Ask a doctor on the topic of Neurology

Cause of overactive sympathetic nervous system?

March 31, 2022 | 25,00 EUR | answered by Dr. med. Frauke Gehring

Dear Sir or Madam,

for almost 2 years now, I have been constantly in fight-or-flight mode. I am really stressed almost every second and just can't seem to relax. My life is not stressful at all and theoretically I have enough time to calm down. But somehow it just doesn't work. The stress also affects my sleep, I can hardly sleep and am always exhausted, yet I can't take a nap or anything. I can't concentrate anymore, I feel foggy and constantly have panic for no reason. I really don't know what's causing it. I have always been a very relaxed person and as I said, I really have no reason to be so stressed. I have seen so many therapists but it probably doesn't have to do with my mental health. I thought it would pass but so far nothing has improved. I am completely overwhelmed. Now someone suggested that I should get tested for illnesses etc. Maybe my body is overwhelmed with something, which is why I feel so much stress. Unfortunately, I have no idea what to get tested for. Does anyone have any idea what it could be? Thank you in advance!

Best regards,

Meus Ludewig

Dr. med. Frauke Gehring

Good day,

The only disease that causes these symptoms is an overactive thyroid, which could be ruled out with a simple blood test. An adrenal cortex adenoma could also be a possibility, in which case cortisol in the 24-hour urine would need to be examined.

However, it may also be worth considering a short-term therapy with a sedating psychotropic drug like Mirtazapine, to help you get out of this mode and start sleeping again. Amitriptyline or Imipramine could also be options, which you should discuss with a neurologist. The treatment duration would be approximately 3 months.

I wish you all the best!

Sincerely, Dr. Gehring