by: Michael Lam, MD, MPH and Dorine Lam, RDN, MS, MPH: When fatigue knocks on your doorstep because of excessive physical or emotional stress, don’t overlook being grateful…
Adrenal Fatigue Syndrome (AFS) is seldom on the list of possible causes for being grateful. In fact, fatigue is simply brushed off as insignificant. Being tired can even be considered normal living in the high stress of the modern world; it is nothing that more rest cannot fix. Our society has taught us that we are masters of the universe and our bodies. We are infallible and can conquer almost anything. In the worst-case scenario, the variety of energy drinks and sugary foods available will provide enough energy to restore your vitality.
Over time, as fatigue becomes more prevalent and severe, the patient’s job performance may be affected. Free time turns into napping time. Social activities are curtailed due to lack of energy, more rest helps but not enough, and energy drinks make matters worse. A sense of frustration and disbelief emerges, usually followed by vigilant research for medical solutions. Multiple visits to the primary care physician and normal laboratory test results lead to a sense of assurance that nothing major is wrong, but that does not help the reality of day to day living —waking up not feeling refreshed, dragging through the day, and being totally exhausted at the end of the day. All of these symptoms make being grateful a very difficult task. Slowly but surely a cognitive dissonance appears, as the patient is unable to resolve the ever increasing fatigue that is obviously a sign of a body gone astray while at the same time being told by trusted physicians that all is well.
Refusing to give up, many visits to specialists and sub-specialists are paid for. Frustration and disappointment with the medical establishment increases as the condition only gets worse, as waxing and waning cycles of energy begin to take hold of the once productive life. Thousands of dollars are spend on numerous tests that continue to be normal. Over time, invariably, prescription medications such as, thyroid replacements, sleeping pills, and anti-depressants are dispensed to patch symptoms of low energy, insomnia, and depression. As the condition worsens, the sufferer becomes couch bound. In extreme cases, the patient is bedridden for an extended time and unable to leave home. An increasing sense of loss, fear, and vulnerability develops. Because of the conventional medical community’s continued failure to effective improvement due to ignorance of this condition, sufferers are terrified of losing their vitality and some are devastated emotionally.
Unknowingly, the body may already be well entrenched in a state of neuroendocrine dysfunction called Adrenal Fatigue Syndrome. In this condition, the adrenal glands are operating sub-optimally. Control of the adrenal glands resides in the brain. Some of the key hormonal and neuronal axes, such as the Hypothalamic-Pituitary-Adrenal (HPA) have been well studied. Dysregulation of the HPA axis is indeed a component of the AFS continuum. Seldom mentioned or studied is how the psychological components of the mind affects the HPA Axis, adrenal glands and ultimately influences AFS. Let’s take a closer look.
The Brain is in Charge
For decades, the conventional medical approach to the healing process has been one based on reduction and compartmentalization of the body’s systems into individual organs for easy understanding and dissection. There is a specialist for every single organ in the body. This concept is so popular in modern medicine that approaching the body as a whole unit, the way we are built, can even be considered unscientific or alternative.
For centuries, the brain as an organ was considered physiologically separated from the rest of the body except for the physical neuronal connections. Mental functions, though part of the brain, were thought to be an independent process unrelated to the rest of the body. How we think and how we function were thought to be unrelated to each other. This hypothesis has been proven false. The fact is that the entire body is a coherent and tightly connected closed system where each organ system is intimately woven into all other systems, like a spider web. The brain is no exception. Some portions of the brain are connected by physical blood vessels and neurons to the rest of the body. Other connections are the hormonal highways and axes, with both positive and negative feedback loops in place mediated by chemical messengers. These are less obvious. Still other connections are known to exist but have yet to be discovered, such as the meridian system advocated by Tradition Chinese Medicine and pathways mediated by electrical or gaseous pathways.
Just as we have yet to find various connections because our current technology is not sensitive enough does not mean that such connections do not exist. Progress is being made. Thanks to advanced scanning technology, the links between mental outlook, brain function, and the rest of the body are under intense investigation in recent decades. We are now able to map out the physiological results in the body from psychological changes in mental function that start in the brain.
We are not only what we eat. We are what we think and how our brain develops. For example, neuronal growth in utero can be visualized with precise details, and it was found that mishaps at six months in utero could lead to schizophrenic conditions later in life. Improper pruning of neurons and delays in pre-frontal cortex development in puberty provides major insights into the maturing brain and explains why adolescents and young adults often behave impulsively and irresponsibly.
It is clear that healthy mental function and brain development are key components of healthy living. AFS, in its advanced stages, represents a classic case of how the brain’s psychology can affect physical outcome.
Adrenal Fatigue Syndrome, Psychologically Speaking
Advanced Adrenal Fatigue Syndrome is, at its root, a complex condition involving psycho-neuro-endocrinological pathways, starting at the brain and working its way through the rest of the body. The typical symptom in early stages is fatigue (stage 1 and 2). As AFS advances, other more complex symptoms including reactive hypoglycemia, heart palpation, insomnia, dizziness, anxiety, depression, and gastric disturbance join the parade. The syndrome becomes very convoluted even to the most astute conventional physician unless they are on the lookout for AFS.
Even when finally acknowledged by health professionals (usually outside the conventional medical world), AFS is seen as a purely physical phenomenon without a psychological link. This may be true in early stages of AFS. Those who are in advanced stages (stages 3 and 4), particularly those who have had major crashes and are couch-bound and bedridden, will tell you a very different story. Their bodies often react quickly and they are held hostage to even the slightest changes in mental outlook and mood swings. A slight verbal argument may trigger an adrenal crash. Even the very thought of failure to heal can lead to heart palpitations, insomnia, anxiety, and dizziness.
A common denominator of those who recover from stages 3 and 4 of Adrenal Fatigue Syndrome is that they often have a positive attitude towards life, no matter how dark the moment may seem and are great at being grateful. It is clear that positive thoughts can calm the body, increase energy, and promote a sense of well-being. Clearly there is an important and undeniable mental component to this condition in its advanced stages, and we can use this to our advantage.
The recognition that positive emotions can affect our physical well-being is not new. Decades of research have repeatedly shown that a positive mental outlook leads to a healthier life physically in a variety of ways.
Positive Psychology and Being Grateful
Mindset matters. For a long time, the scientific community has investigated and knows the value of feeling good and practicing gratitude. Positive psychology, a part of Cognitive-Behavioral Psychology, is a field of psychology that has particular relevance to advanced AFS. It focuses on understanding thankfulness, conducting research on being grateful, and utilizing therapeutic interventions aimed at increasing gratitude and optimism in life.
Numerous research studies have been carried out to test the effects of a thankful attitude and being grateful. The science is clear. There are tremendous physical benefits of being grateful as a person, though we do not yet know each and every mechanism of action.
Gratitude is an important tool we can use in all stages of AFS recovery. However, it is seldom discussed because of the negative social stigma connoted once we incorporate mental health as one of the many factors contributing to AFS. Most prefer to see AFS as a purely physical condition with no mental component. This notion must be dispelled when looking at advanced stages of AFS. Most AFS sufferers are high achievers with Type A obsessive-compulsive personality traits. They think differently than others. They are goal driven, disciplined, and highly focused. This type of mental makeup does have physical ramifications. AFS is one example of such a drive gone astray, when the body is unable to handle the stress that comes with this type of mental drive. While the mental component is not immediately evident in early stages of AFS, those in advanced stages can no longer deny its importance. Failure to deal with this will only deter the recovery process.
This denial of the importance of how a mental outlook can affect a disease state deters our advances towards speedy recovery in any disease state, whether it is cancer, heart disease, or organ transplant. AFS is no exception. It is important for us to embrace our mental state as an important component of advanced AFS at the root level. A proper mental outlook and gratitude are important tools in the AFS recovery toolbox. The more advanced the AFS, the more valuable these tools are.
Gratitude 101
The word gratitude is derived from the Latin word gratia, which means grace, graciousness, or gratefulness. Just like beauty is in the eye of the beholder, gratitude is many things to many people. Gratitude or being grateful is a mental attitude of appreciation for something good and beneficial one has received or will receive from another person or from a higher power. Gratefulness is completed when it is expressed in words and or gestures of thankfulness, smiles and hugs, or other gifts.
Compared to other people grateful people are:
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Happier
Being grateful lowers depression, anxiety, cynicism, obsessive-compulsiveness, guilt, and self-blame. It increases optimism, energy, calmness, self-acceptance, joy, and satisfaction. Positive emotions associated with gratitude neutralize negative emotions’ debilitating effects, and the results can be felt almost immediately.
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Less Stressed
- A US study published in 1998 involving 45 healthy adults found that those study participants who were taught to cultivate appreciation and other positive emotions experienced a 23 percent reduction in cortisol—the key stress hormone—than those who did not. The 1998 study results suggest that techniques designed to eliminate negative thought loops can have important positive effects on stress, emotions and key physiological systems. Those who are in early stages of AFS where cortisol output is high will find this particularly helpful in lowering cortisol levels. They have better coping mechanisms to deal with personal difficulties and life transitions, whether they are marital issues, family disharmony, changes in career, physical relocation, low social interaction, or illness. They are more prone to seek help earlier rather than to deny their problems.
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More Purposeful
Grateful people are more logically focused on their priorities and they are more mature and balanced in their personal growth.
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Fewer Health Complaints
People who are more thankful have less physical illnesses. Their bodies have an enhanced response to external insults and resistance to viral infections.
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Healthier Heart Function
Increased coherence in heart rate variability patterns was observed in studies where participants practiced the art of gratefulness. Gratitude and appreciation sets your heart towards a smooth-waved rhythm, whereas negative emotions like anger and frustration send it into an erratic, disordered rhythm. The more stable the heart rhythm, the healthier the entire cardiovascular system.
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Better Sleep
Higher levels of gratitude were associated with better sleep with lower anxiety and depression.
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Stronger Genes
Expressing gratitude caused the double helix coil of DNA to become more functional and more easily positioned itself for gene transcription. Premature aging is deterred.
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Neuro-transmitter and Hormonal Enhancement
Studies have shown measurable effects on mood neurotransmitters such as serotonin and norepinephrine, reproductive hormones such as testosterone, social bonding hormones such as oxytocin, and cognitive and pleasure related neurotransmitters such as dopamine.
