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

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