Brainy Stuff

Short answer: Yes….ish.

Long answer: Depends on what you mean ‘the same way’ and also which medication you’re looking at. They don’t focus on giving your brain fertilizer like antidepressants do, but they do have some interesting things that are beneficial to your brain. Honestly though we know even less about bipolar than we do depression, so there’s a lot of research to go.

That said, we do know what some of the meds do, so let me go down the list and give you a rough breakdown:

Lithium and Valproate: Promotes cell growth/survival, shows promise of preventing Alzheimer’s disease. Is also an antioxidant. Valproate even alters your DNA to make your cells stronger! It’s also capable of increasing BDNF and brain volume. But these can be risky drugs, especially lithium.

Lamotrigine: Studies have shown protecting neurons in people with traumatic brain injury, and it also promotes growth/survival for cells the same way as the other two above. Neuromodulators in general seem to improve function and stabilize the chemical processes going on.

Antipsychotics can be used with traditional antidepressants - not because you’re psychotic, but because it’s shown that these medicines are excellent in regulating manic episodes, while the antidepressants can do their work on feeding your brain some good BDNF.

Actually, you know what? If you’d like you can tell me some of your medications, and I’d be glad to write about their neurological effects. It’d help a lot of other people too who are either taking them or considering them. :D I’d like to do some drug-related posts. After….my essays and projects, though, which might be the end of this week, with luck.

(Also, I misworded a few things in the last ask: less volume in hippocampus and prefrontal cortex, not frontal/limbic areas!)

There is a case study of a middle-aged man who had never done any criminal activity in his life, until he started acting strange. He began collecting child pornography and hitting on his 13-year old stepdaughter. He was very quickly caught and convicted with pedophilia. 

On the night he was supposed to be sent to prison, he suddenly lost control of his bladder. At first this wasn’t surprising, considering what they do to pedophiles in prison, but someone realized that losing bladder control to such an extent indicated that there was something seriously wrong with his brain.

When they took a brain scan of him they found an absolutely MASSIVE tumor! And it was growing right over his frontal cortex, which deals with reason and inhibition.

And get this: when they took out the tumor, the man went completely back to normal. He was released and went back to not being a creepy fucker.

Until he started doing it again, and when they caught him and did another brain scan, they found the tumor growing back. It was removed, and he went back to normal.

When they interviewed this guy, they asked that now that he’s been through this, should he - and others like him - still be jailed? He said yes, because he knew with rational thought that it was wrong and sick, but he did it anyway.

What does this say about these people? What does it say about other people? Those with depression, those with bipolar, or OCD, or panic? When you know with every rational fiber of your being that what you do and feel is stupid, or wrong, or silly, but you do it or feel it anyway because there is something in your brain preventing you from functioning normally?

The man gave his answer, but it’s not the all end-all and be-all. There is in fact no right answer to this, but it’s certainly food for thought. 

The Effort-Driven Reward System is a pathway that converges the striatum, the prefrontal cortex, and the limbic system into the nucleus accumbens. That is, the centers of movement, thought, and emotion all connect into motivation. And this entire road is severely affected by depression.

Can’t summon the energy to move? Striatum.
Can’t concentrate or think rationally? Prefrontal cortex.
Can’t feel happy no matter how hard you try? Limbic system.
Can’t feel motivated to do a damn thing? Nucleus accumbens.

This doesn’t explain all of depression (my other posts talk about that), but it does tell a heck of a lot. This highway is easily damaged by depression, which in turn makes depression even stronger, creating a cycle so destructive you can’t even get out of bed, things are that shit.

And how are you supposed to penetrate it and cut the cycle off? You can’t control the limbic system or nucleus accumbens, because these are located in the midbrain, a place that is pure instinct and no thought.

The keys here are the other two. The prefrontal cortex requires heavy retraining and rewiring through cognitive therapy, which is hard to do if you have no motivation. The other is the striatum, where you have to move in order to jumpstart the system.

The big word though is effort-driven. You can’t just do any movement, you have to do something with meaning. Drawing, writing, cooking, taking up crocheting or building birdhouses - exercise your creativity. Say what you will about your shitty _____, if you look back at a masterpiece that you just created and go holy shit, I fucking made that, I guarantee you’ll feel at least a little pride. And that’s what you’re looking for, trying to penetrate this system.

If you keep exercising your brain, using this effort-driven reward system, and doing what you can to do meaningful work with your hands, you may just kick it back into gear.

Take a walk in the sun.

We humans live for the sun. It does lovely things for us. Not only does it give vitamin D, but it also triggers the clockwork cells in your brain that keep time. Whenever we’re in sunlight, we kind of wind up our internal clocks and correct the time that we made before.

These clocks are insanely important in running the system - you probably don’t notice much, but your brain keeps a careful schedule of events and activities. You’re more tired in the evening/morning, you get hungry midday, you even have a peak in energy at the same time every day. What time these things happen depends on your genetic makeup, but they all work by the sun. And if you don’t get these events in your schedule addressed, you can have some moodiness happen as a result, or even a prolonged overall state of negativity and sluggishness.

While people with more severe cases are said to have Seasonal Affective Disorder, who are extremely depressed only in winter, it essentially works that way for all of us. So try your best to recalibrate your internal clock, and go out in the sun. If you aren’t in a sun-friendly place, a brightly-lit room can help out as well, though the sun is always better.

Play with a pet.

There’s a notable study that looked at three groups of high-stress career women who had to read a presentation out loud in a room to a researcher: one alone, one with their best friend, and one with their dog. And for every single one of them, the dog group won. The cortisol levels of the people who read with their dog were lower than both the one alone and with their best friend.

Two groups of children had to read a paper to a researcher, one with a stuffed toy, and one with a dog. They then had their cortisol levels measured. The dog group won.

A high school specializing in troubled children instilled a program where distressed students, instead of being taken to detention, would spend time with a specially trained dog. One student lashed out to the entire classroom because his best friend committed suicide. After half an hour with the dog, he was smiling and even laughed. The program has been wildly successful in treating severely distraught students, putting them back on a path to being able to get out.

Not just dogs, either. Cats in pet therapy heal patients in mental institutions, hospitals, and nurseries, helping them recover faster and better. And even if it doesn’t, seeing an animal eases their depression in their circumstances, enhancing their quality of life.

There’s just something about an animal. They won’t judge you, won’t hate you, won’t say rude things. They listen. They love. They’re there for you. Though the cat’s probably just there because the human serves them for life at the cost of a little drivel.

Pets are amazing little creatures! Love your pet, play with them, give them hugs. If you don’t own an animal, try seeing if a pet-owning friend will let you play with them, or maybe try volunteering at an animal shelter. They will heal you as much as you heal them.

Exercise.

Exercise has a strange effect of releasing not only endorphins but also BDNF. One is a mild painkiller and gives that ‘runner’s high’ while the other is brain fertilizer that encourages dendritic growth in your brain!

The endorphins only last a few minutes, but the BDNF builds up. This is why BDNF is good for people with depression or chronic stress! It counteracts what the cortisol does, coaxing back the connections that cortisol scared away.

You’ve probably seen studies where cardiovascular exercise helped patients with depression a heck of a lot, and now you know why!

Try doing 15 minutes a day and work your way up to maybe half an hour. You can run in place, dance, hula hoop, jump rope, etc. Your brain will thank you for it!

There are people who are prone to a lot of stress yet are extremely mentally healthy, while there are people who don’t have much stress at all but at severely depressed or suffering from another kind of disorder. This is because in those cases, it’s less about how much stress you have, but how your brain handles stress, and what kind of things they decide to stress out about.

What kinds of things you stress about is mostly based on your personality and experiences, but how you handle stress is based on things well outside your control.

The control center for stress is the hypothalamus, which looks at how much cortisol (the stress hormone) is running through the body, and adds or takes away when the situation is right.

In a lot of depressed people’s brains, this isn’t working. Whatever the hypothalamus is doing, it’s not doing its job. In fact, it kind of just releases cortisol haphazardly without regulating the levels.

Turns out, cortisol is absolute shit for the brain. It sucks. It’s horrible. It’s like really badly done dubstep of Dev or something. Your neurons hate it, and they try to cover their ears by reducing their dendritic branching. Shit man, can you even imagine that?! And the more cortisol, the more the dendrites are going to pull away.

And that’s not the only thing abnormal stress does, either - with your body and brain in code red, your brain’s going to shut down things it thinks it doesn’t need for the moment, even though ‘the moment’ turns out to be ‘however long it’s going to take to get these three papers and four exams over with.’ And um, turns out some of the stuff your brain shuts down is your immune system, your digestive system, and your reproductive system. Brain-wise it also turns off neurogenesis, messes with the chemicals involving sleep, and screws over your ability to remember things. And that’s only some of the shit stress does!

Considering that all of these things are crucial to your ability to function as a human being, you need to take care of yourself. I cannot emphasize this enough! Not only are you threatening your physical health but mental health as well, and for depressed people you absolutely need to watch for it! RELAX!!

The neuroscience community really can’t figure out the true source of depression, or why it happens, or what’s the actual thing that’s going on. And since they can’t figure it out, they can’t figure out good treatments, either - the history of antidepressants is pretty much nothing but tangents and they still haven’t gotten back on track about it.

But here’s some things we know for sure about depression:

- It’s related to chronic stress.
- It’s a neurodegenerative disease.
- It kinda looks a lot like a concussion on a PET scan.**

That second one probably scares you - there’s some pretty concrete proof that depressed people’s brains are less dense than those without depression. Without BDNF, there’s less dendritic branching, leading to less volume and less ability to function normally.

I had said before that new neurons are made in the hippocampus and an area called the prefrontal cortex. There isn’t enough evidence to say that the cells in those areas are dying, exactly, but what we can see is that no new neurons are being made, which is crucial in how these areas work. So because neurogenesis is halted, because volume is decreasing, and because dendrites are for some reason shrinking away, depression is considered a neurodegenerative disease, right up there with Alzheimer’s and Parkinson’s.

That said, it’s true that depression is way, way easier to treat than Alzheimer’s or Parkinson’s…if only because those two are pretty much incurable at the moment, while depression just takes several months to several years, since those problems I just said can be helped if you add BDNF back to the equation, though there are many other problems that can’t be so easily solved.

So that’s the great news: any neurodegeneration can be reversed with antidepressant treatment. Even if it takes months and years, it is certainly possible, provided that you persevere!

Remember, antidepressant treatment doesn’t necessarily mean pills, either - cognitive therapy works just as well and then some, at the cost of more time and effort. I’ll go over treatments in another post sometime soon, as well as those other things above, so watch for it.

** EDIT: Scratch that thing about concussion, I got it wrong! Stay tuned for an update about that, I guess.

Neurotrophins are brain fertilizer, and your brain loves the shit out of the stuff. There’s a special brand of this miracle-gro that’s called BDNF that’s all the rage in the academic community nowadays, and is easier to type than neurotrophin, so let’s talk about that.

BDNF is that stuff that makes your neurons sprout, grow, and branch out beautifully. Babies spray that stuff all over the place when they’re developing, and adults need it to keep up their lovely brain garden. The more BDNF you have, the healthier your brain, the more active your brain, and the longer your brain’s gonna live.

Unsurprisingly, people with depression or other mental disorders have very low levels of BDNF, which does a number on their brain garden. Modern antidepressants like citalopram and other SSRIs actually increase BDNF levels in the brain, which is great. The problem, though, is that BDNF is only fertilizer and can only encourage neurons to grow, which takes time and energy, and until then those new neurons are extremely vulnerable. That’s (probably) why it takes so long for antidepressants to take effect - an entire three weeks, usually, because that’s the amount of time it takes for those new neurons to grow and branch out.

Whether you’ve got a disorder or not, one way to increase BDNF levels is to exercise often, usually cardio. Eating healthy also helps - antioxidants defend your new neurons from free radicals.

I’m in the middle of compiling several neuroimaging studies in the hopes of finding some pictures but so far it’s nothing but data

stupid academia GOSH I WISH THERE WERE PICTURE BOOKS FOR NEUROSCIENCE JOURNALS

but this is going to take a while so let’s just talk about how concussions and depression are related

People who get a traumatic brain injury often end up getting majorly depressed shortly after, though it eases up in the months afterward. Why? Well, your brain kind of shuts down and dedicates most of its energy towards healing. Think of it as HP.

[ooooooooo] (Full HP) => [ooooo——] (Brain injury!!!!) => [oooooooo-] (Recover!)

So your brain goes into recovery mode and devotes its time and energy towards recovering, instead of, you know, functioning in society. It gets better after a while for them, though depending on how well they functioned before the time it takes to get better varies.

Because of that link between brain injury and depressive symptoms, a lot of scientists are thinking that depression is kind of like a brain injury that the body is not trying to recover from, or it’s trying but is unable to. Now it doesn’t seem to be an all-encompassing Bad(tm) like concussions, which damage every part of the brain, but it is still “damaged” in that you have reduced function in several areas, and you aren’t getting better.

Now, what if you were hit all the goddamn time?

[ooooo——] => [ooo———] => [ooooo——] => [ooo———]

And eventually, it might even start looking like this:

[ooooo———] => [ooo——] => [oooo—-] => [ooo—-]

Your brain just won’t be able to handle being able to function to its full ability after being hit so often. This is why so many athletes get Alzheimer’s in like their 30s, which is normally unheard of. People out on the front line can also develop this along with PTSD, and it’s worse because the force waves of explosions can cause an internal injury because their brain is repeatedly hitting the inside of their skull (it’s normally suspended in liquid). And that’s only a few types of people who can get it. Drug abusers, alcoholics, physically abused people, especially children - any one of them might suffer permanent reduced cognition from trauma to their brain. This condition is called Chronic Trauma Encephalopathy (CTE for brevity’s sake). 

CTE can come about from non-trauma conditions, too - like someone who gets multiple tiny strokes that will eventually do a number on them. See where I’m getting here?

While depression isn’t going to cause CTE exactly, there are suggestions that someone who has major depressive disorder, having multiple episodes of depression, will have something akin to repeated major brain injury. And it may be true - turns out that a lot of people who have Alzheimer’s actually had been through a lot of depression in their before years. But the link is complicated, and you never know, someone might just be unfortunate enough to be genetically disposed to have depression and Alzheimer’s.

Looking at styles of alcoholic abuse, it seems that those who are chronically depressed as opposed to having episodes of depression seem to have it easier on the brain, though of course you can’t exactly change your style of depression.

Don’t be scared, though! Just because you have episodic depression doesn’t mean that you are going to get Alzheimer’s or another neurodegenerative disease. It’s just that it’s then ULTRA important that you take care of your mental health!! Remember, depression can be fixed, you just need a lot of effort, support, and perseverance!

(If you’re interested, the same thing goes for alcohol - if you’re going to be an alcoholic, it’s better to be chronically alcoholic than a heavy binge drinker, due to repeated brain injury. It’s better if you aren’t alcoholic at all, but you know, I guess you can’t help it sometimes if you’ve got exams all week and you want a break friday night)