A Personal Journey and a Scientific Review
It has been a long time since I've written, and honestly I have hesitated with this post too. But it's too important not to start the dialogue.
I share my personal journey here in the hopes it can help others...
I struggle with depression and anxiety.
I have my whole life, even as a child.
I take medications that allow me to share my gifts with the world, and receive the beauty of life in return. They keep me healthy, and perhaps even save my life, given some of my childhood history.
I have travelled the country teaching about mental health and trauma, and my latest book, Ensouling Our Schools, details the work regarding trauma, mental health, and reconciliation. I am also a part of the Neuroscience in Education research cluster at UBC.
I am writing this because of several conversations I have had about neuroplasticity and mental health, and I think it’s critical we come to a balanced understanding of the two: where they intersect, and where they can collide if not understood properly.
There are two main concepts we need to understand here: mental illness, and neuroplasticity.
So what does neuroplasticity have to do with mental illness?
The obvious question is to what extent can the brain be rewired, in the case of a mental illness, to cure the illness. Can someone with bipolar disorder regain emotional regulation? Can someone with depression rewire the brain to respond more typically emotionally?
The answer, so far from research, is yes and no.
Neurological research has shown that unfortunately, mental illnesses damage the very parts of the brain that are needed for plasticity. For instance, in the case of depression, areas of the hippocampus are damaged that are needed for regulation of emotion. Impaired adult hippocampal neurogenesis and depression may therefore be reciprocally causative. High levels of glucocorticoids in depression also hinder adult hippocampal neurogenesis. In other words, it’s a vicious cycle we do not yet have an answer for.
On the other hand, neuroplastic reprogramming – i.e. exercises that promote brain development, can have some effect on depressive and anxiety related symptoms. Mindfullness, meditation, exercise, brain stimulation all have been shown to help. Help, but not cure. The challenge is that the work that needs to be done to reprogram the brain is extensive and in some cases lifelong. If one has to spend many hours a day to do so, it is not really supporting that individual to lead a normal life. Being a monk who prays 6 hours a day is not for everyone.
So here is where my personal journey perhaps can bring to life this conundrum, and the challenge facing people like me with depression. The life I have chosen to lead – spending fourteen hour days working, travelling constantly, being exposed to the trauma of others…is a high stress life. It does not leave room for the 6-8 hours a day of neuroplastic work that an adult my age would need to do to try to reprogram my brain – and even then would have a low chance of success given that my depression began in childhood (so it is chronic, and brain development was impacted), and I am 52 (neuroplasticity does reduce with age).
I had a choice, lead a simpler, more relaxed life with more time to focus on me, without medications, or swallow my pride, accept the medications, and lead the life I was born to lead.
I wrote this essay as a call, no a YELL, to slow the new wave of stigma being thrown at people with mental health issues as a result of the new findings around neuroplasticity and “growth mindset”.
In the last few months, I have had several people tell me I could, or should, get off my meds, because the brain can adapt if I just “do my work,” their friend did! I just need to do more exercise, spend more time in meditation, take classes in a new language, eat low carb, eat high carb (the brain needs glucose, ya know), work less, play more (shouldn’t we all), write reflective journals (will that get me tenure?), try CBD oil or 5htp (so replace one drug with another), and more.
It is shaming. It implies I should just be able to get over this. I could fix it if I just tried harder, was more dedicated, changed my “beliefs”. What it does is make me feel broken, a failure, not good enough.
I am an adult, with a strong sense of self – and I have cried many, many tears over this, even in the last few days. I am a scientist who knows the facts, and a spiritual person who can see beyond them and believes I can help myself to lead my best life, respond to my true calling, bring love and healing to the world, and share in its magic.
How would someone less strong within themself hear such a message?
I workout several times a week, eat a mostly healthy diet, meditate several times a week, have a regular spiritual practice – and I take meds.
Please stop telling me neuroplasticity means I can stop being depressed and get off my meds.
Please stop telling me your stigma around mental health means I should!
And for God’s sake, don’t tell a vulnerable child/youth in your care they can just heal themselves, and are a failure if they don’t, and give their friends the same message.
Yes, give them hope. Tell them living with a mental illness doesn’t have to be torturous. Tell them there are things they can do that will help them to heal, to live full lives, and to find joy. Teach them mindfulness strategies and coping skills, tell them about neuroplasticity and that they can grow and change. But tell them too, that sometimes we need help to heal from an illness, and when we do its ok to go to a doctor, and take the medications that make us well.
Stigma is killing our children, literally. 80% of kids with mental health problems don’t get help – they don’t seek it because they are ashamed. And some of them die from depression/suicide, others suffer silently, and many end up using other substances to cope.
Please, get the facts. It is well intentioned when we want someone to be well, but it is harmful when we imply it is not ok not to be.
4/21/2019 06:36:46 pm
Hi Dr. Katz,
5/2/2019 11:19:29 am
5/16/2022 08:26:15 pm
Please, share this far and wide. As I age, I am slowly becoming more at peace with my own challenges (anxiety) and more people need to hear this; even my spouse still needs to come to terms with this. We are as beautiful as the challenges our neurobiology create for us, and reading this from such an accomplished person give me hope and peace.
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I am an assistant professor at the University of British Columbia in Inclusive Education, and the developer of the Three Block Model of Universal Design for Learning.