I'm Not Dying, but I'm Not Okay
Understanding Adrenal Crisis, Crash and Flare
If I’m not using my emergency injection, that does not mean I’m fine.
Most people are familiar with the medical term Adrenal Crisis. It’s the phrase doctors use. It’s the one that shows up all over the internet. It’s the emergency. While I do experience an adrenal crisis on occasion, I am frequently symptomatic.
What people don’t understand is this: if I’m not using my emergency injection, that does not mean I’m fine. There’s a whole spectrum of “not okay” that exists before a crisis — but I couldn’t find any language for it.
So, I created my own.
Not to replace the medical term, but to help the people closest to me understand what my body is doing and what I’m experiencing.
The Official Term: Adrenal Crisis
An Adrenal Crisis is a life-threatening cortisol deficiency.
It requires:
An emergency injection
Immediate medical care
Rapid intervention
It’s not subtle, non-negotiable, and it’s dangerous.
What I Call an Adrenal Flare
An Adrenal Flare is when symptoms gradually begin to rise.
Fatigue deepens. Dizziness creeps in. Nausea lingers.
My body feels heavier than normal, but I can still function — technically. I can still go to work. I can complete the necessities. I can still show up.
But it costs more.
During a flare, I increase my hydrocortisone — what’s called stress dosing. Most of the time, that stabilizes things.
The important thing I have to remind myself of is that a flare is a warning. It’s like your car beeping when you’re in reverse and there’s something behind you.
It’s telling you to pay attention before you hit something.
What I Call an Adrenal Crash
Last year, about a week before Christmas, I had flares on and off for days. I was stress dosing. I was still working — but that’s about all I could manage.
As the week went on, I was less and less okay.
By Christmas Eve, it shifted. The exhaustion wasn’t just fatigue — it was depletion. Confined to my bed, I was dizzy, nauseous, and running a 104° fever.
That’s what I call an Adrenal Crash.
A crash is more severe than a flare. It’s a significant drop in cortisol levels that dramatically impairs function. Without proper and aggressive intervention, a crash can progress rapidly into a crisis.
When I crash, I double or triple my dose for several days. I monitor constantly. I pull back from everything nonessential.
Why I Created This Language
There’s a critical gap between “fine” and “emergency.” If people only understand what a crisis is, they assume everything else must be normal.
If I’m working, I must be doing well.
If I’m not injecting, I must be feeling okay.
But chronic illness doesn’t always operate at extremes. Most of the time, it’s a rollercoaster in the middle.
Living with adrenal insufficiency, among other chronic illnesses like POTS, Fibromyalgia, and Chronic Fatigue (CFS), means constantly calculating:
Am I okay?
Am I trending downward?
Do I increase my dose?
Maybe I should rest?
Is this a flare… a crash… or something more?
Most of the time, I’m somewhere in between — not in crisis, but not okay.
And that space deserves language, too.
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