Our Manic Depressive World: What Do Testosterone and Cortisol Have to Do With It?

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Have you noticed that we seem continually to go through huge ups and downs in our lives? Our economy goes on a manic run, then crashes. We get all hyped up for another war then become depressed when it never seems to lead to the peaceful result we had hoped to achieve. It reminds me of my father who had to deal with depression and bipolar illness throughout his life. Bipolar disorder or disorder, the term I still prefer, is a difficult illness to have.

I know because I have it as well. Throughout my life, I’ve had swings of wild highs where I’m very creative and get a lot done, and equally wild lows,where I feel overwhelmed and stressed out. When I’m high it’s like being able to juggle ten beautiful balls in the air at once. I can write books, do counseling, write to friends, see six new clients in a day, read three new books, and on and on. When you’re a little bit manic, it’s wonderful. You can juggle 6 balls and everyone is amazed. But then you see another fantastic opportunity that you just can’t pass up and you want to go for number 7, then number 8, and 9 . . . and then they all come crashing down and your world collapses.

For some the up and down cycles may come once every four or five years. For others they can occur four or five times a year, or even more often. When the up and down cycles occur quite often, we call it rapid cycling. As you can imagine, these swings of mood can be very difficult on the people who live with us and love us. When we’re in our manic cycle everything seems wonderful and when we’re in the depressive cycle we hunker down waiting to feel good again. In any case the person who is manic depressive often doesn’t realize the damage that is occurring to themselves or their relationships.

We seem to be living in a world caught up in increasingly rapid cycling craziness of manic highs and depressive lows. A small percentage of us actually get an official diagnosis, but sometimes an entire culture can become deranged.

About 2.5% of the U.S. population suffers from some form of manic depressive illness – nearly six million people. A rapid cycling pattern may occur in about 10% to 20% of people with the disorder. Those with manic depressive illness have a very high suicide risk. My father attempted suicide when I was five years old. I got very close to suicide a number of times in my life.

According to Kay Redfield Jamison, one of the world’s leading experts on manic depressive illness, at least 25% to 50% of patients with bipolar disorder also attempt suicide at least once. In her autobiographical masterpiece, An Unquiet Mind: Memoir of Moods and Madness, she describes her own journey and the many times she got close to ending her own life.
Reading her book gave me the courage to deal with my own moods and madness and reach out to get the help I had been denying I needed. For me, my irritability and anger were ruining my marriage, but I just couldn’t see it. When I read these lines that Jamison wrote, I saw myself so clearly I broke down and cried:

“You’re irritable and paranoid and humorless and lifeless and critical and demanding, and no reassurance is ever enough. You’re frightened, and you’re frightening, and ‘you’re not at all like yourself but will be soon,’ but you know you won’t.”

I finally went to see a psychiatrist, eventually engaged in some excellent therapy, took medications, and began to heal myself and my relationship. I learned that many creative people suffer from manic depressive illness and many, like me, are afraid that if we get treatment or take medications we might lose our creative edge. I learned that creative highs while manic are not worth the depressive lows when we crash. And, I’m happy to say, I’ve actually become way more creative and productive once I acknowledged my manic depressive way of life and got treatment.

Jamison also notes that many creative people suffer from the illness. In her book Touched with Fire: Manic depressive Illness and the Artistic Temperament she says, “Recent research strongly suggests that, compared with the general population, writers and artists show a vastly disproportionate rate of manic depressive or depressive illness.” Here are a few of the creative artists with manic depressive illness:

• Sherman Alexie, Native American poet, writer, and filmmaker
• Dick Cavett, television journalist
• Richard Dreyfuss, actor
• Carrie Fisher, actress and writer
• Ernest Hemingway, writer
• Marilyn Monroe, American actress
• Friedrich Nietzsche, philosopher
• Sinéad O’Connor, musician
• Jackson Pollock, American artist
• Frank Sinatra, American singer and actor, who told an interviewer in the 1950s “Being an 18-karat manic depressive, and having lived a life of violent emotional contradictions, I have an over-acute capacity for sadness as well as elation.”

In her book, Exuberance: The Passion for Life, Jamison offers a clear description of mania. “Mania,” she says, “is a state during which, as the composer Hugo Wolf put it, ‘the blood becomes changed into streams of fire’—is distinguished by an often wildly exuberant mood (albeit one joined by irritability and, not infrequently, depression), expansive and grandiose thinking, cascading speech, phenomenally high levels of energy, little need for sleep, a frenzied tendency to seek out others, terrible judgment, and rank impulsiveness.”

The Hour Between Dog and Wolf and the Balance Between Testosterone and Cortisol

Physiologist and former Wall Street trader John Coates looks at our manic financial system and the periodic crashes that follow. He shows how understanding the hormones testosterone and cortisol can help us stay in the healthy zone and avoid the manic highs and depressive lows that characterize our lives and our society.

He begins the book with a quote from the writer Jean Genet, which says a lot about times in which we live: “The hour between dog and wolf, that is, dusk, when the two can’t be distinguished from each other, suggests a lot of other things beside the time of day. It’s the hour in which every being becomes his own shadow, and thus something other than himself.”
He first began to recognize the craziness of Wall Street during the DotCom boom of the 1990s. “It was like watching A Midsummer Night’s Dream,” he says. “Traders were euphoric and investors delusional.” Coates got caught up in the cycles of winning and losing. “I would see people get on a winning streak on the trading floor and go lunatic. It happened to me as well. For weeks, even months, you feel like the hero of the floor.” Then comes the inevitable crash when the market takes a downswing as it did in 2008.

When he was a trader, Coates saw what was going on, but didn’t understand it. Once he left Wall Street, went back to school, and learned about hormones, things made better sense. Coates calls testosterone “the molecule of irrational exuberance” since it rises and feeds on itself when traders are on a winning streak. The more they win, the more risks they take. This continues, like my manic ball juggling, as the traders feel like masters of the universe, invincible and all powerful. But the balls eventually come tumbling down.

Cortisol is the main hormone of the stress response, which prepares the body to deal with injury or threat. Coates calls cortisol “the molecule of irrational pessimism.” He recognized that stress increases as a result of three factors: novelty, uncertainty, and uncontrollability. All three factors are present in our world today and he shows how these factors influence the hormonal balance in our bodies.

To test how uncertainty affected stress levels, Coates looked at the variance of trading profitability versus cortisol levels. “More uncontrollability in trading results resulted in higher cortisol levels,” he said. He also looked at uncertainty about the future and found that cortisol rises with volatility as much as 68 percent over two weeks.

We all have testosterone circulating in our blood stream (though males have 10 to 20 times the levels as females) and we all need cortisol to prepare us deal with stress. The problem is that we are living at a time with new much novelty, uncertainty, and things we can’t control. Our cortisol levels remain high and we are chronically stressed. As a result we are on a roller-coaster ride of booms and busts, war and peace, manic highs and depressive lows.

Understanding the ways our biology interacts with our psychology and our economic and social systems, can help us find balance in our lives and in our world. When we become unbalanced hormonally, we become unbalanced as people. When large groups of people on Wall Street (predominantly young males high on testosterone) become unbalanced, our economic system swings out of control. When our major institutions (including governments, social, and religious groups) get out of balance the whole world starts acting irrational and crazy. It’s time we found our balance and controlled the stress in our lives. Come to think of it, that’s why I wrote my last book, Stress Relief for Men.

Manic depressive Diamond, PhD, LCSW, is the Founder and Director of the MenAlive, a health program that helps men live well throughout their lives. Though focused on men’s health, MenAlive is also for women who care about the health of the men in their lives. Diamond’s new book Stress Relief for Men: How to Use the Revolutionary Tools of Energy Healing to Live Well.