The Neuroscience of Depression: Creating an Upward Spiral with Dr. Alex Korb

The following is an edited transcript of the podcast recorded interview with Dr. Alex Korb.  This transcript has not been reviewed and is not a word-by-word rendering of the entire interview.

Hi, I’m Dan Lukasik from lawyerswithdepression.com. Today’s guest is Dr. Alex Korb.  Dr. Korb is a neuroscientist, writer, and coach.  He’s studied the brain for over fifteen years, attending Brown University as an undergraduate and earning his Ph.D. in neuroscience from UCLA. He has over a dozen peer-reviewed journal articles on depression and is also the author of the book, The Upward Spiral: Using Neuroscience to Reverse the Course of Depression One Small Change at a Time. Interesting, he’s also coached the UCLA Women’s Ultimate Freesbie team for twelve seasons and is a three-time winner for Ultimate Coach of the Year.  His expertise extends into leadership and motivation, stress and anxiety, mindfulness, physical fitness, and even standup comedy. Welcome to the show.

These 11 Habits of People With Concealed Depression

Blogger Lexi Herrick writes, “Depression often goes unseen, unrecognized, and undiagnosed. A person with concealed depression is someone who is conditioned to deal with their inner demons in a way that doesn’t make them clearly visible. They may or may not be diagnosed, and this may or may not be something they’ve shared with even their closest of companions. The problem is that the world becomes darkest when we all stop being able to understand each other. We tend to believe that hardship is worn openly upon one’s chest like a battle scar, but many of these wounds do not easily reveal themselves to those that do not take the time to look.” Read the rest of her blog.

How to Prevent Stress From Shrinking Your Brain

 

Have you ever felt so stressed out and overwhelmed that you can’t think straight? We now know that prolonged stress or trauma is associated with decreased volume in areas of the human brain responsible for regulating thoughts and feelings, enhancing self-control, and creating new memories. A new research study, published in today’s issue of Nature Medicine, is a first step in uncovering the genetic mechanism underlying these brain changes.

Depressed People’s Brains are More FragmentedIn this study, conducted by Professor Richard Dumin and colleagues from Yale University, scientists compared the genetic makeup of donated brain tissue from deceased humans with and without major depression. Only the depressed patients’ brain tissues showed activation of a particular genetic transcription factor, or “switch.” While each human cell contains more than 20,000 genes, only a tiny fraction of them are expressed at a given time. Transcription factors, when activated, act like light switches, causing genes to be turned on or off. This transcription factor, known as GATA1, switches off the activity of five genes necessary for forming synaptic connections between brain neurons. Brain neurons or nerve cells contain branches or dendrites that send and receive signals from other cells, leading to interconnected networks of emotion and cognition. The scientists hypothesized that in the depressed patients’ brains, prolonged stress exposure led to a disruption of brain systems involved in thinking and feeling. Depressed brains appeared to have more limited and fragmented information processing abilities. This finding may explain the pattern of repetitive negative thinking that depressed people exhibit. It is as if their brains get stuck in a negative groove of self-criticism and pessimism. They are unable to envision more positive outcomes or more compassionate interpretations of their actions.

Glucocorticoids Damage Brain Neurons 

The stress response involves activation of a brain region known as the amygdala, which sends a signal alerting the organism to the threat. This results in activation of the HPA (hypothalamic-pituitary-adrenal) axis and release of a cascade of hormones, including cortisol, widely regarded as the quintessential “stress hormone.” While short-term cortisol release prepares the organism to sustain “fight or flight” and fend off an attacker, long-term exposure appears to cause brain neurons to shrink and interferes with their ability to send and receive information via branches called dendrites. In animal studies, under chronically stressful conditions, glucocorticoids such as cortisol can remain elevated for long periods.

Traumatic Experiences Can Shrink the Hippocampus in Those Who Don’t Recover

This finding is another piece of the puzzle regarding how stress and prolonged distress may impair our ability to think in creative and flexible ways. Research in both mice and humans has demonstrated an association between stress exposure (foot shock in mice, life events in humans) and shrinking of the hippocampus – the brain center responsible for forming new, time-sequenced memories. Studies in women with PTSD resulting from childhood sexual abuse and Vietnam veterans with PTSD have shown 12-26 percent decreases in hippocampal volume, relative to those without PTSD. In another study, patients recovered from long-term major depression showed a 15 percent decrease in volume of the hippocampus, compared to non-depressed patients.

Major Life Stress Damages the Prefrontal Cortex

In addition to hippocampal shrinkage, major life stress may shrink brain neurons in the Prefrontal Cortex (PFC), the brain area responsible for problem-solving, adaptation to challenge, emotional processing and regulation, impulse control, and regulation of glucose and insulin metabolism. In a study of 100 healthy participants conducted by Dr. Rajita Sinha and colleagues at Yale University, and published in the journal Biological Psychiatry, those with more adverse life events had greater shrinkage of gray matter in the PFC, compared to their less-stressed peers. Recent major life events, such as a job loss, make people less emotionally aware while life traumas, such as sexual abuse, seem to go further, in damaging mood centers that regulate pleasure and reward, increasing vulnerability to addiction and decreasing the brain’s ability to bounce back.

Summary 

While the evidence is not yet conclusive, these studies suggest that prolonged exposure to stress can shrink the brain, both via the damaging effects of cortisol on brain neurons and by disrupting expression of genes that facilitate neuronal connections. This raises the question of whether there is anything we can do to prevent such damage. Since we can’t always control how much we are exposed to financial, relationship, or illness stress, are there preventive activities we can do to maintain cognitive resilience so we can continue to deal effectively with the stressors? It is not known if we can reverse the damage by these methods, but we may lessen it and make our brains more resilient to stress.

Brain-Enhancing Activities to Combat Stress

While the below list is not exhaustive, the three activities below have enhanced brain functioning in controlled studies.

Take a Daily DHA Supplement – DHA or Docosahexaenoic acid is an Omega-3 fatty acid that is a central building block of brain tissue. DHA is thought to combat the inflammatory effects of cortisol and the plaque buildup associated with vulnerability to Alzheimer’s disease. According to Dr. Mehmet Oz, in one study, a dose of 600mg of DHA taken daily for 6 months led the brain to perform as if it were three years younger.

Exercise Most Days – In studies with mice exercise led to a more improved performance on cognitive tasks than exposure to enriched environments with lots of activities and stimulation. Exercise leads to increases in BDNF or brain-derived neurotropic factor, a substance that strengthens brain cells and neuronal connections. BDNF is also thought to promote neurogenesis or the creation of new brain cells from existing stem cells in the hippocampus. Although these effects can’t be studied in living human brains, researchers have found increases in BDNF in the bloodstream of humans following workouts.

Do Yoga, Meditate, or Pray – These activities can activate what scientist Herb Benson at Massachusetts General Hospital calls “the relaxation response,” which lowers blood pressure and heart rate and lowers subjective anxiety. Benson and scientists from a genetics institute showed, in a recent study, that inducing the relaxation response can beneficially alter the expression of genes involved in inflammation, programmed cell death and how the body handles free radicals. The effects shown were in the same genes implicated in PTSD and depression. According to Jeffery Dusek, Ph.D., co-lead author of the study, “Changes in the activation of these same genes have previously been seen in conditions such as post-traumatic stress disorder; but the relaxation-response-associated changes were the opposite of stress-associated changes and were much more pronounced in the long-term practitioners.”

About the Author

Melanie Greenberg, Ph.D. is a licensed Clinical Psychologist and expert on Mindfulness and Positive Psychology.  Dr. Greenberg provides workshops and speaking engagements for organizations,  life, weight loss, or career coaching, and psychotherapy for individuals and couples. Visit her website: http://www.drmelaniegreenberg.biz

This article originally appeared in Psychology Today.

 

Weathering the Dead Zone of Depression

There is a dead zone in a depressed person’s life where nothing seems to happen.

Except for the pain of the absence of everything.

Such anguish is so overwhelming that every other concern is squashed in its wake.  Our capacity for willful actions seems to be gone; we can’t “figure it out.”

We are stuck.  And it sucks.

I have learned a lot about this “zone” over the years, its patterns, and how to handle it.  It’s really like learning to surf a giant, dark wave.  To handle these waves, you need to prepare yourself before the next big ones roll in.

When I’m entering a dead zone, I use positive affirmations I’ve created to “talk back” to my depression. I don’t let the toxic voice of depression drown me out.  It’s important to empower yourself in whatever ways you can during these times because depression will lead you to falsely conclude that

New Research Shows Depression Linked With Inflammation

Dr. Marylynn Wei writes, “One traditional hypothesis of depression is that people who are depressed have a deficiency in monoamine neurotransmitters in the body, which leads to low levels of neurotransmitters like serotonin and norepinephrine in the brain. But growing evidence supports that at least some forms of depression may also be linked to ongoing low-grade inflammation in the body.  Brain imaging of people with depression show that their brain scans have increased neuroinflammation. When your body is in an inflammatory state fighting off the common cold or flu, you can experience symptoms overlapping with depression— disrupted sleep, depressed mood, fatigue, foggy-headedness, and impaired concentration.” Read the rest of her blog.

Rediscovering Who You Are After a Severe Depressive Episode

Blogger Joy Biddell writes, “But what I’m finding even harder than mundane tasks is rediscovering who I am. Depression stole my identity and my joy. Trying to find myself again while still feeling exhausted, low and riddled with anxiety is one of the hardest things I’ve ever had to do. Everything I knew and enjoyed feels like a distant memory and building myself back up feels like an impossible task. I can’t remember what genuine happiness feels like. I’ve had glimpses of it, but the feeling doesn’t stick around. I can’t remember how to socialize, even texting friends is difficult. I used to enjoy coloring, church, volunteering, reading, driving with tunes blasting and singing at the top of my voice (even in traffic), going out with friends, going for meals out, long walks with the dogs, my partner and seeing family. All these things are incredibly hard to do now. I either can’t remember how to do them, get too anxious and overwhelmed to do them or physically can’t do them.” Read her full blog here.

Diving Into Hell: A Powerful Memoir of Depression

From The New York Times, book reviewer and best-selling author Andrew Solomon writes, “Not so long ago, the mere fact of writing that you had suffered from depression conferred a badge of courage, but such confessions have devolved into a dull mark of solipsistic forthrightness. Famous people use such disclosures to persuade you that they are just like you, perhaps even more vulnerable; it’s a way of compensating for the discomfort attached to their glamor. Indeed, in an increasingly stratified world, people with any modicum of privilege may reveal their depression as an assertion of their common humanity. Clinical misery has taken over from death as the great equalizer. Vanity of vanities, all is depression. Into this morass daringly comes Daphne Merkin with the long-awaited chronicle of her own consuming despair, ‘This Close to Happiness: A Reckoning with Depression.'” Read the entire article here.

3 Practices for Letting Go of Looping Thoughts

Jenna Cho, lawyer and author of the book, “The Anxious Lawyer” writes, “The ability to gently let go of negative looping thoughts has been perhaps one of the most powerful and unexpected benefits of having a regular meditation practice. Research indicates that meditation can help us process and decrease the impact of negative emotions, such as anger. If you find yourself stuck in an endless negative thought loop, here are three practices that you may find useful.” Read the entire blog here.

8 Ways to Persevere When Depression Persists

Therese Borchard blogs, “Although I like to cling to the promise that my depression will get better — since it always has in the past — there are long, painful periods when it seems as though I’m going to have to live with these symptoms forever. In the past, there was a time when I had been struggling with death thoughts for what seemed like forever. The death thoughts did eventually disappear, but I’m always mindful of my depression. Every decision I make in a 24-hour period, from what I eat for breakfast to what time I go to bed, is driven by an effort to protect my mental health.” Read her entire blog here.

Depression: A Psychiatrist’s Recommendations for Self-care

Psychiatrist Monica Starkman, M.D. writes, “In clinical research, one uses the scientific method and studies just one treatment alone in order to assess its effectiveness. But in clinician mode, I am convinced that a combination of effective techniques increases the probability of a strongly positive result – and I don’t really care which of them did the most good. Here are five simple yet powerful treatments I recommend because they are both scientifically valid and clinically effective. Read her entire blog.

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