Dr. Amy Banks on Keeping Those Grey Cells Fit As We Age

My guest today is Dr. Amy Banks, instructor of psychiatry at Harvard Medical School and  Director of Advanced Training at the Jean Baker Miller Training Institute at Wellesley College. Welcome to OpEdNews, Amy. You recently did a session on "How to Maximize the Brain to Heal Throughout Life" as part of a wellness series.  That's a fascinating topic, especially for those of us with aging brains. What is neuroplasticity and how did it shake up how the brain has been traditionally viewed? 

 

Hi Joan - good to hear from you.  So, neuroplasticity is quite simply the capacity for the human brain to grow and change.  The most helpful book I have read on this topic is Norman Doidge's The Brain that Changes Itself.  This book was the most hopeful thing I have read about our capacity to heal in many, many years.  When I was in medical school in the late '80s, I was taught we are all born with the maximum number of brain cells and that throughout life we lose them through various means such as drugs and alcohol use or simply getting older.  However, in the late '90s, researchers found that some brain cells can be made new.  This was paradigm shifting.  There is now so much research going on all over the world about what allows the human brain to recover from injuries or simply grow new cells...it is actually hard to keep up with the literature.  Now, neuroscientists are imagining the brain as having certain areas that are temporarily used for a certain function.  If stimulation into that area is decreased, then another sensory area of the brain will enlarge and take over the space.  For example, if you put a human being into a dark room for a week, the vision area of the brain decreases and some of the other senses actually take over that "real estate."

There are two basic rules for neuroplasticity.  The first is "use it or lose it."  This means that the more you stimulate a pathway, the stronger that pathway becomes and the less the pathway is stimulated, the weaker it becomes.  The second rule is "neurons that fire together, wire together."  This means that as you stimulate a neural pathway repeatedly it will pull in other neurons around it to make the pathway more robust, larger.  The equation seems to be that simple.  The implications of this are far-reaching.  If you would like to try to change a pathway (i.e., a behavior or habit) you must actively try "NOT" to stimulate it.  In fact, you might want to try building a competing pathway!

I loved Doidge's book. Okay, so now that we know that the brain is more a work in progress than a finished project. What kind of practical suggestions do you have for us to get the most out of these brains of ours?

There are a number of researchers and clinician who have addressed this question....how do you "not" stimulate a pathway.  The answer is, of course, so crucial to brain change.  We can stimulate pathways directly and hope they compete with an unwanted one and take over that space, but also we must actively pull ourselves and our minds away from the the pathways supporting behaviors and feelings we do not want any longer.  Jeffrey Schwartz has written  about a technique where you relabel and refocus.  He has used it for obsessive compulsive disorder (OCD) but I think you can use it for many types of behavioral change.  

So, let's say you are a chronic worrier.  You find that you wake up worrying about different things.  In Schwartz's model, you first relabel it as "my worrying brain or my anxious brain."  This helps place some distance between the thought and reality; you can begin to think, maybe I do not  need to follow my anxious, worrying brain.  Then you refocus to a new and positive thought, or you change and do a positive activity.  I often have people think about a very supportive, positive interaction with someone important in their lives.  That way, the negative, worrying thought is being replaced by a more positive one.  This does two things.  The first is that you are not continually stimulating the worrying pathway and second you are building and reinforcing  the more positive pathway.  You must do this over and over and over again...it should literally become a practice.  Over time, the pathways should shift.  When you think of something/someone positive or do an activity that you enjoy, it stimulates dopamine which helps to solidify the new pathway!

So, adopting a positive attitude or thought is actually good for your health? What else can we be doing as we mature and age to keep those grey cells in top condition?

The most important thing to be doing as we age is to keep stimulating those brain cells.  There is clear evidence that staying engaged in mental activities like reading and learning and communicating with others keeps the brain cells alive and strong.  Not sure if I mentioned it in one of the last questions, but I think it is even more important to have some brain maintenance program ongoing.  

It is important to remember that not only does exercise keep your body fit, but it contributes to keeping your brain flexible and adaptable.  One of the issues, particularly with advanced aging, is a sense of isolation as friends and family may be dying.  I think people need to be able to maintain community and connections, opportunities to interact.  The physiology of healthy relationship contributes to building a brain that is continuing to grow.   

Do you recommend any "brain maintenance programs" in particular? What should we be looking for?

In terms of brain maintenance programs, there is not any "one" that I recommend.  I think each program should  be individualized.  That being said...there are a few musts that I recommend to folks:

1.  The best thing for  a stable brain is stable relationships....that would mean healthy, supportive, mutual - the more the better. 

2.  Drink eight cups of water a day.  Remember, the signals in the brain are electrical and electricity travels most effectively in water (that is why you do not swim in the lightening).  A hydrated brain feels better. 

3.  Exercise - cardiovascular exercise at least three times a week for 20-30 minutes stimulates brain-derived neurotrophic factor as well as a number of chemicals (opiods) that help us feel good and maintain brain structure and function. 

4.  Diet - what you put in your body for food is eventually what is used by your body to build neurotransmitters.  One particular good diet is the Zone diet that balances the intake of fats, carbohydrates and proteins throughout the day.  Those who have followed this diet often feel a remarkable amount of clarity and energy. 

5.  Brain exercises are being promoted - and for good reason.  The brain operates by the premise of "use it or lose it" - so, the more you work your "brain muscles" for memory and concentration, the stronger they will be.  There is one program - Lumosity that is online - I have tried this after losing a fair amount of memory both through surgical menopause and through chemotherapy.  I did these exercises daily for a couple of months and did feel real improvement in my memory. 

6.  Stress - it is essential to minimize your stress levels as we know that high chronic stress actually can be toxic to your hippocampus (which is one area in your brain  that is involved in memory.)  So, given that most people have maxed out their lives and that won't change much....work on a relaxation response...meditation, yoga...something to actively train relaxation pathways in your brain. 

7.  Sleep - one of the best ways to take care of your brain is to get eight hours of sleep a night.  Most of us cut corners on sleep and then walk around paying the price with more irritibility, less memory, poor focus. etc. 

8.  The final thing I recommend is omega three fatty acids.....a daily regimen is a plus for both brain and body.

So, if people can put these in place or as many as possible they will be taking pretty good care of their brains.

Sounds good! You've lectured about PTSD and the treatment for that condition. What can you tell us about that?

That is a very big question.  I could write pages about this (and if fact have, in various places).  Post-traumatic stress disorder is the clinical diagnosis given to a complex of emotional and physical symptoms a person can get after a life threatening trauma.  The first thing to mention is that most people who have a significant trauma do not get PTSD; they might have a three-month period with similar symptoms (hypervigilance, anxiety, heart racing, sweating, intrusive memories or flashbacks of the event, nightmares, numbness, social isolation) but usually your body will reequilibrate  and get back to normal.  About 25% of people will actually develop chronic symptoms.  These can be incredibly debilitating and lead to loss of relationships, employment, spiritual beliefs, confidence.  The list  seems almost endless.  

The good news about PTSD is it is a treatable condition, but you need to see someone who actually works with trauma.  Not every mental health professional has the specific training to deal with PTSD and it is different then a standard depression or even anxiety.  If you feel you fit in this category, ask for specific referrals.  In terms of treatment, many modalities have been tried, and I find a combination of relational therapy and cognitive behavioral therapy can be very effective.  You need the safety and communication of a good interactive therapist to talk about your experiences, but you also need someone who is going to be very concrete about trying to manage the symptoms, developing strategies for relaxation.  

Medications can often be a part of treatment, though anti-anxiety medications, like ativan or valium should not be used as they can make symptoms worse.  Other treatments, like eye-movement desensitization and reprocessing (EMDR) and Emotional Freedom Technique (EFT) are also being used to treat some of the symptoms.  My biggest complaint about traditional therapeutic treatment of PTSD, is that it often does not go far enough in treating the body.  So much trauma gets stuck in our cells, quite literally, and is not accessible through verbal communication.  One can sit through many therapy hours (spending many therapy dollars) with little or nothing to say.  But, first things first...get a treater who actually knows how to treat trauma.

It's interesting that you mention EFT. I learned it a few years ago, use it regularly, and have taught it to numerous friends and family members. Gary Craig [the founder of EFT] had  encouraging results with vets which was documented by filmmaker Eric Huurre in Operation Emotional Freedom: The Answer. LINK I wondered if you were familiar with their work.  Anything else you'd like to bring up before we wrap this up, Amy?

I have, in fact, seen some of the work that Gary Craig has done; I think it is amazing.  I have also done training in EFT and find it very helpful!.  I think I am good in terms of further comments.  

Thanks so much for talking with me, Amy! It was a pleasure. 

Thanks so much! 

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Thanks to Sally Castleman for taking me to Amy's lecture.

Jean Baker Miller Training Institute at the Wellesley Centers for Women website