Welcome back to the Writing Injuries miniseries!

Now, full disclosure, I hadn’t intended to write a full post about adrenaline, but then I realised it has a significant impact on the physical injuries and emotions of our characters (check out the Writing Emotions Series here). It’s also one of those things that books and media often get wrong. So, since we writers find ourselves writing scenes flooded with adrenaline, it just makes sense to explore its ins and outs.

You guys really liked the format of the first Writing Injuries post (it’s about sprains, if you’re interested), so I’ll stick to that. We’ll break down the medical aspects of adrenaline, discuss what it feels like, and I’ll share personal experiences.

Before we start, the usual disclaimers.

I write these posts to help myself and other authors craft more believable stories. The best books allow readers to lose themselves in our worlds while also remaining relatable—and that without minimising anyone’s real-life experiences.

I am not a medical professional, just a writer trying to craft believable stories. Please seek medical help if you need to, and don’t base your medical decisions on what I’ve written in this post.

TRIGGER WARNING. During this miniseries, we will discuss various injuries and recovery time in detail, so if that makes you uncomfortable, turn away now.

Let’s get to it!

Adrenaline

• Adrenaline is a hormone and neurotransmitter, produced primarily by the adrenal glands.
• The body releases adrenaline when a person experiences fear, anxiety, or high stress.
• Adrenaline triggers the fight-or-flight response.
• It is also known as epinephrine.
• Its main function is to prepare the body for survival by:
  • Increasing pulse—the heart accelerates and pumps more forcefully to distribute more oxygen-rich blood to the muscles.
  • Relaxing (dilating) airways—the person breathes faster, promoting oxygen distribution.
  • Greater oxygen distribution causes:
    • Heightened concentration and quicker response times.
    • Enhanced reflexes and speed.
    • Enhanced strength and endurance.
  • Contracting blood vessels and raising blood pressure—redirects the flow of blood to where it’s most needed, such as in the heart, lungs, and muscles. Because of the contracting blood vessels, the skin turns pale and slightly colder, as blood isn’t immediately necessary in that area.
  • Breaking down sugar stores—the liver releases glycogen for an easily accessible source of energy.
  • Dilating pupils—opening the pupils allows sharper sight, even in low-light conditions or the dark.
  • Reducing the perception of pain—allowing the person to keep fighting or fleeing, even when they are injured.
• Medical personnel administer epinephrine when patients experience:
  • Severe allergic reactions (anaphylaxis).
  • Respiratory distress (such as asthma attacks).
  • Cardiac arrest.
  • Shock.
  • Hypotension (severe low blood pressure).
  • They also use it during surgery for purposes such as dilating pupils.
• Adrenaline typically lasts around 20-30 minutes.
• In extreme cases, it can last for up to an hour.
• It can also trigger in short bursts, like when someone experiences a jump scare or reacts to a prank. In these instances, it lasts only a few minutes.
• The average person needs about an hour to recover from the effects.
• Extreme long-term stress and anxiety disorders can lead to prolonged exposure to adrenaline. This, in turn, can cause issues such as:
  • High blood pressure.
  • Heart conditions.
  • Digestive issues.
  • Memory and concentration issues.
  • Headaches.
  • Cold or pale skin.
  • Excessive sweating.
  • Insomnia.
  • Anxiety and depression.
  • And other problems.
• Low levels of adrenaline can cause conditions such as:
  • Low blood pressure.
  • Low blood sugar.
  • Anxiety and depression.
  • Headaches.
  • Chronic fatigue.
  • Muscle weakness.
  • And other problems.
• It is possible to become addicted to adrenaline. In these cases, the addict will exhibit similar symptoms to other substance addictions, such as shaky palms, excessive sweating, dangerous behaviour, and so on. They will chase adrenaline thrills to ‘feel fulfilled’ just as substance addicts will chase their chosen substance. Treatment for adrenaline addiction looks much the same as treatment for any other addiction, including practises like therapy, meditation, lifestyle changes, and sometimes medication.

An Adrenaline Rush Feels Like:

• Rapid pulse and a pounding heart. This can be so hard that it feels like the entire body thrums with the heartbeat.
• Panting, shallow, or forceful breaths.
• Clear mind, easily processing details, especially those that are imperative to survival.
• Enhanced sight. Colours might seem brighter, the person would see clearer in low-light conditions, and details closer to the person could stand out.
• Hearing and olfactory receptors are also heightened during adrenaline rushes, and many people report remembering sounds or smells more clearly than visual cues once the rush fades.
• Lightheadedness or dizziness. In some cases, nausea.
• Heightened anxiety or excitement, depending on what caused the adrenaline rush.
• Shaky hands and knees, trembling.
• Cold hands and feet.
• Tingling or prickling (pins and needles) in hands and feet.
• Excessive sweating, usually a cold sweat.
• Dry mouth.
• Pain might register for a moment, then fade into the background. Sometimes, the affected person might not realise the gravity of their injuries until they’ve reached safety. BUT:
  • Once the adrenaline wears off, the pain sets back in.
  • The injuries might’ve worsened during the fight-or-flight, for example, continuing to run on a sprained ankle could tear the ligament, taking the injury from a grade 1 to a grade 3, or a laceration might’ve torn wider. I know someone who ran from danger on a broken ankle, which caused the bone to cut into tissue and resulted in surgery and an extra-long recovery time.
• If you’re describing a character experiencing an adrenaline rush from another character’s viewpoint, also remember these symptoms:
  • Dilated pupils.
  • Pale or flushed skin.

How it Feels When an Adrenaline Rush Ends:

• Spotty memory, difficulty concentrating, and trouble thinking clearly.
• Aching or throbbing head, especially behind the eyes or between the temples.
• General feelings of dizziness and lightheadedness, sometimes even leading to fainting or black spots crawling in vision.
• Replaying certain elements of the high-stress situation in a loop.
• Irritability and mood swings, and the affected person might not understand why they are reacting in that way.
• Heightened anxiety or depression. Looking over their shoulder for more danger.
• Exhaustion, feeling completely wiped out, and being left with no energy.
• Muscle aches and pains.
• If the person had to run, they might have throbbing feet and sore soles.
• Weak muscles and jitteriness.
• Upset or cramping stomach and nausea.
• Lowered OR heightened appetite, depending on the person’s relationship between emotions and eating.
• Achy jaw and gums if the person gritted their teeth.

Personal Experience:

I’ve experienced adrenaline rushes quite a few times.

The latest one was fairly recent, so it’s nice and fresh in my mind, and that’s the one I’ll reference in today’s sharing circle. For context’s sake, I was already nervous before the actual adrenaline rush hit, but I was also excited and relieved that the day had arrived. I’m certain that it’s different from a typical nervous/excited reaction because of my lifetime of experience with heightened anxiety, the intensity of my emotions and sensory input, and the laundry list of things I experienced afterwards.

For me, adrenaline rushes are similar in certain ways to the early stages of panic attacks (check out this post for more), especially the physical stuff, like shaking, tight muscles, and enhanced senses. The greatest difference is that panic attacks usually come with a good dose of negativity and self-loathing. It’s internalised, a struggle to get loose of panicky thoughts. Meanwhile, adrenaline rushes are all about reacting to external inputs. Emotions feel muted and secondary to survival.

What it felt like:

• Sensory input became brighter, lighter, and louder, BUT my brain honed in only on the information I needed RIGHT THAT INSTANT.
• This means I noticed the closest people, objects, and paths sooner than anything in the middle distance or background.
• I was acutely aware of every approaching person, sound, or movement near me.
• Crossed, really tense arms. In fact, most of my muscles were really tense, but my arms and shoulders were the worst, as if I had to protect my torso.
• I struggled to breathe normally, with just quick, shallow pants.
• My palms were sweaty and shaky.
• I was freezing, and felt like I just couldn’t get warm.
• Thundering pulse, and my whole body kind of trembled to its pace.
• I continuously licked my lips and swallowed, but my mouth was bone dry. I was also too afraid to drink water because I didn’t want to have to go to the bathroom. I had to be ready.
• My bladder felt full, even though it didn’t contain anything to expel—I made sure of that during the twenty nervous trips to the bathroom before the adrenaline rush set in.
• My thoughts felt muted, as if my brain needed to be quiet for concentration. The closest thing I can compare this to is when my hyperfocus kicks in. It’s a state of total alertness, but everything outside of the immediate is shoved aside.
• Clattering teeth whenever I forgot to clench them. (So, of course, I bit my inner cheek, and it hurt for days afterwards.)
• I fidgeted because I needed to GO. Drumming fingers, tapping shoes, and above all, the ADHD knee thing.
• Also, my anxiety was through the roof. My stomach was basically a floating bubble, and everything tingled.
• I didn’t feel physical sensation until well after the rush ended.

Directly After the Crash:

• I shook so violently that I struggled to open the car door or handle my cell phone, and it took me about a minute to put the cap back on my lip balm.
• I wanted to cry and fought off tears a few times in the first hour or so. I remember saying that I didn’t feel like myself, and I wasn’t sure if I was relieved or freaking out.
• Typically, when I feel faint, the edges of my vision turn black and kind of spotty. In this case, the edges turned light and blurry. Imagine an old-timey white vignette on a photograph. My vision in general was also brighter, so I’m guessing the pupils remained dilated for a while. BUT
• My senses felt groggy, as if they were worn out after the intensity of the actual rush. It was like my eyes wouldn’t move fast enough to where I wanted them to see, or I was hearing through earmuffs. I constantly asked my husband (who drove me home) to repeat himself. (As a side note. I don’t drive anymore, but I doubt I’d have been able to drive myself.)
• I’m a verbal processor, so I instantly needed to start talking about it. The first few retellings were completely erratic and out of sync. After that, I could put the events on a semi-accurate timeline, though it had some gaps because I couldn’t remember every detail. I started repeating certain aspects of the event on a loop, then I’d move on and kind of latch onto another part of it.
• I struggled to concentrate or hold on to my thoughts. Now, I have ADHD, so this is my default setting, but it was so much worse than usual that it’s worth pointing out. I’d start a task, forget about it seconds later, then stare off into space or resume the word vomit. For example, I later found I’d typed the first word of a text, and then I must’ve forgotten about it and swiped out of the app.

Hours After the Crash:

• I continued feeling cold for hours afterwards, shivering even beneath layered blankets.
• I had that slightly nervous feeling of waiting for the other shoe to drop.
• I also continued struggling with focus for a good few hours, but memories from during the adrenaline rush kept popping up, and I could fill in the blanks in the timeline.
• All that muscle tightness caught up, and my neck, shoulders, arms, and even the muscles between my ribs ached.
• I turned numb, just as I usually do after a panic attack, and my emotions were subdued until the next day.
• I was so exhausted that I fell asleep almost instantly that night (I tend towards insomnia, so this in itself is strange for me), and slept in a weird position. I had a crick in the neck for days afterwards.
• I was completely back to my old self the day afterwards.

And that’s all I have for you today. Do you have experience with adrenaline? Please share in the comments!

Also, if you have requests for specific posts in this miniseries, feel free to contact me. I love hearing from you!

Until next time.

Yolandie