Thursday, August 29, 2013

Memory Functioning in Depressive Disorders and Bipolar Depression

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Memory Functioning in Depressive Disorders

This is yet another post that I fervently would like to give a complete overhaul but as various things continue to stand in the way and other work keeps piling up, I'll have to let it stand as is. 

Before I begin, I want to be clear that I am talking about what we might call normal day to day memories of life and struggles and not severe traumatic memories. Traumatic memories, especially traumatic childhood memories, are quite different and as such I'll have to address them separately. [BGE - Dec. 2015]

To understand how memory plays a role in long term episodes of either uni-polar or bipolar depression and in how people can get "trapped" in these, we first have to understand how much memory plays a role in our daily functioning, how memory plays a role in our subconscious and, most importantly, how much our subconscious drives our daily behaviours, thoughts and decisions. 

I'm a born and bred do it yourselfer. If something can't be done right, then I'll just roll up my sleeves and do it myself. That's how I came to study neuroscience and how bipolar and depressive disorders work in the brain. I let the mental health care system have a go at it but they royally f**ked it right up - nearly killing me - and so I decided to take the bull by the horns and find out for myself what was going on in our brains that created these terrible mental states. 

When I started looking into why the mental health care system failed me - and so many others - so badly, I saw that the pharmaceutical and psychiatric industries (and I consider psychiatry an industry) were too simplistic in their pharmacological approaches; they overlooked so many other aspects that were obviously going on. In all my time in the mental health care system and psychiatric hospitals and under the care of psychiatrists and psychologists, it seemed that no one could explain to me what was going on and why.

So, deciding I wanted to override this suicidal drive that had taken up residence in my brain and that I wanted to live, I simply rolled up my sleeves, got to work, and started to figure it out myself. 

When I started coming across studies and models for how memory works in the brain and how much it drives our lives, I knew I had a major factor in what drives some, though not all, of the worst negative darkness in major depressive disorder or bipolar depression. My ideas have been supported by a couple of neuroscientist buddies of mine on the Google+ community so I know I'm on the right track. 

Studying my own "data" - learning to become highly aware of my mental states and why - and running "tests" has been further confirming my hypothesis - work on laying down positive new memory "tracks" and you'll take some very critical steps in turning your depression around. 

I realized that with a lot of my own depressive states in the past that my brain was running negatively all the time and that my negative thoughts were fueling yet more negative thoughts and state of mind. This of course all felt “out of my control” and that I “couldn't help it”. And I couldn't – all that stuff runs subconsciously, outside the apparent control of our conscious minds. If yours doesn't run negatively, then you happen to have a healthily running system. 

So what to do about it?

First of all, let's have a quick look at how memory works. Memory is more than just remembering where your keys are or the name attached to that familiar face you met in the supermarket or how to do long division. Memory runs virtually every subconscious function that runs you, your behaviour and your state of mind. From basic physical functions to all the myriad of data that you use in all your daily decisions, memory - impressions, procedures, reactions and all kinds of "data" pertinent to you getting through life acquired and stored up over a life time - play a role. 

What you experience as "decisions" aren't even conscious decisions. Before a "decision" has even entered your conscious mind, your subconscious has already "run the data" and made the decision for you. Your conscious mind is merely nodding along. This is what I mean about how memory partially (in addition to many neurobiological and other autonomous functions) "drives your bus" subconsciously and why it can so badly negatively affect our conscious states. It doesn't have to but we'll get to that momentarily. First, let's look at a diagram that roughly shows how this works (and I do mean roughly ... how this really works in your mind is beyond mind bogglingly complex). 

Through your five senses for your entire life, data (reams and reams and reams of sensory information), represented by the yellow arrows, is entered and shuffled through the process represented in the diagram and stored for future use. Everything about who you are has largely been formed by what your senses have brought in and how you perceived them, which itself is a product of how genetic and environmental factors formed your particular brain

As you grow, new input is matched to existing data - stuff in your memory - to help you understand the world around you. In everything you do day to day, your mind is going to be accessing that data to help you make decisions. This process, which runs like an auto-pilot without any thought or effort whatsoever on your part, plays a very large role in driving who you are, what your behaviour will be and - most importantly to us - your mental states and moods will be while running it through your own unique complex brain system of filters, checks and balances, a system that grew and developed in part in how "you" developed. How you react to something or how you feel is going to be a product of this system. 

Of particular note, see how the amygdala is involved in all memory input. It's going to attach an "emotional value" to whatever your senses pull in and run through the system. I've written in the past the huge role this little brain nodule plays in our behaviour and part of what's happening with negative memory input is this guy is way overactive. 

Now not shown in the chart, but is a large factor, is our own thoughts. Our own thoughts - generated by this system - are going to be recorded as well and this is also going to be accessed and used to create further thoughts, decisions and states of mind. It all becomes a large self generating feed back loop. And in major depression or bipolar depression, this loop is malfunctioning in a negative way. 

Negative memories - known as "aversive" memories - are not bad in their own right. In fact, they're a vital part of your internal guidance system as these memories help your subconscious to know what to avoid or what to handle differently. Negative impression of Mr. So 'n' So? Your brain registers this and even though you may not consciously think it, you'll probably avoid him in the future. The same with a negative food experience and so on and so on. In our evolutionary past, keeping a "file" of negative memories is part of what kept us alive or helped us avoid getting sick from eating something bad or kept us out of bad situations. Even someone with the sunniest disposition will have thousands of negative impressions stored away in their memory banks. In people with healthier mental states, this system runs normally and the negative impressions are not kept on the forefront. Part of what's wrong with those of who struggle with dark depression (whether uni-polar or bipolar depression) is that a) our memory building and filing hardware is building in too much negativity to our memories, b) our subconscious accesses the negative stuff too much or too often - or constantly - and c) we keep building negativity and darkness into our system.

As the negative feedback from our subconscious drives our mood down, our thoughts become predominantly negative. Our negative thoughts get fed back into the storage system where it matches to other negative data which feeds back to our thoughts and on and on in what I call a negative feedback loop system. The worse our mood gets, the darker our thoughts become, the darker our thoughts become the darker our "data base" gets and the worse the depression sets in. The data base, as you can see in that illustration above, has both short term and long term storage. The more we feed negative thoughts into the short term, the more will get transferred into the long term and as it gets set deeper into the long term memory the deeper the depression sets in. As the depression sets in, this starts to reflect itself in our behaviour and what we think and say and this re-enforces negativity and darkness and further attaches this to our memories of what we say and do and this furthers the loop. Soon everything gets dark and negative. 

But it gets worse. Our memory is also what drives our predictive function, IE; how our brain projects our concept of our future, a process that takes place largely outside of our conscious control. It just works automatically; it accesses past data in order to form a predictive model of your short and long term future. Now if your memory storage system is full of dark, negative material, guess what's going to get accessed by your predictive function? The dark negativity! Thus the future "appears" dark and negative. And this further re-enforces the negative feed back loop system that's driving your brain which is driving your state of mind. 

None of this is anything new of course. They've understood the role memory plays regarding our moods for a very long time. It's just that it's one of the things psychiatry overlooks in their drive to correct everything with simple pills. A pill is not going to make your memory function work differently. A pill might have a placebo affect and get it kicked in a better direction but by and large, for most people who really struggle with the darkness of depression a pill just ain't gonna cut the mustard. 

So the question is what to do.

Essentially what we have to do, I believe, is fourfold.

One, is that we have to be aware of what's happening. The concept of awareness is getting our conscious minds to take more control over how we're perceiving both the external world and our own internal thoughts and how this is playing into our memories and memory retrieval. 

Secondly, once we are more aware of what's happening, we have to “rewrite” our active memory. That is, we have to start laying down “new tracks”, new, more positive memories. I've done a LOT of work on this in my own program and I'll have to at some point get to a post on how I did - and continue - to do that.

Thirdly, we have to learn to deal with some of the old, and likely very powerful, negative memories. This requires creating different associations with those memories. The new associations may not exactly be "positive" but they don't have to be; they just have to have the negative associations removed and more "neutral" associations built in. Very difficult for many of us, I know, and the brain regions involved can very powerfully embed certain traumatic experiences, but there are ways to reprocess many if not most of our old memories. I've written a very well received post on Mindfulness Meditation Cognitive Behaviour Therapy that many have told me is very useful as a way to start working through negative associations. 

And lastly, we need to develop a better predictive function and to work on this we have to practice positive visualization through specific meditation techniques.

How to do all this I'll get to in future posts. 

I also need to address further how memory works at the neurological and brain region levels so we can better understand how memories are formed and retrieved and how certain traumatic memories get "seared in" to us and how these come to affect our long term mental states. While I need a whole dedicated column or more to address this, I can say that it is my firm belief after seeing countless studies on how memories are formed and what makes some more powerful (and haunting) than others, that there is a wide spectrum to what is clinically known as PTSD and that more people may be suffering on some lower, subconscious level of something very much like PTSD than we now understand. All of which is to say, that building new and better memories may be much more challenging for some than others. But - BUT! - I deeply believe, just more challenging, not impossible. And probably using more specific methods than my general guidelines here (though this is not to say that anyone could not benefit from these guidelines). 

For now I just want you to be aware of how your memory functioning plays such a strong role in your state of mind. It's important to be aware of this, I believe, so that you'll better understand why it's important to work on re-jigging your memory as part of the strategy for improving your state of mind. As for some basic tips on how to get started, refer for now to my 
Positive Difference Making Fundamentals. I'm hoping to get more detailed tips published soon. 

As for that overactive amygdala, daily practice of some simple meditative breathing techniques are going to go a long ways towards calming this little puppy down and thus calm down how your new memories are formed. There is enormous amounts of evidence that music therapy can also induce positive plastic change in the amygdala and amgydala function (yet another post I'll be getting to at some point). 

Now memory and its role in negative self talk and negative self-perception is not all that's going on in major depressive disorder or bipolar depression - there could be serious issues with 
how the cells in your body and brain create energy along with other biological or brain region problems, of course - but getting your memory function turned around is going to go a long ways towards turning your thought and perception processes into a more positive model and research shows that some "top down" mental work can start turning around the deeper brain regions where the biological factors originate as well. 

As well, much research shows that the more proactive we are on working on all the different parts of our complex puzzles, the stronger we'll get and the better results we'll get. So while working on our memories and how we form new ones is only a piece of the puzzle, it is one that either on one's own or with therapy help, one can work on.

Another big take away from this is that these methods can also help turn around negative self-talk or self-images as well. 

I will say up front though that despite working to form better memory functioning, you're still going to occasionally get blind-sided by episodes of darkness. But don't throw in the towel and think it's all "useless". Just take a break, just "be" for a while, then get back in the saddle and keep riding. These things always go in fits and starts so be aware of that. It's a journey, not a destination. :)

Update from May 2015:

Building new, positive memories has been for some time and continues to be a major cornerstone of my efforts to improve my mental health. Two years in to my self-designed and prescribed treatment program, I feel there is no doubt that my efforts to "lay down new memory tracks" has been a major factor in my ongoing improvement in my mental states, moods and ability to roll with life's challenges. 

And the challenges kept coming. From being asked to leave the apartment where I'd been establishing a new home and life to helping a lifelong dear friend through his own mental health crisis to having my minuscule pension cheque suddenly halved to being technically homeless through a Canadian winter, I continue to work to lay down the best "memory tracks" I can and to break the negative loop I described in my original writing of this post. 

Also linked to this is my daily efforts to let go of old memories and not "replay" them all the time, another very key step to rejigging our memory functions that I'll get to when I write a specific post on The Art of Letting Go. 

1 comment:

  1. From the age of 3 to 7 I was sexually abused by an uncle. I believe that during each one of those incidents, while my mind was doing its best to deal with the fear and other negative emotions, my brain was also not developing the way it should. The tramatic events interrupted normal growth because it had to deal with something else more important. So when I was 4 years old, playing with my dolly, my body is constantly changing, growing, developing when in walks this uncle. Immediately my body and my brain goes into protective mode. My body wants to scream and fight but my brain knows that better not fight because something worse will happen. Now my brain has to take care of itself and my body so the things that would/should have been going on; normal developments; don't happen or don't happen as they are suppose to.