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Brain Renewal Protocol jdmoyer.com Readability

jdmoyer.com

Brain Renewal Protocol

SEPT. 2 4 , 2 0 1 3

Winston Churchills nicknam ed depression his black dog. A week ago I woke up in a black m ood. Instead of feeling excited about m y day , I saw a series of dreary tasks ahead of m e. Looking into the future, I felt despair instead of hopefulness. Things that usually bring m e great pleasure (m aking m usic, tim e with m y fam ily and friends, drinking coffee) seem ed a little less bright. I know the signs. Som etim es I get a little depressed. Life stresses add up and darken m y outlook. A few ev ents conspired to bring m e to this dark place. A fam ily m em ber had em ergency surgery . It went well ev ery one is fine but the episode was unexpected, expensiv e, and inv olv ed an all-nighter in the em ergency room on m y part. Major stress. I had a cold that turned into a cough that lingered for a couple weeks. I hate being sick. Reduced energy and concentration cram ps m y sty le. Iv e taken on a difficult consulting project that is progressing slowly , with a steep learning curv e in sev eral areas (Im working with som eone elses code). Usually m y freelance database work is fun and progresses quickly , but so far this project has just been grinding
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along. I switched dentists, which m ight not be stressful for m ost people, but occupied a surprising am ount of m y m ind-space until I finally had m y appointm ent with m y new dentist (shes great heres her site if y oure in Oakland and looking for a dentist). I was dealing OK with all of these ev ents, but then I gav e blood. I giv e blood on a regular basis and usually feel fine the next day , but it hit m e like a load of bricks this tim e. I felt tired and spacey for a couple day s, and m y m ood worsened. When m y m ood goes dark, I feel less resilient dealing with ev ery day stresses, like m y four y ear olds m ood swings. I worry about ev ery thing, including neighborhood crim e, m usic sales (or lack thereof), the m ental health of v arious fam ily m em bers, the soaring national debt, the corporate hijacking of our political process, the possibility of Iran and Israel going to war, and so on. Ev en though m ost things in m y life are going well, I feel irrationally hopeless. From m y own casual observ ations, I think about 9 5% of adults experience a black m ood for at least a few day s at a tim e, at least once a y ear. And som e people grind through life in a constant state of m ild depression and nev er do any thing about it. W h a t s G oi n g i n t h e S t r essed-Ou t Br a i n ? The brain reacts to stress by signaling the adrenals to release m ore cortisol (a steroid horm one that raises blood sugar, increases m etabolism , and suppresses the im m une sy stem ). In the short-term , in conjunction with a nerv e growth factor called BDNF, cortisol protects the brain, acting as a kind of lubricant that enables brain cells to m ake changes. But long-term exposure to elev ated cortisol is bad news for the body and brain, especially when inflam m ation exists. It is associated with increased belly fat, which is bad for health in m any way s. This study found that otherwise lean wom en with abdom inal fat secreted m ore cortisol in response to stress. Norm ally , cortisol has an anti-inflam m atory effect. Howev er, people under constant stress (like long-term caregiv ers) can becom e resistant to the anti-inflam m atory effects of cortisol, and m ore sensitiv e to inflam m atory factors like NF-B (NF-kappaB). Constant stress, especially when com bined with poor coping strategies and/or poor nutrition, m ay also lead to adrenal depletion and crashing cortisol lev els, and well as low lev els of BDNF in the brain. Low BDNF in the hippocam pus essentially m eans that the brain is atrophy ing, and is associated with Alzheim ers Disease. So whats a stressed-out person to do? My own action plan is based on the following goals: reduce external stressors spiritual practice to reduce reactiv ity (stress spiraling) reduce sy stem ic inflam m ation support healthful lev els and rhy thm s of cortisol increase BDNF
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Theres no reason to stoically endure depressiv e feelings. There are things we can do to im m ediately change our brains and renew our spirits. Br a i n Ren ew a l Pr ot oc ol When I find m y self stressed out by life ev ents, I im plem ent m y Brain Renewal Protocol. The goal is to quickly im prov e m y m ood, life outlook, and sense of well-being v ia im prov ed brain chem istry , reduced inflam m ation, and hippocam pal neurogenesis. Heres what I do, and why : 1 . Talk ab o ut it I dont hide m y feelings, but let m y fam ily and friends know what Im going through. A little sy m pathy and slack go a long way . I try not to be a com plaining sad sack but I dont stoically pretend Im feeling great when Im not. Taking talk about it to the next lev el would be cognitiv e behav ioral therapy (like psy chotherapy , but m ore goal-oriented, with less sexual Freudian stuff). I did som e of this in college when m y parents were breaking up and another fam ily m em ber had som e psy chotic episodes. This was an incredibly stressful period of m y life, and the v arious oncam pus psy chological counseling serv ices at UC Dav is helped m e through it. 2 . Tak e a partial fas t day Interm ittent fasting increases BDNF lev els in the brain, and offers protection against inflam m ation and oxidation. Heres a full post on m y interm ittent fasting practices. I only do IF once a week, but I notice the positiv e m ood effect after just half a day without food. 3 . G o fo r lo ng fas t w alk s Long walks at a brisk pace are an ideal form of exercise for boosting BDNF lev els while still being easy enough on the body to av oid any risk of ov er-training (and associated free radical release and increased cortisol secretion). It m ight be tem pting to exercise y ourself into obliv ion (to get the endorphin rush), but its really im portant to not ov erdo it phy sically if y ou are under a great deal of stress. 4 . I nc re as e DH A and c urc um in intak e DHA (from fish oil or oily fish) and curcum in (from turm eric the spice that m akes curry y ellow) are both associated with higher BDNF lev els. Lately Iv e been using Juliet Mae spice m ixes for curries the spices are super fresh and hav e no bad stuff (like MSG). Curcum in is also a good long-term brain inv estm ent it protects against Alzheim ers disease. I take up to 4 g of refrigerated fish oil a day when Im under increased stress. One Harv ard Univ ersity study showed such a positiv e effect on depression and bipolar disorder that the study was stopped after four m onths so that the placebo group could also be treated with fish oil (the researchers considered it unethical to continue to deny the placebo group the benefits of treatm ent).
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5 . Re duc e s ugar and inc re as e ins ulin s e ns itiv ity Som e researchers hav e begun to refer to Alzheim ers as Ty pe III diabetes (insulin resistance in the brain). This anim al study found that a diet high in both fat and sugar reduced BDNF lev els in the brain (though a follow-up study by the sam e researchers found that exercise m itigated the effect). Theres a great deal of ev idence that a high sugar diet is related to insulin resistance in hum ans. Saturated fat is also im plicated as a possible culprit, but since m ost studies just hav e a bad diet (high in fat and sugar) and a good diet (low in fat and sugar), its hard to determ ine if fat is a culprit or not (ice-cream leads to diabetes, but is it the cream , the sugar, or both?). Mark Sisson has dedicated m any posts to unrav eling som e of these studies, such as this one. For m y self, I notice that eating lots of high carb foods like bread, beer, and ev en too m uch sweet fruit can lead to bad m oods. These are generally cheat foods for m e, so if Im feeling stressed I tighten up m y diet (especially carbs), and eat m ore fish, v egetables, pastured eggs, grass-fed m eats, and so on (m ore paleo). Ill also add som e supplem ental chrom ium (as chrom ium poly nicotinate) which has been shown to increase insulin sensitiv ity . 6 . Mo de rate c affe ine and alc o h o l intak e Too m uch caffeine, especially in the afternoon, can lead to constantly elev ated cortisol lev els. Coffee is generally healthful, and is protectiv e against m any diseases, including Ty pe-2 diabetes. (caffeic acid, found ev en in decaf, is especially effectiv e at clearing out toxic accum ulation of hIAPP [hum an islet am y loid poly peptide], an am y loid protein im plicated in both diabetes and Alzheim ers disease). But its good to giv e y our body a break and let cortisol dip (giv ing y our adrenals a break, am ong other things). Im a fast caffeine m etabolizer (I know this from m y 2 3 andMe.com test results), but I can still ov erdo it. Heres a good post from a coffee drinker who benefited from cutting out afternoon coffee. Thats what Iv e been doing lately , and Iv e noticed on ov erall energy boost (and a tendency towards m ore ev ening productiv ity ). Im also tem pted to drink m ore (booze) when Im feeling m ore stressed (anxiety can reduce BDNF lev els, and alcohol can m itigate this effect and tem porarily increase BDNF). For m e, one or two glasses of wine or beer takes the edge off and m akes socializing m ore enjoy able, but any m ore than that m akes the next day m iserable, and accentuates any depressiv e feelings. 7 . O th e r nutritio nal fac to rs Vitam in D has a protectiv e effect in the brain, especially against dopam ine toxicity related to Parkinsons disease and neurodegeneration related to Alzheim ers. I currently
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take about 3 000IU of v itam in D on m ost day s. Alpha-lipoic acid can cross the blood-brain barrier and is neuroprotectiv e. I take 1 0-2 0m g of r-ALA on m ost day s when Im experiencing increased stress. Both v itam in C and v itam in B5 support adrenal function. I take 2 50-500m g of C on m ost day s, and v ery sm all doses of Thorne m ulti-v itam in supplem ents to offset increased stress (large doses of B-m ultis trigger asthm a sy m ptom s for som e reason, so I cant do high doses of B v itam ins). Most of the B-v itam ins hav e som e role in neurotransm itter production and/or regulation, and niacinam ide (a form of B3 ) is protectiv e against Alzheim ers disease. I find that sm all doses (up to double the RDA lev el) of the B v itam ins boost m y energy and cognition, but higher doses lead to feeling wound up and restless sleep, and asthm a sy m ptom s). I find that m agnesium has a calm ing, anti-anxiety effect, and I take 1 00-2 00m g of m agnesium gly cinate on m ost day s. 8. Bo o s t te s to s te ro ne , inc re as e s e x and h e aling to uc h Higher testosterone is associated with im prov ed m ood in m en, and is also neuroprotectiv e. Iv e written a com plete post about healthy testosterone m anagem ent here. If Im feeling stressed out, anxious, and/or depressed, I err on the side of high T. Ill increase cod liv er oil to about 1 t daily for v itam in A (I only use brands with no added sy nthetic v itam in A, like Nordic Naturals Arctic or Carlson Norwegian cod liv er oil), and also supplem ent with a v ery low dose of tongkat ali. Estrogen is neuroprotectiv e for both sexes (high T in m en m ay be neuroprotectiv e only because som e of that testosterone conv erts to estrogen). Sexual activ ity boosts sex horm ones and is good for the brain. If m ore sex isnt an option, touch of all form s can reduce stress and inflam m ation. Massage feels good because it changes y our gene expression. 9 . No b lue ligh t e arly to b e d While pulling an all-nighter can bring tem porary euphoria (v ia m esolim bic dy sregulation), long-term sleep depriv ation is terrible for the m ind and body . On the other hand, balanced circadian rhy thm s can contribute to m ental health. Two tim es in m y life Iv e done a one m onth experim ent during which our household didnt use artificial light. We read by candlelight and went to bed m uch earlier than usual (especially when we did the experim ent during a winter m onth). As I wrote about in this post, m y wife and I experienced strange episodes of unexplained joy at random tim es during the experim ent. Som ehow the com bination of being fully caught up on sleep, as well as long periods of quiet wakefulness, tilted our m oods towards happiness. Because of this experience, if Im under additional stress, I turn off the lights earlier in the ev ening and go to bed earlier as a result (I find that I cant go to bed earlier unless I turn the lights down earlier blue spectrum light disrupts m elatonin production and therefore prev ents sleepiness). If I use m y com puter during the ev ening, I hav e f.lux
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installed, which cuts back on the blue light after sunset. 1 0. S piritual and re ligio us prac tic e Are depressiv e sy m ptom s inv ersely related to religiosity ? May be, m ay be not. Im an atheist, though not an anti-religious one. There are som e religions (including Reform ed Judaism and Secular Hum anism ) that tolerate or ev en encourage a non-supernatural interpretation of God (lov e, star-m atter, what hav e y ou). I practice personal pray er (I know that sounds strange for an atheist, but heres why ), I say Jewish pray ers with m y fam ily , and I som etim es go to religious serv ices. I would put all these practices in the m ood im prov ing colum n, and I engage in them m ore when Im feeling bad. More im portant for m y own m ental health is m editation, and the general set of practices I call m etaprogram m ing. In short, program m ing m y own brain, choosing helpful thoughts ov er unhelpful ones, and tuning m y attitude towards gratitude, forgiv eness, com passion, a sense of possibility and hope, taking com plete responsibility for ev ery aspect of m y life, and try ing to m ake the world a better place. 1 1 . Enh anc e trib al c o nne c tio ns , th ink w e ins te ad o f m e Wev e ev olv ed as social, tribal anim als. If I spend too m uch tim e alone working in a room , I can trick m y self into thinking Im fine, whereas the reality is Im gradually becom ing isolated and depressed. Much of m y work is solitary by nature (producing m usic, coding, writing), but ev en as an introv ert I know I need daily social interaction to feel right. Though I cant find the source at the m om ent, Iv e read that generally people underestimate how m uch social tim e they need to feel happy . People with com puter addiction (m ost of us?) hav e increased neural activ ity in areas of the brain hav ing to do with fast v isual processing, but reduced activ ity and brain shrinkage in areas related to processing of speech, m em ory , m otor control, em otion, sensory , and other inform ation. This article on Chinese com puter addicts cites abnorm al white m atter integrity in brain regions inv olv ing em otional generation and processing, executiv e attention, decision m aking and cognitiv e control. (Heres the original study .) I call this issue ov erstim /understim . The web and v ideo gam es can giv e us quick dopam ine fixes, but large swaths of our brains rem ain underutilized if we spend too m uch tim e staring at screens and clicking on stuff. I think the cure for ov erstim /understim is engaging social interaction. Collaborativ e work, real conv ersations, team sports, and the like. Heres a great talk from Nancy Etcoff on this subject. 1 2 . Life prio rity re e v aluatio n If Im feeling down for m ore than a few day s, Ill take som e tim e to reev aluate m y core v alues, life priorities, and current goals. Am I liv ing in accordance with m y deepest principles? Am I using m y gifts for the greatest good? Or hav e I lost m y course? If Im reacting to the world (putting too m uch energy into m eeting other peoples expectations), or avoiding the world (av oiding m y problem s,
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engaging with distractions, not engaging m y calling), then I need to reev aluate and reprioritize. I dont execute m ajor life decisions if I feel stressed-out and/or depressed, because m y whacked-out state of m ind is unreliable and untrustworthy . But I do consider big life decisions, and then decide to act or not later (when Im feeling better). 1 3 . Re duc e e xte rnal s tre s s o rs Reality is subjectiv e we create the world v ia our sensory im pressions, and we turn those im pressions into experiences and feelings with our brains. This doesnt m ean that ev ery problem has an internal solution. We cant alway s adjust ourselves to feel better. Som etim es we hav e to change the world, or rem ov e ourselv es from a situation. A ty rant boss, a dead-end job, a nightm are client, an abusiv e relationship, a neighborhood with a high rate of kidnappings and/or m urder, an env ironm ental or natural disaster, social collapse, war, etc. y oure not going to feel better by taking fish oil, eating curry , getting enough sleep. You need to get out. For m e, this week, reducing external stressors m eant taking a few day s off from m y consulting/program m ing work. Im on schedule with m y projects, so this wasnt a big deal. Generally m y life is good and I feel lucky , I dont want or need to m ake any m ajor life changes right now. I do hope that if things ev er got bad (som e kind of social collapse scenario) I would hav e the sense to get out with m y fam ily (if we could). Ill take cy bernetic discom bobulation ov er being the frog in hot water. On som e lev el this seem s unthinkable, but people experienced social collapse during the Great Depression not that long ago, and m uch m ore recently in New Orleans following Katrina. Heres a long essay from an architect who liv ed through social collapse in Argentina. 1 4 . I no c ulate m y s e lf w ith m o o d-b o o s ting b ac te ria Iv e sav ed the weirdest one for last. This episode of RadioLab blew m y m ind. Mice fed large am ounts of a specific probiotic strain were more resistant to anxiety (v ia influencing GABA lev els in the brain, m ediated through the v agus nerv e). Heres the original study , and heres an interv iew with the scientist. So what was the bacteria strain, and can y ou get it at the grocery store? The strain was Lactobacillus rham nonsus, and its in sev eral ty pes of kefir. Does it work the sam e in hum ans as in m ice? Who knows, but it probably cant hurt. Mycobacterium vaccae, found in soil, is another m ood boosting bacteria. It works v ia neurogenesis. May be that explains why pulling stubborn thorny weeds out of y our front y ard is actually fun som etim es. W h a t A b ou t Dr u g s?
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I believ e in better liv ing through chem istry . While I prefer to achiev e better chem istry with good food, exercise, a good nights sleep, curry , and v itam ins, I acknowledge that stronger m easures are som etim es necessary . A quick look at the options C annab is What about m arijuana? Som e of m y friends self-m edicate on a daily or near-daily basis, and seem none the worse for wear. And its not hard (at least in Oakland) to do this legally , with a note from y our doctor. So should y ou? Iv e tried a bunch of tim es, but I alway s skip the fun part and go right to slurry and paranoid. So I abstain totally from this particular drug. What does science say about m arijuana use? Lots of things. For exam ple, m arijuana stim ulates adult hippocam pal neurogenesis and has an anti-depressiv e effect. That sounds great! On the other hand, chronic m arijuana use through y oung adulthood im pairs IQ. And chronic use at any age im pairs working m em ory . Interestingly , the negativ e effect on m em ory is from increased neuroplasticity (weakened neural connections). So teen m arijuana use is probably a terrible idea. But adult use m ight im prov e quality of life in m any cases, especially during periods of prolonged stress. Heres an article in the New York Tim es regarding one such case. MDMA Ecstasy should be legal for the clincial treatm ent of PTSD. Heres why . S S RI s ( S e le c tiv e S e ro to nin Re uptak e I nh ib ito rs ) As this blog post explains, depression is not caused by a serotonin-deficiency . SSRIs like Prozac raise serotonin lev els in the brain within hours, but the anti-depressiv e effects of SSRIs ty pically take weeks or ev en m onths to kick in. Also, serotonin reuptake enhancers (like Tianeptine) which reduce serotonin lev els in the brain also work as antidepressants. Anti-depressiv e drugs work (when they do work) because they encourage hippocam pal neurogenesis. They re helpful for about three quarters of people who use them , and worsen the condition of about 2 0% (and are especially dangerous for teens and children associated with higher suicide rates in these groups). Im not opposed to the use of SSRIs, and Iv e nev er felt depressed for long enough to want to try them . I would be reluctant to try them because the side effects, the expense, and because the alternativ e treatm ents that Iv e discussed in this post seem to work just as well, and are m uch safer. Bi g Pi c t u r e Happiness researchers know, m ore or less, what m akes people happy in general. Money can m ake y ou happier, but the effect caps out at about $7 5K a y ear (depending on
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y our local econom y ). There are way s to spend y our m oney that will bring y ou m ore happiness (like spending it on other people, eating out, concerts and m ov ies), and other way s to blow m oney that dont help happiness at all (fancy watches and sports cars large expensiv e purchases for oneself where the nov elty wears off quickly ). And according to research cited by Dav id Brooks, joining a group that m eets at least once a m onth will boost y our happiness m ore than doubling y our incom e. Incom e equality in a society can m ake ev ery one happier and healthier (and incom e inequality in the U.S. is currently m aking ev ery one less healthy and less happy ). Happiness psy chologist Martin Seligm an asserts that the m eaningful life com es from finding y our highest strengths and using them in serv ice of som ething larger than y ourself. Dan Gilbert explains why what we think will m ake us happy is m ostly wrong. As y ou can tell from the links, m ost of what Iv e learned about happiness is from TED talks. Heres another one Stefan Sagm eister looks at v arious studies and concludes that race, clim ate, age, being rich, and ev en health hav e little im pact on ov erall happiness. But being m arried does generally m ake us happier, as does being m ore sociable and hav ing m eaningful friendships. Once again, we not me. We cure people from neurosis to return them to the ordinary m isery of life. -Sigism und Schlom o Freud Or m ay be we should we giv e up the doom ed pursuit of happiness and settle for Freuds ordinary m isery ? Theres som ething to U.G. Krishnam urtis criticism of all spiritual pursuits as an infantile wanting to feel good all the tim e (and Freud m ight agree). Feeling good all the tim e isnt possible. Life is som etim es m iserable, often boring or frustrating, and only occasionally euphoric. All that is true, but theres no reason to suffer through long periods of depression and anxiety . We can change our life situation. We can stim ulate hippocam pal neurogenesis. A n d a per son a l u pda t e So how am I feeling, a week later? Much better, thank y ou. My brain renewal protocol works, and it works quickly. I feel refocused, hopeful, and m ore dedicated to m y core principles. And Iv e got m y joie de vivre back. When Im feeling down I dont just write it off as the blues. I try to m ake im m ediate changes. I dont want m y brain to atrophy , ever, and I dont want m y life to end in dem entia. So I take brain health (and m y own m ental state) seriously .
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So what works for y ou? Are y ou perm anently stressed out? If y oure not feeling excited about life, and that y our life has m eaning, what are y ou going to change?

Or ig in a l URL: http://jdmoy er.com/201 2/09/24/brain-renewal-protocol/

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