The Idiot Brain

by Dean Burnett

  Sadly, the truth is that many persist in thinking it’s easy to ignore or override a powerful debilitating mood disorder that regularly affects sufferers to the very core of their being. It’s an excellent demonstration of how the brain values consistency, that once a person is decided on a certain viewpoint, it’s hard to alter it. The people demanding that those with depression alter their thinking while refusing to do the same in the face of the evidence are showing just how hard it is. It’s a terrible shame that those who are suffering the most get made to feel worse because of it.

  It’s bad enough when you’ve got your own brain conspiring against you so severely. To have other people’s doing it too, that’s just obscene.

  Emergency shutdown

  (Nervous breakdowns, and how they come about)

  If you go out in the cold weather without a coat, you’ll catch a cold. Junk food will mess up your heart. Smoking ruins your lungs. A poorly set-up workstation causes carpal tunnel and backache. Always lift with your knees. Don’t crack your knuckles or you’ll get arthritis. And so on.

  You’ve probably heard these things before, and countless similar nuggets of wisdom about how to stay healthy. While the accuracy of these claims varies considerably, the notion that our actions affect our health is valid. Our bodies, marvellous as they are, have physical and biological limitations, and pushing these limits has consequences. So we watch what we eat, where we go, how we behave. If our bodies can be badly affected by what we do, what’s preventing the same from happening to our complex, delicate brains? The answer is, of course, nothing.

  In the modern world, the biggest threat to the well-being of our brains is good old stress.

  Everyone experiences stress on a regular basis, but if it’s too intense or too frequent, then we get problems. Chapter 1 explained how stress has very real and tangible effects on our health. Stress activates the hypothalamic–pituitary–adrenal (HPA) axis in the brain which activates fight-or-flight responses, which release adrenalin and cortisol, the ‘stress’ hormone. These have numerous effects on brain and body, so the effects of constant stress become very apparent in people. They’re tense, not thinking straight, volatile, physically wasted or exhausted, and more. Such people are often said to be ‘heading for a nervous breakdown’.

  ‘Nervous breakdown’ isn’t an official medical or psychiatric term. It doesn’t involve the literal breakdown of nerves. Some use ‘mental breakdown’, which is technically more accurate, but still a colloquialism. Regardless, most people will understand what it is. A nervous breakdown is what happens when someone can no longer cope with a high-stress situation, and just … ‘snaps’. They ‘shut down’, ‘withdraw’, ‘fall apart’, ‘can’t cope’. It means a person is mentally no longer able to function as normal.

  The experience of a nervous breakdown varies considerably between individuals. Some experience bleak depression, others crippling anxiety and panic attacks, some even hallucinations and psychosis. So it might be surprising that some see nervous breakdowns as a defence mechanism of the brain. As unpleasant as they are, they’re potentially helpful. Physiotherapy can be exhausting, hard and unpleasant, but it’s certainly much better than not doing it. Nervous breakdowns may be the same, and this makes more sense when you consider that nervous breakdowns are invariably caused by stress.

  We know how the brain experiences stress, but how does something cause stress in the first place? In psychology, things that cause stress are known (logically) as stressors. A stressor reduces personal control. Feeling in control makes most people feel secure and safe. It doesn’t matter how much actual control we have. Every human is technically a meaningless sack of carbon clinging to a rock hurtling through the uncaring void around trillions of tonnes of nuclear fire, but that’s too big for a single human to be aware of. But if we can demand and get soy milk in our latte, that’s tangible control.

  Stressors reduce options for action; something is more stressful if there’s nothing you can do about it. Getting rained on is irksome if you have an umbrella. Getting caught in the rain without an umbrella while locked out of your house? That’s stressful. With a headache or a cold there are medications available to minimise the symptoms, but chronic illnesses cause a lot of stress because there’s often nothing to be done about them. They’re a constant source of unavoidable unpleasantness, providing a very stressful situation.

  A stressor also causes fatigue. Whether frantically running to catch a train after oversleeping or working on an important last-minute assignment, dealing with a stressor (and its physical consequences) requires energy and effort, depleting your reserves, causing further stress.

  Unpredictability is also stressful. For example, epilepsy can cause incapacitating seizures at any moment, so they’re impossible to plan for effectively, which is a stressful situation. It doesn’t have to be a medical condition; living with a partner prone to mood swings or irrational behaviour, meaning you risk a rage-induced row with someone you love if you accidentally put the coffee jar in the wrong cupboard, can be incredibly stressful. These situations provide unpredictability and uncertainty, so we end up constantly on edge, expecting the worst at any moment. Result: stress.

  Not all stress is debilitating. Most stress is manageable as we have compensatory mechanisms to balance the stress reactions. Cortisol stops being released; the parasympathetic nervous system activates to relax us again; we replenish our energy reserves; then carry on with our lives. However, in our complicated, interconnected modern world, there are many ways in which stress can quickly become overwhelming.

  In 1967, Thomas Holmes and Richard Rahe assessed thousands of medical patients and asked them about their life experiences, attempting to establish a link between stress and illness.11 They succeeded. This data lead to the formation of the Holmes and Rahe Stress Scale, where certain events are assigned a certain number of ‘life change units’ (LCU). The more LCU an event has, the more stressful it is. A person then says how many of the events on the scale happened to them in the previous year, and an overall score is assigned. The higher the score, the more likely someone is to become ill from stress. Top of the list is ‘death of a spouse’ with 100 LCU. Personal injury scores 53, getting sacked 47, trouble with in-laws 29, and so on. Surprisingly, divorce scores 73, whereas imprisonment scores 63. Oddly romantic, in a way.

  Things not on the list can be worse again. A car crash, involvement in a violent crime, experiencing a major tragedy – these can cause ‘acute’ stress, where a single incident causes intolerable levels of stress. The events are so unexpected and traumatising that the usual stress response is, to quote Spinal Tap, ‘turned up to 11’. The physical consequences of the fight-or-flight response are maximised (you often see someone shaking uncontrollably after serious trauma), but it’s the effect on the brain that makes such extreme stress hard to get over. The flood of cortisol and adrenalin in the brain briefly enhances the memory system, producing ‘flashbulb’ memories. It’s actually a useful evolved mechanism; when something severely stress-inducing happens, we definitely don’t want to experience it again, so the highly stressed brain encodes as vivid and detailed a memory of it as possible, so we won’t forget and blunder into it again. Makes sense, but in extremely stressful experiences it backfires; the memory’s so vivid, and remains so vivid, that the individual keeps re-experiencing it, as if it were constantly reoccurring.

  You know when you look at something extremely bright and it lingers in your vision because it was so intense it’s ‘burned’ onto your retinas? This is the memory equivalent of that. Except it doesn’t fade, it persists, because it’s a memory. That’s the point, and the memory is almost as traumatic as the original incident. The brain’s system for preventing reoccurrence of trauma causes reoccurrence of trauma.

  The constant stress caused by vivid flashbacks often results in numbing or dissociation, where people become detached from others, from experiencing emotions, even from reality itself. This is seen as another brain de
fence mechanism. Life is too stressful? Fine, shut it out, go into ‘standby’. While effective in the short term, it’s not a good long-term strategy. It impairs all manner of cognitive and behavioural faculties. Post-Traumatic Stress Disorder (PTSD) is the most well-known consequence of this occurrence.12

  Thankfully, most people won’t experience such major traumas. Consequently, stress has to be sneakier to incapacitate them. So there’s chronic stress, which is where you get one or more stressors that are more persistent than traumatic, so they affect you over the long term. A sick family member to care for, a tyrannical boss, a never-ending stream of deadlines, living on the breadline and never clearing your debts, these are all chronic stressors.*

  This is bad, because when too much stress occurs over a long period, your ability to compensate suffers. The fight-or-flight mechanism actually becomes a problem. After a stressful event it typically takes the body 20–60 minutes to return to normal levels, so stress is quite long-lasting as it is.14 The parasympathetic nervous system, which counteracts the fight-or-flight response once it’s no longer needed, has to work hard to undo the effects of stress. When chronic stressors keep pumping stress hormones into our system, the parasympathetic nervous system is exhausted, so the physical and mental consequences of stress become ‘normal’. Stress hormones are no longer regulated and used when needed; they persist, and the person becomes constantly sensitised, twitchy, tense and distractible as a result.

  The fact that we can’t counteract stress internally means we seek external relief. Sadly, but predictably, this often makes things worse. This is known as the ‘stress cycle’, where attempts to alleviate stress actually cause more stress and consequences, which result in more attempts to reduce stress, which in turn cause more problems, and so on.

  Say you get a new boss who assigns you more work than is reasonable. This would cause stress. But said boss is not open to reason or rational argument, so you work longer hours. You spend more time working and stressed, so you experience chronic stress. Soon you start consuming more junk food and alcohol to unwind. This negatively affects your health and mental state (junk food makes you unfit, alcohol is a depressant), which stresses you out further and makes you vulnerable to further stressors. So you get more stressed, and the cycle continues.

  There are numerous ways to stop the ever-increasing stress (adjusting workloads, improved healthy lifestyle, therapeutic assistance, among others), but for many this just doesn’t happen. So everything builds up, until a threshold is crossed and the brain essentially surrenders; much like a circuit breaker will cut the power before a surge overloads the system, so ever-increasing stress (with associated health consequences) would be terribly damaging for brain and body, so the brain puts a stop to, essentially, everything. Many argue the brain induces a nervous breakdown to stop stress escalating to the point where lasting damage can occur.

  The threshold between ‘stressed’ and ‘too stressed’ is hard to specify. There’s the diathesis-stress model, where diathesis means ‘vulnerability’, which describes how someone who is more vulnerable to stress requires less stress to push them over the edge, into a full breakdown where they experience a mental disorder or ‘episode’ of some description. Some people are more susceptible: those with more difficult situations or lives; those already prone to paranoia or anxiety; even those with tremendous self-confidence can be brought low very quickly (if you’re very self-confident, losing control due to stress could undermine your whole sense of self, causing immense stress).

  Exactly how a nervous breakdown plays out also varies. Some people have an underlying condition like (or predisposition to) depression or anxiety, and overly stressful events can bring this on. Dropping a textbook on your toe hurts; dropping it on an already-fractured toe hurts considerably more. For some, the stress causes their mood to plummet to a point where it’s incapacitating, and thus depression occurs. For others, the constant apprehension and persistence of stressful occurrences causes crippling anxiety or panic attacks. The cortisol released by stress is also known to have an effect on the dopamine systems of the brain,15 making them more active and more sensitive. Anomalous activity in the dopamine systems are believed to be the underlying cause of psychosis and hallucinations, and some nervous breakdowns do produce psychotic episodes.

  Thankfully, a nervous breakdown is typically a short-lived thing. Medical or therapeutic intervention usually sees people return to normal eventually, or just the enforced break from stress may help. Granted, not everyone sees a nervous breakdown as a helpful thing; not everyone gets over it, and those who do often retain a sensitivity to stress and adversity that means they could more easily experience a nervous breakdown again.16 But they can at least resume a normal life, or a close approximation of it. Hence nervous breakdowns can help prevent lasting damage from a relentlessly stress-filled world.

  Saying that, much of the problems a nervous breakdown helps limit are themselves caused by the brain’s own techniques for dealing with stress, which often aren’t up to scratch for modern life. Appreciating the brain for limiting the damage caused by stress via nervous breakdowns is like thanking someone for helping put out the fire in your house when they were the one who left the fryer on.

  Dealing with the monkey on your back

  (How the brain brings about drug addiction)

  In the US in 1987, there was a televised public-service announcement that illustrated the dangers of drugs via the use of, surprisingly, eggs. An egg was shown and the viewer was told, ‘This is your brain.’ A frying pan was then shown, with the sentence, ‘This is drugs.’ The egg was then fried in the pan, with the words, ‘This is your brain on drugs.’ In a publicity sense, it was very successful. It won awards, and is still referenced (and, admittedly, mocked) in pop culture to this day. In a neuroscientific sense, it was a terrible campaign.

  Drugs do not heat your brain so much that the very proteins making up its structure break down. Also, it’s very rare for a drug to affect every part of the brain simultaneously, in the way that a frying pan affects an egg. Lastly, you apply drugs to the brain without removing it from its shell, aka skull. If it weren’t, drug use certainly wouldn’t so popular.

  This isn’t to say drugs are necessarily good for the brain; it’s just the truth is far more complicated than egg-based metaphors can allow for.

  The illegal drug trade is estimated at nearly half a trillion dollars17 and many governments spend countless millions finding, destroying, and discouraging the use of illegal drugs. Drugs are widely assumed to be dangerous; they corrupt users, damage health and ruin lives. This is fair because drugs often do exactly that. Because they work. They work very well, and do so by altering and/or manipulating the fundamental processes of our brains. This causes problems such as addiction, dependence, behavioural changes and more, all of which stem from how our brains deal with drugs.

  In Chapter 3, the dopaminergic mesolimbic pathway was mentioned. It’s often called the ‘reward’ pathway or similar, because its function is refreshingly clear: it rewards us for actions perceived as being positive, by causing the sensation of pleasure. If we ever experience something enjoyable, from a particularly pleasant satsuma to the climax of a certain bedroom-based activity, the reward pathway provides the sensations that make us think, ‘Well, wasn’t that pleasant?’

  The reward pathway can be activated by things we consume. Nutrition, hydration, alleviating appetite, providing energy; edible substances that do these things are recognised as pleasant because their beneficial actions trigger the reward pathway. For example, sugars provide easily utilised energy for our bodies, so sweet-tasting things are perceived as pleasant. The current state of the individual also plays a part: a glass of water and slice of bread would usually be considered the most uninspiring meal, but would be divine ambrosia to someone just washed up after months adrift at sea.

  Most of these things activate the reward pathway ‘indirectly’, by causing a reaction in the body that the brain
recognises as a good thing, thus warranting a rewarding sensation. Where drugs have the advantage, and what makes them dangerous, is they can activate the reward pathway ‘directly’. The whole tedious process of ‘having some positive effect on the body that the brain recognises’ is skipped, like a bank employee handing over bags of cash without needing boring details like ‘account numbers’ or ‘ID’. How does this happen?

  Chapter 2 discussed how neurons communicate with each other via specific neurotransmitters, including noradrenaline, acetylcholine, dopamine, serotonin. Their job is to pass signals between neurons in a circuit or network. Neurons squirt them into synapses (the dedicated ‘gap’ between neurons where communication between them occurs). There they interact with dedicated receptors like a specific key opening a specific lock. The nature and type of receptor the transmitter interacts with determines the activity that results. It could be an excitatory neuron, which activate other regions of the brain like someone flicking a light switch, or it could be an inhibitory neuron, which reduces or shuts down activity in associated areas.

  But suppose those receptors weren’t as ‘faithful’ to specific neurotransmitters as hoped. What if other chemicals could mimic neurotransmitters, activating specific receptors in their absence? If this were possible, we could feasibly use these chemicals to manipulate the activity of our brains artificially. Turns out, it is possible, and we do it regularly.

  Countless medications are chemicals that interact with certain cell receptors. Agonists cause receptors to activate and induce activity; for example, medications for slow or irregular heartbeats often involve substances that mimic adrenalin, which regulates cardiac activity. Antagonists occupy receptors but don’t induce any activity, ‘blocking’ them and preventing genuine neurotransmitters from activating them, like a suitcase wedged in a lift door. Antipsychotic medications typically work by blocking certain dopamine receptors, as abnormal dopamine activity is linked to psychotic symptoms.