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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 4 to 28 of 38. Go back in thread:
Posted by Iansf on December 18, 2007, at 21:51:01
In reply to Things turn 'on' around 7:00, posted by linkadge on December 18, 2007, at 20:49:31
Consider that in Spain and Argentina, people don't go to dinner till 11pm and often stay up till 5 or 6 am. Of course, they take a siesta in the afternoon. But my basic point is there's nothing unusual about getting revved up in the evening rather than the day. US culture favors the day, but that doesn't mean there's anything wrong with you for favoring the evening. I don't know where you live, but an evening schedule is easier if you're in a major city like New York where many people follow a similar pattern.
John
> Anyone else have this problem? I feel tired and out of it all day long, then at like 7:00 everthing just "starts up". Everbody else in the world is starting to relax for the evening, but I'm just the opposite.
>
> Linkadge
Posted by Phillipa on December 19, 2007, at 0:00:21
In reply to Things turn 'on' around 7:00, posted by linkadge on December 18, 2007, at 20:49:31
Link hence why I ride my bike in the dark. I chalked it up to the 3-ll work schedule I worked for l5 years. But isn't it also a sign of atypical depression or plain old garden variety depression. I hate the mornings hence sleep til l0 or ll. Always have even in high school took wednesdays off to sleep. And didn't have to get up till 8am. And my first two kids slept from llpm till 9am from the time they were two weeks old. Phillipa and I didn't drug them.
Posted by Racer on December 19, 2007, at 0:01:01
In reply to Things turn 'on' around 7:00, posted by linkadge on December 18, 2007, at 20:49:31
That's often the pattern for melancholic depression. I generally feel better in the evening, and more depressed in the early part of the day.
Posted by oldschool305 on December 19, 2007, at 0:28:16
In reply to Things turn 'on' around 7:00, posted by linkadge on December 18, 2007, at 20:49:31
> Anyone else have this problem? I feel tired and out of it all day long, then at like 7:00 everthing just "starts up". Everbody else in the world is starting to relax for the evening, but I'm just the opposite.
>
> Linkadge
Me tooooooooo. I have no desire to get out of bed all day, see the sunlight, nothing. After sundown, I tend to gain a sudden burst of energy. Too bad my up and coming job is in the am. Darn it.
Posted by your#1fan on December 19, 2007, at 1:24:44
In reply to Re: Things turn 'on' around 7:00 » linkadge, posted by Racer on December 19, 2007, at 0:01:01
hey! im back for a bit. I went on psychobabble vacation and everything...but still going to the doctor. I have been out, and doing things, like applying for jobs and stuff for my ocupation of my time.
Hey..........oh by the way link, i used to feel the same thing!! only at 6pm usally. Isnt it funny sometimes before i was on this medication to make the day feel better, i hated mornings, GABA chemical was too active, i was to calm, or there wasnt hardly any nuerons running in my head in the morning! nothing! thats why i woke up just depressed, didnt want get out of bed, but its that gradul lag that will pull you out "Ugh, alright i'll deal with one more day" ROFL! but that is how i feel.
After Prozac was increased to 40mg this summer, i was really not happy with the way i was living, or feeling. I didnt have well-being, i didnt even knew what the word was until i looked it up, back in like 2003..when i was really feeling awful.
Well, this can apply to racer, and phillipa.. im actaully doing good right now in Prozac and Duplin...but still, um...during the day i have increased energy to go places, well do stuff that has to be done, and i dont usally like to do it. Duplin is still expensive!!
especially for things to get people these holidays! my god thats what i've been doing, shoppin like there's no tommorow! ROFL! but im feeling better, i dont feel that feeling you feel on a stimulant, racey and driven. I just feel im "normal".
But i have too break something to you.... i couple nights ago, i could withstand alot of pressure, but i could not mentally sleep. Im used to being laid back, GABA feeling.... no. Lithium or Abilify or seroquel at night i think would be best, dont you argee? but then i would not feel "lively" the next morning.
Some advice..?:)
Oh and link, thank you so much for letting me post on this. I feel the same way....! my goodness!your#1fan
Posted by Polarbear206 on December 19, 2007, at 12:15:27
In reply to Things turn 'on' around 7:00, posted by linkadge on December 18, 2007, at 20:49:31
> Anyone else have this problem? I feel tired and out of it all day long, then at like 7:00 everthing just "starts up". Everbody else in the world is starting to relax for the evening, but I'm just the opposite.
>
> Linkadge
This was one of my main problems before I was on a mood stablizer. More so in the winter months for me. I read somewhere on depression central that this pattern can be indicative of bipolar spectrum. I always would schedule appointments and other things later in the day. I always had to triple check myself at work in fear of making a mistake, like transcribing a doctors order, etc... I always would exercise late in the day, because I was too tired and my limbs felt like they had weights strapped to them. I'm like in a fog and then it clears as the day progresses. Circadiam rhythm is out of wack. Light therapy in the morning helps with this, but wasn't enough for me.
Posted by bleauberry on December 19, 2007, at 18:16:52
In reply to Things turn 'on' around 7:00, posted by linkadge on December 18, 2007, at 20:49:31
The pattern everyone here has described is experienced by practically everyone who has adrenal fatigue. Cortisol fluctuates and follows a curve through the circadian rhythme. But stress, illness, hidden infections, poor diet, and psychiatric illnesses put so much stress on the adrenal glands that the cortisol curve gets thrown out of sync. It is quite common for there to be an afternoon dip that is worse than any other time of day, usually between 1pm and 4pm. The morning and daytime fatigue and glum mood is the low cortisol; the evening bounce is cortisol on the rise...but at the wrong time.
I had this pattern too. It was so perplexing. Really tired and glum all day. For 2 years every single day the pattern repeated...morning fatigue and depression, a bad sinking in mid afternoon, and a nice bounce in the evening, usually at 7pm, but on rare ocassions when I stayed up later it was even better by midnight. This pattern has mellowed somewhat, but it is still there.
It can be diagnosed with a 24 hour saliva test (4 samples) of salivary cortisol. You can see your curve plotted on a graph and see where the hills and valleys are and how they correlate almost exactly with your mood and energy.
Treatment is tough. Diet is an important basic. Very little sugar. Eliminate or reduce coffee. Focus on meats and veggies, cut down on carbs. But those just set the stage for healing. I've seen in books where doctors heal patients with just diet, but it takes 2 to 3 years.
Adrenal cortex (NOT adrenal glandular) extracts are helpful and usually essential to support the adrenal glands. Allergy Research or Thorne make good ones. Adrenal cortex during the day. Some doctors will prescribe phsyiological replacement doses of hyrdocortisone ranging from 5mg to max 20mg per day. If cortisol is too high at night, phosphatidyle serine will tame it down. The symptoms of it can also be tamed down with gabaergic things like valerian, passion flower, and benzodiazepines.
Though the evening bounce feels good, it is ultimately destructive. As long as that curve is not right, it stresses the entire body and brain in terms of immune response, mood, energy, digestion, and sensitivities.
Some of the psych meds we are all familiar with actually correct the cortisol curve. Some make it worse, such as stimulants or Prozac. Some of our drugs might have even caused it. If you were ever on a drug that caused you longterm anxiety or akathisia, your adrenal glands were taxed to the max. The ones that in research have normalized the cortisol curve are Nardil, Lexapro, Nortriptyline, and St Johns Wort. The common adrenal balancers such as ginsengs and rhodiola mostly tend to reduce cortisol but not balance it. It is my guess that a lot of the antidepressant effect of antidepressants is not due to the direct action on neurotransmitters, but rather the longterm normalizing of the adrenal gland/cortisol axis and its relation to circadian curve as an indirect result of the action on the neurotransmitters. But this takes in the neighborhood of 3 months to occur, so many people who have not improved on their drug by then have long dropped out already and never saw the benefit just around the corner.
I sometimes think of Scott who was a longtimer here. He suffered for so long waiting for Nardil to kick in. What, it must have been 3 months or something like that? Long time. It did finally kick in. I can't help but lean toward the belief that his adrenal/cortisol/circadian axis was at the root of it all and Nardil fixed it. Adrenal problems take time to correct, usually 3 months to 2 years.
Anyway, it is no secret that the adrenal/cortisol/circadian curve is involved in most mood disorders. And it is no surprise that everyone in this thread including me is experiencing a version of the same thing. It's called adrenal fatigue. Easily recognizable, easily diagnosed, correctable but takes time and dedicated strategy. When the curve is right and normalized, that evening bounce we all get is what normal healthy people feel all day long. When the curve is right, everything in our body and brain works. When it isn't, nothing works right.
Sorry so long. Basically, the pattern of daytime fatigue with an evening recovery is typical in almost 100% of people with adrenal fatigue or hypoadrenalism.
Posted by ny2bk on December 19, 2007, at 18:28:20
In reply to Things turn 'on' around 7:00, posted by linkadge on December 18, 2007, at 20:49:31
> Anyone else have this problem? I feel tired and out of it all day long, then at like 7:00 everthing just "starts up". Everbody else in the world is starting to relax for the evening, but I'm just the opposite.
>
> LinkadgeIm am soo feeling that.Mornings are killer,i mean killer,its a fight aganist all of the sypmtoms as they are strong,anxiety mostly.
I take my second dose and last at approx 4pm,and this same dose,as taken in the morning,now instead calms down all my symptoms significantly,and yess as you said starting from 4pm around 7 not only do my meds work 50 percent better,but generaly i feel more at peace,and around 9 as well,also what is usualy a problem is when im in a semi remission i actualy HATE BEDTIME,i simply dont want to go to sleep,opposed to afternoon naps which feel at times like a needed shut down for reliaf.
Im glad im not alone,but yess not only does my meds work better at this time,but also my mood alone which i can distinguish from the med addition is calmer,i often said to friends and family if that was morning id live a lot better.
I see some good answers,wish i could super read,i dont wanna scan them fast and miss the meaning,so i have to wait till i can sit down and read them,need clip notes on them lol.
Look forward to reading the answer post on this regarding the adrenals which i looked at briefly,i have lifted wieghts heavly since 16 and wonder if i actualy did any harm there?
Posted by clipper40 on December 19, 2007, at 18:48:22
In reply to Re: Things turn 'on' around 7:00...Adrenal Fatigue, posted by bleauberry on December 19, 2007, at 18:16:52
Exactly what I've been dealing with! I don't wake up until much later in the day. Then when I finally have energy and feel awake, it's time to go to sleep. Unfortunately, I don't go to sleep. I like feeling alive finally so I end up staying up most of the night. My sleep schedule is all screwed up. It's horrible.
I'd like to add that most traditional doctors don't recognize adrenal fatigue. If you don't have Addison's disease or full out failure of the adrenals, then they don't see it as a problem. Those who want to get healed from this need to look into this for themselves and/or see a holistically oriented practitioner.
My holistic doctor prescribed Sub-Adrene (adrenal cortex extract). Have you heard of that one? I haven't been diligent about the diet however. Must do that soon. This is a double curse for me because I need noradrenergic/dopaminergic assistance for my lack of motivation. I'd really like to try Trivastal soon but I don't dare take anything like that until I'm sure my adrenals can handle it.
I'm also planning on adding licorice and ashwaganda herbs to my schedule. Do you know if these normalize or just reduce cortisol? I thought that aswaganda normalized it.
Interesting observation about Scott. I used to think that there was a physiological problem behind his nonreaction to meds and I urged him more than once to see a holistic physician and get a thorough workup. He knew a lot more than I did, however, about psychotropic drugs and brain chemistry and he completely disregarded my posts. I'm glad he finally got a good response though. If anyone deserved it, he did!
Clipper
Posted by Phillipa on December 19, 2007, at 19:50:30
In reply to Re: Things turn 'on' around 7:00...Adrenal Fatigue » bleauberry, posted by clipper40 on December 19, 2007, at 18:48:22
And he's still doing well. Takes Deplin too. But my Mother had addison's disease from too much cortisone in the 50's it is a very powerful med. Phillipa
Posted by clipper40 on December 19, 2007, at 20:12:11
In reply to Re: Things turn 'on' around 7:00...Adrenal Fatigue » clipper40, posted by Phillipa on December 19, 2007, at 19:50:30
> And he's still doing well. Takes Deplin too. But my Mother had addison's disease from too much cortisone in the 50's it is a very powerful med. Phillipa
That's great news about Scott.
This place just isn't the same without him!
Posted by clipper40 on December 19, 2007, at 20:18:19
In reply to Re: Things turn 'on' around 7:00...Adrenal Fatigue, posted by bleauberry on December 19, 2007, at 18:16:52
Also, doesn't tianeptine normalize cortisol production and function?
Posted by Polarbear206 on December 19, 2007, at 22:42:05
In reply to Re: Things turn 'on' around 7:00...Adrenal Fatigue, posted by bleauberry on December 19, 2007, at 18:16:52
> The pattern everyone here has described is experienced by practically everyone who has adrenal fatigue. Cortisol fluctuates and follows a curve through the circadian rhythme. But stress, illness, hidden infections, poor diet, and psychiatric illnesses put so much stress on the adrenal glands that the cortisol curve gets thrown out of sync. It is quite common for there to be an afternoon dip that is worse than any other time of day, usually between 1pm and 4pm. The morning and daytime fatigue and glum mood is the low cortisol; the evening bounce is cortisol on the rise...but at the wrong time.
>
> I had this pattern too. It was so perplexing. Really tired and glum all day. For 2 years every single day the pattern repeated...morning fatigue and depression, a bad sinking in mid afternoon, and a nice bounce in the evening, usually at 7pm, but on rare ocassions when I stayed up later it was even better by midnight. This pattern has mellowed somewhat, but it is still there.
>
> It can be diagnosed with a 24 hour saliva test (4 samples) of salivary cortisol. You can see your curve plotted on a graph and see where the hills and valleys are and how they correlate almost exactly with your mood and energy.
>
> Treatment is tough. Diet is an important basic. Very little sugar. Eliminate or reduce coffee. Focus on meats and veggies, cut down on carbs. But those just set the stage for healing. I've seen in books where doctors heal patients with just diet, but it takes 2 to 3 years.
>
> Adrenal cortex (NOT adrenal glandular) extracts are helpful and usually essential to support the adrenal glands. Allergy Research or Thorne make good ones. Adrenal cortex during the day. Some doctors will prescribe phsyiological replacement doses of hyrdocortisone ranging from 5mg to max 20mg per day. If cortisol is too high at night, phosphatidyle serine will tame it down. The symptoms of it can also be tamed down with gabaergic things like valerian, passion flower, and benzodiazepines.
>
> Though the evening bounce feels good, it is ultimately destructive. As long as that curve is not right, it stresses the entire body and brain in terms of immune response, mood, energy, digestion, and sensitivities.
>
> Some of the psych meds we are all familiar with actually correct the cortisol curve. Some make it worse, such as stimulants or Prozac. Some of our drugs might have even caused it. If you were ever on a drug that caused you longterm anxiety or akathisia, your adrenal glands were taxed to the max. The ones that in research have normalized the cortisol curve are Nardil, Lexapro, Nortriptyline, and St Johns Wort. The common adrenal balancers such as ginsengs and rhodiola mostly tend to reduce cortisol but not balance it. It is my guess that a lot of the antidepressant effect of antidepressants is not due to the direct action on neurotransmitters, but rather the longterm normalizing of the adrenal gland/cortisol axis and its relation to circadian curve as an indirect result of the action on the neurotransmitters. But this takes in the neighborhood of 3 months to occur, so many people who have not improved on their drug by then have long dropped out already and never saw the benefit just around the corner.
>
> I sometimes think of Scott who was a longtimer here. He suffered for so long waiting for Nardil to kick in. What, it must have been 3 months or something like that? Long time. It did finally kick in. I can't help but lean toward the belief that his adrenal/cortisol/circadian axis was at the root of it all and Nardil fixed it. Adrenal problems take time to correct, usually 3 months to 2 years.
>
> Anyway, it is no secret that the adrenal/cortisol/circadian curve is involved in most mood disorders. And it is no surprise that everyone in this thread including me is experiencing a version of the same thing. It's called adrenal fatigue. Easily recognizable, easily diagnosed, correctable but takes time and dedicated strategy. When the curve is right and normalized, that evening bounce we all get is what normal healthy people feel all day long. When the curve is right, everything in our body and brain works. When it isn't, nothing works right.
>
> Sorry so long. Basically, the pattern of daytime fatigue with an evening recovery is typical in almost 100% of people with adrenal fatigue or hypoadrenalism.
>
>
Check this out and I'd like to hear your feedbackhttp://www.alternativementalhealth.com/articles/walsh.htm#Bi
Posted by saturn on December 20, 2007, at 18:51:54
In reply to Things turn 'on' around 7:00, posted by linkadge on December 18, 2007, at 20:49:31
>>> Anyone else have this problem? I feel tired and out of it all day long, then at like 7:00 everthing just "starts up". Everbody else in the world is starting to relax for the evening, but I'm just the opposite.
Yeah...for me this results in insomnia and considerable daytime fatigue. A sleep specialist called it delayed sleep phase syndrome in my case. I'm a night owl. Days can be a struggle.
Posted by linkadge on December 20, 2007, at 21:59:59
In reply to Re: Things turn 'on' around 7:00 » linkadge, posted by saturn on December 20, 2007, at 18:51:54
Yeah, thats what my psychiatrist said too: Delayed Sleep Phase Syndrome.
It is very disrupting.
I wish there were more answers than AP's.
Linkadge
Posted by bleauberry on December 20, 2007, at 22:43:03
In reply to Re: Things turn 'on' around 7:00...Adrenal Fatigue » bleauberry, posted by clipper40 on December 19, 2007, at 18:48:22
> Exactly what I've been dealing with!
Usually when someone has adrenal fatigue but they don't know it, and then they read a description of it, they suddenly see what's going on.
>
> I'd like to add that most traditional doctors don't recognize adrenal fatigue.True. The tests endos give basically just say if your adrenals are dead or alive, with no consideration at all of how well or poorly they are working, or how wide the normal range is, or how someone's optimal level might be outside the normal range. Kind of like checking for a heartbeat of someone with a history of heart attacks, hearing a heart beat, and saying your heart is normal and ok.
> My holistic doctor prescribed Sub-Adrene (adrenal cortex extract).
Haven't heard of that one.
Diet does help, especially the part about cutting down or eliminating sugars and caffeine.
> I'm also planning on adding licorice and ashwaganda herbs to my schedule. Do you know if these normalize or just reduce cortisol?Ashwaghands is touted as balancing adrenal function, and maybe it does, but the scientific stuff I saw said it lowered cortisol. I don't know. Licorice is excellent though. It prevents the breakdown of your own cortisol, so the little you make stays around longer. Kind of like how an MAOI works to keep neurotransmitters from breaking down. Still though, even with that boost, some people still need more adrenal support.
> Clipper
Posted by bleauberry on December 20, 2007, at 22:48:55
In reply to Re: Things turn 'on' around 7:00...Adrenal Fatigue » bleauberry, posted by Polarbear206 on December 19, 2007, at 22:42:05
>
> Check this out and I'd like to hear your feedback
>
> http://www.alternativementalhealth.com/articles/walsh.htm#Bi
>Excellent stuff. If more chronically ill psych patients were to enlist a doctor who would help them rule out diagnosis or confirm diagnosis with these things objectively, there would be a lot of healed people.
Posted by Phillipa on December 20, 2007, at 23:00:05
In reply to Re: Things turn 'on' around 7:00...Adrenal Fatigue, posted by bleauberry on December 20, 2007, at 22:48:55
Well I googled it and it's exactly what I have. Have been this way since childhood. So just accept it? Phillipa
Posted by clipper40 on December 21, 2007, at 0:16:31
In reply to Re: Things turn 'on' around 7:00 » linkadge, posted by saturn on December 20, 2007, at 18:51:54
You can have both adrenal fatigue and delayed sleep phase syndrome. From what I have read, they often go hand in hand. Delayed sleep phase people tend to be night owls and they tend to want to go to sleep later each night. The part that you describe of not feeling awake until many hours after you've gotten up sounds like the adrenal fatigue part. Since people with this problem don't feel alive until many hours after getting out of bed. They're finally feeling normal and alive and mentally sharper very late in the day so they don't want to go to sleep at that point. They want to finally get some things done and savor the feeling of awakeness. So you can see how each condition would feed the other.
I'm quite certain I have both conditions and it's very tough for me to deal with. I'm having a lot of trouble getting on, and staying on, a normal schedule. I'm also finding it very difficult to get anything accomplished. It's that much harder because most other people don't understand either of these conditions.
Posted by clipper40 on December 21, 2007, at 0:34:50
In reply to Re: Things turn 'on' around 7:00...Adrenal Fatigue, posted by bleauberry on December 20, 2007, at 22:43:03
>>Usually when someone has adrenal fatigue but they don't know it, and then they read a description of it, they suddenly see what's going on.
Exactly how it happened with me! I finally knew that what I was dealing with had a name and could be treated.
>>True. The tests endos give basically just say if your adrenals are dead or alive, with no consideration at all of how well or poorly they are working, or how wide the normal range is, or how someone's optimal level might be outside the normal range. Kind of like checking for a heartbeat of someone with a history of heart attacks, hearing a heart beat, and saying your heart is normal and ok.
LOL. Great analogy!
In the book I have, "Adrenal Fatigue" by James L. Wilson, N.D., D.C., PhD, he recommends Ashwaganda but I'll definitely have to do more research on it before I take it. I don't need my cortisol lowered any further!
I think I'll try adding licorice for now. I'm going to be cutting out the refined sugar and limiting coffee to half a cup of caffeinated in the morning as well. I really want to get better!! Can't stand this low level functioning much longer.
>>Haven't heard of that one. [Sub-Adrene]
Sub-Adrene is a liquid that you take sub-lingually. It's made by American Biologics.
I'm going to check out the glandulars you mentioned also for when I finish the bottle of Sub-Adrene.Thanks for your feedback.
Clipper
Posted by clipper40 on December 21, 2007, at 0:41:42
In reply to Re: Things turn 'on' around 7:00...Adrenal Fatigue, posted by Phillipa on December 20, 2007, at 23:00:05
No, you don't have to just accept it. If you have delayed phase sleep syndrome, you can use melatonin and lightboxes to help regulate your sleep cycle.
For adrenal fatigue, the treatment consists of cutting out caffeine and sugar from your diet, getting 8 hours of sleep a night, taking a reputable glandular like the ones Bleauberry mentioned, taking adequate B & C vitamins. Herbs like licorice can help too. If the condition is severe, some doctors prescribe a little cortisol. There are articles and books on treatment of this for more detail.
Posted by clipper40 on December 21, 2007, at 5:48:52
In reply to Re: Things turn 'on' around 7:00...Adrenal Fatigue » Phillipa, posted by clipper40 on December 21, 2007, at 0:41:42
In my last few messages I mentioned adrenal glandulars. That's wrong. It should have read "adrenal cortex extracts" instead.
Posted by Phillipa on December 21, 2007, at 18:42:09
In reply to Correction- Adrenal Cortex Extracts- not glandular, posted by clipper40 on December 21, 2007, at 5:48:52
But what if your endo did a blood draw and said you were okay? Cortisone can make a person pschotic too as a side effect. My sister gets poison ivy yearly and has to take the medrol pack and it drives her nuts????? Phillipa
Posted by clipper40 on December 21, 2007, at 18:55:41
In reply to Re: Correction- Adrenal Cortex Extracts- not glandular » clipper40, posted by Phillipa on December 21, 2007, at 18:42:09
You don't have to take cortisol. Just take the adrenal cortex extract.
Besides, you don't want to raise your cortisol levels above the normal range in most cases anyway. You just want to make up for what you're missing.
Posted by bleauberry on December 21, 2007, at 18:56:55
In reply to Re: Things turn 'on' around 7:00...Adrenal Fatigue » bleauberry, posted by clipper40 on December 21, 2007, at 0:34:50
I think the way adaptogenic herbs like ashwaghanda work is by blunting the cortisol response. They smooth out and dampen the response to nervous situations, with an overall lowering of cortisol early in treatment but a normalizing of cortisol later. This perhaps gives the adrenals a needed rest and allows them to heal. My doc said these herbs take at least 2 months to 6 months to work. Maybe that's why.
The only reason I mentioned the other 2 brands of cortex is because they are the ones recommended by people at chelation forums who have adrenal fatigue as a primary health problem. They've already done the experimenting, trial and error, and research. The underground research likes those two brands.
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