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Thinking Out Loud: Emotional Stress or Brain Damage?

Thinking Out Loud: Emotional Stress or Brain Damage?

For over a year now, I’ve spewed venomous diatribes, dictated recaps of the day’s interactions, and engaged in generally mindless chattering, all without another person in the room. In each case, I’ve been alone while shouting at the walls and chastising people in my past who did me grave injustices; cracking jokes; explaining my motivations; quoting precedent and reviewing my formal education on various subjects—to nobody. But whenever I am in the company of others, I listen attentively and respond thoughtfully and comparatively sparingly. What in the world is going on?

It started in February 2014 when my mother, with whom I’d been living, was delivered into professional care for her terminal illness, leaving me to live alone for the first time in my life. It would be easy to attribute these peculiar outbursts to the stress of loss and grief, adjusting to being alone at a time in my life when I was at my most disabled and still in the midst of recovering from the then relatively recent break-up of my marriage. To add even more stress, I was also trying to quit smoking while all this was happening–and going through menopause.

Given the above, I can make a strong case for stress and grief causing my inability to remain silent while I am alone. But knowing I have damage in the periventricular white matter and possibly undiagnosed gray matter cortical damage that MRIs don’t pick up prevented me from settling exclusively on the stress hypothesis. This is when I got online and did a little research, hoping to find a piece of information that pointed to one cogent probability.

My reading about typical kinds of brain damage among MS patients yielded only generalities, much like my conversations with neurologists. For example, lesions in the periventricular white matter is a hallmark of relapsing-remitting MS, and yet, when a brain MRI revealed my first such lesions in the brain, I asked my neuro if those lesions were causing any of my symptoms. He told me they were asymptomatic, that the region was considered a no man’s land and was not considered an area of the brain where important functions happened.

Extensive gray matter damage of the cortex is typical in the progressive forms of MS, though high-powered experimental MRIs have revealed cortical damage in new MS patients who are in the inflammatory stage.

Lesions in the frontal lobe can cause irritability, affect working memory, impulsiveness, good and bad judgment, and risk-taking with awareness of possible consequences.

But none of these things really explain my behavior. Being alone for long periods of time removed my inhibitions. Years beforehand, I would carry on with those same diatribes, rages, speeches, explanations and declarations inside my head. Over time my jaw started moving in tandem with my thoughts, so much so that my mother told me she could tell I was thinking intensely because I was moving my jaw muscles. I refrained from vocalizing it for her sake; I didn’t want to scare her. But once she was gone, there was no reason to hold back anymore.

If we step back and view the broader perspective, it’s not such a strange phenomenon. People living with MS carry a tremendous internal burden from the physical stress of pushing our bodies through the typical movements of everyday living, and the emotional burden of coping with such effort on top of the usual stresses of life and the uncertainty of one’s future progression. The larger the burden, the more a person needs to lighten the load. Talking to one’s self can be a comfort, but it can also mean we have unresolved pain associated with some past injustice that we never had a chance to confront. What’s more, it can happen when we don’t have other people to confide in.

One day I confronted someone that had caused me great pain and who had been the focus of my angry rants for many months. Afterwards, I was quieter while alone at home. That particular rant ceased as my pain and anger dissipated. In that case, confrontation was healing, but I was lucky in that the person was sympathetic and helpful. It very well could have gone the other way.

There are no easy answers for or solutions to our pain, our thoughts, our behaviors, or our symptoms. The important thing is to be aware of what we’re doing or experiencing and ponder the possible reasons behind it. No matter how we investigate it, whether by counseling, doctoring or psychiatry, a deep and long talk with a trusted confidant, or a safe confrontation with the object of our discomfort, it all boils down to living our lives consciously.1-4

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Brain Structures and Their Functions. Sonic.
  2. Multiple Sclerosis.
  3. Frontal lobe injury.
  4. Bö L, Geurts JJ, Mörk SJ, van der Valk P. Grey matter pathology in multiple sclerosis. Acta Neurol Scand Suppl. 2006;183:48-50.


  • bffpickles
    4 years ago

    Your thoughtful article motivated me to join the group. Just for the record, I talk to myself (more in whispers) when I’m alone, and I DON’T have MS. But my lifelong best friend did. I lost her to that horrible disease in January, and my heart still aches.

    She lived two states away, so we didn’t get together very often – maybe every 2 or 3 years. A couple of visits ago, when she was still ambulatory (with a cane) we went out to lunch at a very cool Irish pub (we don’t have anything like that where I live.) She mentioned to me that “It’s so good to have you here, to talk to – I get tired of talking to myself.” At that stage, she was the way I had always known her – witty, articulate, the friend I had known since childhood.

    We wrote to each other on email nearly every day, until the last 3 years or so, when she had to go into an assisted care facility, and it was too painful for her to walk (with a walker) to where the computers were, and the chairs were not comfortable for her to sit in due to spinal degeneration, so that was the end of our emails.

    After she went into the care facility, the only contact we had was if I called her. During those three years, she seemed to become more and more distant. There was always some reason why she had to hang up, like “the pill lady is here,” or “it’s time to go to the dining room.” Her son told me that he thought at least part of the problem was that she had to get out of bed to plug the phone into the charger, and the battery got low. I thought that was outrageous, and asked, “Can’t the staff do that?” He said that they probably would if asked, but she had become too lethargic to ask.

    But even during those years, she repeatedly said, wistfully, “I wish you could be here and be my roommate. It would be so good to be able to talk to you.” And yet, it seemed to much for her to talk on the phone. She seemed to want to communicate, but the phone just wasn’t right.

    It was a dreadful heartache to realize that I couldn’t go out there and spend more time with her. My own family and friends there had either died or moved away, so there was no place I could stay for free, and hotel fees were too expensive.

    But I’m wandering. Now, I frequently find myself talking to HER when I’m by myself. I miss the 55 years of shared closeness. We knew each other from junior high on. Regardless of where we lived, we always remained close in spirit. There are things you can tell your best friend that you don’t feel comfortable bring up to your spouse or other friends.

    I would give just about anything to hear her talk back to me, just once in a while.

  • Laurie
    4 years ago

    I too have a dear friend whom I have known for nearly 50 years, but I am the one with MS. Unfortunately we don’t see each other often due to distance; she lives in the Seattle area, where I grew up, and I live in Indiana now. I would give anything to live closer to her but that isn’t likely to happen. I find that sometimes I talk to her, but more often I find myself talking to my deceased parents, or others who are no longer present. I can’t blame it on MS since I have done this since childhood, perhaps because I was an only child. However, I do find myself doing it more often now. I don’t know whether it is MS or stress or boredom, but I am doing it more than I had for a long time. I find it helps me to work out problems in my life.

  • Rachel
    4 years ago

    Wow! About to leave a comment after reading Kim Dolces article,and read Bettys reply. Both of your pieces of writing are lucid,tangible,intelligent. During some voluntary,general testing(of my state as a long term M.S.patient),I remember the consultant commenting that though there was damage,I was able to function well,for a good part,due to the reasonable intelligence I had kept. Was this correct? Anyway,it’s something that stuck with me and that I think of again, when reading your accounts.
    Yes,it makes me think too of my own experience. It also brings more thoughts up. I guess the commonality is a strengthening thought, and to me,the big positives of shared experience,intelligence, and my belief of what’s inside matters (confirmed by inspiring speakers on The Mindfulness Summit (you get the gist). These are things that keep me going. Thanks to all the writers on this site,(and let’s hope the high dose Biotin works – my big supplement at the moment). Rachel Clare.

  • Betty
    4 years ago

    I find I verbalize more when I trying to solve a challenging problem or engaging in creative problem solving. I play 2nd violin in a community orchestra. We have just started work on Cesar Franck’s Symphony in D Minor. It is an incredibly difficult piece. I’m having so significant issues with MS vision in my right eye (as well as double vision and low vision ) I enlarge my music and use highlighters and vivid colored pens to mark fingerings, bowings, accidentals, etc. I talk to myself all the time when I practice. “Watch the g flat in the measure. Yes! I play those 4 measures perfectly! Where do I want to shift?” I say the names of the letters in awkward phrases. First slowly then more rapidly. I am auditorizing to hopefully more rapidly learn my part. Only 5 weeks between performances. So I try to employee as many strategies as possible to increase my rate of learning. Many of the stategies include multimodality activities. Keep on talking!

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