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mental health mondays :: i'm with the gland [part 3]

this is the final chapter in our trilogy about the glandular system and how it can make you crazy... literally. we've already looked at the adrenal glands and the thyroid glands, both of which are thought to have an effect on our moods, our overall mentality and our access to crucial neurotransmitters. but the adrenals and the thyroid are really just the puppets of something far more powerful. ladies and gentlemen, i give you... your pituitary gland.

behold the puppet master...

the thyroid, having received malevolent instructions
ok, the pituitary gland doesn't really look like much [except a very tiny pair of testicles attached to your brain -ed.] but oh, the things it can do. its function is actually to serve as the field general for the hypothalamus, a region of the brain that controls the entire glandular system, among other things. the pituitary takes its orders and then broadcasts them, arming the rest of the endocrine system with the weapons it needs to get the job done. one of the tricky parts about treating glandular problems is that the root cause can often be found in the pituitary gland, which then fails to give the other glands what they need to do their job, kind of like your old boss who kept insisting that the absence of a colour printer did not interfere with approving graphics and then flipped out when the trees in your ads had beautiful teal-coloured leaves rather than green ones and therefore looked like someone's acid trip circa 1965. in either case, the problem rests higher up and the effects can be felt throughout the organisation. or organism, if you're talking about a body.



this article describes the pituitary as your body's thermostat, which it is, but i've never seen a thermostat that produced urine for me. as the water works regulatory authority, your pituitary is ultimately responsible for that. but the thermostat is a good metaphor for what it does in relation to other glands. the pituitary measures how much of a variety of different hormones are floating around in your body and sending instructions to your other glands about how to adjust their work schedule.

your sexy bits, ready to drill, but strangely unable
unfortunately, this mighty little gland is exceptionally prone to non-cancerous tumours called adenomas. and when i say "non-cancerous" i should make it clear that that does not mean they aren't dangerous. these tumours can seriously interfere with the functioning of your entire endocrine system in a few different ways. for starters, they can squeeze the pituitary until it can't work, like some microscopic octopus administering the hug of death. alternately, these things can secrete hormones on their own, sending messages to your other glands to produce hormones that your body doesn't need. sneaky, huh? these tumours can also just cause the pituitary to swell, without causing much change in hormone levels one way or the other.

depression, anger, violent mood swings and other symptoms we associate with mental illness can be side effects of a pituitary problem. after all, this is the part of your body that ultimately regulates stress and the release of hormones that make you feel good about things. if you're getting starved for them or drowning in them, there will be a difference. some scientists theorise that increased pituitary volume has a direct link to the prevalence of psychosis and that treating this with certain antipsychotics may actually make the problem worse, because both can increase the production of prolactin, which can apparently change your mental state while at the same time making milk come out of your boobs. [oh and gentlemen, don't assume that doesn't apply to you as well.]

your adrenals, not dealing with stress properly
so how can you tell when your crazy is just crazy, as opposed to a sign of a screwed up pituitary? the truth is, it's very difficult, because depression, anxiety or severe mood swings on their own aren't necessarily indicative of anything wrong with your glands. second, because a lot of the pituitary's work is making sure that other glands are doing their thing, the problem may present first as something wrong with a part further down the chain of command. in general, the pituitary has such a broad job description that chances are the only way to identify it as a source is by conducting a backwards search.

c.t. scans and mri's can identify swelling of the pituitary, but your doctor will have to actually recommend you get those. there are blood tests to measure various pituitary hormones, but they are complicated and not always helpful, due to the natural fluctuation of hormones through the body over the course of the day. in order to give yourself the best odds of a successful diagnosis, make sure that you detail any other symptoms you've been having, even if you don't think they're related to your crazy issues. a few important ones to keep in mind:


  • general fatigue and/ or muscle weakness
  • a sudden onset or worsening of psychological symptoms, especially in the absence of an obvious trigger event
  • sexual dysfunction and/ or infertility 


your menses, gone fubar
treatment for a pituitary issue, sadly, is only slightly less difficult than identifying it. most commonly, it means surgery. a team of highly specialised doctors go in through your nose or throat and clip the adenoma out. i don't think i have to tell you why you'll want to make sure that you get the best specialists availble for this sort of thing. you're talking about having people shove a sharp object up your nose to clip a tumour out of something the size of a pea that sits in the centre of your brain. this is not the time where you want to take your chances.

of course, the position and size of the tumour may preclude surgery, which means that you can end up on drug/ hormone therapy for a very long time or you could have to undergo some kind of radiation therapy. [in one of those really harsh ironies, radiation therapy can also cause pituitary tumours, so good luck with that.]

the end result of all this gland talk is just to make you aware that you don't need to accept your mental disorder at face value. a hundred years ago, medical professionals were certain that mental disorders were the sign of a weak mind- thank you for that little stigma, doctors. now they know that there are physical causes of mental malfunctions, but many are still unwilling to look outside the brain for the cause. make sure that your treatment is actually treating the problems you have. ask questions, take notes and remember that it can and does get better.

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