Pondering stress, cortisol and drunken sailor syndrome

I read a really interesting report linking cortisol (the chemical controlling stress in our body) and bipolar disorder (BD):  

http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8267925&fulltextType=RA&fileId=S0033291711000523

In a nutshell, the article found that people who were diagnosed with BD had higher sensitivity to stress and tended to produce significantly more cortisol than people without BD.  This makes sense to me as my triggers have always been caused by intense stress. My first episode occurred when my parents divorced.  Next when I moved away for grad school and had social integration issues. And again when I eventually dropped out of grad school.  The death of my step-father, and most recently, the huge fight I had with my biological father.  I think its important to note that all 5 of these episode inducing stressors were emotional, not physical or environmental, in origin. 

If my brain has a natural genetic tendency to produce too much cortisol, then my ability to deal with stress will likely be negatively impacted, resulting in the severe mood swings I experience.  That makes sense. 

To help reduce stress in my life I have adopted a healthy lifestyle.  I exercise daily, participate in recreational sports twice a week, eat healthy foods and try to avoid personal conflicts as much as possible.  Besides certain aspects of my escort work (which I really do enjoy most of the time, e.g. orgasms are good for relieving stress), I live a really healthy lifestyle which should help me deal with stress.  Since I have difficulty taking long term medications its important for me to make a proactive and sustained effort in this area. 

There are some things about stress and its affect on me that I am still confused about though. I am a bit of an adrenaline junkie, and considering my genetic predisposition regarding cortisol and stress, I wonder if my thrill seeking habits are detrimental to my mental health.  For instance, I love competitive team sports, scuba diving with sharks, ice-climbing in winter, hiking up volcanos, so on and so forth.  Surely these activities must significantly increase my cortisol levels. 

Come to think of it, I realize that I react differently to the 2 types of stress (physical vs emotional). Physical stress I manage quite well.  For example, I discovered just how far I could push my body physically under both physical and environmental stress when I did my divemaster training. I am able to objectify, compartmentalize and break down into tasks what I need to do to handle/neutralize the physical stressor. I surprised myself with just how calm, cool and collected I am when surrounded by sharks, or when I’m searching for the valve on my air tank while holding my breath at 10m depth without the visual aid of my face mask.  I trained well, think positive and complete tasks.  I think I am good at problem solving because it is something that can be learned.  I can apply logical thinking to these kind of stressors. I have a scientific mind evident in the fact that I have a Bachelor of Science degree with Honours.  My mind craves and excels in scientific exploration, which I apply to getting through thrill seeking adventures.  I’m just like Indiana Jones or Lara Croft.  Seriously, I’ve worked on projects in Europe, Africa and SE Asia before becoming an escort. 

Emotional stress on the other hand, I simply can not handle. Let me try to explain... Normally people have a coping mechanism to manage an emotional stressor, which in turn causes the neurotransmitters in their healthy brains to re-adjust to normal levels. The bipolar brain lacks the mechanism to control the neuro-transmitted chemical hormones in the brain evoked by certain stressors. It begins to overload, short-circuit (e.g. swing into an episode) and given time could even induce a network crash (e.g. hospitalization).  

Gives a certain insight into the use of ECT (shock therapy) for mental illness doesn’t it?? I’ve never had ECT just in case you were wondering. Its not a primary treatment for BD anymore, it tends to be employed only for severe cases when all drug therapy options have been exhausted. 

Reflecting on my past personal relationships, where intense emotional stress has occurred (e.g. death of a love one, family conflict, rejection, deceit and betrayal), I typically have nasty downward spirals. Just like in the cartoons where a snowball rolls downhill growing bigger and faster the longer it goes until it crashes. 

I try to solve all stress using logic but as most men will telI you, emotions are hard to understand because they often make no sense at all - they are illogical. I’m like a cross between a Vulcan and a Klingon.  I expect my male readers will give me a little sympathy in this regard!  Maybe I should seek advice from men in this regard. How do men handle their girlfriends during PMS? What coping strategies do men employ when they are emotionally attacked? I mean besides punching them in the face. As tempting as that is it will probably just add to my list of problems. 

For the longest time I blamed these emotional meltdowns and their resulting mood swings, on being a woman and a scorpio. It was the only thing that made sense. But now I realize that its probably due to this suspected cortisol imbalance, among other neurally transmitted hormones, which cause bipolar disorder.    

Now that I think about it, I tend to react to emotional stressors like someone who is completely loaded drunk.  You know that drunken over-reactive, loud, hyper-sensitive, assumptive, crying uncontrollably type of reaction people have when arguing drunk? That’s what it reminds me of. Mess with my emotions bad enough and I turn into the proverbial drunken sailor: 

Oh what do you do with a drunken sailor, 

what do you do with a drunken sailor, 

what do you do with a drunken sailor, 

early in the morning?  

You can’t reason with someone that is drunk or high. Its futile, forget it. You just have to wait until they sober up. That’s kinda what its like dealing with someone having a bipolar episode. Manics reason like a meth head, and depressives use drunken logic. The shitty thing is that bipolars need alot of time and help to sober up.  Take an aspirin and call me in the morning? Not quite, try taking lithium and call me in a month, and keep doing it for the rest of your life.  

Whoa. Stop. See what I’m doing here? I’m trying to apply logic to explain this situation. I’ve gone off on what’s an interesting, amusing and, hopefully, sensible tangent that I’m passionate and sometimes emotional about.  Its OK though b/c it might help to explain some common bipolar behaviour that normal people don't understand.

I’m going to re-focus this blog now before it spirals out of control.   See, I can recognize it. 

There are a couple things that have been going through my mind since reading that article linking cortisol and bipolar disorder.  

  

1. I wonder if there is a specific cortisol inhibiting drug that I could take when I have to deal with emotional stress?  I bet that could potentially stabilize my mood swings. Exactly which hormones do popular mood stabilizing drugs like lithium or valproate affect? 
2. Why is it only emotional stress (not physical stress) that trigger my episodes? From what I’ve read there is no difference between the body’s response to physical stress as compared to emotional stress. Apparently it produces the same hormones in response to stress regardless of its nature.  E.g. there are no specific emotional stress hormones or physical stress hormones, essentially cortisol is the multitasking stress hormone.  

I hope the authors of this aforementioned article continue to explore this topic of research. There is so much yet to learn about bipolar disorder.   In particular, the effects of emotional stress on the brain and how to manage it. 

It could help the world be a little less crazy.