syndrome, the theory is that the brain is sending erratic “fight or flight” signals to the adrenals and the adrenals are obediently responding with adrenaline and cortisol, as they are designed to do.

The normal diurnal cortisol cycle may be exaggerated, as we see when people wake up with panic or anxiety due to the morning cortisol spike.

However, there may be waves or surges of cortisol on and off throughout the day, felt as waves of what we call neuro-anxiety, neuro-melancholy, or neuro-panic (they seem to be coming from the body instead of the emotions), as well as other symptoms of autonomic upset such as palpitations, dizziness, and brain zaps or tingling.

A 4-times a day saliva test for cortisol will not reliably pick up these odd surges, and if it does, the results will be nonsensical, as they may capture a spike. The 24-hour urine test may show an *average* higher level of cortisol — it’s capturing all the urinary cortisol throughout the period.

But — nobody knows what to do with these results, absent a tumor.

Unless you want to rule out a tumor or can afford to do the 24-hour cortisol test out of sheer curiosity, it’s not worth it to do it. (For 24 hours, you have to pee into a bucket every single time you pee.)

Because people with withdrawal syndrome often suffer a harsh insomnia, frequent nighttime waking, or early waking with the morning cortisol increase, they may feel fatigued from lack of sleep. But stimulating the adrenals would be exactly the wrong thing to do in this situation. Their faithful output of cortisol surges is causing the problem, you don’t want to encourage them.

The adrenals control many essential functions in the body.

Unless you really know what you’re doing and you absolutely have to do it, you don’t want to directly interfere with their operations in any way.

As opposed to adrenal fatigue, elevated cortisol in withdrawal syndrome keeps you going even though you’re dead tired. People also report a surprising low incidence of colds and flu.

While most people seem to get the “alerting” kind of withdrawal symptoms, a minority seem to become exhausted and sleep a lot. (I’ve never seen this become prolonged. It might be a protective way for the body to heal itself.)

It is possible one might have had chronic fatigue syndrome or an adrenal or endocrine problem *before* withdrawal, and withdrawal syndrome exacerbates it. I guess it is possible that although they are tough little organs, after a very long time, one’s adrenals might poop out from the stress of withdrawal.

However, adrenal fatigue does not seem to be central to withdrawal syndrome. 

Please do not experiment with stimulating your adrenals. Don’t take adrenal tonics or licorice. Like the rest of your system, with calm and stability, they will return to normal functioning.

If you believe you have adrenal fatigue, there are sites that specialize in discussing and supporting it. You may wish to visit them to see if the symptom patterns people report are a better match for your symptoms than withdrawal syndrome.

Since we believe any kind of chemical or herbal messing with the adrenals is not good for most cases of withdrawal syndrome, we won’t have much information on them here.

If you have non-invasive ways of calming the adrenals, reducing cortisol, and calming the nervous system, please feel free to post them in this forum. 

**End of article

When I read the above piece by AltoStrata I thought of an incident with a doctor I had a couple of years ago. Alternative doctors and integrative doctors often want to diagnose psychiatric drug withdrawal as adrenal fatigue. This can be quite dangerous and we need to know how to protect ourselves. SEE: Another doc bites the dust.

Dealing with doctors is an artform we need to develop so it helps to see what happens with others.

I’d like to add one caveat after reading the article by Alto Strata. She does elude to this in the article but I want to make it clear. There are times when adrenal fatigue is likely an issue for some people some of the time during the course of a withdrawal journey. But it’s also very clear  that more often it really is the opposite. For me early on I did respond to supplements that helped support the adrenals and perhaps at that time I truly had adrenal fatigue. Later I became gravely hypersensitive to such things and now they are plain dangerous.

Our bodies may need different things at different times.

And it’s true that very often and probably most often our adrenals are  producing too much cortisol rather than too little. That is part of what appears to be the iatrogenic autonomic nervous system dysfunction caused by the psych med use and subsequent withdrawal.  (**updated note: some years out, adrenal fatigue has reasserted itself but needs to be treated very gently)

Update 2016: It’s become clear to me that whenever it’s possible that it’s helpful for folks who’ve not begun withdrawal and have the time to consider a carefully thought out plan to attempt to bring greater well-being to your body before starting the withdrawal. That means learning how to profoundly nourish your body/mind and spirit prior to beginning a withdrawal. For suggestions on how to go about doing that check the drop-down menus on this blog for ideas.

Anything that helps you learn how to live well can be part of your plan.

That plan will look different for everyone as we learn to follow our hearts and find our own unique paths in the world. Things to begin considering are diet, exercise and movement, meditation/contemplation etc. Paying attention to all these things as you do them helps too. The body will start letting us know what it needs as we learn to pay attention.

More by

Alto Strata:

• Andrew Solomon, poster child for psychiatric misdiagnosis
• Alto Strata speaks at the Occupy Psychiatry Protest at the APA conference: psychiatric drug withdrawal
• What should I expect from my MD about psych drug withdrawal symptoms?
• Introduction to psychiatric drug withdrawal syndrome
• Psychiatric drug withdrawal: Why taper by 10% of your dosage?
• (Antidepressants and Talk Therapy Go Hand in Hand) — Really?
• Withdrawal syndrome vs adrenal fatigue
• Neuropsychiatry: Same baloney, different sandwich
• Protracted withdrawal from SSRIs and SNRIs antidepressants
• GABA/Glutamate cycle in withdrawal from psychotropics– SSRIs, benzos, and Lamictal

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