Thursday, February 25, 2016

Neurochemical in Focus - Dopamine




Way, way, way back in Neuroanatomy 101 I briefly mentioned neurotransmitters and the neurotransmitter dopamine (pronounced DOUGH-pah-mean). I've also written about dopamine in my other blog in a post called Dopamine the Bus Driver (which was a very popular post among my neuroscience and brain nerd buds back in its day, or at least among those who liked fun ways of explaining something complex) and it came to me this morning that it was about time we had a closer look at neurotransmitters like I had promised.

As I've talked about ad nauseum, whatever it is we are experiencing, or are able to do or not do, or all of our behaviours good or bad, compulsive, impulsive or planned, all of our thoughts and emotions and motivations, everything - in other words - about "you" and who and what you are, even your very soul - is all one hundred percent created by the unfathomably complex biological organism that is our brain. So when we want to know what's going on when we are experiencing difficulty or witnessing someone else who is, it is understanding how our brains work where the answers lie. Which is why I am so motivated to study neuroscience and then - tada! - crunch all the complicated stuff down into something that makes sense to mental health suffering peeps following this blog and those who want to know how to get themselves to move forward. 

The brain does a lot of things as it hums away 24/7 from not long after conception to not long after you draw your last breath, all of which requires communication of one kind or another among the eighty-six billion or so neurons you have and among the hundreds of small and large individual and highly specialized regions that must be coordinated to produce "you" and guide you through life. There are several different modes of communication and coordination that the brain utilizes but today we're going to look at the critical and essential role of neurotransmitters or neurochemicals (so called because a) they help to transmit information and b) they are relatively straight forward chemicals). 

Now we could spend forever poking around among the astronomically (sort of literally) complicated brain looking for answers out of countless (almost literally) possibilities, but today we're just going to examine dopamine because a) it is one of the best understood neurotransmitters and b) its role in our moods and behaviours is probably most pertinent to us long suffering mental health peeps. 

To be clear up front, I am not saying that what we look at here today is the thing with, for example, a particularly entrenched or "treatment resistant" case of depression but it is, as we'll see, a very important aspect to understand, consider and ultimately work at.

There are a number of things about neurochemicals that are vitally important to understanding a good number of other things we're eventually going (or have already started) to look at as well - such as memory function, brain fatigue and cognitive difficulties, neuroplasticity and the stress response system among others - so I thought this morning that it was high time we got to this. I understand that this may all look rather intimidating to some, but we're going to set that aside, let ourselves believe that "I got this" and we'll get ourselves to a better understanding of how all this works and why it's important. 

Okay, first let's get to the why this is important part. 

There are all kinds of things us mental health peeps will be experiencing as part of whatever it is we're suffering from (my main guess would be depression, but our topic here today is also critically important to understanding bipolar disorder, schizophrenia, ADD/ADHD, and others). Whatever the case, there is a very good chance that the two main things we will be suffering are: difficulty in experiencing pleasure and being motivated, the two very things in which dopamine pathways play major roles. 

We hear a lot about "brain chemicals" and the reason for this is how the popular press has picked up on and repeated the psychiatric and pharmacological explanations for "mental illnesses" which in a nutshell is explained as "chemical imbalances". This explanation has reached virtually mythical proportions since this enticing idea first took wing back in the sixties. Unfortunately, a) there remains no conclusive proof that any mental illness is due to a chemical imbalance, b) decades of subsequent neuroscience research has revealed that all human behaviours and mental experiences are vastly more complex and involve possibly dozens of other brain functions other than "brain chemicals" alone.

And there is much more to brain function than neurons, axons, dendrites, synapses and what we're going to look at here today. There is another class of cells called glia cells that provide massively important additional support to all brain functions and human brain function would not be what it is without this very critical class of cells. 

Nonetheless, what we're going to look at and learn here - the role of neurotransmitters at the synaptic level - is unquestionably important. However, we must understand them in broader contexts and that they are only a part of a enormously complicated set of processes. 

Okay, let's now look at what neurotransmitters do. 

As mentioned, we have billions and billions of neurons. There are many kinds of neurons with many specialized jobs. Whatever their job, neurons are like infinitesimally complicated "storage devices". Regular readers will remember that whatever is stored in a neuron or a given set of neurons is useless to the "big picture" if they cannot pass on what they "know" or "want to do" to neighbouring neurons or neuronal groups and thus contribute to broader brain wide functions that create all the actions and mental experiences that make up us and what we do. The main method neurons utilize to communicate with each other is via axons and dendrites. Axons send "data packets", dendrites receive.

These look something like this:




Okay, so there are a couple of neuron cell bodies, an axon extended from one to the other, and a number of receiving dendrites. This is a highly simplified artist's rendering, of course, but it allows us to see the basic idea. In this case the neuron on the left is sending a signal, an electrical pulse is depicted going towards the receiving neuron and you can see that the axon branches out to contact many dendrites. In actuality, however, a single neuron will have many axons branching out and may have up to ten thousand such connections with neurons near and far (depending on its job(s)). Now, you can have all the wiring you want running all over the place, but without a very key "connector", nothing is going to go from one set of wires to another. No transmission will take place. 

And in the brain, those "connectors" are called synapses. 

A synapse looks something like this:



For our purposes here today we don't need to understand that in too much detail, but you can see that at the axon end of things (sending) you have little sacks of neurochemicals and on the other side of the "cleft" (that little space between the two sides, about 20 nanometers across) you have little receptors. 

Let's look at something more familiar to help us understand what synapses do. Some of you may recall what old switchboards look like and how they worked. For those of you who don't, they looked like this:



As you can see, there are wires and all kinds of possible circuit combinations. You see that thing in her hand? That's a jack. That's going to connect a wire from one circuit to another. Until that is plugged in, there's no connection or transmission of information from one party to the other. Or once it's unplugged, the connection is broken and the transmission stops. 

So we can think of a synapse as that thing in her hand, a jack of sorts. Except that in the brain, it's a two step process. First we have to create a connecting point, a jack and a socket - that's the two sides of the synapse. The second process is once the connection is made, the actual transmission of information from one party to the other will be a chemical process (which is the norm throughout animal and plant cellular structures that need to somehow communicate and coordinate). 

What happens between neurons when they want to communicate is that one will get all excited (to a point called action potential), and want to send messages to all kinds of neuron buddies near and far to get something going. Once a neuron reaches a certain level of excitement, it will send an electric impulse down its axon or axons (in what I likened before to Morse code) which will stimulate the release of the neurochemicals in the axon side of the synapse to travel to the dendrite side and thus complete the transmission - to possibly tens or hundreds of thousands of neurons! The receiving neurons in turn pass all the exciting news on to hundreds of thousands more neurons and thus big thoughts or memories and all kinds of things happen. We can think of it as like sending out a mass Twitter message to thousands of receivers. 

Your brain "just" has a few more "jack and socket" connections than that switchboard above; like several hundred trillion more. 

Okay, so that's the small end of this neurochemical business and several hundred trillion is a crazy big number, so we'd better further clarify what's going on with dopamine and break that down to size. 

Each neurochemical will have one or a few specialized communication roles (but only roles) to play that involve specific brain (and thus behaviour) functions.

Let's have a look at the broader picture of the roles dopamine play.




I chose this image because it shows serotonin as well. Serotonin has become practically a household word on account of advertising's and popular press's roles in making SSRI (selective serotonin reuptake inhibitors) based antidepressants one of the most popular drugs in the western world. This is something we must really examine more closely but we look at that in a dedicated post of its own so we're going to leave that aside for now. We'll instead focus on the left side of the illustration. There are a few key brain regions illustrated there as well that are critical to our understanding of the big picture of dopamine's roles in the brain and our behaviours so we will look at those in a wee bit more detail. 

Let's first look at some basic functions. We have (as you can see):

  • motivation
  • pleasure
  • motor function
  • compulsion 
  • perseveration 

Motivation is what keeps us driving towards a goal. When we are feeling driven, or "locked on", that's dopamine at play. It's involved in a complex signaling system that makes sure we stay locked on to that goal. Sounds great, right? Not so fast. Unfortunately, what your brain decides is a "goal" may not be in alignment with what goals are best for you. This is absolutely critical for understanding many addictive behaviours and other undesirable behaviours. More later.

Pleasure is what we feel when we achieve something that our brain considers rewarding. Like motivation, however, this could be a good thing or bad thing. Pleasurable feelings, like motivated feelings, can keep us locked on to or driven toward a task or goal in anticipation of that all delicious "reward" hit the dopamine gives us. Motivation and pleasure are intrinsically linked in what we'll call our "drives".

Motor functions are what's involved in our coordinated physical movements (both conscious and unconscious) that are in part controlled by a set of nuclei located in the limbic region called the basal ganglia. This region is connected to very important brain stem regions and the cerebral cortex. It's critical for all kinds of fine motor control functions. This area - and dopamine's roles there - are at the root of Parkinson's disease. When we look closer at the dangers of long term pharmacological treatments of various psychiatric disorders and the use of anti-psychotics, we'll learn why these are so damaging. The most commonly used class of anti-psychotics "dampen" dopamine circuitry and synaptic transmissions which can cause all kinds of havoc in the long term. 

While somewhat different, I'm going to group compulsion and perseveration together because to most observers they will appear very similar. Both refer to some sort of repeated behaviour that goes against our greater good. I'll make it quite clear why this is below. 

The dopamine pathways are a very old (as in hundreds of millions of years old) part of our brain hardware and systems. All animals have essentially the same system from reptiles up to birds to all mammals. Its role was and remains very simple - keep a creature doing something critical to its survival. Find a great source of food? Bam, a dopamine hit helps insure that the creature remembers and goes back for more. Successfully mate? Bam, a dopamine hit makes sure it remembers that and to do it again.

It is not, I'm afraid to report, for the most part much different among us members of the homo sapien species. Just more sophisticated behaviours and "goals" involved. 

And, as world renowned neurobiology and human and animal behavioural expert Robert Sapolsky has demonstrated, it's not just the "hit", it's the anticipation of the hit that keeps this system - and thus "us" - jacked up about all sorts of things both good and bad. 

For example, a mouse might be trained to pull a lever in order to get a treat. To start, it will get a treat each time it pulls the lever to condition into it the expectation of a reward (the treat). What's happening here is that dopamine pathways and (very important) feedback loops are being tuned towards associating the dopamine hit with this specific task and reward. Afterwards, the treats can be reduced to only being released every tenth time. But the mouse, once conditioned, will keep pulling on that lever until it gets the treat (and thus the big dopamine hit). It will get to the point that you can remove the treat element all together and it'll keep pulling that lever over and over and over again until it drops with exhaustion because that dopamine hit and even the anticipation of the dopamine hit keep it locked into that behaviour.

Silly mouse, right? 

Well, it seems silly until you go to Las Vegas (or any casino) and watch people sit at slot machines. They, like the mouse, will sit there pulling that lever (or press buttons in modern machines) in anticipation of a reward despite astronomical odds against that reward happening. They will eschew food, going to the bathroom, going home to their families and all kinds of other essentials for a proper life to sit at that machine and what keeps them glued there, my friends, is our dopamine reward system. "Silly" mouse indeed. At least the mouse isn't pissing away the family fortune.

Thus we can also see the connection to compulsive behaviours or perseveration. 

But laugh not. Many if not most people will have similar "dopamine kick" addictions. Or compulsive behaviours and so on. Nobody gets to play judge here. Shopping is like this. Buying and eating food. Buying a new vehicle. Our paycheque. A college degree. Going to heaven. You name it. When we feel turned on and motivated about and towards something, this very old system is very much at the root of it. (1)

About the only difference in humans is the variety of things we'll do in order to achieve that reward and the time we'll take to achieve it. Not to mention what we'll put up with to achieve it. We can stay locked on a dopamine anticipation loop for years. That's the "planning and judgment" parts of our vaunted frontal lobes that plays a role. 

Okay, so there's the "up side". 

Now to us depressed, demotivated peeps who struggle with feeling pleasure and sticking with things.

What's up there?

Now is the time to understand that we're somewhat more complex than mice (or primates or lizards or birds or ...) after all.

To understand "us", let's go back to the diagram. You can see that these all important motivation and pleasure pathways originate in a deep brain nodule called the Ventral Tegmental Area. 

Let's look at a more isolated image showing the VTA. 


That's where dopamine originates (a process the details of which we'll leave to more advanced brain nerdery). 

We can think of the VTA as a "switchboard" lady like we saw in the image above. 

Now, what's extremely unfortunate in virtually all the images we see depicting the dopamine pathways (and serotonin, for that matter ... or any region of the brain) is that they do not show the massively complicated feedback loops connected to the VTA, the incoming circuitry. The VTA switchboard lady doesn't just sit there all by herself ringing up our frontal lobes and whatnot getting us all excited and motivated all on her own volition. No, no, no. That's more akin to lizard level dopamine pathways. Our "human grade" VTA Lady has dozens and dozens of incoming circuitry sending information packets or demands of varying sorts. She takes an incoming call - "shoe sale ahead!", for example - and connects that to the pleasure/reward destinations in the brain. 

These "calls" can come from all over the brain. Which, despite our remarkable similarities to lizards, baboons, birds, dogs and all other animal species, is what makes humans vastly more complicated and varied; for all the circuitry that can potentially stimulate the VTM is an incredibly complex set of feedback networks (yes, yes, I know what many of you are thinking but really, we are more complicated, even the persons you may regard as simpletons). 

It's these incoming calls that we want to better understand. What rings up VTA Lady? What rings her bell? Or, to understand lack of motivation and pleasure, what does not ring her bell?

Okay, mentally suffering peeps, this is where the rubber meets the road in our understanding of our moods and this deep brain system involved with them. 

Let's look at one such feedback loop system, one that may be the most important - and the most uniquely human.

I talk in numerous posts a lot about belief. Various brain circuits involved in creating and disseminating back to us our beliefs are a huge feedback loop to the Ventral Tegmental Area (hereafter known as "VTA Lady"). Belief and imagination are tightly linked and it is the belief of good things to come and the strong imagination thereof that will often keep us moving forward despite possibly great odds against us or obstacles in our way. This can be seen throughout our evolutionary history (and is thus tightly linked to religious beliefs and the comforting and motivating thoughts of going to heaven). A lot of what we think is "good behaviour", for example, is really just having a really strong connection to VTA Lady keeping that pleasure/reward system locked on to a goal related to beliefs associated with religious morals (sorry, morally superior feeling people).


So, let's look at this through the lens of our experience. 

We don't get "depressed" and demotivated out of the blue for no reason (though I know it feels that way; this is the big disconnect between our subconscious brain mechanisms - like this one - and our conscious awareness or experience that I often refer to). 

If you look back on your life, all kinds of painful events will have pounded the living shit out of your beliefs and motivations. So often your greatest beliefs and desires have been crushed by life. We often keep going, but for a variety of possible reasons, we get crushed again and again. This will begin to have effects on all the circuitry involved in motivation and pleasure we're looking at here today. The feedback system just keeps sending too many painful messages to VTA Lady. Pain becomes too associated with desired rewards. VTA Lady just gets to the point where she says "fuck this shit, I'm not taking any more calls from that belief area". And after a while, the lines of communication between various brain areas associated with beliefs and VTA Lady begin to atrophy (literally). Worse yet, because of the resultant lack of stimulation the areas in the brain associated with feeling the hits of dopamine and thus pleasure and motivation begin to atrophy as well. This is part of what some think of as the "dark side" of neuroplasticity

And this same process can happen with many of our goals and desires as we experience defeat, disappointment, hurt and other negative impacts and results for things we started out feeling excited and motivated about.

There are people who are more resilient to this, but for many of us for a number of reasons this is a huge part of the process that creates the sense of "giving up" that we so strongly experience so often as part of depression. 

So there's that. 

But we may also notice other painful experiences associated with what we'd normally think of as motivating and pleasurable and this too will send negative feedback information to VTA Lady and again, after a while she just throws in the towel and stops taking calls from those areas. And slowly, bit by bit, almost without being aware of it, we find ourselves getting more and more down and demotivated and less and less able to feel pleasure, excitement, senses of gratification (a kind of reward feeling) and/or be unable to feel any "good" sense of anticipation. There will probably have been major blows and a good number of smaller ones. Either way, gradually our abilities to feel motivated and pleasure are eroded. This is not our imaginations, this is the result of actual changes in vital brain circuitry; the circuitry outlined here in the dopamine motivation/reward system. 

However, in a good number of people where pain and pleasure get "crosswired" in key areas of the brain they actually become motivated to seek pain and their dopamine pathways become somewhat tragically dialed into these behaviours. Something to consider when we try to understand seemingly incomprehensible behaviours like cutting, carving or why people keep returning to abusive relationships and other what appear to be destructive behaviours. This is a very dark side to neuroplasticity indeed (I may at some point get to recounting some very interesting case studies and the inspiring resolution of them).  

Or - OR! - this system may get "hijacked" and drive us towards behaviours that seemingly dull our pain by giving us pleasure elsewhere. Hello almost all addictive behaviours. There is some very good recent clinical and real world research (2) that is now more deeply understanding the very strong relations between pain and trauma, the dopamine reward system and destructive/addictive behaviours of all kinds. Very important to understand and keep in mind. 

Okay, now that we have a better understanding of all that - or at least the seed of understanding planted - we come to the $64,000 question. What the hell to do about it?

Regular readers should see the first two coming - we begin with self-forgiveness and compassion for ourselves. For if you are struggling in any of the ways we looked at here, that is not "you", but instead very deep and powerful brain systems that for all kinds of very strong reasons have gone awry. "You" don't just reach in there and magically fix that. Nor does "helpful" advise from well meaning friends and relatives. This is why you can't just "cheer up" on demand. Deep stuff is not as it should be. 

So can we get it back to, or at least closer to, what it "should be"? 

Yes.

This is what many people have successfully done and continue on the road to doing. This is why I talk about the importance of belief, thoughts, spirituality, brain training, the concept and power of neuroplasticity and so on. For it is small daily tasks that will slowly dampen down the pain circuits and rebuild better hope and belief circuits that will begin to reawaken motivation and pleasure regions involved. This is why I work on at least some or even just one or two, of my positive difference making fundamentals daily - all of those can help to repair and rebuild what we briefly looked at here today. 

In other words, what we need to do, in essence, is rebuild the dormant or broken down communication lines to VTA Lady who will in turn start to "ring up" and connect us to the feelings of more proper motivation and pleasure that we so often struggle with and away from those "rewards" we've been driven to seek to dampen pain. 

We will look more deeply at how meditation and mindfulness CBT can help, how certain positive visualization exercises can help, how specific mental and physical "letting go" exercises can help and much more. 

And I know - I deeply know - that it is not easy. But I can assure you one hundred percent through my experience, that of dozens of case studies and just by the pure science of how it all works that is possible. Even for you. Yes, you.

What's important to know and understand, however, is that we can never go back to who we were and what we had before. This is why the practice of letting go is so important. We must learn bit by bit let go of past events and models of ourselves in order to set our aims to new horizons, to slowly build new and pleasurable memories and thus a changed person. Again, I deeply know how hard that is.

But step by step, day by day, if we take the right steps, we can get there. 

Yes. We. Can. 

Thank you as always for reading. 

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(1) Contrary to the belief of some (or many, who knows), I do not randomly make this up. I have very solid and world renowned go-to sources for everything I write, and I am merely taking their findings and reporting it to you, the reader, often in very similar ways to how they explain their experiments and findings. 

(2) In a future more academic version of the posts of this blog, I will include many more source citations for segments like this. 

Saturday, February 20, 2016

Positive Difference Making Fundamentals in Focus - Habit Change




Back in my original post outlining My Positive Difference Making Fundamentals, I wrote in the section introducing habits that "It's very simple; bad habits equal bad outcomes and good habits equal good outcomes (or as good as you can be). Almost everything we do is habitual including how our brain works. If we change our habits we transform how our brain works and therefore our lives."  

I also said regarding habits in that piece;  "But it takes work and this work is not easy because habits, as we all know, are NOT easy to break" and we're now going to finally take a fairly in depth look at why it is difficult to break old habits or create new ones that we specifically desire. 

Now, in previous posts I've talked about a few important things about the brain and how it works that we're going to bring to the fore now in furthering our understanding of habits and change. 

They are:



Also of great importance, but for which I have yet to write a dedicated post, is what we're going to think of as the brain's "energy economy". 


Briefly again, "zombie programs" is a fun term for the vast array of autonomously running brain systems, networks and programs that account for the great majority of your mental processes, thoughts, and actions and reactions throughout any given day. They are what make up your routines, the "way" you naturally do things and behave and even how you think and what you think about. As you can easily see, these subconscious systems are greatly related to what we think of as "habits". 

Neuroplasticity is how the brain responds to life around you and rearranges its own circuitry in response to what it must do to guide you through life. As a simple example, take the way you drive to work every day. If you're in a big city and the route unfamiliar, the first time was difficult, then with each time it got easier and finally you could do it with hardly any conscious effort at all. It started out hard but became progressively more effortless because at first you had little memory of all the important points along the way you needed to know - there was no internal "map" in your head - and with each time you drove the route and got to know all the important roads and turning points, etc, your brain filed all these away in a process that is, in fact, a form of neuroplasticity; tiny new circuits were created, old circuits disabled (to a degree) and soon you had a new little "circuit" in your brain specifically dedicated to getting you to work without having to put so much energy and conscious effort into it. Or we could also think of it as a new "zombie program" labeled "get to work". The concept of neuroplasticy and how your brain must rearrange itself in small ways to adapt to each new task you give it is also not hard to imagine being very relevant to habits and habit change. 

And the stress response system is very critical to understand, for it is this deep and very powerful system and set of programs that will greatly shape your behaviours and reactions and - ta-da! - your abilities to break an old habit and create a new one. As this system is one of our oldest in evolutionary terms, it operates for the most part very, very deeply subconsciously. In other words, it's having great effects on your behaviour, actions and choices without you at all being consciously aware (except, probably, when it's already too late and you're beating yourself up about doing the habit you're trying so hard to break).


Consciousness and thought also comes into play because each new habit we want to create or each old habit we want to break involves a certain degree of conscious awareness, effort and thought. 

Conscious effort and thought ties into the brain's energy economy because it takes - as you've no doubt noticed - more energy to make conscious efforts and thought towards new tasks, which is also related to maintaining conscious attention on the new task.  As well, often when we fall back into an old habit, it's that we've "forgotten" to be consciously aware of it (something that's very common, by the way).


Let's now take a broader and deeper look at what we think of as "habits" but which I think of as part of the deep autonomously running brain programs that make up the vast majority (if not all) of our behaviours and reactions and actions all of which for the most part operate subconsciously. 

For the sake of simplicity, we're going to refer to any behaviour, emotional reaction or thought pattern that we realize is not good for us or is impeding our lives in some way or that for whatever reason we don't want or want to change as a "bad habit".

We may be aware of - or conscious of - these "bad habits" but we generally have little understanding of why that behaviour or emotional reaction or thought pattern, etc is there and even if we do and we try to change it, we discover that we have little or limited conscious control over it.


This is what creates anger and frustration within ourselves and then a repeated pattern will take place that goes something like: become or be made aware of a bad habit, feel the pain of the consequence of the bad habit, vow to change the bad habit, work to change it, find that we fall back into the bad habit (or pattern) again, feel even more pain of the consequences, become angry with ourselves and beat ourselves up. Rinse, repeat, you know the drill. 





Or we may not only become angry
 with ourselves, we project blame and anger on others, or even on inanimate objects - blaming and getting angry at someone close to us for our bad habit, or the car for the consequences of a bad driving habit, for example. Thus we see patterns of anger and frustration in ourselves and then among others in our lives (for the most part without knowing why), things spiral out of control and we descend into some sort of low mood or if we're prone to strong depressive episodes, we plunge into the pits of darkness.

And then while we're down there in that pit of darkness we'll just have a jolly good time beating and thrashing the absolute shit out of ourselves about how "weak" we are, how little "willpower" we have, how "pathetic" we are, how we'll never amount to anything and worse and worse and for a good number of us there's a good probability that we'll reach a point where we just want to give up on life altogether and ... well, end it all. Again, many of you will deeply know the drill.

So we've all read no shortage of articles and books on habit change. We set resolutions. And we try and and we try. 

And never quite get there. 

Which is why, when I came across The Willpower Instinct by Kelly McGonigal, and she explained habit change through the neuroscience of habit and willpower and brain energy and why it was all so hard, that I finally began to understand why change is so hard. 

And it's not simply because we, dear mental health peeps, have trouble changing. Change is hard because it's a fundamental human difficulty and it's hard because that's just the way brains are. Now, it's true that some people seem to manage change more easily but they are the exception and not the norm. As well, many people who seem to change easier only imagine that they do or they don't try to change the things that are most difficult or they simply grew up in blessed ways where change for them may not be as necessary. 

Since reading McGonigal's book early in 2013 (which inspired and kicked off a great deal of what now makes up the content of this blog and coming book), I have of course learned much, much more about the brain and human behaviour and can now add some key additional insights into why the brain - and thus we and our habits - is so difficult to change.

So here's the thing with habits or habitual behaviours (good and bad) - they didn't just drop out of the sky and plop themselves into us. No, no, we picked them all up at various points of our lives, most probably without a whole lot of conscious input or awareness. We pick them from our parents, from our siblings, from our peers, coworkers or because at some point in our past we thought that a given behaviour was cool or it got there as part of a simple stimulus-response mechanism that played itself out over very long periods of our lives and which goes something like this; something happens (an outside or internal stimulus of some kind), various brain regions create a response to the stimulus, yet other brain regions go "okay, this seems to bring desirable results", the response gets repeated, also seeming to create favourable results and this stimulus-response pattern gets built into our general grab bag of behaviours and habits. They become, in actuality, part of our automatic "zombie programs".

Additionally, there are some fundamental brain systems that can create certain impulses and cravings that have very deep evolutionary roots and thus are a deep and powerful part of how brains work (sugar cravings would be one; there are some very key neurological reasons why most (though not necessarily all) brains create sugar cravings (or what is colloquially known as a “sweet tooth”).

Not only that, in hearing what the people I coach go through as they try to change certain behaviour or thought or emotional patterns is that even though rationally we know the new pattern is better and that we have to let go of the old pattern, on deep levels the new pattern feels weird. There are brain systems that monitor everything going on in there and if these detect something different, they'll go "that's weird, that shouldn't be there". These systems aren't the brightest bulbs on the brain tree. They just detect "this is not normal" and default us back to the more comfortable "normal" even though the new thing is better. So this is something we have to be aware of; sometimes the new habit feels weird to our brain and we kind of have to try mentally overrule that deep zombie program that's sensing "weird". 

Now, some of these habits we'll naturally leave behind as we age and mature. Your brain is very good at this as well (all appearances aside) but for a variety of reasons that can generally be covered in the post Genetic and Environmental Factors in Individual Brain Development, some habits, behaviours and responses really get ... well, "hard wired" in there or the various brain regions involved don't work as well as they should.

There are other more psychological reasons that habits, behaviours and responses can be hard to change, the biggest, in my estimation, is that good or bad, all of these become and are a part of Who We Are; they are - for better or worse - part of our identity and on some level or even in conscious thought we think, "screw it, this is just who I am, damn it". There becomes a level of acceptance - or even defiant pride!
 - to all our less glamorous or desirable aspects. After all, we tell ourselves, nobody's perfect (which is of course true). We create a handy narrative that goes something like "anyone who wants to be around me must accept me warts and all".

Until, of course, that point when the poor behaviour or habit or response really screws up something we deeply want and then boom, down the rabbit hole we go and we just get so bloody fed up with ourselves that we want to ... you know. 

So we play out this dance, this back and forth between acceptance and even pride in our worse aspects - or wanting to shoot ourselves we're so sick and tired with ourselves. Many will recognize and understand this cycle. 

Or, worse, because of our bad habits or impulsive behaviour, so much of the better parts of life - maybe a better job or career, a better life partner relationship or better general relationships with friends and family, or travel and adventure - all slowly begin to pass us by, we begin to give up and say to hell with it and then we fall into deep morose sad states about that. 



However, here we are, we've discovered this blog - or just this post - we feel intrigued and a flower of promise and hope has blossomed and have begun to think "hey, maybe it is just possible".

And yes, it absolutely is possible to change and create better habits while leaving old ones behind. Even for you, no matter how hard change has been in the past. 

But first, I need you to pause, take a deep breath, and say to yourself (I'm serious about this), "Okay, this guy is right. I can see that it's hard, that's it's human, and that it's not my fault that I haven't been successful at change in the past" and forgive yourself. Regular readers will by now know how important self-compassion and self-forgiveness is for change and making ourselves better people so you have to start there. Okay?

Alright then, let's start looking at the what to do part. 

First, we have to take a very brief look at a little more brain stuff to remind us of a few things. 


Most of those lobes and regions are not of interest to us here today and you can completely forget about needing to remember most of those region names. What we're basically looking at there is the cerebral cortex, the complex outer layer of the brain with all those weird little folds in it where most higher functions are housed. Of primary interest to us here today is the part in blue called the "frontal lobe". 

It is in that area of the brain - right behind your eyes and forehead - where all the stuff that make us "human" (hopefully) is located. There are all kinds of critical brain "systems" located there, and I will touch on some of them in other posts, but what we're specifically interested in today are all kinds of small sub-regions in the frontal lobe - particularly in the pre-frontal cortex - that have to do with key functions like impulse control, behavioural regulation, delay of gratification, morality; in other words, the self control functions in human brains that set us apart (again, hopefully) from our less impulse controlled primate cousins (I suspect a good number of readers may disdainfully think that most humans have less control than primates. And while the daily news may give this impression, I can assure you that all humans by and large have at least the capacity for far greater impulse and behavioural control than primates, except in cases of lesions, neurodegeneration or other forms of brain damage in this region).

Let's briefly look at the concept of that seemingly all important brain power necessary for habit change - willpower. Willpower can be thought of as either a directed and sustained drive towards a goal or desired outcome or the ability to control a negative action or impulse or craving. In other words, it can be a number of things and as such there's no exact willpower "centre" in the brain. It is instead a number of networked regions in those frontal lobes. 

Now, let's have a quick look where many impulses and habits originate:



That's a rather simple image but that's okay, we just need to quickly look again at our old friend the limbic region. That's a "cut away" look. In your brain, it's all tucked inside the outer cortex, roughly in the middle of your head. This area does a good deal of initiating behaviour while your frontal lobes do all the regulating of behaviours. If you ever feel like there are two "yous" battling for control, that's actually quite correct and what you are experiencing is to a large degree the battle for control between the impulsive limbic region and the control centres in the prefrontal cortex. I talked a little about this in the post The Why of the Emotional You, explaining that because the limbic region evolved first and is designed for "fast reaction" for dealing with immediate threats, it gets first and higher priority over your energy reserves and that the control centre in the PFC tends to get less energy while at the same time consuming more energy, which is why emotional control and things like impulse and behavioural control are more difficult and tiring. 

As well, there are enormously complicated circuits of "wiring" (long distance axons) that run between the two regions, not to mention among smaller specific regions. There's no way we could begin to cover briefly how intricately complex the connections are between all the dozens of smaller regions in both the frontal lobes and various parts of the limbic region, but if we were to look, you would immediately grasp how unrealistic it is to expect all those operations to go perfectly swimmingly all the time. If you had a better conscious idea of the dozens and dozens of second by second, minute by minute, hour by hour and day by day work that the control centre in the pre-frontal cortex does perform to keep you going through your day to day world in a relatively well behaved and morally and socially acceptable manner (the vast majority below your conscious awareness), you'd understand that to do all those with one hundred percent perfection is just really not all the reasonable to expect. So again, cut yourself some slack when you can't resist that doughnut you swore you would avoid or you lost your temper or any of the other things we try so hard not to do.

As Robert Saposkly has argued, the pre-frontal cortex (the most advanced “human” part of the frontal lobes) developed to bias the brain (IE: “you”) towards doing the “hard thing”. This is where all the stuff is that makes us able to plan for the future and set aside or save things accordingly. It's here that makes us do the “right thing” when other parts of the brain are tempting us with foods, stopping work when we shouldn't, saying something inadvisable and so on.

Of significant note is that age is a critical factor to consider. All that fancy regulatory equipment in the frontal lobes? The entire frontal lobe region does not fully form and mature until the age of approximately twenty-five. As well, starting in the mid-teens, the brain undergoes a large "reconstruction" project where all kinds of behavioural regions that were fine for pre-teen and post-puberty years get "torn down" and all the regions necessary for the adult world get formed and "wired in". So expect behavioural regulation to be particularly difficult in late teens to early twenties. The enormity of this brain change (known by some in neuroscience as the second "critical period") almost defies description. This deserves a whole post on its own, but for now please try to bear this in mind. 

Okay, now that I've blown through almost an entire post trying to give a sense of how and why change of any kind is difficult, let's start to set the table for how you are going to begin implementing the changes you'd like. 


Firstly, I'd love you to think of change not so much in the sense of stopping a bad behaviour but of cultivating a better behaviour or habit. 

Secondly, and for regular readers I hope this idea is beginning to take root, I'd love for you to think of this as just one aspect of personal growth (there's a whole "growth mindset" movement that I think is very interesting and beneficial that I'd love to get to one day). In other words, it's not just a single habit we want to focus on, but it's part of creating a new and improved version of ourselves.

Thirdly, whatever we are going to do, it's going to take time. Please revisit the post on neuroplascticity. It is there where we learn that in changing any habit or old way of doing things, we must break down the old brain "circuits" and build new ones. I also go into some detail on this in my post on my brain training exercises. In some cases and circumstances it can happen quite quickly but it is generally not reasonable to expect this. 

Fourthly, for now, I think it is unwise to start with a real difficult habit like smoking or dieting. Again, it can be done but generally these are two of the hardest and we may be setting ourselves up for failure if we try to tackle these first.

Okay, now I'm going to more or less steal wholesale from McGonigal's book, The Willpower Instinct. (which is quite alright, I can assure, because I know for a fact that at least four readers of my blog have purchased her book due to my recommendations, so it is in effect free advertising for her).

What is thought of as “willpower” is in fact a collection of several functions of the pre-frontal cortex (the very front part of the frontal lobes) and McGonigal breaks these down into three simple concepts for us – I will, I won't, and I want.

Briefly;

“I will” is the part of the PFC that helps us stick to boring, difficult or boring tasks, things that are important for self-motivation (there are other very key brain systems that drive us towards goals, in particular the dopamine reward system), but for today we want to focus on this specific task master in the PFC (upper left side, to be more precise).

“I won't” is the part that helps us resist temptations or impulses. If we are tempted to do something unwise or against our better judgment – like have Cap'n Crunch for breakfast (speaking of that "sweet tooth") rather than something more substantial and healthy – it is this part of the PFC (upper ride side) that plays an important role in the decision not to.

“I want” is the part in the very most forward and advanced (and last to develop evolutionary wise) part of the PFC that keeps track of our long term and important goals and desires. If you are saving for a new car or home and are tempted to blow a wad of money on some short term gratification – like an expensive ski vacation – it is this part that tracks and remembers what you really want and – hopefully – reminds you.

Now, motivation and goals and all of that is rather more complicated in the brain, of course, but these are the three key regions in which we're going to start building some “neuronal muscle” so that we can begin to better build improved habits and leave undesired ones behind.

So here's a brief little exercise to help us get started practicing the will, won't, and want steps. And remember, we're only getting started. It is here I must invoke the time honoured (and often rather trite, I'm afraid) maxim of “this is a journey, not the destination”, or in other words, this is just the first few steps towards rebuilding ourselves. This is something I'll get to in more detail when we examine staying in the present and living one day at a time.

Okay, first we have to decide on a want.

Let me tell a personal anecdote as an example. I am, I will confess, a compulsive snacker. Often I just need to have something to steadily nibble on. Most of us will be afflicted to varying degrees with this habit, which is what drives the multi-billion dollar snack industry. In the years I fell apart, I'd developed many bad eating habits and was becoming rather “bloated”, we shall say, but there was one habit that infuriated my daughter – I'd pilfer all her gummy bears. Bad dad. A really double whammy of badness. And I was baaaad. I'd demolish a large tub of them in days.

Then I had my big breakthrough for wanting to beat mental illness, I learned that better nutrition and eating habits were crucial and thus I created a strong “want” - I wanted to give up bad snacks and eat healthier snacks.

Then, having already read this chapter in McGonigal's book, I employed her “will” and “won't” steps, simply following her instructions. It went like this; each time I walked by the tempting tub of gummy bears and could just imagine those sour and sweet little sugary blobs of gummy goodness, I'd remember my “want” (healthier eating) and stop myself. That's the “won't” little brain region exercised. Then I made a “will” choice – I will snack on something healthier. I got baby carrots and snacked on those instead, or later I got yummy peanuts or almonds and snacked on those. That's the will part of the brain exercised.

Then over the course of a week or two, voila – I'd stopped snacking not only on my daughter's gummy bears, but all kinds of bad stuff (Dorito's was another real bad snacking choice that I had been overindulging on). It was not always easy, of course – the freaking gummy bears were right there on the kitchen table and I'd have to walk by them a dozen or more times a day – and I naturally slipped now and again, but each time I'd just remind myself of the “want”, “won't” and “will” formula and do better the next time.

This simple habit change then led to me completely restructuring my diet towards better nutrition and away from harmful processed foods, all designed to create a healthier brain and body and then helping to change many other habits.

So create a little “willpower” challenge for yourself and try employing the want, will and won't steps. I'd just advise, again, to keep it simple and doable. For example, I didn't try to tackle my whole diet at the outset, I just started with one bad habit of my eating patterns, then worked up from there.

And as we saw at the end of the post on my brain training exercises (which are great to use to help train our brains to change), one change often cascades into other changes as we "wake up" our brain's natural neuroplastic ability to rearrange itself in response to new tasks and demands, something for which there is volumes of evidence that music therapy can also help.


Now that we have a better understanding of the neuronal basis for "willpower", it is time for me to remind you of the importance and power of meditation. For it is practicing very simple methods of meditation that actually helps to build better control and build up "neuronal muscle" in the areas of the pre-frontal cortex that we looked at here today. My introductory post on meditation has some very simple steps to learning the kinds of meditation that will work just fine for our beginner purposes.

There is more to come to further understand habit change and willpower, but our goal here today was just a primer on a) why it's difficult and b) give some simple steps to start with.

To recap why change is hard:

Remember that when we are trying to create different mental or physical habits or reactions we in fact need to "rewire" small and/or large brain circuits. This takes both time and repeating new steps. This is important to understand when we set expectations for changing ourselves in any way. We must go into it knowing that it's going to take time and patience. 


Changing of habits or habitual behaviours draws heavily on energy reserves and is tiring. This is another factor in why we may "give up" trying to change; our own brains sort of guide us away from change because they detect too much energy drainage. Again, we just have to be aware of this aspect of the challenge and if we are trying to change make sure we a) start off small so as not to overtax our energy reserves and b) take steps to make sure our brains are getting as much oxygen, hydration and nutrition as possible. 

Stressful situations will tend to activate our stress response system and this will tend to activate older circuits and habits. This is quite natural and nothing at all to blame ourselves for; it is merely something we have to be aware of. Thus, if we look at our missteps and slips, I think we'll see that we were probably stressed at the time and this is why. 

Understand that we're going to make missteps and perhaps fall backwards. This is perfectly normal and okay. We must remember self-compassion and forgiveness, allow for these stumbles and try again. 


Support Taming the Polar Bears

 

If you enjoy or benefit from the information you gain from this blog, or see the importance of it for yourself or for others in understanding and working on your/their mental health conditions or if you're in the mental health professions or otherwise see the importance of the work done and presented in this blog, please consider donating and supporting it. 

All the writing and research is done by a single individual - Brad Esau - who himself has been disabled due to the long term effects of his condition and who lives on a very minimal pension and thus has great difficulty supporting himself. 

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Friday, February 12, 2016

Endorsements from Professional Associates and Readers





The world of mental health, both clinical diagnosis and treatment, is bewildering at best. Complicating the picture further are the stereotypes imposed on those who most need support from their families and communities. While well meaning community leaders, scientists and mental health practitioners can press forward with changing the quality of lives for those challenged by the extremes of mental experiences, it takes the honesty, bravery and intellect of someone like Brad Esau to bridge the gap for those in need of understanding and guidance. Brad isn't a trained scientist or clinician. Brad is a compassionate and intelligent individual who can speak directly to the experiences of some diagnosed with a mental illness. Whatever your diagnosis or lack thereof, there's something about the raw honesty and well thought out advice in Brad's conversations that will help raise the quality of your life. I recommend that you add Brad's work to your reading regimen.



Jeffery Mercer,
Clinical Psychologist



I came across Brad and his blog about two years ago (fall of 2013) and have known him and followed his blog since then. From the enormous creativeness of the blog's name to the meticulous and well worded prose translated from very difficult science content, there is nothing not to love about Brad Esau's blog, Taming the Polar Bears.

Working with neuroscientists on a daily basis, I've been taught to distinguish the real from the fake and to appreciate the enormous abilities it requires to sort through the paths of the mind as well as searching for the truths that explain many of our lives. 

Brad explores bipolar and other mental health disorders with a rarely seen authenticity of mind, spirit and scientific integrity. In my opinion, his material is worth archiving and you can't get any better than that.

Christy Johnson, Business Manager, Society for Mind and Brain Sciences





Brad Esau is one of the most remarkable persons in the neuroscience scene dealing with mental health disorders. It's his personal perspective and experience, powered by a tremendous amount of neuroscience knowledge, that invite the reader to walk in his shoes and to better understand what so-called mental health disorders are and what they mean.

It's not primarily a scientific interest to understand the matter. Brad's "Taming The Polar Bears" is first and foremost written based on the burning desire to understand what's going on in his brain and to develop and share principles and models how to live with those mental health disorders.

Brad's unique perspective of neuroscience, knowledge, experience and expertise, and his wisdom from walking the path - leveraged by his passion for writing - make a huge difference and create a very specific value for the readers of Taming The Polar Bears."



From my first interactions with Brad in early 2013, I could sense his passion for neuroscience.  Over the last several years I have seen him take that passion and blend it with an unmatched discipline to delve deep into the world of understanding the brain, its functions and human behaviour.  Brad leverages his own personal history of bipolar disorder as a resource as he takes readers on a first person tour of the working of the mind on his blog Taming the Polar Bears.  He has done years of meticulous research into the disorder and other aspects of neuroscience through a combination of reading research articles and daily conversations with the leading minds in the field.  I continue to be impressed with his insights and daily diligence and look forward to his continued contributions to the field.


Mani Saint-Victor, M.D.



I heartily recommend Brad Esau's wonderful and courageous blog full of wisdom, insight, compassion, and brilliance. We all struggle with something or another in our lives. Brad lays bare his own journey so that we can learn and grow alongside him. I am moved to the very core of my being by Brad's courage and generosity. 



One of the things that impresses me most about Brad is the inexhaustible personal integrity he brings to his struggles and his efforts to understand them as fully and deeply as possible. Brad plumbs the depths of neuroscience literature, consults experts, and subjects conventional pharmacological treatment approaches and his own thought processes to equally fierce scrutiny. He is unflinching in his honesty, unflagging in his persistence, and deeply committed to sharing his hard won understanding of the complex, interconnected biological and psychological processes that drive bipolar disorder, schizophrenia, and mitochondrial disease. 

Rebecca McMillan

Founder, The Brain Cafe

Senior Editor | The Creativity Post

Founder & Ambassador, GHF Online


It's difficult to translate the complexities of the brain to layman's language so I read how different people do it and get ideas on how to frame things in the classroom to make it understandable. Yours (Brad's) is a good approach. So many people - smart people like yourself - are brought into the neurosciences because they wrestle with depression or something that affects them and I pay attention to their interpretation because they are motivated from the heart instead of some obscure, even academic interest. You are closely linked to understanding neuroscience and your passion shows. I encourage you to continue on your path and share your thoughts with the world.

Gerald Paul Kozlowski, Ph.D., BCN                                             
Board Certified Senior Fellow in Neurofeedback
Department of Clinical Psychology, Saybrook University