Bipolar or Adrenal Fatigue Part 1 of 3

Bipolar or Adrenal Fatigue

There are many causes of variable energy levels. If you used to be OK and now you are not so OK, you may be wondering what is going wrong.

How you describe your struggles can make a huge difference in how you recover and get back to something like your usual self.

I am only just starting to study Adrenal Fatigue, so bear with me as I make tentative efforts to show the similarities and differences between this and bipolar disorder diagnosis. I intend to come back to this article and make it more detailed and precise as I learn more about Adrenal Fatigue. In fact I am going to publish this only part written and add to it bit by bit when I have the energy to do so.

Similarities and differences:


  • Both diagnoses involve changes in energy level
  • Adrenal Fatigue is likely to affect you to some extent every day until you deal with whatever is causing it. Bipolar disorder is said to come and go and is said to allow you to have days that are symptom free. If you are running out of energy during daylight hours when you did not used to run out of energy then this is likely to be related to poor functioning of the adrenal glands.
  • If you are suffering from Adrenal Fatigue you are likely to have or seem to have periods of higher energy as you are likely to need to be very busy while you do have energy to catch up for when you do not have energy. If you have Adrenal Fatigue and are not dealing with it then you will find these periods of higher energy get shorter and perhaps less frequent. The bipolar diagnosis does not necessarily predict shorter and less frequent high energy periods.


  • There are no medical tests for bipolar diagnosis. Bipolar disorder is a psychiatric label that covers a range of physical and psychological troubles. It cannot be detected by brain scans or blood tests. Bipolar is diagnosed by observing someone who appears to have variable moods and involves asking questions of that person, their family and people who come in contact with them. To a psychiatrist or similarly informed doctor anyone with Adrenal Fatigue could be thought to have bipolar disorder.
  • Adrenal Fatigue blood tests – The adrenal glands produce cortisol and a hormone (maybe technically better described as a hormone precursor) known as DHEA. The adrenals produce the ideal level of these chemicals to match your body’s requirements. Both these naturally occurring chemicals can be detected in the blood. The level detected in a blood sample gives a snap-shot of how your adrenals are working. Exceptionally low levels are associated with Adrenal Fatigue. However, you and your doctor need to know the time of day the sample is taken as cortisol and DHEA vary throughout the day.
  • Adrenal Fatigue saliva testing – Cortisol and DHEA are small molecules that travel to all parts of your body including the saliva glands. The test involves spitting in a sample tube and this being sent to a laboratory for analysis. With no need for syringes and needles this test is relatively inexpensive. The main advantage of this test over blood tests is that it is easy to take several samples in one day and with less stress than making a trip to your GP for blood to be taken. How the cortisol and DHEA vary during the day allow a precise measure of how your adrenals are working and it only takes one day of testing to confirm your level of adrenal fatigue.
  • I will repeat here that there are no medical tests for bipolar disorder. If you suspect you may be diagnosed with bipolar disorder a good option is to ask for a day of saliva testing just to be sure your symptoms are not related to Adrenal Fatigue.

If your adrenal glands cannot produce enough cortisol quickly enough you will struggle with all situations that you find stressful. With insufficient cortisol you will be displaying all sorts of symptoms of Adrenal Fatigue that match symptoms of bipolar diagnosis.

  • Sleep pattern: Variable and seen as problematic for both bipolar and Adrenal Fatigue
  • Need to lie down during daytime – only said to happen during depressed phase of bipolar. With Adrenal Fatigue this is going to be happening most days unless you are consistently stimulated – perhaps having a demanding daytime job, so have to keep going and then collapse in the evening.
  • Irritability – You need a good level of cortisol to be able to cope with annoying people and without enough you will react in a way that ‘bipolar people’ are said to react.
  • Concentration – same as bipolar.
  • Pessimism, periods of feeling hopeless/helpless, negative thoughts and feelings – all the same as bipolar.
  • Reaction to stimulants such as caffeine – as for bipolar
  • Appearance – likely to be over-weight or under-weight with a tendency to lose weight when not taking sedatives, such as ‘antipsychotics’ / ‘antidepressants’ / ‘mood stabilizers’. Often looking tired – as for bipolar
  • Development of food intolerances – as with bipolar this may be several years after diagnosis.


  • As with bipolar lifestyle changes, such as; what you eat, what you drink, what drugs you take and avoid, who you spend time with, the time you go to bed and so on, will decide the course of the disorder.
  • In general, bipolar disorder diagnosis (in the UK at this time) results in a lifetime of medication. Adrenal Fatigue rarely requires any drug treatment and recovery usually involves finding ways of living with minimum use of drugs.
  • Treatments for bipolar will in the long run make your Adrenal Fatigue worse.

I have typed all the above without reference to any text books or on-line articles. There may be errors. I am going to publish this as blog on in this rough draft form, as I think it is such an important debate that needs to happen. Are millions of people whose adrenal glands struggle to cope with the modern world being diagnosed as bipolar, and not being given advice on how to look after their glands and feel less stressed?

About Roger Smith (in the UK)
Helping you to think about bipolar disorder in different ways so that we can eliminate the disorder and eventually eliminate the need for this diagnosis.

18 Responses to Bipolar or Adrenal Fatigue Part 1 of 3

  1. Rebecca Shaw says:

    Excellent article. I believe that most, if not everyone, who is labelled as bipolar has adrenal fatigue or other hormonal/nutritional imbalances. e.g. Vitamin D levels are often overlooked and even when tested by the NHS you can be told they are fine at levels as low as 40 even though the level required for good health is between 75 and 150. This is one example of many. Having these things not balanced means moods will fluctuate and adrenal glands will struggle.

    I view our bodies like an eco-system and when one things go wrong it effects other parts and it all goes wonky. I see it that if we can get our bodies in good health and back in balance then our moods do too. These things are not looked at by the NHS as they have very little, if any, training in nutrition despite nutrition being our key to health and wellbeing.

    Adrenal Saliva test can be done privately through It is very easy to do. Email them for current prices.

    NHS doctors are not allowed to recognise adrenal fatigue, even though they know it exists and it is very common, because they are not allowed to diagnose illnesses that are not on their list of illnesses they can diagnose as they would not be covered by the medical council if they did


  2. Pingback: Roger Smith: #Bipolar or Adrenal Fatigue? #ukmh #MentalHealth « Mentally Wealthy

  3. Ruth Redd says:

    Very interesting as always. Think I might get the test done. More news as soon as you know please.


  4. Heather Lee says:

    This is an interesting link between adrenal fatigue and bipolar disorder. There are certainly some similarities with the 2 conditions, and from my limited experience I would suggest that at least some people with bipolar also have underactive adrenal glands. However there are differences as well – people with adrenal fatigue tend to feel tired (exhausted) most of the time with spells of feeling less tired, but they don’t feel as though they have enough energy to rush around. Some people with adrenal fatigue do feel depressed too, but they tend to recognise that it is their condition that is making them feel this way and it is often short-lived, although it can reoccur. So I don’t feel that the 2 conditions are the same, but that adrenal fatigue may be involved in bipolar disorder.
    The brain is part of the body and when there are imbalances in biochemical systems it can be affected as much as other body systems. Imbalances can be caused by stress and of course by lack of nutrients, so there may be other factors at work including a blood sugar imbalance, poor digestion and food allergies, low essential fats and low magnesium
    It is worth addressing all of these factors (and there may be others) to get the right nutrients to support the body (and the mind) in regaining its balance.


    • Hi Heather,

      Thank you for your useful contribution to my comparison of adrenal dysfunction with bipolar diagnosis.

      Poor diet is one of the main causes of mood disorder, so the link to the Institute of Optimum Nutrition is going to help a lot of readers. The nutrients mentioned are all important and as you know there is a lot more about our diets that need to be taken into account. Moving on from a bipolar diagnosis will involve dietary improvements as part of a recovery plan.

      In saying adrenal fatigue is mistakenly being diagnosed as a psychiatric disorder I was very much thinking all forms of bipolar other than the old manic depression diagnosis that involves people getting extremely busy, having grandiose plans and as you say, “have enough energy to rush around.” This state is described as mania and may also involve noticeable loss of touch with reality, with delusions and/or hallucinations.

      In the more modern forms of bipolar, which are now by far the more common diagnosis, there is a much closer match with adrenal fatigue. With the Bipolar 2 diagnosis the patient has long periods of low energy and negative feelings, with short-lived periods of having a little more energy often not even noticed by friends and relatives. With another form of bipolar called cyclothymia the periods of low mood are not usually disabling but just keep on happening, and again without any extreme highs.

      What I have noticed is that like me, people may initially come to the attention of psychiatry through having plenty of energy and asking for help, but after several years of involvement with psychiatry the high energy periods become shorter and less extreme until the pattern of moods looks more like on-going fatigue.

      I am sure we are agreed that Adrenal Fatigue is best not described as a psychiatric disorder. I am hoping is that my articles will remind doctors that there are many reasons for apparent mood disorders. The other imbalances you mention (hormones, nutrients, food intolerances, blood sugar) do cause imbalanced moods and do need to be addressed first along with external stressors.

      Most people who start off appearing to ‘be bipolar’ eventually end up fatigued and coping with exhaustion becomes our biggest daily challenge. (As discussed elsewhere sedative psychiatric drugs can cause more fatigue.)

      Too often a bipolar diagnosis is given without looking for other possible causes. Adrenal Fatigue is just one of these possibilities and there are many more that I wish could be checked out before psychiatric labels are considered.

      I think the above could be my third and final (for now) blog on adrenal fatigue and I may post this as an article inviting discussion especially from any doctors who may read it.


  5. masykes says:

    I think you may be onto something. I am such a patient. I have enough good sense to know that my bipolar diagnosis was wrong. I am currently in the process of getting my cortisol levels checked via saliva so that I can get a handle on the adrenal fatigue. Well wishes in your search to liberate the trapped.


  6. Some people with bipolar have variable moods throughout the day, but most have manic periods sometimes lasting for months and depressive periods lasting for months. So your adrenal glands would have to OVER function at an incredibly high level for a long period of time and then underfunction for some period as well. (Some have no depression or minor periods of depression, and are mostly manic or normal.) Some role of the adrenal gland has been suspected before because manic patients feel very high on adrenaline. In the 1940s Dr Perry Baird, himself manic depressive, suspected a biochemical component to his disease and used his mentor’s lab to remove the adrenal glands from cats. This would normally cause them to die within a day. He injected some of the cats with the blood of manic patients. Those cats lived for up to five days, suggesting that manic patients had higher levels of adrenaline in their blood, enough to keep the cats alive even without adrenal glands of their own. This preliminary study was accepted for publication but passed by without comment as researchers and medical personnel who would have been interested were away at war. Baird was recommitted to psychiatric wards, eventually lobotomized, and died. After that lithium’s role as a treatment was discovered by accident and the treatment vs causal exploration path was explored instead. And most of the investigation has been centered on the brain because of the way the meds seem to operate, rather than on the endocrine system. You may be onto something by focusing on the adrenals, but I don’t think it’s as simple as adrenal fatigue. Adrenal malfunction, possibly, but on a level you’re nowhere near suspecting, it sounds like. You can read about Baird’s experience in He Wanted the Moon, by Mimi Baird, which contains some of Dr Baird’s own writing. You’ll quickly see that fatigue is very little of the bipolar person’s experience.


    • Hi Claudia,
      Sorry I only just got around to approving your comment. It was a couple of years ago that I was looking into the role of the adrenal glands in some detail. It is interesting stuff and very related to energy levels.
      What our adrenals do is going to be relevant, while I agree with you that it is just one factor of many involved in bipolar diagnosis.


  7. Scarlett says:

    I am 42 and was diagnosed bipolar at 30 after a lifetime of anger, lashing out, highs and lows and everything that characterizes “bipolar”. However, my symptoms got much worse after ignorantly going vegan and eating all of the wrong things for 1.5 years. My decline absolutely coincided with my decline in my nutrition and I started to have physical symptoms along with my “bipolar” irritability, fatigue and mood swings. This time in my life absolutely confirmed to me that everything I had gone through in life stemmed from something physical. I have learned a lot about adrenal fatigue and that is absolutely a part of it. I know now, as I change and improve my nutrition and my bodies ability to detox heavy metals and toxins, that bipolar is only a psychiatric label for the physical breakdown of a persons body. With each day that I remain on a candida diet, eat impeccably well, take proper supplements to help detoxify and to help fix leaky guy caused by gluten, sugar, dairy and many other inflammatory foods I have energy and clarity that I have never had in my life. The book that helped get me here is the autoimmune solution by Amy Myers. I have also been working with many functional medicine drs to rebalance hormones with food and supplements and rebalance my blood sugar levels and remove any parasitic infection. I hope this helps you even a bit. Good luck on your journey.


    • Hi Scarlett,
      It sounds like you are on the right track. I realized this morning that it is well over 4 years since I needed any kind of medication and how little I think about bipolar these days. I never would have thought this possible as I was so very confused and unwell when first put on the psychiatric drugs, and was told that I would not recover or ever be able to manage without the support of psychiatry.
      Vegan is not all bad, but as you found you have to know what you are doing and be sure to stick with real foods and minimize processed junk.
      You may be interested to link up (just exchange an email or two) with an associate of mine who eats; no meat/eggs/fish and is doing really well now largely through great dietary choices, with a lot of raw and organic foods. I am nowhere near vegan myself, but taking notice of the way he lives has helped me with improving sleep and having more consistent energy. It is just a thought, but I’ll only suggest he contact you if you feel that may be mutually beneficial.


  8. Excellent article and I am in full agreement. As a practitioner I work with hair analysis and this shows if you have adrenal exhaustion if the sodium level is low. Sodium level on a Trace Minerals test should be around 24 so anything less than 10 shows adrenal exhaustion. This means that a person can have highs and lows frequently and also this affects the health of the blood. I find that people with low sodium are also magnesium deficient as exhausted adrenal glands cause magnesium to be used up quickly. By taking Siberian ginseng, high levels of magnesium with B6, eating a diet high in protein and fat and low in carbs, it stabilises the blood sugar and gives the adrenal glands time to recover thus moods start to settle down. Getting over excited about certain things in life can still cause highs and lows depending upon how long you are excited le meeting someone you really like but overall using these two supplements and keeping blood sugar balanced can make a significant difference to mood swings.


    • Hi Elaine, Sorry it took so long to approve your comment. I’ve been away for a few days. I like what you say. Personally, I am not thinking so much about adrenals these days, as my focus is on a lifestyle that avoids the kinds of stresses I used to suffer from. I very much agree that if we are getting stressed or judged to be bipolar then it is worth paying extra attention to minerals. I use just a little pink Himalayan salt each day, which matches up with author, Aspen Morrow’s advice in her book, ‘Med-Free Bipolar’.


      • Hi Roger. Thank you for your reply. I didn’t expect one. I am glad to hear all is good with you. I love when people think differently as there is so much depressing medical info out that doesn’t give people a lot of hope. I find that keeping it simple is by far the best way. I hope you continue to live a stress free life and all is great for you.


        • Thank you Elaine, Not quite stress-free 🙂 It is great though to be med-free, learning, working and having days off like today – off to pick redcurrants in sunshine now on a glorious day here.


        • I hope you enjoy picking your redcurrants and enjoy your lovely sunshine. For stress I always recommend Siberian ginseng and magnesium these I find are the keys to knocking off the adrenal glands and feeling good again. I should know I was born with adrenal exhaustion and so was my daughter but it is easily remedied. Lovely to have been in contact with you. Very best regards Elaine


        • Hi again Elaine,
          I have been so busy that I’ve not added any new posts on Rethinking Bipolar for months so I’ll say more for anyone who is interested in following this thread. Yes, I used to have a magnesium supplement and often magnesium (Epsom salts) in bath and would again if I felt the need. It can be very beneficial. Currently, I am eating so much green leafy food that I believe I am getting enough magnesium from food (I also have nuts and other magnesium rich foods). Everyone of us who is surrounded by processed foods needs to check we are getting enough magnesium.
          Redcurrant picking was lovely – picked 3kg, followed by gooseberries, joosterberries, loganberries and raspberries. A great afternoon at allotment 🙂
          I have very little experience of ginseng and readily admit that if I had time I’d experiment more with herbs, spices and similar.
          No need to reply, but love to hear from you again sometime.


  9. Krystal Ruhl says:

    So glad I found your article. Changing my food choices the past 3 months have had a huge impact on my “diagnosis”. Working with a functional medicine doctor and a nutritionist, I have felt like my best self (without any lithium) that I have in the past 10 years. I wonder why there isn’t more of a push for this type of treatment compared to pharmaceuticals.


    • Thank you Krystal, You may have read that I took lithium for 14 years and have been lithium-free for 9 years. Right now I am not coping as well as I was with lock-down mixed with other troubles making it hard to stay med-free. Please take care and know that almost everyone will say that it is better to take small doses of medication than to risk a damaging manic episode.


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