Remember those “brain on drugs” commercials? I think it’s about time for a discussion of your brain on stress.
Chronic Stress and Your Brain
While trying to understand how dopamine works in depression and whether there’s any useful research on anhedonia reversal (little to none), I learned that the chronic stress I experienced throughout childhood and to this day (thanks BIGlaw) has been destroying my brain. Through processes as of yet unproven and partially unknown, the brain of the chronically stressed experiences significant malfunction over time in the hippocampus (atrophy), amygdala and neuron production, which are related to anxiety, mood disorders and memory problems. The same malfunctions are observed in patients experiencing chronic depression.
If you’re one of those depressed people who has responded positively to antidepressants and/or exercise — even if not completely — then maybe the research that I’ve been reading lately will be helpful to you too.
How Do SSRIs Work?
It turns out the popular theory of SSRIs — that they essentially keep serotonin accessible in the brain longer to keep you calmer and happier — was largely debunked nearly 10 years ago. Instead, SSRIs may actually be helping the brain to heal itself, create new neurons and stop, and even reverse, atrophy of the hippocampus by helping the body create more of a protein called brain-derived neurotrophic factor (BDNF). That’s why it takes weeks to improve after you start an SSRI, rather than days (despite increased serotonin availability within hours).
What Does This Mean?
Why does this matter? Because the research also suggests that there are many ways to halt and even reverse this atrophy! It appears voluntary exercise, calorie restriction, intellectual stimulation, cumin, antidepressants and electroconvulsive therapy could all work to increase BDNF expression in the brain. Am I crazy for thinking that it’s about time I start working out daily, going on a calorie restricted diet made up of 30% Indian food and reading more interesting books?
The important thing to note here is that the jury is still out. It is not clear whether this is a cause-effect relationship or simply a random correlation. Further, it is certainly clear that too much calorie restriction, for instance, can actually lead to lethargy and depressed mood, orthorexia and other unhealthy food relationships. But in my n=1 experience, I do feel better when I exercise nearly daily, limit my food intake so that I’m never stuffed/eat when actually hungry and do work that stimulates my brain. I have had rather positive experiences with intermittent fasting as well. And look, I will take any excuse to eat Indian food. (Pass the naan!)
What Else Can We Do?
But there is something else. Something that’s potentially more important for mental health over the long haul. If the cause of these troubles is chronic stress — which I’m still struggling to manage — then the highest long-term priority of those suffering from depression should probably be to learn and utilize better coping strategies. Learning to both minimize stress where possible, and process it and expel it from the body in effective ways may be protective against future depressive episodes.
Maybe stress management and increased BDNF production are the keys to recovering from depression now and helping to prevent its recurrence — for good.