- Do antidepressants shrink your brain?
The short answer is no, depression does.
And that's what I'm gonna talk about today.
I'm Dr. Tracey Marks, a psychiatrist,
and I publish weekly videos
about mental health education and self-improvement.
If you don't want to miss a video,
then hit subscribe and the notification bell.
This topic is based on a viewer comment from Marc.
And I'll read the comment.
And this was a comment on a video
about why antidepressants cause vivid dreams.
And he says,
"Those beautiful and exciting dreams that you guys have
"are the nasty effects of the antidepressants
"shrinking your brain.
"Sad, but it's true.
"I don't want to tag this drug
"as evil products from the devil.
"But this is a little bit like that.
"Every time we buy a drug,
"either by Big Pharma or the drug dealer,
"we are paying the evil receipt of brain shrinking
"by altering your normal sleep cycle."
Thanks Marc for this comment,
because I think it's pretty common
for people to believe this.
But in actuality, the illness major depression,
that hangs around for a while,
that's what causes brain cell loss.
And antidepressants protect you from this brain cell loss.
- Says who?
How do we know this?
- The way we know how illnesses affect the brain
is by using a couple of methods.
One is by taking a picture of the brains of depressed people
and comparing it to the brains
of people who are not depressed.
We use magnetic resonance imaging studies
to get still pictures,
and then we use other scans like PET or SPECT,
those are a mouthful,
to see brain activity.
And then we compare the results of the two groups
to see how the illness affects the brain.
Another method for studying brains
is to look at the brains of deceased people,
and we call these post-mortem studies.
- Who's gonna defile my brain after I die?
- These would be the brains of people
who donate their bodies to science.
To study a live brain, researchers typically use rats.
And rats have been found to have brains
very similar to humans.
At least enough to get useful information.
So that's how researchers get this information.
And I'll have references in the description.
Here's what they've found.
And when I say depression, I mean the illness depression.
Not the adjective I'm depressed,
which refers to your state at the moment.
And to tell the difference, see my depression playlist.
Depression, the illness,
tends to last between six to nine months on average
if you do nothing to make it go away sooner.
The something that you can do
can either be therapy or medication.
When you get depressed,
there is an increase in the stress hormones
like cortisol and others.
And stress in this case
doesn't mean that you're under too much stress.
Think of it as hormones secreted
when your body is in distress.
When these hormones are elevated,
you get cellular changes in your neurons,
which are your brain cells.
And these neurons produce less serotonin
and other brain chemicals that affect your mood.
And this is the process of depression.
One of the cellular changes that happens
is your neurons produce a protein called REED1.
REED1 blocks the production
of another protein called mTORC1.
mTORC1 has the job of repairing cell damage.
So without mTORC1, you get dried-up, withered neurons.
Did you get that?
The place where we see these shrunken cells the most
is in the hippocampus.
The hippocampus is responsible
for consolidating your memories,
both short-term, long-term, and spatial memory.
So decreased cells in your hippocampus means poor memory.
What's spatial memory?
Spatial memory is the ability to remember
where things are relative to one another.
I recently upgraded from a sedan to an SUV.
And I love not having to squat to get in and out of the car.
But now I have trouble estimating
how far I can pull in into my garage before I hit the wall.
And a friend of mine told me,
"Oh, you'll get used to it."
And I have, sort of.
But that's an example of spatial memory.
Being able to remember how things relate to one another
in space, or in your environment.
So with depression,
you get shrinkage of hippocampal cells and impaired memory.
And this is how depression can cause you
to have memory and thinking problems.
People who are severely depressed
can be so impaired that we call it pseudodementia.
They don't really have actual dementia as a diagnosis,
but their thinking is so bad
that it's like they have dementia.
And with the spatial thing, you can even become clumsy.
How long does it take this to happen?
We don't have an exact answer to that.
But we do know that it's a cumulative effect.
So the longer you have depression over your lifetime,
the greater the effect.
And that's why untreated depression is bad.
So where do the antidepressant drugs come in?
Antidepressants increase TORC1.
That's the protein that helps repair the cells
and keep them from shrinking.
Antidepressants also stimulate BDNF,
which is called brain-derived neurotropic factor.
And it's the chemical,
the brain chemical that promotes neuron growth.
So here's an important point,
so lean in so you don't miss this.
Remember I said that the cell shrinkage
is a cumulative, long-term effect of untreated depression?
What if you take medication,
but it doesn't work all the way,
and you're still a little depressed?
Does this mean that your brain is still shrinking
even though you're on medication?
Since the medication has the effect
of increasing TORC1 and BDNF,
it's like it counteracts the brain-shrinking effect
of the depressed state.
It doesn't eliminate the effect completely,
but at the very least, it lessens the effect.
So this is how antidepressants actually help the brain
and protect it from the shrinking effects of depression.
Does this mean that everyone who is depressed
needs to take medication?
No.
I keep saying untreated depression.
Another treatment for depression is therapy.
And the most common therapies for depression
are cognitive behavior therapy and interpersonal therapy.
If those treatments resolve your depression
in a reasonable amount of time,
then you can still protect yourself
from the damaging effects of a long-term depressed state.
But if it doesn't work,
that's where medication can be of benefit,
even if it doesn't resolve things 100%.
Share this video so other people can be aware of this issue.
It's a concept that's been talked about
in the scientific community for about 10 to 20 years,
but I don't think it's something most people know about.
And I hope this video helped you understand
how and why this happens.
Like the video if you liked it, and thanks for watching.
See you next time.
(hip hop music)