Hi Mark

I've noticed you mention this adrenal cortical hyper function a few times. I am wondering if you can elaborate on what this is exactly and how you manage it?

I feel like my body has a large over reaction to stress and that it can even be triggered for no reason. It feels as if I am constantly in flight or fight mode - my heart pounds - sometimes my chest gets tight, I feel as if I can't get air in my lungs, feel more lightheaded.

My doc. thinks I should go on zoloft to manage anxiety and reduce the symptoms.

Thank you.

I know I have to work hard at avoiding triggering situations. Sometimes, I fail. I had this same problem while on max dose paroxetine/Paxil, an SSRI. So, for me, meds did not help. If I remove myself from the situation, I settle down. My wife will play interference if she has the opportunity. Any distraction can help. The common trigger is somebody verbally attacking/challenging me. I will respond and get very loud very quickly.

Some times, it is a slow building stress with a release point where I finally let loose. The straw that breaks the camels back situation.

I also get triggered by sensory overload into lasting anxiety reactions but they are different than the other explosions. I may need a klonopin or propranolol to get my system to settle down.

I wish I had a better solution. But, understanding this problem and taking ownership of it versus making excuses can be a start.

Thank you.

I was also wondering about a physiological explanation for this - if you have one. I have not been able to get a doctor to tell me what is happening in my body and if it is doing long-term damage to my heart or other body systems.

I have read some theories that say there is dysfunction in the hypothalamus-pituitary-adrenal axis, some theories that say it is C1 pushing on brainstem causing sympathetic nervous system dysfunction, and some theories saying it is an over-stretched ligament in cervical spine causing sympathetic nervous system dysfunction.

I guess I'm just wondering if you ever got an explanation or diagnosis for why you have an adrenaline and cortisol hyper function?

I guess if I understood it better, maybe I wouldn't worry about it so much.

I've never heard an explanation but I do have a C-1 problem so the explanation could be valid.

I would think there is some credibility to the C1 pushing on the brainstem theory, at least in my case. I have a neck injury from my concussion - and as Mark often notes, it is too small to detect, but it's there!

I've been diagnosed with GAD (General anxiety disorder) and the only thing Lexapro does for me is to help me sleep. It has not helped with the anxiety. Oddly enough, I seem to get relief (sometimes) from sleeping in a recliner with my head up vs laying on a pillow. When I sleep in a bed, I have a much higher level of anxiety as soon as I wake up, and there is no escaping that feeling.

Exercise does help me somewhat, but I am going to have to explore the psychological aspect of this (if there is one) to hopefully be able to control it.

I do better sleeping in a recliner, too. It helps me keep my head and neck in a better posture. When I sleep in poor positions, I have nightmares or stressful dreams and even anxiety attacks. I will usually have a day of brain fog after such a bad night sleeping. I believe it is a vertebral blood flow restriction that causes it.