I tend to think that one of the best treatments for depression is epinephrine (adrenaline). This is based totally on my subjective experience. Although I know that high amounts of epinephrine are not necessarily healthy for the long term in regards to physical health, they can significantly increase arousal, improve mood, improve mental acuity, cognition, and increase motivation. In some cases an adrenaline boost may be what people need to get them out of a rut of major depression.
Understand that this is strictly my theory, I do not know of any scientific literature regarding this subject. All I have been able to find is that in general “low arousal” can be linked to depression, while “high arousal” can be linked to mood improvements. I’m taking things to a further step and hypothesizing that adrenaline could serve as a treatment for depression if properly utilized.
Part of me thinks that the entire sympathetic nervous system is our body’s natural antidepressant and helps by flooding our body with stress hormones to cover up painful emotions. Although it may be masking the painful emotions, I believe that masking is better than experiencing unnecessary pain. Below I’m going to discuss the transition from low adrenaline to high adrenaline levels as well as how I felt in each of these physiological states of functioning.
Low adrenaline: Physiological Homeostasis (Normal Arousal)
Most individuals will be locked in a state of homeostasis unless some outside trigger increases their level of arousal or changes them. If you put someone with low arousal in a room full of people, something is bound to happen that changes their level of arousal. It is for this reason that I believe that social isolation can lead to low arousal and low adrenaline, which promotes stagnation of a person in regards to social health.
- Experience: Relaxing, calm, normal range of human emotions
Adrenaline climbing: Physically and mentally uncomfortable
Your adrenaline levels can climb from something as simple as an environmental stressor such as having a bad day at work. This stress response from your body will make you feel uncomfortable both physically and mentally. You may notice that your brain will not “shut down” and you are unable to sleep – resulting in insomnia. You may also notice that your body is tense and that you are more prone to headaches. This ranges from low adrenaline to a moderate amount.
- Experience: Discomfort, anxiety, unwanted emotions, negative thinking, fatigue
Medium adrenaline: Fight or Flight Response / Depersonalization
This is a level of adrenaline that most people never reach. Most people experience minor elevations in epinephrine, but nothing that would allow them to reach the “moderate” level of arousal. This is characterized by uncontrollable emotions, obsessive thinking, and extreme discomfort. Most individuals do not reach this medium phase unless they are exposed to significant stress.
A person may feel highly uncomfortable around others and may have a difficult time understanding what they are dealing with. They may experience what I call stress-induced depersonalization. Meaning the person will feel unlike they have ever felt before – they are unable to experience their normal range of human emotions and instead feel numb with stress.
Many people going through withdrawal from SSRI’s are stuck at this medium adrenaline level. It is a very uncomfortable experience that may be characterized best by anxiety with comorbid depression. In other words, it is a state of relatively high arousal that is primarily anxiety-based which can lead to the individual becoming extremely depressed.
- Experience: Extreme discomfort, adrenaline climbing, sensitization, depersonalization, adrenaline rushes
High adrenaline: Extreme anxiety
This is characterized by extreme anxiety and stress. It may take between 6 months and 2 years to transition from the medium level of adrenaline to high adrenaline. Usually the anxiety is not of other things in the environment, it is of symptoms that you are experiencing yourself. People with this degree of arousal are prone to symptoms of hypochondria – which is caused by intense anxiety. People in this high adrenaline state are individuals that have not been able to cope with environmental or physical triggers.
It is not uncommon for these individuals to experience various addictions as a result of their high adrenaline. People may become addicted to the internet, gambling, drinking, etc. Their bodies are producing such high levels of adrenaline that something like alcohol only provides temporary relief from the symptoms. As soon as the alcohol is cleared from their system, they go right back into high arousal and are seeking a way to cope with it.
Individuals with high adrenaline are often unable to channel their excess energy. Productive ways to channel the energy include work, school, or learning a new skill. It is important that these individuals do not become overly addicted to their work or school though. Exercise can be beneficial in this state and usually feels highly pleasurable. With that said, exercise may lower our arousal gradually over a period of time, especially if done extensively.
- Experience: High cortisol production, insomnia, rapid thinking, high dopamine, over-focused ADD, high beta brain waves, increased cortical activity, addiction, pleasure, adrenaline rushes
High adrenaline conditioning: Navigating high arousal
When individuals are stuck in this high adrenaline state for an extended period of time, they may have difficulty learning how to cope with it. Once the person learns how to cope with their high level of arousal and learns how to use it to their advantage, this state can actually become very beneficial. The difference between individuals stuck in a state of hypochondria, anxiety, and traumatic stress and individuals who have learned to navigate the sensitization is profound.
People with hypochondria still feel stuck by their adrenaline because they have not realized that what they are dealing with is merely a byproduct of the sympathetic nervous system. People that have learned to navigate with high levels of arousal can be some of the most productive, go-getters on the planet. The whole key is understanding the triggers for adrenaline sensitization and using them to your advantage.
Adrenaline peak: Hypomania
When the adrenaline peaks, usually the individual will become talkative, highly motivated, competitive, hedonistic, excited, and highly productive in his or her work. It may seem as though the person has been reborn with a new life. They may have a positive outlook on life and feel very grateful for their experience. Although the person is still highly aroused both physically and mentally, they actually become less afraid of external things.
For example, the person will no longer have any social anxiety and/or depression at this level of adrenaline. The person is too aroused to become depressed, their brain is too active to become sad. The individuals EEG brain waves will typically be in the beta range (high or moderate). It is not uncommon for individuals at this level of adrenaline to become addicted to healthy activities such as: exercise, work, sex, socialization, volunteering, etc. People essentially become more extroverted and pleasure seeking.
Really the only thing that will bother a person in this state is a trigger. If the person reached this state through a traumatic experience, they may become very agitated or irritated by triggers. Bright lights and loud sounds may really make the person uncomfortable. However, as long as no triggers interfere with the person, he or she is usually able to cope very well. The overall experience is similar to (a low grade) hypomania.
- Experience: Hypomania, euphoria, social, positive, pleasurable
Adrenaline addiction… not necessarily a bad thing
I wrote an article about how to overcome adrenaline addiction, but I want to make it clear that I don’t necessarily think being addicted to adrenaline is a bad thing. Usually our bodies flood with adrenaline as a response to a certain stimulus. Whether that stimulus was going to war, significant trauma growing up, stress from events that happened in your life, withdrawing from illicit drugs, etc. – your body is capable of producing high amounts of adrenaline on its own via the sympathetic nervous system.
It does this when we have difficulty coping with deep, difficult emotions – especially that of major depression. It should be known that if you were a certain type of person before the adrenaline addiction and like who you have become better after the spike in adrenaline, it may not be a bad thing that you are addicted. With that said, if you were happy with your life and functioning before you experienced trauma that lead to a spike in adrenaline levels, it is highly recommended that you return to a state of low arousal.
I have gone through the full cycle and somewhat regret coming down from the high adrenaline. I guess when you are in that state of mind, you feel as though you have nothing to lose because everything feels so great – you feel unstoppable. I would advise to come down ONLY if you liked the person you were before the initial adrenaline spike.
Side note: This is also my theory as to how someone with avoidant or schizoid personality disorder transitions to becoming a “covert” schizoid. This is also partially my theory regarding Bipolar 1 and Bipolar 2… Although Bipolar 1 may transition to the high arousal very rapidly as a result of brain dysfunction. What I’m describing in this article is high adrenaline as a result of outside environmental influence.
Adrenaline decline: Comfortable / Stable
When stuck in the peak adrenaline level for awhile, you feel good, but start to realize that you would feel better if you were more relaxed. You crave feelings of relaxation because you still feel some anxiety and are trying to get rid of it altogether. Eventually you engage in healthy behaviors such as getting proper sleep at night, meditation, eating healthy, and getting good exercise. Eventually your adrenaline levels will subside and you will experience a comfortable, stable, and more relaxed level of arousal.
It is this level of arousal that will lead you to feel focused, pretty calm, emotional, motivated, and somewhat happy. You may wish that you felt happy all the time like you did in the higher adrenaline state, but realize that being happy all the time isn’t normal. You actually may crave feeling some sadness, depression, anger, and the entire scale of human emotions. You embrace wanting to be fully human – with all emotions.
You eventually think back to your state of high adrenaline and realize that anything is possible. You still may feel unstoppable, but you may start to get some minor glimpses of human emotion during this decline. Most people experiencing an adrenaline decline are still fearless and tend to only have basic anxiety as a result of their high arousal. People are still focused and motivated in this state of arousal. In my opinion, this combination of arousal and adrenaline feels amazing – you are physically relaxed, but your thinking is fast, highly focused, and sharp.
- Experience: More relaxed, natural, emotional, focused, motivated, fearless
Further adrenaline decline: Uncomfortable
At this point, you may notice that your lowered adrenaline is causing your mood to become more depressed. At some point during the medium phase of the decline, you will likely experience trapped or repressed emotions coming to the surface. This is a very difficult experience if you do not have a therapist or another professional to help you deal with them.
This may involve frequent crying spells, depression, and you may lose motivation. Additionally, during this point you may feel somewhat suicidal. This feels equally uncomfortable to when you first experienced an adrenaline spike to the medium phase. In some aspects it may even feel more uncomfortable. It’s almost comparable to going through the first phase of a drug withdrawal.
Although the adrenaline was produced naturally by your body, it still is somewhat like a drug that you were accustomed to on both a psychological and physical level. You will experience similar withdrawal symptoms to that of other drugs. In fact, you may intentionally seek out ways in which you can raise your adrenaline back up for an antidepressant effect. Unfortunately, this isn’t generally sustainable. What goes up must come back down in a counteractive manner.
- Experience: Highly emotional, desensitization, withdrawal, sadness, low energy, low motivation
Homeostasis: Low adrenaline / Standard arousal (Square 1)
Many people have a difficult time going through the entire adrenaline cycle from homeostasis to high adrenaline, back down to their natural level of arousal. In order to feel like you once did before the spike, this is necessary. It is healthier to have lower levels of adrenaline for both physical and mental functioning. With that said, when you drop back down to this state, you may not like the fact that you don’t have the motivation, high-on-life, positive, productive attitude that you once had in your high adrenaline or state of high arousal.
If you make it back to your initial state of homeostasis (i.e. pre-trauma, pre-adrenaline), you will know with 100% certainty. If you think you have made it back to homeostasis because you are starting to feel emotions again, this is a sign that you are starting to see the light, but you are not close to the end yet. It takes roughly one full year from when you start feeling those initial emotions and/or more like your old self before you will return to your original state of homeostasis.
- Experience: Back to normal, Square 1, normal range of emotions
What does adrenaline have to do with depression?
I think it has a lot more to do with depression than people think. With that said, there are some people that may not respond well to increasing their level of adrenaline. At its maximum, high adrenaline is characterized by a state of fear, high arousal, etc. Once a person learns how to use this extra energy to their advantage though, it can be a huge motivator and serve as an antidepressant. It is common for people that have experienced something like PTSD and/or are recovering from hypochondria to note these changes in adrenaline levels.
I wrote about how to overcome PTSD and a lot of my advice has to do with managing adrenaline and arousal. Keep in mind that this is simply my theory, and may not be true – but is true for me because it is my exact experience. Adrenaline is nothing more than another drug to help treat symptoms, despite the fact that it is naturally made by our bodies. My theory is that adrenaline can help people stuck in a deep depression by acting as a stimulant. It is naturally manufactured by our bodies and thus when produced, can actually give depressed people energy to do tasks.
The only real trade-off is that the individual may experience extreme levels of anxiety while the adrenaline is climbing. When it reaches a peak, the individual already knows how to cope with the anxiety. Typically the anxiety itself is of a somatic nature (e.g. the individual is preoccupied with their own bodies). This actually helps reduce social anxiety in some cases and certainly doesn’t allow time for an individual to be depressed.
It is known that higher arousal is linked to less depressive symptoms, so why are SSRI’s a first-line treatment option? Who knows. This is why I tend to think stimulant medications are more favorable for targeting depression. Perhaps due to my experience of taking Adderall for depression and how well it worked and how quick I noticed it working. With that said, there’s nothing wrong with an SSRI provided that it actually works. The success I’ve had with an SSRI in the past had to do with the fact that they actually sped up my thinking, increased my emotional resilience, and overall energy levels.
I am over a year into an adrenaline issue caused by antidepressants. (Low dose over less than a week that made me manic) following with insomnia and depression and huge anxiety. I suffer from adrenaline surges through the night… I wake and feel like my breath has been taken away. I have such a pressured feeling in my body that it can be terrifying.
It will happen 2, 3, 4, or more times in a night… usually after 2am. I will get this through the day but I can for the most part cope by remaining very active. I am on a low dose of propranolol… which I recently tried stopping and it was a big mistake. Now back on the propranolol I truly appreciate how much it helps.
Although I still wake through the night, the surges are now somewhat controlled and manageable. This all stems from what I believe was postpartum depression and anxiety that wasn’t properly addressed. I would gladly go back to how I felt before taking the antidepressants. Glad I found this article… very interesting points and a lot I can completely relate too.
Curious that there seems to be no report on the Net of the effect of slow and low Adrenaline (Epinephrine) infusion to treat depression. In the situation of Anxiety, symptoms are made worse, perhaps understandably and I see a report of worsening in schizophrenia… but no report of the effect in depression, where theory suggests that it should be beneficial in at least some cases.
I have ptsd from childhood abuse and combat. Over 23 years I have tried “everything”. I am now on 2.5 mg Prazosin at bed time. It has completely resolved my mental issues associated with ptsd although my body is still adjusting. Prazosin is an adrenalin blocker that is made for blood pressure. Blocking adrenalin (at a very low dose) has had unbelievable impact on my mental status.
The response to stress is normal. I am very keen to observe how medications are working during the daily up or down titrations (it takes 30 days for Prazosin to build up to the dose level). The most interesting part is how these minute daily changes affect things. One or two days of feeling totally normal then a day or two feeling some different way. Minuscule changes are unbelievable.
I am titrating up from 2 to 2.5 mg. 1/2 mg increase spread over 30 days. This suggests to me that the primary (and possibly only) best treatment for ptsd is adrenalin regulation through Adrenergic receptors. I have had very much improved GI system as well. It is my strong opinion that ptsd drugs should be developed around adrenalin.
I think this is “cutting it off at the pass” and eliminates the need for regulation of other neurotransmitters whose dysregulation is a function of adrenalin dysregulation in the first place. I also believe, because of the many effects from tiny management of adrenalin, that Adrenergic regulation may be the key to many forms of mental illness.
For PTSD it should be obvious. Practitioners have, over the years, told me – your Adrenalin toggle switch is broken.
I tend to agree with you. I wished there was more research in this in regards to bipolarism. I have found very few psychiatrists who will even try to approach bipolar people from this angle. Can you suggest any treatments available.