Grief Happens in the Brain: Healing After Loss

The human condition is complicated and sometimes painful. In times of loss, in particular, it is especially hard to cope and work one’s way through the stages of what we know as grief. In technical terms, grief is “keen mental suffering or distress over affliction or loss; sharp sorrow; painful regret.”

In essence, grief is your brain trying to recover from the shock and disorientation that comes with loss and extreme change; in other words, your brain is trying to look out for you. Your body begins to experience deep biological responses to the painful circumstances, physically, psychologically, and emotionally. Just as chemicals and hormones are released in times of joy and excitement, so are chemicals and hormones released and bodily systems shifted in times of sorrow.

These responses begin in the brain.

Emotional Pain in the Brain

When the brain is going through grief, it experiences increased activity in the regions responsible for processing physical pain and emotions: the insula, anterior cingulate cortex, amygdala, posterior cingulate cortex, and prefrontal cortex. In the case of prolonged grief, pain actually accompanies the brain’s reward-process centers, meaning it reinforces (in a sense) the yearning for the lost loved one, almost creating an “addiction.” This is seen when grief persists and even disrupts everyday life.

The effects of grief can also be seen in increased cortisol levels, a hormone mainly released in times of stress–a major part of the grief response as a whole. As a result of excessive cortisol, the prefrontal cortex, which regulates emotions and memories, appears to shrink. This typically affects one’s ability to concentrate, recall things, and articulate or express feelings. Instead, expressing one’s feelings or desires in times of mourning can actually become difficult or even exhausting. Maintaining a normal level of this hormone is essential to human health, but if it remains high, it can take grief to a more prolonged or serious condition, like depression or anxiety.

That’s why it’s very important to be aware of all of the above as it relates to grief’s impact on the human body and mental state. It’s even more important that we treat ourselves kindly through the grieving process.

Appetite and Exercise in Mourning

While grief has its place in the brain, it also has its place in the body and mind. It all comes down to stress. Stress responses require attention in order to aid in healthy healing. Through the grieving process, make your physical, cognitive, emotional, social, and spiritual healths top priorities.

During the grieving process, it’s common to lose one’s appetite, overeat in pursuit of comfort, or even experience gastrointestinal issues as a result of grief’s major stressors. In this time, it’s very important to help yourself eat healthy foods that will not only comfort you but also keep your energy up, strengthening communication between brain cells.

Accompanied with eating right (occasional pizza and ice cream are acceptable, of course), exercise (even if mild) is a major help in healing from grief. Being active in some way, especially out in nature, can release neurotransmitters such as endorphins, serotonin, dopamine, and more, which are central to mood control and may help you fight feelings of depression. Meanwhile, it also helps relieve other symptoms of grief, such as anxiety, pain, lack of sleep, fatigue, and more. This can come in the form of a brief 10-minute walk, if that’s all a person can manage–any bit of movement helps.

Grief: The Sleep Thief

Sleep disorders may crop up in certain stages of grief. Try to take measures that will make you adequately restful by bedtime. That might mean setting some daytime or bedtime practices for yourself, such as no napping in the late afternoon or evening; developing a bedtime routine, in which you read a book or wind down with a bath; keep your bedroom at the right temperature, not too hot or cold; try to avoid electronic devices right before bed; use low lighting in the evenings; exercise at regular times each day (again, even if it’s a 15-minute stroll); stay away from caffeine late in the day; and try to avoid alcohol, for it may actually make it more difficult to stay asleep and can also destroy brain cells (you really need those).

Social Support As You Grieve

Because we are emotionally exhausted during this time, it’s difficult to express our needs. This is when social interaction and support crucially comes in to play. Having those around you who know you best and love you will encourage your healing and provide you the support you need to take it one step at a time. This doesn’t mean forcing yourself to be social; it means simply having loved ones nearby who understand and are there for you.

Be Patient. Healing Takes Time.

Ultimately, take it easy on yourself. Healing from loss takes time, and that’s all you can do: wait and treat yourself kindly. Remember that those around you should also understand that this grieving process takes time; that way, you don’t feel needy or rushed in the stages, which can lead to unearned guilt. Allow yourself to move through all of this organically.

Never feel selfish for grieving. As mentioned, grief is your body and brain’s natural approach to healing from something incredibly painful; let them do their job for you. Then, do your job in aiding your body and brain to heal by loving yourself, getting the sleep you need, eating as well as you can, and seeking support from others around you to combat any feelings of loneliness or ruminating thoughts.

In the end, you are not alone. Everyone in the world experiences grief at some point; let us all support each other through it and let ourselves grow from it.

This article was originally authored by Leigh Richardson and posted on Prime Women. Read the article here.

Social Media and Mental Health

Social media has become a way of life in today’s world. Facebook, Twitter, Instagram, and plenty of other platforms display our “profiles” and act as the primary mediums by which we communicate. There were nearly 2.5 billion social network users worldwide in 2017, and around 81 percent of Americans had a social media profile last year as well. Although social media has its upsides, such as keeping in contact with distant friends and relatives, it can actually have a negative impact on relationships nearby and even our mental health.

Social Media and Communication

According to some researchers, online social networking can be associated with several psychiatric disorders, including depressive symptoms, anxiety, and low self-esteem. As social media use increases, interpersonal communication with family members and friends seems to decrease. Online access allows a connection with a large number of people, indeed; however these cannot replace face-to-face communication adequately. This alone can lead to feelings of loneliness.

According to a 2016 study, there was reported a significant increase in depression and suicidal thoughts in the past several years. This was seen especially in teens who spent multiple hours a day using some sort of digital device with a screen. It’s possible that, due to the decline in communication with family members as well as reduced interaction within the person’s social circle could be leading to these feelings of self-inflicted isolation and depression. In turn, for those younger, it could have a negative effect on a child’s social development if they are constantly absorbed in social media–or being online in general.

Keeping Up Appearances And Making Comparisons

In a study of a high school population, researchers found a statistically significant positive correlation between depressive symptoms and time spend on Social Networking Sites (SNS’s). Partially responsible could be the false personas that people see and compare themselves to based on portrayed social media profiles. These are often altered, but many see them as reality, which leads to incorrect conclusions regarding physical appearance, educational level, intelligence, moral integrity, and many other characteristics. This perception of others’ lives is believed to be a potential contributor to these depressive symptoms, as users view others as happier, more successful, and may even see life as “not fair.”

What Does Depression Look Like? What Can Be Done?

Depression is a disorder of the brain, so treating depression means treating the brain. Many areas of the brain appear to be involved in depression. The left frontal area of the brain is associated with positive emotions and approach motivation, which is a desire to be involved with other people. The right frontal area is associated with depression and fear, accompanied by motivation to withdraw from and avoid other people. When there is over activation of slow wave in the left frontal area, this creates an imbalance, causing the right frontal area becomes more dominant, thus producing fear and withdrawal from other people. If your brain has too much slow wave in left frontal, you will become depressed easily, withdraw from other people, and may become anxious.

For those with depression, it’s wise to avoid exacerbating one’s negative emotions. If social media is causing you to feed yourself a false impression of the world, thus affecting your own quality of life, limit your usage. It can become an addiction, as the use of digital devices actually releases similar neurotransmitters (dopamine, the happy hormone) that drugs do. If you find it difficult to make these decisions alone, it’s important to seek counseling from a second party, who can help you in an unbiased way. Medication is also an option, along with other alternative therapies such as cognitive behavioral therapy–a common type of talk therapy that helps you become aware of your inaccurate or negative thinking. By becoming more aware, you can then challenge situations more clearly and respond them more effectively.

Research has also shown the effects of neurofeedback and biofeedback as treatment for the parts of the brain linked to depression and mental health. The plasticity of the brain allows new neural connections to be formed at any time, so in this treatment founded in neuroscience, professionals can retrain the brain from old, depressed patterns to new pathways that more closely resemble patterns of non-depressed people. That’s the beauty of plasticity–our brains are always able to change.  

We encourage you to never stop changing for the better. That way, you can feel better too.

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Brain Imaging Helps Identify and Treat Different Types of Depression

Millions of Americans suffer from depression. And few find relief even after several months on antidepressants. Research suggests the problem may stem from the way mental illness is diagnosed.

Diseases such as cancer or heart disease can be physically confirmed with objective lab tests, but the problem with diagnosing psychiatric conditions is that they are classified somewhat vaguely as clusters of reported symptoms. A person can be diagnosed as clinically depressed if they say they have low mood and meet at least four additional criteria. Depression can manifest differently from person to person – and symptoms can vary wildly. There really hasn’t been away to differentiate patients who have different kinds of depression. Until now, this has been a
big obstacle in understanding the neurobiology of depression.
Previous studies have shown that stress throws off the flexibility circuits in certain depressed individuals – whereas other people become depressed for different reasons. That is consistent with the view that depression is not just ‘one biological thing.’ In 2008, the National Institute of Mental Health initiated a new set of research priorities which encourages scientists studying mental illness to drill down to core mechanisms rather than placing disorders under blanket labels. This shift in thinking has invigorated the search for a range of biomarkers for depression
—toxic free radicals, the stress hormone cortisol and even epigenetics (environmental triggers that switch genes on and off).
Researchers have previously used functional magnetic resonance imaging (fMRI) to check for differences in brain connectivity between depressed and healthy people. The analysis showed depressed people could be distinguished from healthy ones based on brain connectivity differences measured by fMRI in the limbic and frontostriatal areas. The limbic system controls emotions and frontostriatal networks help coordinate motor and cognitive functions. One brain area, called the subgenual cingulate cortex, has unusually strong connections with other regions of the brain in people who are depressed.
But in the most recent study, researchers used fMRI, to measure the strength of brain connections between neural circuits. Four subtypes of depression were analyzed. These fMRI-based subdivisions could be linked to particular symptoms. Patients falling into the first two subtypes reported more fatigue whereas those in the other two reported more trouble feeling pleasure. This subtyping has implications not just for diagnosis but potentially for non-pharmaceutical treatment.
People with depression subtype 1 were three times as likely to benefit from a newer therapy known as transcranial magnetic stimulation, or TMS. This technology uses a magnet to produce small electric currents in brain areas affected by depression.  Another technology being successfully used is trans cranial direct stimulation or alternating current, tDCS/tACS.  The brain will mimic or emulate the tDCS/tACS fed into it and the capillary blood flow increases.
These findings and future research could help develop clearer diagnoses and enable doctors to tailor more personalized and new therapies targeting the specific form of depression in each individual patient.

Is There a Link between Depression, Anxiety and Minor Injuries?

One out of 10 U.S. adults goes to an emergency department every year for injury.  Most injuries are considered relatively minor and providers often don’t look beyond what’s initially required to help that person heal.  But what happens when a person arrives in the emergency department needing help for a minor injury and who also expresses symptoms of depression and anxiety?

Researchers wanted to find out how such patients fared long-term, something relatively well-studied for people with severe injury but uncharted for minor emergency treatment.  They turned to data they had collected from previous work about long-term recovery from minor injuries.

In that initial study, the researchers used standard criteria to identify 1,110 patients who had sustained minor injuries, after excluding those with head trauma, those with a previous psychiatric diagnosis and those hospitalized during the past year for another minor injury.  From this group, 275 men and women were randomly selected and interviewed at intake in the emergency room, as well as at three, six and 12 months after injury.

Along with the larger diagnostic exams that were given, they collected each patient’s symptoms of depression and anxiety using symptom-severity scales called the Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale.

They learned that people with more symptoms of depression at the time of their injury still had trouble working a year later and more frequently required bed rest due to health problems. They found connections, though less substantial, for anxiety, too.

Although it’s unclear what’s driving the relationship between psychological symptoms at the time of injury and long-term recovery, they do know there is a range of symptoms which, if identified and evaluated, could change the way we allocate resources or suggest more intensive follow-up for certain people who might be at higher risk for poor recoveries.

It’s an important link between physical and mental well-being for these patients.

The study further validates that health care providers can’t separate people into psych and physical because there’s an interplay between both that’s important to understand.  If the goal is to get patients back to their normal activities, psychological wellness must be incorporated to treatment after injury in order to meet that goal.

The researchers noted that future research should focus on building a better understanding of the pathways through which psychological symptoms influence long-term recovery.

What the Brain Waves Can Tell Us About Depression!!

A UCLA study finds noninvasive method that may help speed relief from depression disorder.

Depression is a major public health problem and leading cause of disability that affects 17 million people in the United States every year. The good news is: There are several antidepressant drugs on the market that are effective in treating depression. The bad news is: Less than one-third of people with the disorder find relief from depression with the first antidepressant that is prescribed for them. Finding the right antidepressant for individuals is a process of prolonged trial-and-error. Patients must wait weeks, months or even up to a year to see if the antidepressant will be effective for them.

Ready for some GOOD NEWS?

A 10-minute procedure in your doctor’s office can significantly help speed relief from this disorder by shortening this process of prolonged trial-and-error. A study by researchers at the Semel Institute for Neuroscience and Human Behavior at UCLA has found a new noninvasive way to predict which individuals will respond favorably to the most commonly used medications to treat depression — using brain wave recordings. This biomarker- a simple pair of brain-wave recordings, or electroencephalograms (EEGs) can predict whether the person will enter remission after just one week of treatment. Knowing whether a medication is going to work could eliminate months of waiting by the patient, and get them on effective treatment more quickly.

The researchers used the electroencephalogram recordings to predict recovery from depression in those taking escitalopram, a common antidepressant sold under the brand name Lexapro. Escitalopram works by increasing the levels of serotonin, a chemical messenger or neurotransmitter in the brain that helps to regulate mood.

Serotonin levels in the brain also maintain the ratio between slow ‘delta-theta’ brain waves and faster “alpha” brain waves. The brain uses this ratio between fast and slow waves to form chemical or electrical networks that support normal mood and thinking. Researchers reasoned that the effect of escitalopram in shifting the balance between delta–theta and alpha activity would predict the effectiveness of the drug in relieving symptoms of depression.

The researchers tested whether brain wave recordings in the first week of treatment would show that the antidepressant (as compared with a placebo) corrected the frequency imbalance — and predict a beneficial effect of medication on an individual’s depression after seven weeks of treatment.

After one week of taking escitalopram, the brain wave recordings of the people who eventually responded favorably to the treatment differed significantly from the measurements of those who did not benefit. The people whose brainwaves showed a large shift toward producing more delta–theta waves were less likely to enter remission with escitalopram treatment. Conversely, those people who shifted toward producing more alpha oscillations after one week of treatment with escitalopram were significantly more likely to find relief from their depression.

The study is notable in a number of ways, the researchers say. For example, although some previous studies have reported on biomarkers that can predict response — that is, whether an individual will get better — few have been able to predict whether a patient will enter remission.  The other important finding — and the pleasant surprise — is that the biomarker was also tested in a group of subjects treated with placebo. Many patients with depression who are treated with placebo also get better or well, but frequently this improvement is only short-lived.
The biomarker selectively predicted remission with medication, but did not when a placebo was used. This confirmed that we can differentiate a true, specific response to a drug from a non-specific placebo response. This is the first time that a biomarker that differentiates placebo remission from drug remission has been reported.
The researchers next plan to use brain wave recordings to evaluate other antidepressant medications as well as cutting-edge non-medication treatments such as trans cranial magnetic stimulation, a magnetic method used to stimulate small areas of the brain.
At the Brain Performance Center we do use brain wave recording to guide treatment plans that do offer magnetic therapy to treat depression.  These include pEMF pulsed electrical magnetic frequencies) and tDCS/tACS, (trans cranial direct or alternating current stimulation).  Please watch the video to get an overview of what we do, or call 817-500-4863 to learn more.

Use tDCS to Improve Depression, Memory and Brain Plasticity

Transcranial Direct Current Stimulation, or tDCS has been used for years to treat patients suffering from conditions such as stroke, depression and bipolar disorder. A new breakthrough study from the researchers at the Catholic University Medical School in Rome shows that this non-evasive treatment could also improve how people learn and retain information.

The study, sponsored by the Office of Naval Research (ONR) Global, involved the use of tDCS on mice. tDCS is applied using two small electrodes placed on the scalp, delivering short bursts of extremely low-intensity electrical currents. After exposing the mice to single 20-minute tDCS sessions, the researchers saw signs of improved memory and brain plasticity (the ability to form new connections between neurons when learning new information), which lasted at least a week. This intellectual boost was demonstrated by the enhanced performance of the mice during tests requiring them to navigate a water maze and distinguish between known and unknown objects. Using data gathered from the sessions, it was discovered that synaptic plasticity in the hippocampus, a region of the brain critical to memory processing and storage, was increased.

While tDCS has been used for years, this study is unique as it supports the theory that there is a direct link between tDCS and improved brain plasticity. Understanding how this technique works biochemically may lead to advances in the treatment of conditions like post-traumatic stress disorder, depression and anxiety–which affect learning and memory in otherwise healthy individuals. The implications of this research also have great potential to strengthen learning and memory in both healthy people and those with cognitive deficits such as Alzheimer’s.

More important, the researchers identified the actual molecular trigger behind the bolstered memory and plasticity, increased production of BDNF, a protein essential to brain growth. BDNF, which stands for “brain-derived neurotrophic factor,” is synthesized naturally by neurons and is crucial to neuronal development and specialization.

While the technique and behavioral effects of tDCS are not new, this study is the first to describe the technique and potential behavioral effects of tDCS which could help improve how people learn and retain information.

Is Depression All In Your Head?

Brain Scans May Predict Recurrence Risk in Major Depression

A recent study funded by the Medical Research Council and published online in JAMA Psychiatry has found that neuroimaging/neurofeedback can add value in psychiatry, in this case specifically in major depressive disorder.

The study focused on 64 non-medicated patients who had been in remission from major depressive disorder for at least 6 months and 39 healthy control participants who had no personal or family history of MDD.

During fMRI, participants were asked to imagine acting badly toward their best friends, and they experienced self-blaming emotions such as guilt. Over the next 14 months, 37 patients remained in remission (stable group), and 27 developed a recurrent major depressive episode.

During the experience of emotions of guilt, the group with recurring MDD showed higher RSATL-SCSR connectivity than the group with stable MDD and the control group, the researchers reported. They noted “We corroborated our hypothesis that during the experience of self-blaming vs. other-blaming emotions, RSATL-SCSR connectivity predicted risk of subsequent recurrence.”

“The group with recurring MDD also exhibited RSATL hyperconnectivity with the right ventral putamen and claustrum and the temporoparietal junction. Together, these regions predicted recurrence with 75% accuracy (48 out of 64 predicted cases),” the researchers say.

The importance of the finding is to show a likely causal relationship between depression and altered functional connections in a neural network that is selective for blaming oneself relative to blaming others. This is in contrast with a common assumption that an overall increase in negative emotion–related brain responses is key to understanding depression.

Although more clinical study is needed to convince healthcare stakeholders to apply these findings to daily clinical practice, this exciting research has reinforced the concept that neurofeedback can be a way to help identify those individuals who are more likely to suffer from recurrent episodes of depression and will therefore benefit most from long-term treatment.

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