Category Archives: Brain

Brain Changes in Youth with Depression

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youth brainJoining the quest to discover the brain basis for depression, a group of scientists recently published results from a study of youth (ages 4-24) with clinical depression (*).  The scientists compared the brain activity of 250 depressed youth to brain activity of a non-depressed group.

The study suggests that over-activation of two brain areas (Cingulate gyrus and thalamus) lead to “hypervigilance toward emotional stimuli”.  In other words the youth could not stop themselves from focusing on negative emotional ideas – this despite an increased activation of the dorsolateral prefrontal cortex (an area of the brain responsible for logical control of emotion).

While not offering final answers to the question, “What happens to the brain of people with depression?”, the article does provide evidence that brain malfunctions associated with depression can start in childhood.  The findings might also compel us to more urgently get help for children with depression, not to simply excuse depressive behaviors as a phase of childhood or something they can work out on their own.

(*)  Chris Miller and others. Meta-analysis of Functional Neuroimaging of Major Depressive Disorder in Youth, Journal of the American Medical Association -Psychiatry.  Published online September 2, 2015.

Shrinking Brain – Cause or Effect of Depression

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brainNew research provides evidence that long-term depression is associated with a shrinking brain (1).  The study, published last week, suggests that shrinkage in the hippocampus is a consequence of long-term depression.

Scientists compared brain imaging of 1700 patients with clinical depression to brain images of control subjects with no history of depression.  The hippocampus, a region responsible for memory function, was smaller in patients with long-term depression.  Hippocampus shrinkage was not seen in patients who had only experienced one depressive episode.   From this finding, scientists concluded that brain shrinkage comes after, not before, the onset of clinical depression.

In Breaking Through Depression (2), my book on causes and treatments of depression, I explain how stress can lead to brain cell injury.  Being depressed is certainly a stressful experience, one that might lead to brain cell injury. Breaking Through Depression also explains how this brain cell damage appears to be reversed by successful treatment.  Whether brain cell loss is a cause or consequence of depression remains to be conclusively determined but the point is made stronger by new research: stress and depression can damage the brain.

Do what you can to un-do depression.  Find healthy ways to relax and take care of yourself.  Exercise: huff and puff and break a sweat.  Hang-out with good friends for a while.  Engage your spirituality through prayer, meditation, or reading something inspirational.  If these self-care steps don’t lift your mood, then seek professional counseling and consider talking with a physician about medication.  Depressive illness comes with brain cell injury that can be reduced and reversed.

1. Molecular Psychiatry advance online publication 30 June 2015

2. Breaking Through Depression: A Biblical and Medical Approach to Emotional Wholeness. Harvest House Books

Too Many Antidepressants?

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photo (13)Over 10% of the US population use antidepressants each year, according to a recent study.   Researchers at the National Center for Health Statistics*, also found that antidepressant use rose nearly 400% between approximate years of 1998-2008.

Clearly antidepressants can be over-prescribed.  Doctors may rush to treatment  when they hear complaints of  “I’ve been feeling a bit depressed lately”.  Visits to the doctor tend to brief encounters and quick answers may appear necessary.  It takes a little longer to explain that talking therapy or better self-care may be the better choice for relieving sad and worried moods.

On the other hand, many people who could benefit from medication are not getting the help they need.  This can lead to job loss, broken relationships, and social isolation.  Some people refuse to see the problem.  Others refuse to consider medication as a solution.

Yes, there a lot of people taking medications.  Some should be using psychotherapy, exercise, or another health-promoting alternative instead.  Still many others should recognize that the brain develops chemical imbalance just like any other body part and consider medication. Most people using antidepressants have been properly diagnosed with some form of depression or anxiety disorder.  These people should continue using antidepressants under the care of a medical professional.

So yes, antidepressant medications are over-prescribed.  But they are also under-prescribed.  A thoughtful discussion with a psychiatrist or other mental health professional can usually identify who is who and what is what is this dilemma.

 

* National Center for Health Statistics.  Health, United States, 2010.  Hyattsville, MD. 2011.

Anti-inflammatory Medicines May Have a Future in Depression Treatment

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New research out in October suggests that anti-inflammatory medications may prove helpful in treating depression (1).  Scientists are becoming more interested in this class of medication due to a growing body of research suggesting that depression and many other illnesses develop, in part, due to inflammatory processes in the brain.

Stress hormones and inflammatory products produced when the body is stressed make their way to the brain and damage neurons.  They also interfere with natural brain cell repair mechanisms.

Although prior studies of aspirin have failed to show improvements in treatment of depression, scientists in this month’s report looked a 18 studies (over 10,000 participants) of anti-inflammatory medicines and found that treatment with this class of medication was associated a significant reduction in depressive symptoms.

Studying the link between inflammatory processes and the onset of depression may lead to a completely new way of treating this illness.  While it is not time to rush out to the drug store and begin self-medicating ourselves with anti-inflammatory products to improve mood, this research does offer hope for a new class of antidepressant medications being developed in the future.

(1) Ole Kohler and others.  Effect of Anti-inflammatory Treatment on Depression, Depressive Symptoms, and Adverse Effects.  JAMA Psychiatry (Online First), October 15, 2014.

The Heart – Brain Connection

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photo (16) As a psychiatry intern at Walter Reed Army Medical Center, years ago, I was asked to evaluate a woman admitted to the ICU due to chest pain. I asked the standard questions.

When I asked about the picture of a man displayed on her bedside table, she burst into tears and clutched the picture to her chest. She began sobbing about the recent loss of her husband. Nurses rushed into the room and asked what was going on. Her EKG monitors were showing signs of ischemia and risk of myocardial infarction. Grief was leading to heart-attack. Nurses gave her nitroglycerin and her heart recovered without injury.

The mind-body connection is real. It can promote health or lead to death. Our stress response system, mediated by the hypothalamus of the brain and the adrenal glands in the abdomen, needs to be regulated.

We can work toward a healthy balance of stress and relaxation by making smarter behavioral choices. Exercising five times per week has been shown to reduce mild depression, a stress-related injury of the brain. Practicing meditation has been proven to relieve unhealthy levels of anxiety, a gateway to physical illness. Even a walk through the woods has been studied and found to promote brain and cardiovascular health.

It’s a busy world out there, where taking time to relax or to focus on emotional health seems like a waste of time. Relaxing from a busy schedule is not a waste of time. Healthy levels of rest promote improved brain efficiency and a sense of emotional wholeness. Put that on your schedule and do it!

Donald Hall. A Widow’s Grief: Language of the heart, Journal of the American Medical Association, 1992. 268:871-872.

Sin on the Brain

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photo (39)Life experiences change the brain. As we learn new things, brain cells sprout new branches and make new connections. These synaptic connections create new pathways on which nerve impulses travel.

Learning new things is like forming a path through an open field. If you walk through a meadow, following the same route many times, you will tromp down the weeds and create a path. The more you use that pathway, the more entrenched it becomes.

Choosing to obey God also produces pathways. The more you travel paths of righteousness, the easier it gets for your brain to go that way.

Disobeying God creates alternate pathways. The more you make wrong turns and choose sin-pathways, the easier it becomes for your brain to go that way again.

Sin is not caused by the brain but is reflected in brain cell networks. Sinful choices leave marks – changes in synaptic connections. When too many pathways lead to the amygdala (anger center) unrighteous rage erupts. If too many connections lead to the nucleus accumbens (pleasure center) addictions corrupt healthy ways to find pleasure.

Spiritual growth, on the other hand, can be reflected by building healthy behavioral choice pathways to the prefrontal cortex, the region responsible for reasoned responses. Growing connections to the prefrontal cortex, through spiritual experience and religious practice, may facilitate wise choices.

So, open your mind to God. Meditate on the life of Jesus. Read something that stirs your spirit. Brain cells will spout in new directions.

It may be hard at first. Treading out a new pathway though a meadow may cause scratches and bruising. Likewise, building new behavioral choice pathways around your brain may provoke annoyance and frustration at times; but God never promised an easy path. He promised the Holy Spirit to comfort you along the way.

For a video clip of brain cell pathways, click: http://www.youtube.com/watch?v=hRLhlf6hDgU

Spirituality* and Brain Thickness

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Photo source: willamette.edu

Photo source:
willamette.edu

In the quest to understand religious experience, scientists study the brains of religious people and ask questions like: “Where do spirituality and the brain meet? Does religious belief promote emotional health? Can we watch spiritual experience change the brain?”

While I share this curiosity, I realize that study of nature will never provide satisfying explanations for spiritual experience. Supernatural experience, by definition, lies beyond the scope of nature. Even so, looking for reflections of spiritual experience in the activity of the brain can be fascinating.

One recent study (1) examined the link between brain structure and spiritual viewpoint. Researchers studied the brains of 103 people and found that those who professed a strong spiritual belief had thicker cortical regions of brain. The neuroscientists also found that people with strong spiritual beliefs were less likely to develop depressive illness.

This does not mean that people with strong religious belief will always have healthier brain structure. Neither does it mean that people of faith will never get depressed. It does, however, suggest that spiritual commitment may help to preserve emotional and physical health.

The religious sage and brain scientist appear to be reaching agreement that prayer, worship, and meditation are good for your mind, body, and spirit.

* While clearly not equivalent terms, spirituality and religious belief are used interchangeably in this posting since they were found to have comparable links to brain thickness and emotional health.

(1) Published by Journal of American Medical Association, Psychiatry (on-line) at: http://archpsyc.jamanetwork.com/article.aspx?articleid=1792140

Antidepressants Make Brain Cells Act Like Youngsters

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Antidepressants cause brain cells to act like juveniles. A report this month in JAMA Psychiatry states that antidepressant medications induce “juvenile-like plasticity” in the adult cortex.

Basically, antidepressants help to sprout and reshape brain cells. This branching and reconnecting makes it easier for those using this medication to learn new behaviors – like how to cope with stress.

The report also notes that medications and counseling work well together. Antidepressants fertilize the field of brain cells, if you will, making it easier to grow new behaviors. Combining receptive brain cells with good counsel leads to better coping and, hopefully, improvements in work productivity and quality of relationships.

Castrén, Eero. Journal of the American Medical Association (JAMA) – Psychiatry. September 2013