Hi Jade,

First of all as you will probably know, adrenals are responsible for making three different types of steroids.  Those being Glucocorticoid, Mineralcocorticoid and also Sex Steroids known more familairaly as Anabolic Steroids.  The latter is what you adrenals make when you are not receiving enough treatment.  The former are what are used to treat CAH and it is possible for those to cause prolonged periods of depression if the doses are too high and greatly above what would be normal for you if you did not have CAH. 

There are periods where CAH’ers have come off med’s and infact the it is commonly known for a sense of euphoria to occur with elevated levels of dhea’s and androgens in the first few weeks of withdrawal from the med’s.  There have also been studies of male body builders who take elevated levels of anabolic steroids to enhance performance having such periods and having a tendency towards more aggressive emotions and also mental health problems in the later stages.  Upon withdrawal from such obviously there is a dramatic rise in Cortisol due to the elevated levels of anabolic steroid and this in turn can cause a dramatic mood swing to depression also.  As a CAH’er you would achieve something very similar to this after a period of say under treatment or going back onto Glucocorticoids after a prolonged period without med’s where anabolic steroid levels were high.  

Although Doctors have done very little research in these areas, the steroid that body builders use in conjunction with their body building regimes have the same effects.  They also are known to cause the same physical sympoms in women also-so any studies into what happens for these people are very relevant to the exposure that CAH ’ers are exposed to also. 

It is also very common in Cushings for moods to be leaning towards melancholia and suicidal type feelings would be applicable in both directions --both under and over treatment. 

I think that once you feel more in control and have these knowledges it can be a turning point  as you can recognise what is occuring and use these symtoms as your bodies way of telling you and giving you signs that all is not well and that you may need blood tests or checks or a slight adjustment of med’s.  It is more common in LOCAH individuals because they are exposed to prolonged period of undertreatment and lack of cortisol, and especially in Men as they may not be diagnosed as early as women.  Women having symptoms of PCOS or Hyperandrogenism and all the symptoms that go with this (which can occur for the average CAH’er that is not treated with correct levels of Corticosteroid) and Hirsutism tend to be picked up a little earlier.  So men may suffer the extemes that anxiety can go to with this condition and indeed may make a better group to study where the psychological effects of CAH are concerned and the extent to which this can affect mental health.  

There is not a great deal out there that is tied to depression and CAH, but the answers are there if you search deep enough.  once thing I would advise is to try to stay stress free, as stress means more of the demand of cortisol and that leads to problems, even when CAH is treated.  Look at your diet and keep cholesterol to a minimum.  the less cholesterol there is to convert to other hormones when your treated the better.  Talk to friends and family about the way you feel and also acknowledge that it is not your life that is bad, it is the hormone imbalances that are making it "appear" that way.  Take control of your treatment and your med’s by learning more about CAH, treatment, how it should be monitored to avoid great deviations in hormone imbalances. 

Once you take control and get things back on track everything else will all fall into place for you and your emotions and moods will lift a great deal.  

Take Care,

Anne-Marie