Norepinephrine: A Key Player In Stress, Depression, And ADHD

Via: Piotr Marcinski


by Deane Alban

on March 9, 2016

Hormones and neurotransmitters are chemical messengers involved in almost every function of the body. Most chemicals are one or the other, but norepinephrine works as both a hormone and neurotransmitter. It doesn’t get as much attention as the stress hormone cortisol or the feel-good neurotransmitters dopamine and serotonin, yet it plays a big role in stress and depression.

Let’s take a look at the roles this under-appreciated chemical plays in some of the most common mental maladies of our time — stress, depression, and ADHD. But before we get started, let’s clear up the confusion about the nomenclature. Norepinephrine is also called noradrenaline. Its counterpart epinephrine is commonly called adrenaline. In the United States and most of the world, norepinephrine and epinephrine are the preferred scientific terms. But in the United Kingdom, noradrenaline and adrenaline are still used. However, it’s likely that if you experience a fright, you probably say, “That really got my adrenaline going!” — not “That really got my epinephrine going!”

The adrenal glands are two walnut-size structures that sit on top of your kidneys. Via: CLIPAREA l Custom media | Shutterstock.


The Role Norepinephrine Plays In Stress

Norepinephrine, or noradrenaline, is one of several stress hormones released by the adrenal glands, two walnut-size structures that sit on top of your kidneys. Dr. Christiane Northrup, a leading authority in the field of women’s health, calls the adrenal glands your body’s primary “shock absorbers,” helping you respond to life in a flexible way. These small workhorses are in charge of releasing stress hormones as needed.

The inner layer of the adrenal glands secretes both norepinephrine and epinephrine (adrenaline). These two stress hormones are released in substantial amounts in response to sudden stressors, raising blood pressure and blood sugar, and sending more energy to muscles to get you ready to fight or flee from danger. If you’ve nearly been in a car accident or received shocking news, you’ve experienced what these stress hormones can do.

According to Dr. Amit Sood, director of research and practice at the Mayo Clinic Complementary and Integrative Medicine Program, “The primary role of norepinephrine is arousal. When you are stressed, you become more aware, awake, focused. You are just generally more responsive.” He believes the reason we have both norepinephrine and adrenaline, which have very similar structures and functions, is as a backup system.

If your adrenals aren’t working as they should, a built-in redundancy can save you from catastrophe in the face of danger. Sood says that, depending on the long-term impact of the stressors you’re facing and how you personally handle stress, it could take anywhere from half an hour to a couple of days for your body to return to its normal pre-arousal state.

The purpose of stress hormones is to prepare your brain and body to deal with a life-threatening physical emergency. But, in the modern world, most of us are reacting to actual and perceived stressors constantly. And few of them are actual physical events. Unfortunately, the body’s arousal system can’t distinguish being chased by a wild animal from the continual barrage of modern stressors like road traffic, crowds, noise, 60-hour work weeks, and the constant demand for attention from our electronic devices.

Norepinephrine initiates changes that might keep you safe from physical danger, but this comes at the cost of biological wear and tear. When you are under constant stress, your adrenals never stop pumping out stress hormones and this has profound effects on your physical and mental health.

Stress contributes to anxiety, depression, digestive disorders, heart disease, sleep problems, weight gain, and cognitive impairment. It lowers your immune system function and increases your risk for cancer and psychiatric disorders. Chronic stress can cause your adrenal glands to eventually burn out from fatigue leading to a plethora of symptoms. One adrenal gland specialist lists 75 symptoms of adrenal exhaustion on his website! But most commonly, people with adrenal fatigue alternate between being tired and feeling wired.

The inner layer of the adrenal glands secretes both norepinephrine and epinephrine (adrenaline). Via: Designua | Shutterstock.


Low Norepinephrine: An Unexpected Cause Of Depression

Since norepinephrine’s primary goal is to get you into a state of heightened arousal, it’s no surprise that a lack of norepinephrine has the opposite effect. A low level of norepinephrine can leave you feeling fatigued and mentally foggy, with little interest in life.

Depression is generally associated with low levels of the neurotransmitter serotonin. This is the reason that the most commonly prescribed drugs for depression are selective serotonin reuptake inhibitors (SSRIs). These medications, which work by increasing brain levels of serotonin, are used by millions. It’s frustrating and puzzling to doctors and patients alike why they work for less than half of those who try them. One answer may lie in the fact that, for some, depression is caused by low norepinephrine, not low serotonin.

This idea is not new. In the 1960s, Joseph J. Schildkraut, a psychiatrist at Harvard University, proposed that a lack of norepinephrine rather than serotonin was the root cause of depression. This is now called the catecholamine theory of mood disorders. He also proposed that the mania experienced during a manic episode of bipolar disorder arises from an overabundance of norepinephrine.

Some of the newer antidepressants target norepinephrine. Cymbalta addresses both norepinephrine and serotonin imbalances while an older drug, Wellbutrin, boosts levels of norepinephrine and the neurotransmitter dopamine.

Norepinephrine and epinephrine. Via: lyricsaima | Shutterstock.

Norepinephrine and epinephrine. Via: lyricsaima | Shutterstock.

Norepinephrine Deficiency Is Linked To ADHD

It’s currently believed that there are three subtypes of ADHD (attention deficit hyperactivity disorder):

  • 1. Predominantly inattentive.
  • 2. Predominantly hyperactive-impulsive.
  • 3. A third type that exhibits features of the other two types.

One explanation for the three subtypes of ADHD is that patients have different imbalances of neurotransmitters. This theory may be substantiated by the fact that no one ADHD medication works for everyone.

Each ADHD subtype is more likely to respond to a different class of drug. People with predominantly inattentive ADHD are believed to have low norepinephrine levels. Most ADHD patients take stimulant drugs such as Ritalin and Adderall which increase dopamine levels, but people low in norepinephrine do better with non-stimulant medications such as Strattera.

Psychiatrist Dr. Bernard D. Beitman, Visiting Professor of Psychiatry and Neurobehavioral Sciences at the University of Virginia, finds that some people with attention deficit disorder focus better when excited by a challenge or when facing a perceived danger because this causes their norepinephrine levels to increase. Some people with ADHD self-medicate by intentionally seeking out high-risk activities to pump up norepinephrine to improve their focus.

I have a few family members with ADHD who swear they do their best work when under pressure. They get their norepinephrine boost by waiting until the last possible moment to do just about everything. They say it helps them focus on the task at hand. And while I can’t argue with their results, their procrastination stresses me out more than it does them!

An apple a day could help keep stress, anxiety, depression, and ADHD at bay. Via: Kovaleva_Ka | Shutterstock.

An apple a day could help keep stress, depression, and ADHD at bay. Via: Kovaleva_Ka | Shutterstock.

Increase Norepinephrine With Food And Supplements

Two straightforward ways to increase norepinephrine are diet and supplements. The amino acid tyrosine is the precursor of norepinephrine. It is found in many common foods especially foods high in protein, both animal and plant based. Meat, dairy products, fish, chicken, and legumes are all good sources of tyrosine. Other foods that promote norepinephrine synthesis include apples, bananas, beets, watermelon, and wheat germ.

You can’t take norepinephrine supplements directly since they cannot cross the blood-brain barrier and, therefore, cannot act on the brain. But you can take tyrosine supplements instead. A tyrosine supplement is a good natural option to consider if you have depression, and it works surprisingly fast.

According to integrative health pioneer Dr. Andrew Weil, “Taking tyrosine on an empty stomach is supposed to cause an increase in norepinephrine and dopamine in the brain, which can lead to increased energy, alertness and improved moods, thus relieving depression. Unlike Saint John’s wort, an herbal remedy that can take two months to work, and prescription antidepressants, which probably won’t kick in for about six weeks, tyrosine works very quickly.”

Another supplement to try is Arctic root (Rhodiola rosea). Arctic root is one of the few dozen herbs that meet the criteria of an adaptogen. Adaptogens are herbal remedies that are neither stimulating nor relaxing. Instead, they work by increasing overall resilience to stress and bringing the body into a state of functional balance known as homeostasis. Arctic root increases the activity of norepinephrine, serotonin, and dopamine. It’s been shown to work faster to reduce depression than antidepressant medications. It is particularly good for fatigue, making it a useful supplement for anyone with fibromyalgia or chronic fatigue syndrome.

Lastly, since low norepinephrine levels can result from worn-out adrenal glands, it helps to give them some nutritional support. Dr. Marcelle Pick, founder of and author of Is It Me or My Adrenals?, recommends a regime of ashwagandha (Withania somnifera) and Siberian ginseng (Eleutherococcus senticosus), along with a complete vitamin B complex for restoring tired adrenal glands back to health. Other steps you can take to heal your adrenals are eliminating stimulating foods like sugar and caffeine, getting adequate sleep and rest when you feel tired, and taking time every day to relax and do something you enjoy.
