The stress is killing me

Say hello to Brad Pituitary, before it's too late. Also, 7 other things worth your time.

Note from Bill: I’m really proud of Understandably, and I’m especially proud of the improvements we’ve made and the good work we’ve done over the last few months. One of the big reasons for our success lately is that I was able to recruit Kate Sullivan to the effort. Kate is a fantastic colleague, an incredibly knowledgable collaborator, and she’s become a good friend—even though we’ve still never met in person. (We talk over Zoom or Streamyard almost every weekday, but she’s in Scotland; I’m in New Jersey.)

Starting next week, Kate will be taking a short hiatus, and she wanted to explain in her own words what’s going on. So with that, I’ll get out of the way.

Here’s Kate:

“The stress is killing me.”

Whether it’s a deadline at work, or making cookies for the bake sale you learned about at the last minute, or trying to organize your taxes, I think we’ve all used this slightly hyperbolic expression at some point.

Stress builds up. You hit fight-or-flight. It feels as if you’re going to snap, melt, or both at the same time.

But what happens when things get even more intense? What happens when it’s no longer hyperbole, and stress is literally killing you?

You itch. A lot.

I would know. It’s happening to me.

I’m going to explain a medical issue I’ve faced, and what we’re doing about it.

Soon, I’ll have something in common with ancient Egyptian royalty: the experience of having someone stick a crochet hook up your nose to reach your brain.

The difference of course, is that the ancient Egyptians did this post-mortem, while I’m going to endure it as part of a surgical plan to allow me to remain alive, well, and hopefully a bit better.

Why share all this? First, simply to be honest about why I might be a bit quiet for a couple of weeks, and also to shed some light on my rare condition.

I’m also very interested to learn how to put my personal experience to practical benefits in my profession as a work psychologist—sharing ways to cope when it seems like your stress is simply too much to bear.

(That would make the whole “might become a Boris Karloff movie” thing worth it.)

So, the background. For about a year, I struggled with some mysterious health issues.

I started waking at 4:30 in the morning, totally wired. I kept to my usual healthy diet but I started gaining a lot of weight, especially around my face and belly. My hair started falling out. My pulse and blood pressure soared. And man, did everything itch.

Things came to a head in early spring. I found myself in the emergency room, with a guy in manacles behind me and three drunk football hooligans to the right. They were welcome distractions as I tried not to worry too much about my off-the-charts blood pressure and abdominal pain.

After ruling out the usual (burst appendix, heart attack), an overnight-shift resident pronounced the cause of my woes: Cushing’s disease.

Several months and many, many complicated tests later, that diagnosis was confirmed.

In endogenous Cushing’s disease, your pituitary gland goes haywire and instructs your body to make way more cortisol—the fight-or-flight stress hormone—than you can handle.

It’s exceedingly rare; only 1-2 people per million are diagnosed each year.

My case is exemplary—it sounds flattering when you put it that way. It’s literally textbook; I’ve signed permissions for my records to be used in teaching.

Next week, I’ll be doing the ancient Egyptian thing: having a small, hopefully benign growth removed from my pituitary, via my nasal passages. In theory, it’ll cure most, if not all, of my woes; there’s an 80% remission rate with successful surgery.

Because I’m strange, I’ve named the unwanted growth: Brad Pituitary. Eviction day is Tuesday, and Brad seems to be throwing a kegger inside my skull with the knowledge that he’s only got so long to go.

I’m jittery, flushed, and itchy, with a massively elevated heart rate—despite being on serious medication to control my cortisol levels (which are about 1,000 times that of a normal human).

I’m not worried about the surgery, but I am anxious about getting all my cats herded before then.

And this, dear reader, is the interesting bit. There’s a non-zero chance that this surgery will (in addition to canceling the risk that I will actually, literally die of stress whilst doing my PhD) change my personality.

I’ve always been a driven perfectionist. I’ve also always bounced among a thousand interests and ideas. In the past few years, I’ve chalked the latter up to my adult-diagnosed ADHD; I attributed the former to the realities of adult life.

Turns out, it may have been the doing of a 5mm hitchhiker in my endocrine system.

I’ve been told that my stress levels—not just my physiological reactions, but my actual perceived stress and emotional response to that stress—may change temporarily or permanently after surgery.

I can’t decide how I feel about this.

That’s part of why I’m sharing these fairly personal life details. As a psychologist, I study burnout, satisfaction, and feelings of overwhelm. I know that some stress is necessary to thrive, but too much destroys us from the inside out.

I’d like to think I can use this literally life-threatening stress to help others cope.

To consider that a large chunk of what I’ve experienced and perceived in my life, possibly for decades, has been caused by this condition is fascinating, but also eerie.

And so I’m keeping a journal. I’m documenting physical symptoms, along with thoughts and reactions. I’m wondering how much of my experience is nature, how much is nurture, and how much is Brad hitting the big red button at the base of my brain.

This is going to be an interesting journey, folks. I hope you won’t mind if I bring you along on a bit of it, occasionally sharing thoughts from my cortisol recovery, how my outlook changes, and how this all connects to stress and life management for people with more normal stressors and cortisol flows.

We all get stressed sometimes, but you don’t want that stress to literally kill you. We only need so many mummies.

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7 other things worth your time

Thanks for reading, as always. Photo credit: Pixabay. Want to see all my mistakes? Click here.