The Role of Adrenal Glands in Mental Health

Adrenal glands (also known as suprarenal glands or "kidney hats") are triangle-shaped endocrine glands located on top of the kidneys. These glands release hormones that can have an effect on a variety of body processes, including regulating metabolism, supporting the immune system, and even managing stress responses.

The Anatomy of the Adrenal Glands

The adrenal glands are part of the body's endocrine system, which is composed of a system of glands that release chemical messengers called hormones. These hormones are carried through the bloodstream to specific tissues and organs.

Adrenal glands are made of two main parts:

• The outer part of the adrenal glands is known as the cortex and releases hormones including androgens (male sex hormones) and cortisol. The hormones released by the outer part of the adrenal glands help control things like the immune system and metabolism.
• The inner area of the adrenal glands is known as the medulla and produces the hormones norepinephrine and epinephrine. The hormones released by the inner cortex control the body's stress response.
  

How the Adrenal Glands Work

The adrenal glands release hormones into the bloodstream that regulate metabolism, blood pressure, the stress response, and immune function. The key hormones produced by the adrenal glands include:

• Cortisol
• Aldosterone
• Dehydroepiandrosterone (DHEA)
• Epinephrine
• Norepinephrine

Cortisol

Cortisol is a naturally occurring steroid hormone that plays a role in a variety of body functions. Often called "the stress hormone," cortisol is best known for its role in the body’s stress response and is also involved in the regulation of the following functions and more:

• Blood pressure regulation
• Glucose metabolism
• Immune function
• Inflammatory response
• Insulin release

Aldosterone

Aldosterone plays an important role in regulating blood pressure as well as the body’s sodium and potassium levels. It sends signals to the kidneys to absorb sodium and release potassium through urine, regulating both blood pressure and electrolyte levels in the body.

Dehydroepiandrosterone (DHEA)

DHEA is a naturally occurring steroid hormone that converts into a range of hormones, including androgens and estrogens, the male and female sex hormones.

Epinephrine and Norepinephrine

The hormones epinephrine (adrenaline) and norepinephrine (noradrenaline) are released during the body's stress response. They help to cause that "adrenaline rush" you have probably felt when you're scared.

Adrenal Glands and the Stress Response

When the fight or flight response is triggered, the body rapidly prepares itself to cope with danger, either by confronting the problem or by escaping. Physical signs of this reaction include dilated pupils, increased or decreased blood flow to the skin, increased heart rate and breathing, and muscle tension.

The long-term activation of the adrenal glands causes too much exposure to stress hormones, including cortisol. This can disrupt the body and increase the risk for a variety of health problems, such as:

• Anxiety
• Cardiovascular problems
• Concentration and memory problems
• Depression
• Headaches
• Muscle tension
• Sleep disturbances
• Weight changes
  

Adrenal Gland Disorders

In addition to the effects of chronic stress, certain health conditions can also cause problems with the adrenal glands. When the adrenal glands produce too much or too little of a hormone, illness can result.

If there's a disorder in the pituitary gland, which signals to the adrenal glands when to make certain hormones like cortisol and aldosterone, the functioning of the adrenal glands can also be impaired. 

Different types of adrenal disorders include:

• Addison’s disease develops when the adrenal glands can no longer adequately supply the body with cortisol and aldosterone.
• Congenital adrenal hyperplasia is an inherited group of diseases in which the body cannot make adequate amounts of key enzymes, often including cortisol and aldosterone.
• Cushing’s syndrome occurs either because cortisol is being overproduced by the body or from the overuse of corticosteroids like prednisone.
• Pheochromocytoma is a rare type of tumor found in the adrenal glands that can secrete large amounts of certain hormones produced by the adrenal glands (catecholamines).
  

Diagnosis

If you are experiencing symptoms that might be a sign of an adrenal gland problem, you should have your symptoms evaluated by a medical professional.

Typically, a healthcare provider will assess the function of your adrenal gland by taking blood and urine collections to measure certain adrenal hormone levels and functions. There may also be imaging studies such as a CT or MRI scan.

If your symptoms do not appear to be related to an adrenal gland disorder, a healthcare provider might suggest that your symptoms are related to excessive or chronic stress.

Treatment for Adrenal Gland Problems

There are a variety of treatments for adrenal gland disorder, depending on your specific diagnosis, including:

• Medication to control the overproduction of the hormones
• Hormone replacement therapy to replace the cortisol and aldosterone the body is lacking
• Surgery to remove one or both adrenal glands or to remove the tumor in the case of pheochromocytoma

Treatments for Stress-Related Problems

Because chronic stress is a significant contributor to many health problems, healthcare providers may advise treatments that target stress levels. Such strategies may help ease the body's stress response and minimize its damage to health and well-being. Treatment strategies that target stress include:

• Psychotherapy: A few different types of therapy can be particularly effective for lowering stress levels. These include cognitive behavioral therapy (CBT), which helps people change the negative thoughts that contribute to stress, and mindfulness-based stress reduction (MBSR), which incorporates mindfulness and meditation to help people find relief from stress.
• Medication: Healthcare providers may also prescribe medications that can ease feelings of anxiety and stress. Antidepressants and anti-anxiety medications can reduce anxiety and improve mood, which can help people feel calmer and less distressed.

How to Cope With Overactive Adrenal Glands

Under normal circumstances, the body's relaxation response eventually kicks in to return to the same state it was in before the fight-or-flight response was triggered. While chronic stress and anxiety might keep you in a heightened state of alert, there are strategies that you can use to ease stress and induce a relaxation response.

Learning these stress management skills can also help you better control your body's stress response. Various techniques that people may find helpful for lowering cortisol and other stress hormones released by the adrenal glands include:

• Deep breathing exercises
• Exercise
• Guided imagery
• Journaling
• Meditation
• Mindfulness
  
• Progressive muscle relaxation
• Yoga

These techniques can not only provide quick relief when the adrenal glands release stress hormones, but they can also help people develop greater resilience to long-term stress. 

Summary

The adrenal glands play an important role in many body functions, including the stress response. Excessive stress can lead to prolonged activation of adrenal glands, and long-term exposure to the stress hormones that this gland produces can have serious detrimental effects on both physical and mental health.

If you have concerning symptoms, talk to a healthcare provider. They can determine whether you might have an underlying condition such as an adrenal disorder. There are also strategies you can use to help get stress under control and induce a relaxation response that will ease anxiety and calm feelings of stress.