Category Archives: Neuroscience

The Changeable Brain

“We are all born with a far more adaptable, all-purpose, opportunistic, brain than we have understood.” – Dr. Norman Doidge, MD

I’ve explored aspects of neuroscience in prior blog posts. My latest foray into the subject came through Norman Doidge’s book The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Neuroscience. What I learned from his research made me all the more impressed by this amazing little organ.

cerebral lobesMost of realize that our brains are the master controllers for sustaining bodily functions, processing sensory input, and incubating consciousness. Yet we may not grasp the extent to which the brain alters its structure and function in response to thoughts, activities, and environmental factors. Scientists refer to this phenomenon as neuroplasticity – i.e., the neural network’s ability to change through growth and reorganization. Through it, we can improve mental activities, heal from injury, and establish robust routing systems that bypass blocked pathways as the need arises. With attentive effort, we can sustain this remarkable capacity to the end of our days.

Much like physical fitness regimens, stimulating the brain makes it grow. Brain weight may increase up to 5% through mental training or life in enriched environments; targeted areas may increase up to 9%. This weight gain finds expression in stimulated neurons that increase in size, develop 25% more neural connections, and command increased blood supply. These “beefy neurons” become more efficient, taking less time and resource to perform tasks for which they’ve been trained. Powerful signals have greater impact on the brain.

A leading researcher on neuroplasticity, Dr. Michael Merzenich proved that substantive improvement in cognitive function is possible at any age. The key to success lies in giving the brain the right stimuli in the right order at the right time to drive plastic change. He says:

“When learning occurs in a way consistent with the laws that govern brain plasticity, the mental ‘machinery’ of the brain can be improved so that we learn and perceive with greater precision, speed, and retention.”

For example, through use of specially designed computer programs, users receive specific challenges that target their developmental needs and add difficulty at a pace consistent with their learning styles. Struggling learners at school may take advantage of Fast ForWord, an evidence-based, adaptive reading and language program that boasts 1-2 year gains in 40-60 hours of use. Merzenich’s BrainHQ offers 29 exercises that address attention, brain speed, memory, people skills, navigation, and intelligence.

Brain maps are neither static nor universal; we allocate neural capacity competitively. If one area goes dormant, another area will take it over. As such, if we stop using a skill, that brain map space will be placed in service of an active skill. It’s the law of the jungle: use it, or lose it. For example, a blind person cannot use the visual cortex to receive input from the eyes. That processing power may be repurposed to provide heightened sensitivity in hearing and touch. Unfortunately, if we stop exercising our analytical skills or creative capacities in favor of mindless activities, those vital cognitive resources will also be repurposed. Once a bad habit claims (and sustains) brain space, it can be difficult to dislodge.

The brain can reorganize itself after devastating injury so long as there is adjacent, healthy tissue that can be recruited to take over for lost function. Treatment must address both neural shock and learned nonuse. To that end, motivated patients put themselves through a series of physical and cognitive efforts to support their brains’ rewiring. Legendary actor Kirk Douglas famously worked his way back from his 1996 stroke and continued to act and publish. Actor Christopher Reeve regained a modicum of feeling and movement after sustaining a paralyzing spinal cord injury.

So why do so many of us lose brain function as we age?

Give the right combination of stimuli and experience, we are learning sponges throughout our childhood and teen years. As we grow into adulthood, we lean more heavily on mastered skills in lieu of acquiring new ones. By middle age, we’re settled into our careers and rarely engage in the kind of focused attention that produces long-term neural growth. In a word, we’re comfortable.

We’re also prone to be far less active physically than when we were young. Physical exercise elevates brain-derived neurotropic factor (BNDF), a substance that starts to wane as we age. BDNF plays a crucial role in neuroplastic changes by:

  • Consolidating neural connections
  • Promoting fatty growth around neurons to speed transmission times
  • Helping the brain pay attention (and remember) through nucleus basalis activation

So, if you’d like to hang on to what you’ve got (or add to it), be prepared to challenge yourself throughout your life. Activities that involve deep concentration – e.g., reading/studying, learning a new language, developing proficiency on a musical instrument, playing complex board games, taking up dancing – have been associated with a lower risk of dementia. Effective use of imagination also helps. If hesitant to take action (or temporarily constrained to do so), visualize the activity in attentive detail. It strengthens the cognitive muscles and increases the speed at which you can attain competency when taking action.

Forecasting Future Happiness

crystal ballIn Stumbling on Happiness, Daniel Gilbert asserts that choices we make today carry an expectation of benefitting our future selves. After all, we’d like to set up our older incarnations for happiness. In fact, researchers tell us that we spend on average 12% of our waking hours thinking about the future. But are we really any good at anticipating our future tastes, preferences, needs, and desires?

Gilbert’s answer: NO. He uses neuroscience to make the case that we consistently misremember the past, misperceive the present, and misimagine the future. In short, we’re not terribly well connected to reality, and our crystal balls are hazy at best.

We don’t store memories as if they’re live action films with every shot recorded. If we did, we’d need really huge brains! Rather, each stored memory engram captures a few critical threads and small sets of key features. Upon retrieving the memory, our brains quickly “reweave the fabric” to give the illusion of an accurate record and fills in the details under the radar. Our recall of emotional states tends to be weighted heavily toward our sensibilities during the closing moments and theories about how we must have felt. And memories change ever so slightly every time they are retrieved and then stored again.

This bit of “brain magic” applies in the present, too. We fill in gaps in our visual fields in places where our optic nerves would otherwise leave a blind spot. And what we see gets colored by what we already think, feel, know, want, and believe. We interpret the world as much as experience it. Thus, two people witnessing the same scene can have quite different accounts of what happened.

We make the same cognitive error when imagining the future. When a friend invites us to a party, we fill in the gaps on all of the information that isn’t provided – what it will be like, how we’ll feel when there, what the energy in the space might be. And the further our imaginations stretch into the future, the fewer details we’ll register.

We have a very strong bias toward the present. It colors our remembered past and thoroughly infuses our imagined futures. For instance, we can’t feel good about an imaginary future while feeling lousy about a present circumstance. And even when the present is relatively rosy, we’re just not adept at walking in our future selves’ shoes:

  • We pay more attention to favorable information, surround ourselves with folks who provide it, and accept it uncritically. This filtered input does not provide a realistic view of the past, present, or future.
  • The comparisons we make now (and which influence our choices) may not matter to us in the future. We fail to acknowledge that we’ll think differently as we age an accumulate life experience.
  • We don’t forecast our hungers accurately – for food, emotional support, social connection, intellectual stimulation, or sex. We really can’t imagine how we’ll feel.
  • Negative events don’t affect us as badly (or for as long) as we think. Our psychological immune system mitigates against unhappiness by helping us find silver linings and effective action. It also helps us craft narratives that diminish emotional pain.
  • When considering the past to foretell the future, we remember the best of times and the worst of times… but not the most likely of times. Unusual events come to mind easily, so we tend to think that they’re more common than they really are.

So, if we’re not very good at predicting our futures, to whom or what should we turn to for our “crystal balls”? Gilbert suggests that we talk to people who are currently living in the state that we might imagine for our futures. Studies have shown that such “surrogates” provide a far better indicator of our future emotional well-being than the portraits our imaginations paint. Unfortunately, few of us act on that advice as we consider our experiences and vantage points to be so distinct from everyone else as to render such feedback useless. But the truth of the matter is that we’d profit from their insights.

One other piece of sound advice… When weighing the choice between action and inaction, lean toward action. Nine out of 10 folks regret not have done things more than the things they did. Moreover, our psychological immune system has an easier time rationalizing an excess of courage than a surge of cowardice.

Cognitive Error

Last week, I shared some insights regarding memory from Dr. Catherine Sanderson’s Introduction to Psychology. As she points out, our memories are not nearly as good as we think they are. It’s also the case that our powers of discernment and problem-solving skills are not all that ship-shape. Here are a few ways that we tend to go wrong:

mistakeOverreliance on Intuition: “Gut instincts” serve us well when our survival depends upon the ability to make and commit to a course of action quickly. They’re also helpful when providing a “sixth sense” that something demands our considered attention. However, sometimes snap judgments are flat-out wrong.

Confirmation Bias: Even when we slow things down and give an issue our due consideration, we have a tendency to pay attention to data that affirms our earliest sensibilities and ignore information that does not fit our preconceptions.

Fixation: When we become rooted into one way of thinking, we can find it difficult to see a circumstance or problem with new eyes – e.g., doggedly searching the same place for our house keys even though they’re clearly not there.

Functional Fixedness: We may perceive a person, issue, object, or circumstance as fixed and unchanging. We aren’t open to new information or new approaches – e.g., insisting upon using a screwdriver instead of making do with a dime, nail file, or knife.

Availability Bias: We perceive an event as more likely to occur if it more readily comes to mind. For example, we may forego air travel for fear of death by plane crash (a 1 in 11 million chance per annum) as a function of the harrowing publicity that accompanies air traffic accidents. Yet we don’t worry so much about motor vehicle accidents for which our risk of death is 1 in 5,000 annually.

Stereotypes: When a superficial description fits a preconceived rubric, we make mental short-cut and fill in the blanks with our stereotypes rather than let the page stay blank and fill it in with the new experience. Racial, gender, and cultural biases top this list.

Representation Bias: Wording affects our perceptions. We feel good about consuming something that is 95% fat-free without stopping to consider that it’s actually 5% fat. Likewise, an item purchased for $19.99 feels like more of a bargain versus one price at $20.00. And, as folks approach a milestone birthday – say, 80 – they’ll confidently state that they’re in their 70s the day before even though they’ve clearly lived 80 years already!

Overconfidence: We tend to overemphasize our known knowns, down regulate our known unknowns, and outright dismiss our unknown unknowns. This phenomenon comes to the fore among groups whose participants share similar views and come together under a strong leader. Their belief in the power of collective judgment fails to recognize the inherent aversion to outside perspectives and the social pressure to conform.

Dr. Sanderson ends the lecture with a message of hope. We can overcome our vulnerability to error by recognizing our affinity for shortcuts and opening our minds to possibilities. Helpful strategies include:

  • Slowing down and enjoying the exploration.
  • Actively seeking out persons with different perspectives and listening attentively to their views
  • Encouraging dissenters to speak up and welcoming their full-throated participation
  • Choosing leaders who take seriously the mantle to draw everyone out


Ever since I watched Dr. Sam Wang’s 36-part educational series entitled Neuroscience of Everyday Life, I’ve been fascinated with the brain. I’ve done additional research and written a few blog posts on the subject. This week’s installment on memory comes courtesy of Dr. Catherine Sanderson and her series entitled Introduction to Psychology.

memoryMost of us think that our memory processing works like a computer. We receive input through our five senses, we encode the data, and we place it in storage. When we want to retrieve the data, we go back into our data repository and pull it back up. While we might admit that we don’t quite capture or retain all of the data, we generally believe that the parts we store accurately reflect the source data.

The truth of the matter is that memory is a constructive process. As discussed in an earlier post, memories get stored in shorthand based on what the brain considers important. In particular, we pay attention to certain bits of data and ignore the rest. There’s also good evidence that we erase and re-write our memories every time we recall them, often changing them in the process. And, we invent details to fill in the gaps and create a more coherent story.

Of all of the memories that we might think we’d retain accurately, those related to major life events would top the list. Dr. Sanderson refers to them as “flashbulb memories” – e.g., where you were and what was happening when the twin towers fell on 9/11. Yet even those memories are subject to change, in part because we tend to process them a lot. And with each recall, we make subtle changes to the story arc. At first, we might get a twinge to suggest that something isn’t quite right. Over time, those small adjustments become entrenched. As my father used to say about one of my relatives: “The first time she tells a lie, she knows she’s made it up. The second time she tells it, she’s believes it’s true because she has heard it before.”

Here are a few other factors that put a monkey wrench into our total recall:

  • Memories fade over time, especially when they lack periodic reinforcement (a.k.a., the Decay Theory).
  • Similar memories compete with one another when vying for our attention (a.k.a., the Interference Theory). With proactive interference, old stuff interferes with our ability to learn new stuff. With retroactive interference, new stuff interferes with our ability to remember old stuff.
  • We remember some piece of information, but we don’t remember where we picked it up (a.k.a., Source Amnesia). This issue can prove troubling in the medical or political realm because we can be manipulated into believing false information.
  • We block out information that we don’t want to remember (a.k.a., Motivated Forgetting) – e.g., how much buttered popcorn we ate while watching TV.

Based on our current understanding of neuroscience, Dr. Sanderson offers the following advice for those who’d like to improve memory:

  • Chunk it. When tasked with learning (or memorizing) something new, break the information down into manageable units. Focus on processing a chunk at a time.
  • Create retrieval cues. Exercise your creatively to come up with devices that help you retrieve information. Use acronyms or clever phrases to prod memory. For example, musicians use the phrase “Father Cooks Good Dinner Always” to remember the order in which sharps appear in a key signature (F, C, G, D, A).
  • Organize it. Create an outline to identify the major points and the associated details. Focus on the major points first and create a memory structure to solidify them.
  • Repeat it over and over. Studies show consistently that we do best when breaking up our study periods into multiple sessions and reviewing content at each session. By contrast, cramming is an ineffective way to learn. We’re handicapped in the moment, and our long-term retention suffers mightily.
  • Focus on it. Really pay attention to what you’re doing when learning something new. Stop multitasking. Bring your full senses to bear on the task.

One final little tidbit from Dr. Sanderson: Our most vivid life memories form between the ages of 15 and 30 because that’s when many of our first-time life events occur. Perhaps those of us on the far side of 30 should try squeezing in a few novel experiences!

Cultivating a Healthy Brain at Any Age

keep sharp

As noted in a previous blog post, I’ve experienced being a caretaker for folks with cognitive impairment. My father suffered from geriatric dementia for several years prior to his death; my mother had full-blown Alzheimer’s disease. So, I took a keen interest in Sanjay Gupta’s latest book, Keep Sharp: Build a Better Brain at Any Age. As the title suggests, Dr. Gupta’s book carries a message of hope for those of us who fear loss of mental competency as we age. Here are a few encouraging facts based on the latest research:

From the day we’re born to the day we die, the brain shapes and reshapes its synaptic connections and neural networks in response to experiences, learning, and even injury. The more we learn and challenge ourselves, the more extensive (and agile) our neural networks. This phenomenon is referred to as neural plasticity.

The brain can also manufacture new brain cells throughout our lives – a process known as neurogenesis. Each of us maintains a reservoir of neural stem cells in our hippocampus. These cells can differentiate into the different types of brain cells that we need. And when the reservoir depletes, the brain can replenish its supply.

Much like a muscle, the brain needs stimulus and challenge to grow. It also needs regular work outs to maintain its existing “muscle mass.” For example, people with memory training and other specialized cognitive skills must continue exercising them to retain them. (The brain works on the use-it-or-lose-it plan.) However, we can’t simply work existing skills and expect growth in our neural networks. We need to acquire new skills and knowledge. You might say that the brain wants new places to go if it’s going to build new neural roads.

While some cognitive skills decline with age, we never lose our capacity to learn. Moreover, the elderly outpace their younger counterparts in vocabulary, character assessment, social communication, diplomacy, and emotional regulation.

Brain function can be impaired when refuse creates arterial blockage (plaque) or embeds twisted insoluble fibers within neural cells (tangles). While plaque and tangles can damage neural pathways, brains with extensive neural networks can re-route with no perceived loss of function. In particular, Dr. Gupta noted that autopsies of nonagenarians may reveal similar levels of plaque and tangles in the brain. Those with agile neural networks avoided cognitive impairment because their brains figured out how to route around the blockages.

So, what are the factors that contribute to a healthy brain?

EXERCISE is the single most important thing we can do for a healthy brain. Physical inactivity is a BIG risk factor cognitive decline. We need at least 150 minutes per week of aerobic exercise alongside strength training and stretching/balance work. Ideally, we should log 450 minutes of aerobic exercise – which can include brisk walking – and find ways to move in acts of daily living.

PURPOSE, LEARNING, and DISCOVERY provide stimulus for the brain that increase the density of neurons, synapses, and dendrites. Brain networks that operate with greater efficiency, complexity, and reserves are less susceptible to disruption or decline. A few ways to stimulate the brain outside of work include learning to speak a foreign language, learning to cook or paint, taking up a musical instrument, programming a computer, taking ballroom dancing, or writing a novel. Don’t worry about whether or not you are any good at the activity. Your brain loves a challenge!

SLEEP. The brain needs 7-8 hours of good quality sleep every night to regenerate, store memories appropriately, and clear out its refuse. Chronic sleep deprivation carries elevated risk for dementia, depression, mood disorders, high blood pressure, weight gain, and fall-related injuries. We also need to RELAX during our waking hours. Healthy practices include meditation, mindfulness, yoga, tai chi, breathing exercises, progressive muscle relaxation, and guided imagery.

EAT NUTRITIOUS FOOD. A heart healthy diet is a brain healthy diet. Here are the A-B-Cs of Dr. Sanjay’s diet:

A: Consume Regularly B: Include these foods C: Limit these foods:
Fresh vegetables, especially dark leafy greens
Whole berries
Fish and seafood
Healthy fats
Nuts and seeds
Beans and other legumes
Whole fruits
Low sugar, low-fat dairy
Whole grains
Fried food
Pastries, sugary foods
Processed foods
Red meat
Red-meat products
Whole-fat dairy

BUILD HIGH-QUALITY SOCIAL CONNECTIONS. Close ties with family and friends as well as participation in meaningful social activities keeps a mind sharp and memories strong. Social engagement proves most protective when centered around a challenging activity. Socially connected folks are healthier, happier, and live longer.

Is Happiness All in Your Mind?

“Nothing is miserable unless you think it so; and, on the other hand, nothing brings happiness unless you are content with it.” ― Boethius, The Consolation of Philosophy

happy facePersonal development coaches often tell us that we are in the driver’s seat when architecting lives full of purpose, fulfillment, and pleasure. If we control our perceptions of reality, we control the world in which we live. Armed with a rosy outlook and confidence in our ability to co-create the future, we can point our ships toward fruitful destinations and take full advantage of the opportunities that present themselves along the way. At best, we find this perspective empowering and use it to enrich our lives and those around us. At worst, we berate ourselves when we’re unable to find or capitalize on our personal mojo.

In The Happiness Hypothesis: Finding Modern Truth in Ancient Wisdom, Dr. Jonathan Haidt sheds light on this mind-over-matter psychology with the benefit of scientific research.

Our brain structure reflects millions of years of evolutionary development. While we have an oversized neocortex relative to other mammals, we retain ancient structures – i.e., the limbic system or “lizard brain” – geared toward ensuring our survival. It responds to stimuli in ways that that call for feeding, fornication, fight, flight, and freezing. It also sets off a gaggle of other bodily responses with the intent of protecting our lives and/or propagating our species. When the limbic system runs the show, it takes a good deal of effort for the neocortex to bring our behaviors into awareness and exercise control.

As I discussed in Our Guts Have Minds of Their Own, the human body also comes equipped with a “second brain” (dubbed the enteric nervous system) with 100 million nerve cells to manage our gut’s biochemical activities. Haidt suggests that this lower body intelligence may do more than simply digest food and manage immune function. It may respond to sensory input in a way that drives insights, decision-making, and behavior beyond our conscious control. One might say that there’s thought behind our gut feel.

As with the enteric nervous system, our brains attend to most of its daily functions without the benefit of conscious thought. The autonomic nervous system regulates bodily functions, such as the heart rate, respiratory rate, pupillary response, skeletal muscular activity, and sexual arousal. We’re also creatures of habit. When learning a new routine, our brain activity remains high from start to finish. Once a routine has been mastered, brain activity elevates only when encountering the initial cue and when reaping a reward for a completed task. We’re on autopilot between points A and B. (That’s why it’s so hard to break engrained habits!)

Finally, our brains are highly adept at rationalization. As Dr. Baba Shiv and others have demonstrated, we make decisions emotionally and then filter all subsequent facts through a lens that supports our previously rendered judgment. Feelings come first; reasons are invented on the fly. Again, it’s how we evolved to survive. Per Haidt, this internal “wiring” explains why it is so difficult to win an argument. Morality is like beauty; it lives within the eye of the beholder. Once entrenched, it’s hard to dislodge and even harder to persuade others of its merits.

So, what does all this have to do with happiness? It tells us that our consciousness is not as powerful as we might have thought. Haidt likens it a rider atop an elephant, where the elephant represents all the parts of the brain over which we have little or no control. The rider has the ability to influence the elephant’s path, but only if the elephant is motivated to move in that direction.

If life is indeed shaped by how we perceive it, Haidt reminds us that such perceptions happen quickly and (largely) unconsciously. Furthermore, our survivalist nature causes us to give far greater weight to perceived threats, setbacks, and violations than it does to opportunities and possibilities. It takes effort and training to overcome this negative bias. We need to work with our “elephant brain” to move it in forwarding directions. Haidt advocates three methodologies:

  • Meditation to focus attention non-analytically and break attachments, thereby taming and calming the elephant
  • Cognitive therapy to catch negative thoughts, name the distortions, find alternate patterns of thinking, and change behaviors accordingly
  • Selective Serotonin Uptake Inhibitors (SSRIs) to ease symptoms of moderate to severe depression, as needed

In my next post, I’ll dive into Haidt’s formula for happiness and explore evolutionary responses to achieve it.

Language and the Brain

I’ve never really given much thought to how we learn and store language. If pressed, I’d have guessed that we had a language database somewhere in the neocortex that pairs words with meanings. I’d also have envisioning this cerebral dictionary growing over time as we learn new words, new uses for existing words, and foreign languages. As it turns out, our brains are a lot more sophisticated than that.

neocortexOur neocortex assumes responsibility for the higher-order brain functions of sensory perception, cognition, motor control, spatial reasoning, and language. It is divided into four pairs of cerebral lobes:

The frontal lobes engage in planning, problem-solving, decision-making, and behavioral control. They provide an awareness of our own thought processes as well as our ability to predict what others will be thinking or doing.

The parietal lobes process somatic (pertaining to the body) sensory information including touch, pressure, pain, heart, cold, and tension.

The occipital lobes are the main centers for visual processing (size, depth, texture, spatial orientation, color).

The temporal lobes engage in long term memory processing, audio processing (hearing), language comprehension, and emotional responses. Visual areas interpret sensory input – i.e., identifying objects (including facial expressions and body language) and anticipating what they might do.

These descriptions make it appear as though the brain supports a clear delineation of responsibilities for the various functions it performs. Science tells us otherwise. As a case in point, the cortical premotor areas of the frontal lobes and the parietal lobes work together to understand actions, objects acted upon, and locations toward which actions are directed. This collective of perception/action circuits also form a crucial role in language processing.

Through the wonders of brain imaging technologies, neuroscientists have been able to measure activity in various regions of the brain when we use language. In one experiment, subjects were asked to observe, name silently, and imagine using various man-made objects – e.g., hammers, screwdrivers, etc. In all cases, the brain regions that would be employed using these tools fired when the subjects simply called them to mind. This neural circuitry gives us a richer sense of meaning for our otherwise spartan vocabulary. Here’s a simple illustration.

Suppose a pro-business commentator decried government regulation for putting a chokehold on investment. Upon hearing or reading this assertion, our brains would ignite circuitry that would be used to execute a chokehold, visualize a chokehold, and experience a chokehold, even though the original sentence has nothing to do with cutting off air supplies. It’s simply how we’re wired. We imagine or simulate the words we speak or hear in a sensory way.

Great authors and orators understand this dynamic. Their words leap off the page/podium and create vibrant imagery in the minds of their readers/listeners. For example, when Toni Morrison describes a little girl’s dress as “lemon drop yellow,” I not only see the color, but I’m firing off taste buds that give me an extra measure of freshness for that Spring fashion choice. Cognitive scientists refer to this construct as embodied language.

Why might our brains work that way? Words underspecify meaning. By themselves, a simple word-meaning pair doesn’t provide enough information to capture what we’re seeing, doing, or experiencing. They don’t help us predict what comes next, what might be expected of us, or what we might be necessary for survival. We recruit resources from across our cerebral spectrum to fill in the blanks.

Of course, not all words evoke multisensory reactions. The pro-business commentator mentioned earlier could have stated that government regulation discouraged investment or limited funds available for investment. We’d come away with the same general meaning. By evoking the imagery of strangulation, the speaker created a much more powerful literary imprint and very likely induced an emotional response.

As we move into the final stages of the upcoming election cycle, I’m playing close attention to the rhetoric employed by candidates for political office and their handlers. While they may not have been trained on embodied language, they’re certainly availing themselves of its precepts. There’s quite a lot of trafficking in words and imagery that engender fear and anxiety. Those emotions play upon our survival instincts. I hope and pray that the electorate separates their visceral reactions to this onslaught and makes informed choices based on facts and reasoned arguments regarding what’s in the best interest of the nation and the world going forward.


  • Jerome Feldman and Srinivas Narayanan, Embodied meaning in neural theory of language, August 2003 (published by Science Direct)

Alzheimer’s Disease

With last week’s focus on mental health, I thought I’d zero in on a particularly challenging form of mental disorder, Alzheimer’s disease. The Mayo Clinic characterizes the condition as “a progressive disorder that causes brain cells to waste away and die. Alzheimer’s disease is the most common cause of dementia — a continuous decline in thinking, behavioral, and social skills that disrupts a person’s ability to function independently.”

alzheimer's diseaseThe Alzheimer’s Association has published a rather alarming set of statistics regarding the prevalence of this disease:

  • 8 million Americans live with Alzheimer’s disease, with estimated growth to 14 million by 2050
  • 16 million Americans provide 18.5 billion hours of unpaid care for people with Alzheimer’s disease and other forms of dementia, valued at nearly $235 billion
  • 1 in 3 seniors dies with Alzheimer’s disease or senior dementia

There is no treatment that cures Alzheimer’s disease or alters the disease process in the brain. However, as documented elsewhere in this blog, healthy lifestyle habits appear to be protective of brain circuitry and forestall its development.

I have some experience in this area. My father had geriatric dementia in his later years. While his cognitive functioning was impaired, he was still able to carry on an animated conversation until the last couple of months before his death at 96. My mother has fill-blown Alzheimer’s disease and has been substantively impaired for quite some time.

It turns out that while most seniors think it’s important to have their cognitive abilities checked regularly, only 16% of them actually follow through with testing. I can understand why. Of the many things that fall away with old age, the loss of one’s cognitive capacity and memory just might be the most frightening. It’s a clear marker of infirmity that foretells the loss of independence. And, as noted in last week’s post, any condition identified as detrimental to mental health tends to be stigmatized.

My mother was among the smartest people I’ve ever known, and she viewed her intelligence as one of her primary assets. So, I imagine that it was really bothersome for her to experience a decline in her analytical capacity and  stellar memory. Early indications came 5+ years ago when she asked me to take over their finances when Dad went into skilled nursing. The cover story was that it would be easier for me to navigate all the administrative details that accompanied payment of fees and reimbursement by their long-term care insurance provider. But a quick glance at their books revealed that Mom’s accounting skills had really fallen by the wayside.

Mom was once our chief purveyor of family stories, providing extraordinary detail on names, relations, conversations, events, etc. In the last few years, she spent more time listening to the stories and acting as if she were following the conversation (but may not have been). A little over a year ago, she stopped being able to watch movies or TV shows – even familiar ones or those with really simple story lines. She just couldn’t follow the action and would say over and over, “What’s going on?” Within the past couple of weeks, she seems to have forgotten who I am.

As caregivers go, I am really, really lucky. My parents acquired long-term care insurance 25 years ago. As such, Mom can afford to live in one of the nicest Memory Care facilities in the area. Her room and the common areas are beautifully appointed. The organization attracts competent, caring staff. They do the “heavy lifting” (literally and figuratively) so that I can focus on being a daughter. Even so, it is still really difficult to watch my Mom struggle with everyday living. And there’s very little I can do these days other than sit with her.

As noted above, 1 in 3 older adults passes on with some form of dementia or Alzheimer’s disease. The sad reality is that the person you knew leaves long before his or her body finishes its earthly existence. I miss the mother who knew me. I miss the mother who shared my memories. I pray that she is as safe, comfortable, and peaceful as we can make her in these final days.

Mental Health

Ten years ago, a former colleague published an evocative memoir about her struggle with depression, her road to recovery, and her ongoing management of the condition. I was floored by her revelation. When we worked together, she was an “it” girl – intelligent, witty, beautiful, athletic, and seemingly successful in all aspects of her life. And yet her struggles were very real, very painful, and very nearly fatal.

She is not alone.

mental healthTIME magazine’s special issue on mental health tells us that 450 million people worldwide struggle with mental health issues. In the United States alone, one in five people experience some form of mental illness each year. Those afflicted increase their mortality risk by 26% and are decidedly more susceptible to metabolic syndrome, chronic stress (and the attendant physiological distress), and altered immune function. TIME estimates the worldwide annual cost of mental illness to be $2.5 trillion and projects growth to $6 trillion by 2030. Suffice it to say, it’s an emerging health crisis.

The stigma attached to mental illness creates an impediment to effective treatment. It takes courage to seek help in a society that often deems mental disorder as a sign of weakness. Yet the emerging science tells us that these brain disorders have their basis in biology and require intervention. We need to change the public discourse to create a safe space for people to get the help they need.

For the past 60 years, antidepressants have been a bedrock of psychiatric treatment. However, 30% of the target population do not respond well to them. Of the remainder, it could take a process of trial-and-error to find the right medication and dosage to produce a workable result. Unfortunately, the longer one stays in a state of depression, the harder it becomes to set things right.

While depression can affect every one of us at any age, we are at increased risk in our 60s and beyond. There’s an increased incidence of seniors living without family members nearby. Upwards of 20-25% of Baby Boomers do not have children. That combined with a plethora of solitary entertainment can result in a downward spiral of loneliness.

So, what can we do to maximize our own mental health?

  1. Get a good night’s sleep every night. Try to go to bed at the same time every night and arise at the same time every morning. Have a calming ritual at night that helps you prepare for sleep.
  2. Eat a healthy diet. The same dietary risk factors that give rise to heart disease also affect brain health.
  3. Exercise! It’s not just good for the body; it’s good for the brain! Physical activity elevates mood, bolsters energy, and stimulates the production of endorphins. It also desensitizes the body to certain kinds of emotional distress.
  4. Prioritize spending time with people. Socialization is one of the best things you can do to sustain a healthy brain and ward off depression. Stay in the workforce. Volunteer. Join clubs. Put the welcome mat out and invite friends over.
  5. Consider living in an intentional community. The younger generation has embraced this lifestyle, often as a function of economic necessity. The fifty-five-and-over crowd has access to a broad range of planned communities all across the country, primarily in warmer climates. A handful of multi-generational communities are sprouting up as well. Or simply forge connection within your neighborhood.
  6. Engage in mindfulness training. It helps you focus on the present rather than ruminate on the past, among other benefits. For those of us who have trouble sitting still, try floating on water. Early evidence suggests that it lowers anxiety, relieves muscle tension, and engenders a relaxed state of mind.
  7. Seek professional help. As a case in point, cognitive behavioral therapy focuses on changing negative thought patterns and finding new approaches to problems.
  8. Get a pet. Research has shown that pet ownership lowers blood pressure, heart rates, and heart disease risk. And pets are a proven antidote to anxiety and loneliness.
  9. Use light therapy if affected by Seasonal Affective Disorder. It can be a mood and energy booster first thing in the morning.
  10. Focus on all the things about which you can be grateful and let go of grievances and disappointments. Make a habit of forgiving yourself and others. Pay attention to the blessings that each day brings.

What Neuroscience Tells Us About Emotional Styles

I’m a regular patron of the Beaverton library. I usually work from a specific reading list based on recommendations from friends and colleagues. But I happen to browse the neuroscience section and came upon a title that caught my eye – The Emotional Life of Your Brain: How Its Unique Patterns Affect the Way You Think, Feel, and Live… and How You Can Change Them. Mmmm… a self-improvement guide for nerds!

It turns out that the author – Dr. Richard Davidson, PhD – was intrigued by the varying emotional responses that people manifest when dealing with all the things that life throws at them. As he entered graduate studies at Harvard in the 1970s, he wanted to establish a scientific basis for describing these variances while developing concrete methodologies that help people lead healthier, happier lives. His efforts helped birth affective neuroscience, the study of brain mechanisms that underlie our emotions.

The book introduces readers to his six dimensions of “emotional style” along with a summary of the research that led to their development. You learn a bit about how the brain works and the differences that show up in varying manifestations of the six dimensions. He talks about the mind-body connection (a topic on which I’ve written previously). And he also talks about the ways in which our brains adapt and change based on the experiences we have and the thoughts that we think. I commend interested parties to read the book and dive into the details. It’s fascinating!

The six dimensions of “emotional style” for which Dr. Davidson found a clear neurological correlate are:

  1. Resilience measures the speed with which one shakes off the anger, sadness, or other negative emotion after a loss, setback, hassle, or other bothersome event. He labels the extremes Fast-to-Recover (insufficient reflection on, and learning from, an experience) and Slow-to-Recover (trapped in a cycle of excess rumination).
  2. Outlook reflects one’s attitude toward lived experience. One with a positive outlook sustains joyful, interconnected, outgoing, upbeat sensibilities. One with a negative outlook can experience positive sensations intermittently but is unable to keep them going.
  3. Socially intuitive people are adept at discerning and interpreting non-verbal communication, such as body language, facial expressions, vocal intonation, etc. They tend to exhibit high activation in the fusiform face area (which deciphers faces), and relatively low activation in the amygdala (which triggers the fight, flight, or freeze response).
  4. Self-Awareness provides consciousness of one’s thoughts and feelings; they’re mindful of the messages that their bodies are sending them. This capacity plays a crucial role in empathy for others. Those low in this capability may manifest emotions in their bodies (e.g., anger, stress) yet be completely unaware of them.
  5. People who exhibit Sensitivity-to-Context are attuned to their social environment and possess a keen awareness of the prevailing rules and expectations. Those who lack this ability are prone to inappropriate speech and behavior.
  6. People who rate high on the Attention scale can sustain focus even in the midst of a gaggle of distractions. They can zero in on a single conversation in a noisy party; they can forge ahead on projects and tasks in the midst of emotional turmoil. They’re also less susceptible to “attention blink,” a heightened response to a stimulus that causes “blindness” to a secondary one in close succession.

Prevailing wisdom suggested that “emotional styles” form early and stay with us throughout our lives. Dr. Davidson and his colleagues disproved this assertion. Sensory experience can rewire the brain. Thoughts and intentions increase or decrease the amount of cortical real estate dedicated to specific functions. And cognitive-behavioral therapy can alter brain activity in fundamental ways.

While Dr. Davidson does not place value judgments on one’s positioning on the six dimensions of emotional styles, he makes the case that certain patterns seem to be associated with better life outcomes and greater happiness. To that end, he practices meditation and encourages others to do so.

  • Mindfulness-based stress reduction (MBSR) enhances left prefrontal cortex activation which has been associated with Fast-to-Recover resilience.
  • An intensive period of mindfulness improves selective attention and reduces attentional blink.
  • Compassion meditation has been shown to encourage a Positive Outlook.

Also included in his prescription for happier lives: Pay attention to positive characteristics in yourself and others. Express gratitude. Compliment others regularly.