By Majid Fotuhi, MD, PhD
You know exercise, eating right, and engaging your mind are vital steps for a healthy, well-functioning brain. But how can you hit the gym when just getting out of bed seems like a monumental effort? Even cooking a healthy meal or tackling a simple crossword puzzle might seem overly ambitious for someone struggling with depression.
It’s a dilemma my patients often mention. Depression, after all, alters the brain’s chemistry in a way that reduces a person’s energy level, lowers motivation, reduces the ability to sustain attention, and heightens the perception of pain. It may increase irritability or anxiety, making it hard for people to engage in social activities. Depression has even been shown to shrink the hippocampus, a key part of the brain that plays a vital role in memory and learning. As a result of these brain changes, depressed patients may experience memory lapses, sluggish thinking, or an inability to “connect the dots.”
The exciting news is that for most people depression is highly treatable. And not just with medication (although I do often prescribe medication for my depressed patients). In addition to medication and therapy, there is a host of simple lifestyle changes that can help reduce the symptoms of depression and put you on the path to recovery. As a bonus, many of these changes have also been shown to improve brain fitness, leading to a brain that functions better now and well into old age.
The key for those suffering from depression is to start small and to recognize that every tiny step they take makes a real, measurable difference in their brain health. A five-minute walk, for example, might not seem like a boast-worthy accomplishment to a healthy person, but to someone who spends most of his day on the couch, it may be the first critical step on the path to better health. Of course, any lifestyle changes should be made under the watchful eye of a medical professional, so if you are depressed, or suspect you may be, be sure to talk to your doctor.
Here are nine brain-boosting tips to help you conquer depression:
Get a checkup
This may seem like a no-brainer, especially if you’ve already been to your doctor for your diagnosis and treatment of depression. But many long-standing health conditions can contribute to reduced brain fitness, while not being the primary cause of your depression. Being overweight, for example, has been shown to reduce brain function and can contribute to depression. It may also lower your ability to exercise, robbing you of a key brain- and mood-booster. High blood pressure, high cholesterol, diabetes, anemia, thyroid problems, concussions or other brain injuries, stroke and other health problems can all take a toll on brain fitness, as can low levels of Vitamins B12 and D, and testosterone (in men). Getting these conditions under control can help boost your brain, which in turn will put you in the best condition to bounce back from depression.
Check your medications
I often see patients who have no idea their medications are causing side effects. In particular, medications given for anxiety, insomnia, pain and even depression can cause mood changes, brain fog, or other cognitive and health problems, so it’s a good idea to review your total medication list with your doctor to ensure they’re not interfering unnecessarily with your brain function or health.
Insomnia and sleep apnea, in particular, have been shown to reduce brain function, which can contribute to depression. Many people put up with sleep disorders and incorrectly assume they’re untreatable. Not only are both conditions often treatable, but treatment can help reverse the damage done to the brain and lead to dramatic improvements in brain function. My sleep apnea patients are often amazed at how different they feel after treatment. And diagnosis is easier than ever before – with a small device provided by your doctor you can do a sleep study in your own home.
You no doubt know that exercise is good for the brain. But recent research has shown us that exercise can actually grow the hippocampus and improve brain function. Exercise is a tremendous mood booster and an invaluable tool in the treatment of depression. Because depressed people may find the thought of exercise physically and mentally daunting I always advise they start small. Walk five minutes a day for four days, then add two minutes every other day until you’re walking 30 minutes a day, five days a week.
Depression can be socially isolating but making a strong effort to socially engage is brain- and mood-boosting on many levels. Taking a dance class, attending a spiritual gathering, or volunteering helps to engage parts of the brain that are vital for brain fitness. Even Skyping with a far-away grandchild can help kick the brain into gear and offer long-lasting cheer.
Eat well and take DHA
I recommend the Mediterranean diet, which is low in fat and cholesterol and high in Omega 3s, vegetables, fruit, and nuts. But I also recommend adding the Omega 3 fatty acid DHA to the diet. DHA, which is found in fatty fish and in supplements, has been shown to improve brain function and also to reduce symptoms in those with major depression.
Easier said than done, I know. But stress is a major brain drainer and can be both a contributor to depression and a byproduct of depression, so stress reduction is a worthwhile cause. Cognitive behavioral therapy and other therapies can help change unhealthy thinking patterns, while simple stress reducers can help you take some of the pressure out of your life. Set aside time to think about the stressors in your life and brainstorm ways to reduce them. And when you’re feeling stressed, try my 7-7-7 breathing exercise: close your eyes and breathe in while counting to seven, hold your breath and count to seven, breathe out while counting to seven.
Meditation has been shown to help in the treatment of depression and has also been shown to boost brain function, even in healthy people. If you can’t take a class, look online for tutorials on how to go it alone, or borrow a DVD from your library. If even that is too much, enlist the help of a friend or loved one to take the basic steps to get you started. Begin with just a few minutes of meditation or calm breathing a day and then work your way up to 20 minutes, several times a week. Yoga and tai chi are other pursuits that may have mood and brain benefits and drumming therapy – which involves rhythmically banging on a drum – shows similar promise in helping people calm their mind and body.
I’m a neurologist, so I delight in telling people to use their brain, but I’ve got science on my side as well. Fascinating research in recent years has shown that the adult brain is malleable in ways we once didn’t even imagine. Using your brain – by performing complex mental tasks – has been shown to boost brain health, which in turn can help you reduce the symptoms of depression. It’s hard for a depressed person to muster the energy mental gymnastics required, so start by simply making an attempt each day to do something slightly mentally challenging – read the newspaper for 10 minutes, try to memorize five items on your grocery list, learn the names of three flowers that grow in your garden. Then aim to increase your daily “thinking time” each week.
Majid Fotuhi, MD, Ph.D., received his MD degree from Harvard Medical School and his doctoral Ph.D. in Neuroscience from Johns Hopkins University School of Medicine. He is Founder and Chief Medical Officer of the NeurExpand Brain Center based in Lutherville, MD, and author of Boost Your Brain: The New Art and Science Behind Enhanced Brain Performance.