Shrinking Brain – Cause or Effect of Depression


brain
New 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?

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.

Energy Balance in Depression and Anxiety

photo (54)Two things I ask nearly every patient on every visit: “How are you sleeping” and, “Are you getting some exercise.”

If the answers are fine and yes, then I begin to relax in the belief that things are going pretty well for this person.  It’s a remarkably sensible formula: Rest + Exercise = Improved Health.

Our bodies were made to do things; and then, to rest in order to more things the next day.  People have been getting physical exercise since the time we lived in caves and hunted for dinner.  In modern times, we spend less time foraging through the woods for dinner and more time standing in front of the microwave oven.

Exercise researchers have shown that regular exercise is good for your mind and body.  It can even be a remedy for mild depression (see earlier blog).  The huffing and puffing of exercise blows off the emotional steam that comes with anxiety.  It is one of the few documented factors that help to reduce the risk of dementia and heart attacks.  Need I say more about the need to make some time for exercise?

Sleep researchers recommend 6-10 hour s of sleep.  Most people need about eight.  Some of us do better with nine.  Very few people function well with less than six.

In many ways, sleep seems like one of the easiest things to do with our time.  It is not.  A healthy sleep pattern takes discipline.  Reduce or eliminate caffeine if you sleep poorly.   Good sleep hygiene also requires that you spend the last hour or so of your day unwinding – not finishing a work or school project, not watching an adventure movie or reading a scary book. Let your mind and body relax.

Then make yourself go to bed.  Your mother does not control your bedtime anymore, so tell your own self “It’s time to go to bed so I can get up in the morning and exercise.”

Mind-Body Medicine in the Forest

iphone June 2014 085Relaxing in the woods may reduce the risk of developing anxiety and depressive disorders. Scientists in Japan compared the physical signs of stress in city and forest settings. They studied the levels of stress hormone (cortisol) and blood pressure in 300 people, and found that spending time in the woodsy setting was associated with fewer signs stress (1).

In the book Breaking Through Depression, I describe the links between prolonged stress, cortisol elevation, anxiety, and depression. In the simplest way, it can be said that chronic high stress damages the brain which may lead to depression.

We all have a lot to do this month – many things to manage in our work and personal lives. So how do we reduce the risk of stress injuries in the brain which may lead to or worsen depression?

One answer appears to be spending some time in the woods. Relax. Enjoy the green colors of summer, the yellow leaves of fall, and the curiously bare trees of winter. As you focus on the novelties of nature, forgetting about problems with work and relationships, your mind and body relax… Be calm… Be quiet… Enjoy the beauty of nature for a while.

(1) Bum Jin Park, and others. The physiological effects of Shinrin-yoku (taking in the forest atmosphere or forest bathing): evidence from field experiments in 24 forests across Japan. Environmental Health Preventative Medicine. Jan 2010; 15(1): 18–26.

(2) Donald Hall. Breaking Through Depression. Harvest House, 2009.

Exercise: Part II – Prayer Walking

Photo source: prayerideas.org

Photo source:
prayerideas.org

As the new year arrives, many of us plan to build better habits – to take better care of ourselves – mind, body, and spirit. Physical exercise can help all three.

Exercise wakes up the body and mind with physical arousal and keenness of thought. A good workout can also restore spiritual perspective when combined with prayer.

“Prayer walking” mingles physical exercise with spiritual thinking, promoting emotional wholeness. As you walk on the treadmill or jog through the neighborhood, take a few moments to think about God and his interest in your life.

In your mind, list the worries or concerns that you have about today. Now, give them to God. Maybe saying, “Lord I can’t handle (name the hardship) on my own. I trust You to take care of it or give me the wisdom to respond rightly.”

As you continue huffing and puffing, think about the trials you will face tomorrow. Again, list them… and release them to God. Still walking, your heart pumping oxygen and energy to your brain, tension fades and you begin to relax as your feet hit land in soothing rhythm.

Now list the concerns that you have about next year – your family and friends, finances and faith. Breathing deeply, give them to God – the creator of your body, your community, and reality.

Pairing prayer with exercise in this way helps to focus your mind and spirit. It may help you to maintain a stepwise process of analysis – no distracting i-phones or no e-mail – just you and God walking along your pathway of life.

Exercise Part I – Pumped Up Moods

Heavy breathing, pounding heart rate, and sweating are your body’s natural responses to emotional stress and physical exercise. These arousal responses may also aid in mental processing and emotional relief.

Rapid breathing and racing heart rate pump oxygen and energy products to brain cells. More power for data processing translates into better problem solving.

Aerobic exercise also elevates mood. Short term mood elevation follows the release of pleasure compounds (endorphins). Longer term changes in mood follow release of Brain-Derived-Neurotrophic-Growth Factor. This natural ‘brain fertilizer’ promotes brain cell repair in regions responsible for mood regulation.

For cases of mild depression, exercise may be as helpful as professional treatment. Psychiatric researchers suggest “the benefits of exercise may be comparable to cognitive or group therapy” (Sidhu). Experts recommend a daily dose of 30-45 minutes of aerobic exercise such as running, swimming, or dancing.

It may seem difficult to start but once begun exercise usually gets easier and may end up feeling pretty good. It can pump you up with confidence before a social event or help to blow off steam from daily hassles. It may even help relieve clinical depression.

If you are not already fit for aggressive exercise, talk to a physician before you start and begin with light 10 minute routines each day. Go ahead. Get pumped up.

Kawaldeep Sidhu and others. Exercise Prescription: A Practical, Effective Therapy for depression. Current Psychiatry, June 2009.