Your Brain on Depression: A Fascinating Interview with Neuroscientist, Dr. Alex Korb

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The following is an edited transcript of the podcast recorded interview with Dr. Alex Korb.  

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 Frisbee 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 anxietymindfulness, physical fitness, and even standup comedy. Welcome to the show.

Do You Need To Take Medication For Your Depression?

Today’s guest post is by Dr. Eve Wood, a psychiatrist who treats lawyers, judges, and law students dealing with depression, anxiety, burnout or extreme stress.

Do you find yourself wondering if you need to be on medications for depression, or hoping you can stop them? If so, you are not alone!

In 1980, Americans filled 30 million prescriptions for antidepressants, and in 2010, 30 years later, the number of prescriptions for antidepressants filled had risen to 264 million in a year!

Increasing numbers of attorneys are being diagnosed with and treated for depression. According to the 2017 report of the National Task for on Lawyer Well-Being, …of nearly 13,000 currently practicing lawyers…approximately 28 percent, 19 percent, and 23 percent are struggling with some level of depression, anxiety, and stress, respectively.

Dealing With Negative Emotions at Work

We seem to really get a kick out of complaining about work. We hover around the water cooler, confide in our friends, and even share our workplace horror stories with our spouses.

But recounting all the things that made us miserable one day doesn’t help us enjoy our workday more tomorrow. A better strategy is to actually address the negative feelings we have.

When annoyance, self-doubt, or the blues surface at work, we can learn to work through these feelings. Here are three emotion regulation strategies you can use—and how to put them into practice for a happier work life.

  1. Mindful acceptance: Let the things you cannot change be.

Negative emotions exist. Pushing them away or ignoring them does more harm than good, even if we might be tempted to do so.

Instead, try acknowledging your emotions and giving them a seat at the table. Maybe you feel bad because your boss plays favorites—and you’re not the favorite. Or maybe you’re frustrated because your teammates are always running late. It’s okay to feel these negative emotions. You don’t need to judge yourself.

To learn how to practice acceptance at work, start at home by writing out a list of the things you can and cannot control. First, focus on the things you cannot control. Let any emotions you have rise to the surface. Work on accepting these emotions, and yourself, just as you are—saying things like, “I am angry that I didn’t get a promotion, but that’s okay. I am allowed to feel angry.” Experience these emotions, but don’t hold on to them or ruminate on the causes. Just let them fade in their own time.

A word of caution: You might be better served by actually changing your situation if you have the ability to do so, rather than accepting an abusive boss or unhealthy work environment. Use that list of things you can control to take action.

  1. Self-distancing: Observe your situation like a fly on the wall.

We all experience unpleasant situations, especially at work. You may ruminate about a meeting that went poorly, a coworker who slighted you, or a lack of acknowledgment for a project you poured your heart into. But the longer you feel bad, the more that bad feeling compounds.

To calm these negative emotions, mentally removing yourself from the situation is a helpful trick. Research suggests that a more distanced, third-party perspective can reduce the intensity of the negative emotions you feel. To try it, imagine that you’re a fly on the wall, observing your situation. How do you see the situation? How do both people look—you and the other person? By cultivating a broader perspective, you’ll often discover that the situation is not as bad as you thought it was.

A word of caution: Be careful not to mentally remove yourself from the situation permanently. There are many benefits to staying mindfully present for your work life.

  1. Reappraisal: Find the positives in negative situations.

Finding the positive in negative situations is an especially useful regulation strategy when something happens at work that you judge to be undesirable.

To begin to change your perspective, learn to pause in the face of something negative and think of or write down at least one positive. For example, did you get critical feedback on a recent presentation you gave or a report you wrote? Might you reappraise this as helpful information for your career growth—an opportunity to learn how to do better next time? The more frequently you challenge yourself to find the positives, the easier it will be for your brain to start noticing them on its own.

By Tchiki Davis, Ph.D.

Tchiki is a consultant, writer, and expert on well-being technology. Over more than a decade, she has helped build happiness products, programs, and services for non-profit and for-profit businesses, for children and adults, and for online as well as in-person audiences. Tchiki is currently working with Silicon Valley tech companies and UC Berkeley’s Greater Good Science Center to build more effective well-being technologies.

 

 

Top 5 Traps That People With Depression Fall Into

A trap for those suffering from depression and anxiety is that many of people’s natural coping reactions make the problem worse rather than better.   Here are a few examples of that, and some practical solutions.

Note: Please be compassionate with yourself if you can relate to any of these patterns. They’re common pitfalls, not an indictment on you as a person.

Number 1: You don’t fix problems that frustrate you.

Feeling irritable is one of the main symptoms of depression for many people. Some problems that trigger repeated irritation and frustration are easily fixable. However, people with depression often go into a passive “survival” mode and don’t address these issues, even though they could.

For example, you don’t have enough power outlets in the spot where everyone in your household likes to charge their devices. You’re constantly annoyed about people unplugging your device in favor of their own. This is the type of tension that can be solved by getting a multi-plug or another similar practical solution.

People with depression often just put up with this type of issue (and complain about it), rather than deploying a solution. It’s understandable to do this, but not very helpful.

Number 2: You’re waiting for your sleep to improve before you take other actions.

Difficulty sleeping is one of the most horrible symptoms of depression.  Unfortunately, it’s often the last symptom to resolve when people’s mood starts to improve. Therefore, even though it’s hard, it is important that you start other strategies even though you’re feeling tired and grumpy. For example, exercise. If you over-focus on getting your sleep right before you start other strategies, you’re setting yourself up to fail.

Number 3: Wanting a pill as a cure-all.

Medication is helpful for many people with depression but it certainly doesn’t address all of the thinking and behavioral patterns that are associated with depression. For example, you’ll likely still need psychological strategies to deal with tendencies towards rumination (overthinking) and avoidance/procrastination.

Solution: Try drawing a pie chart and estimating what role you think medication has in your depression recovery. Include whatever is relevant to you in your pie chart, such as thinking changes, exercise, meditationlaughter, problem-solving etc.  Your personal pie chart won’t be the same as someone else’s since everyone’s preferred mix of strategies for depression recovery is a little bit different. When you start adding all these other components to your pie chart, you’ll see that medication is only a part of the picture.

Number 4: Asking for help too often.

People with depression frequently struggle along on their own for far too long before seeking effective help, and may not realize they’re depressed. However, sometimes people can become over-reliant on others when their mood is low. Examples include too frequently asking for help with: making decisions, using technology, or reaching out socially (such as making phone calls).

The same person can be too resistant to seeking help in some respects and too reliant on others in other respects!

When someone who is depressed constantly leans on others it can create anger, resentment, and other problems in relationships. This is especially the case when the depressed person repeatedly asks the same people for help or asks for help with the same task that they could learn to do themselves.

This point relates to the next one, so keep reading to learn more.

Number 5: Putting life, learning, and projects completely on hold.

People often feel like their brain is foggy and their concentration is impaired when they’re depressed.  Therefore, it’s natural that people withdraw and think they’ll put off working on projects or learning anything new until they’re feeling better.

When you’re depressed, it’s a great idea to go easy on yourself and resist taking on too much. This does not mean putting off anything and everything challenging or unfamiliar. If you do this, you’ll, unfortunately, dig yourself into a very big hole, where you withdraw from life and avoid, and your confidence and energy erode further.

Don’t push yourself too hard, but understand that experiences of both pleasure and mastery are incredibly important for mood hygiene and depression recovery.

Solution: For this tip, I like to think of each day in three chunks – morning, afternoon, and evening.  Aim to have one experience of pleasure and one experience of mastery in each of these chunks.  These can be tiny, like canceling a subscription you’ve been paying for but not using.

You can actually fold other advice for alleviating depression into this strategy. For example, exercise could be either a pleasure or mastery experience for you or both. Something like taking the stairs rather than the elevator could be counted.

If you include mastery experiences in your day, you’re not likely to fall into the traps of asking for help too much or failing to solve easily fixable problems that trigger your irritability.

Wrapping Up

Which of these problems seems most relevant to you or your loved one? Which of the solutions presented seems most important for you to try? How can you implement that in the easiest way possible? How can you bypass the most likely obstacle to your succeeding with your strategy?

 

By Alice Boyes, Ph.D. Alice has had her research about couples published in leading international journals, including Journal of Personality and Social Psychology.Her work focuses on how people can use tips from social, clinical and positive psychology research in their everyday lives and romantic relationships. She is regularly interviewed for magazines and radio about a wide range of social, clinical, positive, and relationships psychology topics. She can be contacted for media interviews by emailing admin@aliceboyes.com

 

 

 

Don’t Let Burnout Get the Best of You

Burnout often results from extended periods enduring the emotional stress precipitated by unaccomplished expectations or failure to fulfill unreasonable demands. The symptoms can include intensified emotional exhaustion, physical fatigue, lowered self-worth, changes in eating and exercising habits, social withdrawal, sleep disorders, anxiety, and depression.

There are specific and reproducible patterns of changing neural activity and brain connectivity associated with the stress buildup that leads to burnout. In the high-stress state subjects’ neuroimaging scans reveal less activity in the higher, reflective brain (Prefrontal cortex/PFC) and more activity in the lower, reactive brain that controls involuntary behaviors and emotional responses.

Prolonged stress correlates with structural increases in the density and speed of the neuron-to-neuron connections in the emotion-driven reactive networks of the lower brain and corresponding decreases connections in prefrontal cortex conscious and reflective control centers.

The explanation of these changes is attributed to the brain’s neuroplasticity defined by the phrase: “neurons that fire together, wire together.” The brain literally rewires to be more efficient in conducting information through the circuits that are most frequently activated.

When stress is frequent, the more frequent activation of the neural pathways to the lower, stress-reactive brain results in their strengthening from enhanced wiring (dendrites, synapses, myelinated axons). These pathways can become so strong that they become your brain’s fast route to its lower, reactive control centers. The stressful, burned out state when the lower, reactive brain is in charge overcomes the calm, reflective, and productive higher neural processing in the (PFC) – the preferred brain locale for control of behavior and emotional self-management.

As your efforts to achieve unreasonable goals are thwarted or increasing demands recur, and the lower brain dominates more frequently, you lose touch with your reflective brain. With less management coming from your reflective PFC, it becomes harder and harder to logically see these challenges in realistic perspective or to solve problems creatively.

Disappointments take on more emotional power and without your higher brain’s perspective, they are interpreted as personal failures. Your self-doubt and stress further activate and strengthen your brain’s involuntary, reactive neural networks. The spiral down to burnout accelerates as these circuits become the automatic go-to networks. Your brain achieves less success in problem-solving and emotional control and ultimately reacts by withholding efforts to escape the burnout state.

Reset Your Brain’s Default Neural Network from Retreat to IGNITE!

The good news is you can apply what we’ve learned from neuroscience about your brain’s survival mode to take actions to retrieve voluntary control of your choices and emotional wellbeing.

You can activate the same neuroplasticity, that gave dominance to the lower brain networks in the burnout state, to construct a new, stronger positive default response. With increasing successful experiences in achieving goals, you can reset the circuits to redirect your brain to access its highest cognitive resources. You can build up newly improved circuitry switching your responses from retreat to IGNITE for mindful awareness and creative problem-solving!

Since an effort-failure pattern sets up the brain’s survival response to withhold effort, you’ll need to strengthen your brain’s recognition that effort toward your goals can result in success. Your weapon of mass reconstruction can come from your brain’s very powerful drive for its own intrinsic neurochemical reward— dopamine and the deeply satisfying and motivating pleasure it brings. When the brain releases dopamine in rewarding bursts, you experience a deep intrinsic satisfaction along with increased motivation, curiosity, perseverance, and memory. Dopamine is particularly released when your brain recognizes that you’ve achieved a challenge (from the “I get it” of figuring out a joke to the satisfaction of completing a marathon).

To get the dopamine-pleasure response from challenges achieved, you’ll need to plan for your brain to experience frequent recognition (feedback awareness) of incremental progress. The choices of what you set as a goal should be guided by their desirability and the goal’s suitability to be broken down into clear segments. You want to set goals, the progress of which, you can chart or easily recognize with each stepwise challenge and success. The pleasure burst of dopamine’s intrinsic motivation accompanying your brain’s recognition of each progressive increment achieved in the goal pathway will keep you motivated to persevere.

Goal Buy-In for Your Brain’s Neural REWIRING

Buy-in and relevance are important in choosing your rewiring goal. Since your goal is to rewire your brain’s expectations that your goal efforts do yield progress, despite increasing challenge, you need to really want the goal. This is not the time to challenge yourself with something you feel you should do, but won’t really look forward to, such as dieting, climbing stadium stairs, or flossing after every meal.

The idea of planning and achieving goals as a burnout intervention is probably not new to you. These are likely to be activities you’ve considered but didn’t do for the obvious reason. They take time. when it comes to adding another activity to your schedule, past experiences have left you with the expectation that there is not enough time.

These first goals that can provide ongoing awareness of your progress are often tangible (visible, such as planting a garden or making pottery on a wheel, or auditory such as playing an instrument, or physical such as learning tai chi), but your goal can also be spending more time on something you already do, but want to do more frequently or successfully, such as journaling, practicing yoga, or sketching.

You’ll Find Your Own Goal for Buy-In, but Here are Some Examples of Planning 

Physical goals: Notice I didn’t say exercise. That’s not as motivating as “training” for a physical goal you want to achieve, even though they often overlap. If you want to run a 10K, and you enjoy running, the goal for an achievable challenge could first be building up to the distance starting with your baseline distance you comfortably run now. Then, plot out the increments that you’ll consider progressive successes, such as adding 100M each day or a week (with increments based on what you consider both challenging and achievable). Once you reach 10K goal, speed can become the next goal again plotted out in segments of incremental progress before you start.

Hobbies: From woodworking to shooting wooden arrows, hobbies really are opportunities for brain rewiring. Again, plan your stepwise achievable challenge increments. If you select darts, start with a home dartboard—low initial investment and throw from a close, but challenging distance at first. As you get better in accuracy move back further. Record your results with the notations of the distance of each improvement you set as an achievable challenge. If you get so good that you are no longer challenged by the dartboard, try that archery!

Mindfulness and meditation are certainly positive interventions for burnout and will be topics of a subsequent blog.

Your Rewired Brain’s Default Changes from Defeat to Ignite

With your understanding of what happened in your brain to create the hopeless frustration of burnout, you’ll hopefully have more positive expectations to help you put in the effort to try (or retry) suggested interventions. Your own natural dopamine-reward system will then be at work deconstructing the resistance network built by your burnout as you reset your circuits of motivation.

The repeated experiences of dopamine-reward you’ll experience as you monitor your goal progress will literally change your brain’s circuitry. Repeated effort-reward experiences promote the neuroplasticity creating neural networks that expect positive outcomes in your new default network. This is because your brain will build stronger connections into the memory pattern. The expectation in achieving this challenge will bring pleasure. As with other less used networks, the previous lower brain stress-activated go-to response network you developed in burn-out, that caused you to react negatively to stressors, will be pruned away from disuse.

You’ll be rewired with optimism and renew positive expectations about your self-efficacy. With your higher, reflective brain back in control, as you access your perseverance, innovation, and creative problem-solving when you need them.

Just be sure to take the time to break down big challenges into opportunities to recognize incremental progress as you achieve each small step en route to your goals. With that positive recharge, your well-deserved dopamine reward will sustain your brain’s motivated perseverance on to the next step of the path to your goals.

By Judy Willis, M.D., M.E

Dr. Willis is a board-certified neurologist and middle school teacher, specializing in brain research regarding learning and the brain. After graduating Phi Beta Kappa as the first woman graduate from Williams College, Willis attended UCLA School of Medicine where she was awarded her medical degree. She remained at UCLA and completed a medical residency and neurology residency, including chief residency. She practiced neurology for 15 years before returning to university to obtain her teaching credential and master’s of education from the University of California, Santa Barbara. She then taught in elementary and middle school for 10 years and currently is on the adjunct faculty of the Graduate School of Education, University of California, Santa Barbara.

This article first appeared in Psychology Today magazine

Seasonal Affective Disorder: What You Need to Know

We set our clocks back an hour in early November, resulting in shorter days, and darker skies before most of us leave work each afternoon.

It is important to understand the effect that light has on us. If you find yourself falling into the doldrums at this time of year as the number of daylight hours dwindle, seasonal affective disorder (SAD), sometimes called seasonal depression, may be to blame. Most SAD sufferers experience symptoms during the winter months, causing researchers to conclude that inadequate sunlight may play a role. But you don’t have to spend the winter months feeling depressed and unmotivated. Here’s what you need to know about SAD and how to alleviate it.

What Causes Seasonal Affective Disorder?

Most researchers believe decreased access to sunlight plays a role in seasonal affective disorder. Light affects our circadian rhythms, and UV rays can also change how the body processes vital minerals and other nutrients. For example, inadequate sunlight exposure is linked to low Vitamin D, which, in turn, has been linked to depression and other physical and mental health woes. So, the effects of darkness on the body—not just darkness itself—might be partially to blame.

A recent study, published in the Journal of Affective Disorders, bolstered the connection between SAD and inadequate sunlight. It found that weather and climate—including rain and pollution levels—don’t appear to alter mood. But access to sunlight is a major predictor of mental health. In the study, people who lived in regions with shorter, darker days were more likely to experience poor mental health.

While light almost certainly plays a role, not all cases of SAD occur during the short, dark days of winter. A small fraction of cases occur on a seasonal basis during the spring or summer, which suggests that no single factor can fully explain SAD. Other potential risk factors include:

  • Seasonal lifestyle changes. If you only work during a portion of the year, have less to do during a specific time period, or face annual stress, you may experience seasonal depression.
  • Seasonal associations with previous trauma and grief. Our minds form strong connections between the sights and sounds of seasonal shifts and memories of the past. You may find yourself growing depressed each year around the time you suffered a trauma or loss.
  • Cultural norms and traditions. The high of the holiday season followed by the low of the new year can spur depression in some people.
  • Certain health issues are more likely to manifest at specific times of the year. For example, if you have severe allergies, you may get depressed in the spring, while chronic bronchitis can make the winter months depressing.

Each of these factors alone is unlikely to trigger depression, but in conjunction with other risk factors—including a family history of any form of mental illness—they can lead to SAD.

Symptoms of Seasonal Affective Disorder

Cyclical depression that occurs around the same time each year or that relents when the season changes, is the hallmark of SAD. If symptoms are not cyclical, you might be diagnosed with another disorder, such as major depressive disorder or dysthymia.

People with SAD often experience depressive symptoms which are less severe than those associated with major depressive disorders. Though suicidal thoughts can and do occur—particularly if SAD is left untreated—these thoughts are less common. Some common symptoms include:

  1. Low energy, feelings of grogginess, or excessive sleep. People with summer SAD may experience insomnia.
  2. Changes in appetite. People with SAD are vulnerable to weight gain. SAD sometimes causes carbohydrate cravings, because carbs offer a temporary energy boost.
  3. Irritability and anger.
  4. Changes in your relationships with others: People with SAD often feel lonely and rejected.
  5. Loss of interest in previously enjoyed activities.
  6. Feelings of guilt.
  7. Dread or uncertainty about the future.
  8. Loss of motivation.
  9. Feelings of sadness.

Treatment for Seasonal Affective Disorder

People with winter SAD often respond well to light therapy, which involves sitting under a UV lamp for a short period of time each day. If you have access to daylight and can spend time outdoors, you might also find your symptoms improving if you receive 20-40 minutes of daily direct sun each day.

Treatment for major depression can also prove effective at treating SAD. Those treatment options include:

  • Psychotherapy to help you talk through your feelings, identify problematic thought patterns, and more effectively cope with your depression. If causes relationship problems, therapy may also help improve your relationships. Your therapist can also talk to you about lifestyle changes—diet, exercise, activities—that may complement your treatment and help to alleviate your depression.
  • Antidepressants: Depression alters chemicals in your brain. Sometimes lifestyle remedies are inadequate to get things back on track. Antidepressants can be effective and often need only to be taken for a short period.

Is It Possible to Prevent Seasonal Affective Disorder?

Research on the prevention of SAD is mixed. However, there is some evidence that light therapy can help prevent SAD in people with a previous history of the condition. If you’re worried that you might develop SAD this winter, talk to your doctor about preventative strategies. Also, maintain a healthy lifestyle—overeating during the holidays, excessive spending, and low motivation can all make SAD worse.

If you experience SAD, you don’t have to suffer through months of misery. SAD is one of the most treatable forms of depression, and with the right care, you can feel better in weeks, or even days.

This article originally appeared in Psychology Today magazine

Joel L. Young, M.D., is the Medical Director of the Rochester Center for Behavioral Medicine outside of Detroit and teaches Psychiatry at Wayne State University School of Medicine. Trained at the University of Michigan, Dr. Young is certified by the American Board of Psychiatry and Neurology and holds added qualifications in geriatric and forensic psychiatry. In addition, he is a diplomate of the American Board of Adolescent Psychiatry.

Dr. Young and his clinic have been primary investigators in a number of clinical trials involving antidepressant, AD/HD, and bipolar medications. He has authored three books and more than 70 textbooks and articles. His most recent book, When Your Adult Child Breaks Your Heart: Coping with Mental Illness, Substance Abuse, and the Problems That Tear Families Apart, was published by Lyons Press in December 2013.

 

References

 

Too Much Stress Can Lead to Depression

 

I listened to a National Public Radio segment about the connection between playing NFL football and brain trauma.

One retired running back said that each time he was hit when carrying the ball it was “like being in a high-impact car accident”. What a tremendous cost to pay, I thought.

For many of us, daily life is so demanding and stressful that it’s like being in a series of high-impact “stress collisions”. The word “stress” doesn’t even seem to do justice the corrosive experience of so much stress. “Trauma” is more like it.

This trauma isn’t the type inflicted by bone-jarring hits during a football game — it’s psychological, though no less real.

Psychiatrist Mark Epstein, M.D., author of the book The Everyday Trauma of Life, writes in a recent New York Times article,

“Trauma is not just the result of major disasters. It does not happen to only some people.

Rewire Your Burned-out Brain

Burnout often results from extended periods enduring the emotional stress precipitated by unaccomplished expectations or failure to fulfill unreasonable demands. The symptoms can include intensified emotional exhaustion, physical fatigue, lowered self-worth, changes in eating and exercising habits, social withdrawal, sleep disorders, anxiety, and depression.

If You’re Burned Out, Your Brain Has Rewired to Survival Mode

There are specific and reproducible patterns of changing neural activity and brain connectivity associated with the stress buildup that leads to burnout. In the high-stress state subjects’ neuroimaging scans reveal less activity in the higher, reflective brain (Prefrontal cortex/PFC) and more activity in the lower, reactive brain that controls involuntary behaviors and emotional responses. Prolonged stress correlates with structural increases in the density and speed of the neuron-to-neuron connections in the emotion-driven reactive networks of the lower brain and corresponding decreases connections in prefrontal cortex conscious and reflective control centers.

The explanation of these changes is attributed to the brain’s neuroplasticity defined by the phrase: “neurons that fire together, wire together.” The brain literally rewires to be more efficient in conducting information through the circuits that are most frequently activated.

When stress is frequent, the more frequent activation of the neural pathways to the lower, stress-reactive brain results in their strengthening from enhanced wiring (dendrites, synapses, myelinated axons). These pathways can become so strong that they become your brain’s fast route to its lower, reactive control centers. The stressful, burned out state when the lower, reactive brain is in charge overcomes the calm, reflective, and productive higher neural processing in the (PFC) – the preferred brain locale for control of behavior and emotional self-management.

As your efforts to achieve unreasonable goals are thwarted or increasing demands recur, and the lower brain dominates more frequently, you lose touch with your reflective brain. With less management coming from your reflective PFC, it becomes harder and harder to logically see these challenges in realistic perspective or to solve problems creatively.

Disappointments take on more emotional power and without your higher brain’s perspective, they are interpreted as personal failures. Your self-doubt and stress further activate and strengthen your brain’s involuntary, reactive neural networks. The spiral down to burnout accelerates as these circuits become the automatic go-to networks. Your brain achieves less success in problem-solving and emotional control and ultimately reacts by withholding efforts to escape the burnout state.

Reset Your Brain’s Default Neural Network from Retreat to IGNITE!

The good news is you can apply what we’ve learned from neuroscience about your brain’s survival mode to take actions to retrieve voluntary control of your choices and emotional wellbeing.

You can activate the same neuroplasticity, that gave dominance to the lower brain networks in the burnout state, to construct a new, stronger positive default response. With increasing successful experiences in achieving goals, you can reset the circuits to redirect your brain to access its highest cognitive resources. You can build up newly improved circuitry switching your responses from retreat to IGNITE for mindful awareness and creative problem-solving!

Since an effort-failure pattern sets up the brain’s survival response to withhold effort, you’ll need to strengthen your brain’s recognition that effort toward your goals can result in success. Your weapon of mass reconstruction can come from your brain’s very powerful drive for its own intrinsic neurochemical reward— dopamine and the deeply satisfying and motivating pleasure it brings. When the brain releases dopamine in rewarding bursts, you experience a deep intrinsic satisfaction along with increased motivation, curiosity, perseverance, and memory. Dopamine is particularly released when your brain recognizes that you’ve achieved a challenge (from the “I get it” of figuring out a joke to the satisfaction of completing a marathon).

To get the dopamine-pleasure response from challenges achieved, you’ll need to plan for your brain to experience frequent recognition (feedback awareness) of incremental progress. The choices of what you set as a goal should be guided by their desirability and the goal’s suitability to be broken down into clear segments. You want to set goals, the progress of which, you can chart or easily recognize with each stepwise challenge and success. The pleasure burst of dopamine’s intrinsic motivation accompanying your brain’s recognition of each progressive increment achieved in the goal pathway will keep you motivated to persevere.

Goal Buy-In for Your Brain’s Neural REWIRING

Buy-in and relevance are important in choosing your rewiring goal. Since your goal is to rewire your brain’s expectations that your goal efforts do yield progress, despite increasing challenge, you need to really want the goal. This is not the time to challenge yourself with something you feel you should do, but won’t really look forward to, such as dieting, climbing stadium stairs, or flossing after every meal.

The idea of planning and achieving goals as a burnout intervention is probably not new to you. These are likely to be activities you’ve considered but didn’t do for the obvious reason. They take time. when it comes to adding another activity to your schedule, past experiences have left you with the expectation that there is not enough time.

These first goals that can provide ongoing awareness of your progress are often tangible (visible, such as planting a garden or making pottery on a wheel, or auditory such as playing an instrument, or physical such as learning tai chi), but your goal can also be spending more time at something you already do, but want to do more frequently or successfully, such as journaling, practicing yoga, or sketching.

You’ll Find Your Own Goal for Buy-In, but Here are Some Examples of Planning 

Physical goals: Notice I didn’t say exercise. That’s not as motivating as “training” for a physical goal you want to achieve, even though they often overlap. If you want to run a 10K, and you enjoy running, the goal for an achievable challenge could first be building up to the distance starting with your baseline distance you comfortably run now. Then, plot out the increments that you’ll consider progressive successes, such as adding 100M each day or a week (with increments based on what you consider both challenging and achievable). Once you reach 10K goal, speed can become the next goal again plotted out in segments of incremental progress before you start.

Hobbies: From woodworking to shooting wooden arrows, hobbies really are opportunities for brain rewiring. Again, plan your stepwise achievable challenge increments. If you select darts, start with a home dartboard—low initial investment and throw from a close, but challenging distance at first. As you get better in accuracy move back further. Record your results with the notations of the distance of each improvement you set as an achievable challenge. If you get so good that you are no longer challenged by the dartboard, try that archery!

Mindfulness and meditation are certainly positive interventions for burnout and will be topics of a subsequent blog.

Your Rewired Brain’s Default Changes from Defeat to Ignite

With your understanding of what happened in your brain to create the hopeless frustration of burnout, you’ll hopefully have more positive expectations to help you put in the effort to try (or retry) suggested interventions. Your own natural dopamine-reward system will then be at work deconstructing the resistance network built by your burnout as you reset your circuits of motivation.

The repeated experiences of dopamine-reward you’ll experience as you monitor your goal progress will literally change your brain’s circuitry. Repeated effort-reward experiences promote the neuroplasticity creating neural networks that expect positive outcomes in your new default network. This is because your brain will build stronger connections into the memory pattern. The expectation in achieving this challenge will bring pleasure. As with other less used networks, the previous lower brain stress-activated go-to response network you developed in burn-out, that caused you to react negatively to stressors, will be pruned away from disuse.

You’ll be rewired with optimism and renew positive expectations about your self-efficacy. With your higher, reflective brain back in control, as you access your perseverance, innovation, and creative problem-solving when you need them.

Just be sure to take the time to break down big challenges into opportunities to recognize incremental progress as you achieve each small step en route to your goals. With that positive recharge, your well-deserved dopamine reward will sustain your brain’s motivated perseverance on to the next step of the path to your goals.

Dr. Judy Willis is a board-certified neurologist and middle school teacher, specializing in brain research regarding learning and the brain. With a unique background as both a neurologist and classroom teacher, she writes extensively for professional educational and parenting journals and has written six books about applying the mind, brain, and education research to classroom teaching and parenting strategies. The Association of Educational Publishers honored Dr. Willis as a finalist for the Distinguished Achievement Award for her educational writing. Check out her website.

 

 

Up, Up and Away: Lifting Depression By Tweaking Your Antidepressants

In my last post, I wrote about a recent downward turn in my mood. While not severe, it still sucked: low energy and motivation,  sadder more often than I’d like, and lack of joy in things that formerly made me happy.

If felt like I had one foot in gooey, hot asphalt. I keep trying to yank it out to no avail. Finally, I called my trusty psychiatrist. His name’s Chris.

We hadn’t seen each other for six months. Over the past ten years or so since he’s been my shrink, that was about normal because not much had changed in the past decade: we’d found a combination of two pills seven years ago that was effective in managing my depression.  Sure, there had been some ups and downs over that period of time. But nothing like the psychic hurricane that blew through my brain when I first experienced major depression years ago.

He suggested I stay with my two old friends: Cymbalta and Lamictal. But, he said that we could “tweak” my treatment by adding

Depression and Loss of Energy: A Waiting Game

Reversing the downward spiral of depression takes less energy than you think.

Depression and loss of energy — it is the beginning of a waiting game that does not end well.

Sometimes depression is born from loss of achievement, loss of goals, and loss of positive feelings about oneself. When low energy plays a role, a person who is not blessed with high drive and physical energy can see a spiral into depression start quickly. But even people with more energy lose it while bearing the weight of the losses. And, without a lot of energy, people begin to wait for things to get better around them rather than take action to make a change.

The Downward Spiral

Spiraling — the word makes it seem like a gentle way to go down, but when it comes to depression, going down is hard to stop, and once at the bottom, reversing the spiral takes intention and support. I hear about this often from my younger depressed clients — those adults who started out of high school or college ready to be successful but who found the world did not fulfill the vision they had.

Jeremy (not his real name) was one such young man. He never had to work too hard to get a passable grade point and was popular enough to have a solid romantic relationship. He was ready happy with his life. But, as commonly happens, the college romance did not last, which made him feel down in the dumps. Then the company he worked for, facing hard times, cut his hours. He now did not earn enough to live on but he expected the company, not himself, to change and he took no action. He waited for work to increase his hours, but in the meantime, he felt like a failure, and the waiting sapped him. His self-esteem, already suffering from being single again, took another hit as he saw his money dwindle to nothing. He started to isolate himself from friends without funds for fun and without a date to go along. Waiting was his enemy. Without meaningful activity beyond limited work hours, that isolation increased his depressed mood.

Waiting also intensified the mental and physical fatigue, so he slept later in the morning since he did not have to get to work early. He began to think he had a lot of time every day to work on his situation, so he did not start on possible job hunting and, as the day melted away, it was too easy to let himself decide that tomorrow was a good day to start fresh. But that waiting also increased his fear that nothing could change and his mood became very depressed. That depression and his situation robbed him of the very things he needed to reverse the spiral: meaningful work (purpose, as well as money), positive interactions with others, pride in his achievements, sense of competency, and a feeling of being loved.

This spiral is one I have seen repeatedly in young adults who have not met with easy success out of high school or college. They often did not have to work at jobs during those years to obtain phones or cars or clothes or do costly activities, such as attend concerts or sporting events. One young man I worked with as he finished high school, Casen (again, a pseudonym), felt literally terrified of applying for a part time job so that he could begin developing job skills and a resume and have some spare cash. Without classroom demands, he moved into waiting mode: waiting to apply to community college, waiting for a job that might fall into his lap. (The job that a friend would provide not that Casen would go search for since the friend said he could get his boss to hire Casen). Waiting did not bring him the job or the college acceptance letter, and he felt even more scared and more depressed. And he judged himself rather mercilessly: believing he would never succeed. That negative mindset robbed him of even more energy, and the more time he spent watching shows on his laptop, the less energy he had to reverse the downward spiral to depression.

What can be done about this? It is typical that an outside force will help. If you are reading this you might be saying to yourself phrases like, “Yeah — the outside force of getting evicted or starving! That would work!” If so, you would be correctly identifying motivators! At times, though, a person in a downward spiral ends up living with family or friends who are being helpful to them in averting disaster, but the pattern of waiting on something outside themselves does not change until motivation can pick up.

Reversing the Downward Spiral

How is it possible to reverse the spiral? Raising energy is a primary initial goal — with or without motivation. To start the spiral on an upward trend, simply:

Stop telling yourself negative things: you only reinforce the belief they are true. Interfere with negativity, saying, “Stop! I choose to believe I will solve this!”

Stop isolating. Get in contact with people, any interaction with others will help you also get outside of your own negative thoughts or mood.

Stop talking about your own life for a short while. When you only ruminate on your troubles, they seem larger. Ask someone else about his or her life. Hearing about another’s life, you can look at your reactions. I love the saying that troubles shared are cut in half and joys shared are doubled.

Then start the upward spiral with attention to developing a sense of purpose. Don’t assume this is a deep spiritual quest. In fact, it can be initially as simple as scheduling your day and meeting some regular commitments. An important brain change toward a less depressed mood occurs results from intentional activity. You get a blip of glutamate, an activating neurochemical, and one of dopamine, the feel-good neurochemical, and the combination is energizing. The bigger the step you take, the more you get. And any action will supply enough energy to do a little more.

My Tips

If you are underemployed — set a daily schedule that begins with a reasonable wake-up time.

Have a pattern to the day what news show you listen to or watch when you have your coffee when you feed a pet or meet a friend for tea.

Leave the house — you might have to start with leaving your room and interacting with others in your home- but forcing yourself toward less isolation is important.

At work, be sure to talk to your colleagues and ask them how they are; It improves the chance of a positive social exchange that can increase your self-esteem a bit and moves the spiral upward a fraction.

Set small goals — like walking the dog an extra 5 minutes — and notice you achieved them. There’s a bit more glutamate and dopamine!

Do something physical. When you move your depressed body you gain energy rather than lose it, so even a few minutes of tidying up can raise enough energy to do a bit more.

The above ideas tend to work best when you are working with another person who supports you, such as a therapist, a 12-Step sponsor, or a good friend who knows your goals and will help you keep track of them.

As you stop the waiting game — that passive waiting for life to change without you doing something to change it — the spiral reverses. You will be surprised that you will slowly feel your energy rise so you will be more able to take the next steps toward success.

 

By Dr. Margaret Wehrenberg, Psy.D.

This article first appeared in Psychology Today website.

Dr. Wehrenberg is the author of 5 books published by W.W. Norton, including The 10 Best Ever Anxiety Management Techniques, The 10 Best Ever Depression Management Techniques and her most recent 10 Best Anxiety Busters, an ideal book for the general public. She earned her M.A. studying psychodrama and bioenergetics, and had years of experience as a certified drug and alcoholism counselor, before earning her Psy.D. She now specializes in treating anxiety and depression and has a private practice in Naperville, IL. She is a frequent contributor of articles to The Psychotherapy Networker magazine, has contributed a chapter to Clinical Pearls of Wisdom (Ed. M. Kerman), and has produced CD for breathing, muscle relaxation and imagery for anxiety management. Check out her website at www.margaretwehrenberg.com.

 

 

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