Neuroimaging has indeed revolutionized and continues to revolutionize our understanding of mental disorders, because it is based on learning about how the brain grows, develops and functions.

This is so far removed from earlier ideas about how “society” or “the environment” or “culture” or “religion” or “monsters” created mental illness, that some people whose beliefs or other investments are in these explanations will have problems accepting its value. When linked to other new tools of understanding such as genetics and molecular biochemistry, we are beginning to learn how the brain functions in health, when it is challenged by the environment and in disease.

The recent article in the Globe and Mail by Elizabeth Scott brings to life the importance of this technologically enabled explosion in understanding. She shows us how valuable this harnessing of new methodologies can be as we pull away the shrouds of uncertainty and begin to lift the veil of confusion caused by centuries of invalidated explanations of why mental illness occurs.

The real challenge however will be in changing our perspective based on new knowledge. Simply put, old ideas die hard and the new understanding will be strongly resisted by those who either do not or will not wish to be informed. On the other hand, this new information will need to stand the rigorous and unfriendly critical scrutiny of science, as different researchers conduct different studies and argue about what their results mean. This is a messy business and science is not about “the truth”. It is merely about being less wrong, most of the time.

All of which brings me to an exciting study recently published in the Proceedings of the National Academy of Sciences which demonstrated an almost 1/3 reduction in the right cerebral cortex (the outer cell layer on the right side of the brain) in the brains of people who have a family history of depression. These changes were associated with a number of difficulties in thinking and when the left side showed thinning, these difficulties became part of the syndrome of what we call major depression.

To me, these findings suggest that depression (at least the type that runs in families) may be a degenerative brain disorder. That’s right, a degenerative disorder – much like Parkinson’s disease or Alzheimer’s disease. And the thinking problems that we have noticed in people with depression may not be the result of the mood problem but may actually be part of the same disease process that gives rise to the depressed mood. That is, our theories that negative thoughts cause depression are likely wrong. Both the mood problem and the thinking problems are due to the same disease process in the brain.

This finding supports observations that many researchers and clinicians have been making for years. And, this finding suggests that we may have to change how we search for better treatments for depression. Maybe we should be looking at medications that can arrest brain degeneration or maybe we should be looking at medications that can improve cognition. Whatever the outcomes, these findings are exciting, offer new hope for future research and challenge what we “believe” to be true. Stay tuned – the story will unfold as it should!

~ Dr. Stan Kutcher

The battle against chronic illness is long, expensive and can involve a lot of guesswork. But closer monitoring of our body in real time is improving chances for better long-term health – and, ultimately, quality of life.

Over the past decade, the evolution of medical technology has produced sophisticated, hi-tech and non-invasive tools. Devices like advanced brain scans and semi-invasive blood sugar sensors are opening exciting new doors to research – and in the face of new data, whole medical disciplines are shifting focus as science debunks theories of the past.

For a long time, brain researchers could only theorize about how the brain worked; there was no way watch it in living colour.

But thanks to neuroimaging, “what we know today compared to a decade ago blows your mind,” says Stan Kutcher an expert in adolescent mental health based at Dalhousie University in Halifax.

“Explanations for mental disorder [used to be] what I would call ‘brainless,’ ” Dr. Kutcher says. They were “based on theories of mind or psychological models in which the brain did basically nothing.”

This was because, until recently, data gleaned from CAT scans and EEGs wasn’t sufficiently sharp.

“The data was overwhelming, but it wasn’t specific enough because both psychoneuroendocrinology and our special EEG analysis of function were still so far removed from what was actually going on inside the brain itself. They were very, very rough tools. So it was like trying to have sex wearing five condoms. You’re sort of in the general area, but you haven’t got a clue what should be going on.”

But where brain scans of the mid- to late eighties proved there were structural differences in the brains of people with mental disorders compared with healthy ones, today we can also actually watch the brain in action as it functions, both in health and in disease: “How does the brain control anger, listen to music, read, express love?” Dr. Kutcher asks.

Answers to those questions are being found, thanks to today’s functional MRIs and PET scans – technology that has eclipsed former scanning methods. Dr. Kutcher believes that will soon lead to direct diagnosis. The hope is that brain illness – from injury to stroke to mental illness – will become precisely and accurately diagnosable, in turn making targeted, consistently successful treatments possible.

“I wouldn’t be surprised if in the next 15 to 20 years two things happen,” Dr. Kutcher says. “We will have abandoned our current nomenclature, which is based on science and symptoms, for one based on a much better understanding of brain dysfunction and the symptoms that are a result of that … and at that time neuroimaging may well become diagnostic.”

Read the rest of the article on Globe and Mail.

There is no health without brain health. A healthy functioning brain is the foundation for all successful learning, social, civic and economic development. The school environment is an important component of healthy brain development. Just as schools are locations in which physical health can be encouraged and improved, so are they locations in which brain health can be encouraged and improved.

How and when a young person’s brain develops affects how they learn. An understanding of how a young person’s brain functions may help us better create brain-healthy environments and educational approaches that can enhance learning outcomes.

The human brain is the most complex entity in the universe. It has more connections than there are stars in the Milky Way. It is the organ of adaptation and of civilization. What we are, what we think and what we do, as individuals and as a human species are the outcomes of how our brains work. That in turn is influenced by a variety of other factors including our genetic endowment, the way our brains naturally develop over time, and the impact of the environment on the way our brains develop and on how they work.

The adolescent years (puberty to about age 25) are characterized by a second major period of brain development (the first is during the early years of development). New brain connections are developed, old connections are pruned, and complex systems that guide emotional integration, motivation, craving-induced behaviors and the capacity for good executive functioning (impulse control; problem solving; empathic/cognitive integration; etc.) come online.

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