I remember lying in bed that February, watching motes of dust drift in a limp ray of sunlight. It vaguely occurred to me that I had not moved in over 24 hours—not to use the bathroom, not to eat, nothing—and that, even realizing this, I had no desire to move. I had been a trained dancer, a mother, a full-time college student and someone who had worked full time in a job I was told “women could not do”—though I had, and fiercely. I had done all of these things at the very same time. I’d had energy and stamina and, dare I say, moxie. But there I stayed as directionless as the dust that floated all around me, though altogether less alive. I’d been clinging to that mattress for three months and had I the energy to feel desperate about my situation, I would have.
As a result of luck or excellent networking, I had the best neurologist money didn’t have to buy (he continued to see me for free after my insurance ran out and I could no longer work; something unheard of in America). This sainted neurologist took several brain images including an MRI and a PET scan and informed me of something I was certain spelled disaster: I had a “shrunken hippocampus.” It turns out that people with a history of depression often have a smaller hippocampus, which is strongly correlated to childhood abuse. The hippocampus is a structure in the brain that is largely responsible for the integration of memory, as well as spatial navigation. I had begun to have consistent difficulty with word and name recall, and my once excellent depth perception had taken a nosedive. Could it be that my hippocampus was actively shrinking as a result of current stress and the accumulation of past trauma? My doctor said, “Yes.”
What I heard: “You are irrevocably brain damaged.”
Depression Changes the Brain
It’s true that depression changes the brain, and it’s important to understand how. For me, the information was validating; I’d spent years trying to understand why I functioned so differently.
Because the hippocampus governs the integration of memory, individuals who suffer clinical depression, particularly over the long-term, often experience problems with short-term and long-term memory. Relaying the events of yesterday or remembering a close friend’s last name may become a consistent problem for the depressed person, even someone quite young. The hypothalamus is also changed by depression. It plays a critical role in endocrine governance and in maintaining the body’s autonomic nervous system. The hormones triggered by the hypothalamus inform the body and brain regarding attachment to loved ones; the monitoring of thirst; of fatigue; sleep; the circadian rhythm; and body temperature and appetite. In each of these areas, I had begun to experience dysfunction and was simply different than everyone around me. When I began to read about the experiences of other depressed people, I realized for the first time that these symptoms were truly all related, that they had a cause and that I was not alone.
Wait, There’s Hope
Perhaps the coolest thing about the “most complex object in the universe”—as the brain has been repeatedly called—is that it is highly plastic, it can form and reform throughout our lifetime. Dr. Dan Siegel, author of Mindsight: The New Science of Personal Transformation, wrote about a patient in his 90s who had been suffering neurologic deficits as a result of depression after losing his wife. Dr. Siegel treated his patient’s depression with activities intended to strengthen the communication between the left and right hemispheres, and over several months, the results were outstanding. This elderly patient’s brain had grown, changed and adapted: it had become stronger than it had been perhaps ever before.
Depression and Addiction
Studies continue to reveal that depression is more common in addicts than non-addicts, and that for certain addictions—as in the case of alcoholism—the overuse of a substance can lead to reduced serotonin levels, which is directly linked to depression. Addicts are generally more at risk for depression and other mental health challenges, and often turn to compulsive behaviors as a means of self-soothing or self-medicating. It is the nature of addiction to eventually begin to create more pain than pleasure, but by the time this becomes true, the habit has become wired in; the addict can’t stop on his own.
Examining the nature of brain changes caused by major depression does not have to reify the hopelessness experienced by either depression or addiction. The same brain science that discovered these changes also acknowledges the brain’s ability to heal throughout the lifespan. Treating depression is absolutely essential, not only if one hopes to recover from addiction, but also if one has any hope of recovering from the direct effects chronic depression has on the brain and body. The sooner we turn this beast around—with the help of therapy, diet, exercise, meditation and medication (if necessary)—the sooner we can get our lives, and our brains, back on track.