How Chronic Inflammation Causes Stress, Anxiety, Depression and Chronic Fatigue
Updated: Feb 6
Chronic Inflammation leads to a cascade of hormonal, metabolic and neurotransmitter burnout and imbalance states all associated with Stress, Anxiety, Depressive and Chronic Fatigue States.
Chronic fatigue is by far the most prevalent symptom of chronic immune and inflammatory disorders. How does an inflammatory condition lead to fatigue and how do we fix it?
Chronic fatigue can be caused by many different things. Thyroid disorders (clinical and sub-clinical), menopausal hormone imbalances, blood sugar imbalances and poor eating behaviors, medication side effects just to name a few. This article will focus on how chronic immune and inflammatory processes can lead to fatigue and how to combat it. Interestingly, the inflammatory processes we will discuss, are very often the root cause for the other fatigue causing conditions mentioned earlier.
Chronic inflammation and immune issues come in many different forms. Recurrent tonsil problems, strep throat, ear infections in children; persistent skin issues like eczema or psoriasis, asthma in children or adults; all are disorders that produce a chronic and persistent inflammation in the tissue affected. Since inflammation is an immune system process, these conditions can put an exceptional strain on the immune system over time. Certain infectious agents can also produce the same strain on the immune system. There are viruses such as Mono or the shingles virus that we never really get rid of once we have it. We don't always experience the symptoms of these infections after we had them, because the immune system now recognizes they are in the body and works overtime to make sure they remain sub-clinical. This again puts excessive strain on the immune system.
These persistent strains on the immune system can have a weakening effect on the overall functioning of the immune system. This can make us more immunologically reactive to things we others might not be as reactive to (such as seasonal allergies, etc.) It can also make us more susceptible to immune deficiency issues such as more frequent and persistent colds, flus and infections. This in turn puts more strain on the immune system. You can see how this can create a repeating cycle weakening the immune system even further.
The immune system requires fuel and resources to function properly. One of the primary sources of this fuel is another hormonal body system called the Adrenal gland system. The adrenal glands are two glands that sit on top of the kidneys. They produce various hormones such cortisol, epinephrine, norepinephrine, DHEA, aldosterone, etc. For the purposes of this article, we are going to refer to all these different forms as "adrenaline" as they all perform a similar purpose in the body. They are stress suppressing hormone. Stress comes in many different forms in the body, therefore we need different types of adrenaline to suppress the different types of stress.
Most people think of stress as just psychological. Relationships, spouses, bills and finances, school, careers, grief situations, etc. These are types of stresses, but stress can be equally physiological as it is psychological. Every cold, flu, infection of inflammation you have ever had, is a stress on your physical immune system. Every menstrual cycle a woman goes through is a significant hormonal stress on the body that the liver, kidneys and bowels have to metabolize and excrete. Menopause is another significant hormonal stress on the body. Pregnancy and lactation is a huge physiological stress on the body. Medications are a stress on the liver. You can see that physiological stress can be just as significant on the body as psychological stress.
The adrenal glands sit in the middle, and secrete various forms of adrenaline to help cope with and suppress both psychological and physiological stress in the body. When we are young and healthy and have lots of adrenaline in the system, we are able to cope with stress and manage it quite well. When various stresses become chronic and occur over many months or years, this can lead to a weakening of the adrenal system (and in extreme cases, a burnout of it) and this is where people can start to have signs of adrenal fatigue or adrenal burnout. We all know what an adrenaline rush feels like. What would the exact opposite of an adrenaline rush feel like? Fatigue and exhaustion.
Signs and Symptoms of Adrenal Fatigue and Adrenal Burnout
Fatigue and exhaustion
Anxiety and panic disorders
Overwhelmed and over sensitive
Focus and concentration difficulties
Salt, sugar and caffeine cravings
Weight gain and metabolism issues
Muscle weakness, cramping
Sleep disorders, insomnia
Hormonal imbalances (Menstrual, Menopausal)
Reactive blood sugar issues
Low (or high) blood pressure
Ringing in the ears
Worsening pain and inflammation issues
Immune deficiency symptoms
So from a chronic inflammatory point of view, the process leading to fatigue can be quite simple.
1. Chronic immune / inflammatory response leads to immune system strain and weakening
2. Immune system strain leads to chronic strain on the Adrenal gland system
3. Adrenal system strain and weakening leads to chronic fatigue and other symptoms
As you can see by the diagram below, most of the conventional medical interventions for the symptoms associated with adrenal fatigue are treating the symptom of the condition (adrenal fatigue symptoms) and not the cause of the symptom (Inflammation leading to adrenal fatigue symptoms). Many in the natural health world are guilty of taking the same approach but use natural products to address the symptoms rather than the cause of the symptom. St. John's Wart for depression rather than antidepressants, anti-inflammatory botanical medicines instead of prescription anti-inflammatory medications. Valerian and Melatonin for sleep disorders rather than sleeping medications. You can see that although this approach to managing the symptoms is more "natural" which has obvious benefits, the approach is still symptomatic at its core. Many conditions do require symptomatic support and management at the initial stages of treatment. These treatments are necessary and life saving for many people. Steroidal treatments for significant autoimmune disease sufferers, antidepressants for significantly depressed patients, etc. My point is that in addition to symptom management, we always have think one step "deeper" to address the cause of the symptom.
We can suppress and cover up many symptoms quite effectively with prescription and in many cases, natural products. But if we don't work at addressing the root cause of the symptom, the processes that lead to the symptoms will continue and ultimately the medications (natural or prescription) will become less and less effective as we get older.
The adrenal glands and immune system can be repaired and restored to relatively normal functioning once the cause of the drain has been identified and removed (if possible). If we try and repair and restore this function while the strain on the system is ongoing, it will be much more difficult to achieve results. It's like trying to fill up a bucket with water, that has holes in the bottom of the bucket. What we pour in on top, will run out through the bottom. If we plug the holes in the bottom of the bucket, the supplements and restorative treatments will be much more effective.