Being Grateful and Advanced Adrenal Fatigue Syndrome – Part 1

By: Michael Lam, MD, MPH; Carrie Lam, MD; Dorine Lam, RDN, MS, MPH

Keeping the right attitude can help you in being grateful and fight Adrenal FatigueWhen 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.

Being grateful during the hard timesUnknowingly, 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 what we think, being grateful is importantWe 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

We don't know every mechanism of action, but being grateful is good for you!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:

  • 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.

  • Less Stressed

    Being grateful has many positive effects in lifeA 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.

  • More Purposeful

     Grateful people are more logically focused on their priorities and they are more mature and balanced in their personal growth.

  • 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.

  • 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.

  • Better Sleep

    Higher levels of gratitude were associated with better sleep with lower anxiety and depression.

  • 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.

  • 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.

Read Part 2

© Copyright 2014 Michael Lam, M.D. All Rights Reserved.

Dr. Lam’s Key Questions

As humans, we all have weaknesses. Defense mechanisms can be healthy to a certain degree, but can also be overwhelming that they become negative.

There are many supplements that can be beneficial to you. Vitamin C and fish oil are great for healing and would be a good place to start. Just don’t over do it.

Keeping the right attitude can help you in being grateful and fight adrenal fatigue
5 - "I am grateful for this article!"
I am grateful for this article! Thank you for affirming the benefits of gratitude. I will continue to practice gratitude!


  • Robyn Hope says:

    Thanks a million for recommending this article on gratitude…makes a lot of sense.
    I’ve been doing this for a couple months: naming 3 things I am grateful for…problem is, I don’t feel emotionally connected to it. I was raised in an extremely negative home, you see. So, reframing my weary brain at my age is nothing short of herculean.
    Any hope for me?

  • Shawn says:

    This is wonderful literature! Enjoy reading them every time!

  • Abel says:

    Are there any techniques you can suggest for improving the outlook of situations or how to reduce negative thoughts? Thanks

  • Shayna says:

    Thank you do much for this article!

  • Dom says:

    This is great. I want to be grateful and positive and hopeful no matter what state of health I’m in. Count your blessings one by one.

  • Anastasia says:

    Yes, Positivity is key! Being thankful for what we have and keeping a positive mindset is so important to our health and wellness. Spot on.

  • Clyde says:

    This is definitely a good read for the closed minded types, which I used to be. Thanks to the power of prayer and positive thought, things are really working out for me. I’ll be passing this article along to my buddies. Thanks.

  • Mike says:

    This is so true! There is definitely a connection between the mind and body when it comes to health

  • Danica says:

    This article is a wonderful tool for me to keep in mind in those “woe is me” moments. I’m grateful for you and all that you do Dr. Lam. Thank you for this informative reminder to remain positive as much as possible!

  • Amanda says:

    Even though it seems like such a simple task, practicing gratitude has tremendously helped shape a positive outlook in my day to day life…thank you!

  • Kaitlin says:

    I love your site and how informative it is- Thank you for providing article for both the mind and body and how they both tie into recovery!

  • Brandie says:

    I am grateful for this article! Thank you for affirming the benefits of gratitude. I will continue to practice gratitude!

  • Gerrle M. says:

    I find this article to be very interesting and it holds a lot of truth. I used to be, what I call, a stick in the mud, type of person. Most people would have called me negative. But after finding some faith and turning my thought process around, I find that positive energy just seems to come my way. I hope others can find that common ground as well.

  • Gineen says:

    Thank you so much for this post, Dr. Lam. Thank you for all of your posts. I just learn so much from everything on your blog. I am 3 years into my recovery from stage 3 Adrenal Fatigue and the road to recovery has been mentally very challenging at times. I try to be grateful for the experience of my journey and getting to know my body better. I try to look at Adrenal Fatigue as a blessing in disguise. It has forced me to slow down and breathe. It’s not always easy, but all that any of us can do is try our best and be grateful 🙂

    Thank you so much!

    • Dr.Lam says:

      Thanks for your kind words. Recovery is a journey. I am glad you are leaning and doing well.

      Dr Lam

  • Martin says:

    How much impact can your attitude really have on AFS?

  • Aurora says:

    What resources can you share that show how gratitude has a positive impact on our mind and body?

  • Jenny says:

    I always knew that getting a good amount of sleep is vital, what would you say is the ideal amount of sleep that you would want to get every night.

    • Dr.Lam says:

      Your body has an automatic mechanism for sleep. It will wake you up when you have enough. The number of hours are not very accurate. There is no ideal as everyone is different and also varies with age. Studies have shown generally speaking that 8 hours is enough but everyone is different so general guidelines dont work well , especially if you have AFS or biological rhythm issues. Click Biological Rhythm Disruptions & AFS for more information.

      Dr Lam

  • Sara says:

    Thank you so much for this article. I struggle daily with being grateful when I feel so terrible.

    • Robyn Hope says:

      Exactly so. Last night I felt I was on my deathbed and was supposed to come up with positive things to say, which I managed to do, but don’t feel emotionally connected. I’d say, do it anyway. ..and hopefully, start to feel it down the road.

  • Donna says:

    Hello Dr. Lam. Your website has been really helpful! Thank you for sharing your knowledge! I am so glad I stumbled upon your site. I have a lot of symptoms of adrenal fatigue – not sure what stage though (fatigue, insomnia, brain fog, palpitations usually at night that wake me up – did EKG 48hr monitor but all is fine with my heart). I am seeing a holistic physician who prescribed me DHEA 5mg for now (and a sleep aid to help me sleep at night). I hope this is a good start in my case? Please advise. I’d love to get a copy of your book! Many thanks and more power to you!

    • Dr.Lam says:

      Thanks for your kind words. I hope it is educational for you. The use of hormones such as DHEA has it place, but also with significant drawbacks. We seldom find the need to use it because there are many other better alternatives without long term issues associated. The same goes for glandulars except in very unusual circumstances. They are all covered in detail in my book of over 500+ pages. The more you know, the better you are able to have an intelligent conversation with your doctor and map out a comprehensive course of recovery because improper use of supplements can be a major roadblock to recovery. Click Adrenal Fatigue & Hormone Therapy for more information. Also click 7 Adrenal Fatigue Recovery Mistakes for more information.

      Dr Lam

  • Ade Adesanya says:

    Hello Dr. Lam. Sincerely, your website is about the most resourceful I’ve come across on AFS. I thank you for being so knowledgeable on the topic. However, you do not cover much on Addisons disease, which is completely different from AFS. My Cortisol level is extremely low. so is that of my teenage Sons. Knowing what I know now, my Dad’s most have been too. Any advise?

    • Dr.Lam says:

      Addisons’s Disease is quite different and is a medical condition that you can google and find plenty of information on . low cortisol can be present in both AFS and Addidson’s. there is also a hereditary component to AFS. See article below. Recovery need to be personalized and start asap for reasons the article will go through with you. Click Adrenal Fatigue Syndrome in Teenagers & Young Adults for more information.

      Dr Lam

  • Kasia Licari says:

    Dr.Lam I am a 53 year old female and I know I am going through advanced adreanal exhaustion. For years I have ignored my poor sleeping habits and strees. Recently I have been suffering from debilitating anxiaty, loosing weight. I have been looking for answers every where, seen more doctors, took supplements, bought organic food and nothing seems to work. I stumbled upon your website and feel like you were writing about me. Thank you for all the great information.

  • Robyn Hope says:

    I much appreciate all the information you provide for us.

    One symptom I never saw you mention is poor appetite, which I think should be mentioned. Ofttimes, depression and poor appetite are linked. I never had trouble losing weight, as I am trying to gain a few lbs.
    Also, I can’t relate to insomnia. I need about 10 hrs of sleep to function…even then, I feel groggy and tired.
    And one more thing: it is very difficult feeling gratitude when I came from a place of disadvantage and abuse, but I am trying, as I believe in it.

    Thank you again..

  • Britney Hagele says:

    Both part one and two are extremely good articles explaining what adrenal fatigue suffers go through and the benefits of gratitude and how to make good attitudes applicable to healing. Very well done !

  • Royce says:

    Great article Dr. Lam. I was recently in a car accident a received a concussion. I have felt very down ever since. I understand my brain is still healing from the injuries, but it’s been a frustrating recovery. Are there any supplements or nutrition I can use to help my body and mind heal so that I can begin to be my old self again?

    • Dr. Lam says:

      Vitamin C and fish oil are very good for healing. start with that if you are not familiar with supplements. there are so many supplements on the market and each has its own function ,but no need to get carried away.

      Dr Lam