THE BRAIN TERRAIN

How does the Brain deal with a pandemic?

Of all things that hit us this year, we can safely conclude that Covid-19 hit us the hardest. 4 months into this global pandemic already, and it is impossible to deny the toll that "stay-at-home" protocols have taken on our mental healths. Someone said rightly, that if the disease itself spared us, keeping ourselves contained at home would kill us sooner or later, and this is because every brain is wired differently to cope with stressful situations like the one at hand. A mind that is programmed to fend for itself and reach out to the external world in distressed times, suffers an unprecedented setback when it is forced to grovel in between the four walls of a house. Mental illnesses are by far the most neglected of all illnesses when it comes to assessing the overall health of an organism. Chronically affecting more than 43.8 million people worldwide, it is the subterfuge nobody wants to talk about. With environmental stigmas oscillating in-between unchanged and amplified, our neuronal pathways are being compelled to respond to changing triggers differently under a rather strenuous and untimely selection pressure. Did you know that anxiety and depression are also contagious in the way that they cue others in your aura to feel a certain way about a given situation? Although non-communicable, it is an overbearing liability for friends and families who are in turn also predisposed to the stress that stems from the chaos of dealing with a depressed or anxious person. Behaviorists like Hans Selye and Richard Lazarus have elucidated how the brain processes stress by mechanisms that are either problem-focused or emotion-focused. One's susceptibility to any mental illness is a consequence of one's genetics as much as it is an outcome of the more generic circumstances that are often held accountable for it.

The corticotropin-releasing-hormone (CRH), commonly known as the "stress hormone", stimulates the release of norepinephrine, a hormone that triggers the fight or flight response in both humans and animals alike. This in turn activates the hypothalamic-pituitary-adrenal (HPA) axis which is responsible for the  alternation of neural networks in terms of the integrity of their building blocks, a phenomenon popularly known as "neuroplasticity". This underlying neuroplasticity categorically influences our behavioral and emotional responses to stress. Anxiety and depression, collectively inducing stress give way to varying degrees of neuroplasticity, which is often hard to detect, considering that there are many changes in a neural circuit that ultimately give way to any stress response. Biologically, stress is defined as a state of disturbed homeostasis. This leads to a change in the body's mechanism of  regulating normal physiological processes, thus giving way to an altered homeostasis, also known as allostasis. A good example of stress-induced neuroplasticity is how certain receptors, such as the 5HT3 receptor (as seen in the rat brain), controls the psychological manifestation of bodily fatigue and pain due to premenstrual syndrome (PMS). For an example, depression, a common outcome of the infamous PMS, has been explicitly discussed in a paper authored by F. Li et al., that further went on to highlight how Shuyu, a Chinese herb could relieve some of the above mentioned symptoms. The prefrontal cortex is the most affected by stress due to the activation of a large number of neuronal circuits. The autonomic nervous system is centrally regulated by the hypothalamus. Hormones such as the corticotropin-releasing-hormone and vasopressin (AVP), are secreted by the neurons of the hypothalamus, when stimulated. These hormones further control the secretion of corticotropin (ACTH), from the anterior pituitary of the brain. Cortisol, a glucocorticoid, secreted by the adrenal cortex of the brain due to stimulation by ACTH is vital in mediating our adaptation to acute stress. Cortisol signals the suppression of hormones CRH and AVP, through a feedback inhibition pathway. In the absence of a functional corticosteroid signalling loop, cortisol fails to significantly dampen the levels of AVP and CRH, thus leading to an accumulation of high levels of cortisol. This attenuated regulation of the HPA axis, is a very common laboratory observation in the clinical diagnosis of depression and bipolar disorder. 

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5530430/

In this context, I'd also like you to watch this video, which brilliantly explains how neuroplasticity affects our neural circuits:

“The Most Important Lesson from 83,000 Brain Scans”, by Daniel Amen

 THE  GENETICS:

                                                                  

A large part of our stress response is accounted for by genetic factors that are estimated by ones heritability and genetic vulnerability to certain stress disorders. The HPA system that controls our stress response is regulated by the GR gene (glucocorticoid receptor gene), which has been previously identified as a crucial candidate for drug-targeting and gene editing in experimental genetic studies.  The angiotensin converting enzyme (ACE) gene also shows certain associations with CRH suppression pathway. Most stress disorders are related to a low to moderate degree of heritability. Coronary artery diseases and hypertension are among the leading causes of stress related diseases such as bipolar disorders and unipolar depression. Variations in genes associated with the sympathetic system and the hypothalamic-pituitary-adrenocorticotropic-axis are major contributors of the genetics underlying our stress responses to everyday stimuli. Panic attacks are among the most common occurrences that are also centrally controlled by the Corticotropin-releasing-hormone (CRH). These attacks are usually studied by introducing an interoceptive subthreshold stimulus in the form of a sodium lactate infusion in mice models. It has been previously found, that atrial natriuretic peptide (ANP), a hypotensive hormone encoded by the NPPA gene is closely associated with the build-up of a panic attack. The anxiolytic activity of nonpeptidergic ANP receptor ligands make them a potent target for the treatment of some anxiety disorders. 

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181835/

 SO, WHAT CAN WE DO?

Over-the-counter antidepressants and neuroactive steroids critically affect the glucocorticoid and mineralocorticoid receptors of the HPA system. Depending on an individual's tolerance, drug interactions can sometimes adversely affect the functions of useful neurotransmitters and hormones that are essential for our survival. Battling the odds of these interactions can induce detrimental immune responses that can sometimes take a toll on the heart, blood pressure and pregnancy. Nausea, diarrhoea, crying spells and anxiety are common symptoms that antidepressants commonly elicit as an offshoot of their correctional signalling pathways. Clinical models of the brain are still being studied to bridge the gap between genetic factors, signalling pathways and stress related disorders. Genetic studies such as linkage analysis are still required to understand the brain's genetic predisposition to stress.

But that being said, there is a lot we can do as individuals to combat the surging levels of stress in our lives. Lifestyle changes go a long way in relieving the stressful symptoms of anxiety and depression in our day to day lives. Owing to the current Covid-situation and the lockdown that has confined us free-spirited beings to the safety of our homes, social isolation has been the most exhausting and traumatising experience for most of us. However, even during these trying times, there's a lot we can do to improve the health of our brains and achieve a mental state that allows us peace and sanity. 

I hope reading this gives you an insight into how the brain copes with stress and anxiety and you find some go-to coping mechanism to deal with any ongoing dilemma in your life.

You my dear friend, aren't alone. We are in this together!

                                       

  Just some breathers now. No rocket-science or sorcery :

• Make it a point to wake up to something that helps you stay positive, hydrated and energized the whole day. It could be the kick-start you get from a freshly-brewed cup of coffee, yoga that uplifts your mood, meditation of your choice, a podcast which puts your thoughts into actions, a conversation that you deem healthy and vibrant or a meal that makes your gut microbiota a happy place. 
• Drink lots of water and get the vitamins popping, so that you don't have to whine away your dehydration or compromise on your immunity in any way. 
• Approach books and articles like you'd visit a friend. Get on top of your work and constantly enlighten yourself  about worldly affairs that keep you informed and motivated. Reading books can alleviate many stressful symptoms, keeping a check on the amount of useless time you often end up spending on your screen and also regulating your sleep cycle.
• A goodnight's sleep of at least 7 to 8 hours is essential to your well-being and upkeep. Try not to alter your sleep cycle because it might make you feel drained and tired throughout the day even if you overestimate your total hours of sleep in a day.
• A well-rounded diet comprising of fruits, juices and veggies (any fruit and vegetable that's easily available during this time) can go a long way in boosting your metabolism, thereby enhancing your overall health. 
• Chocolate is a must even if you consider it a tad bit too injurious for your flabs. A cube or two of chocolate won't do you much harm. In fact, you'll be surprised at the useful effects of cocoa on your mood and the way a little bit of chocolate ups your endorphin game even in the deadliest of times. 
• Sometimes we might find ourselves on the receiving end of criticism, which makes intent listening imperative for arriving at a peaceful understanding with ourselves and with another.
• Mind boggling challenges at home and at work might be difficult to juggle at a time like this when everything seems to be going awry. It is okay to feel exasperated but we should find ourselves venting and releasing all the pent up negative energy by means of indulging in a hearty conversation or a relaxing hobby when we can afford ourselves some free time.
• Music has an overpowering effect over the feeblest of hearts and weariest of minds. Just lose yourself in a concoction of good music when you can, and come back feeling empowered to confront your challenges.
• Living minimally may seem to be hard for those who are used to the abundance of life and hence keeping the things and people that matter to us as close as we can and being grateful for the  little things we take for granted in life can be an epiphany of sorts for you!
• This time away from the outer world is a time to reflect on our deepest concerns, emotions and decisions. Quarantine is a boon in the way we can constructively use this time in so many ways to find the true meaning of our lives. 
• Staying away from the world at large, should not deter one from interacting with others digitally and engaging in thought-provoking discussions on how to make the most of this time to the best of one's abilities. 

Lastly, I sincerely hope you come out of this in the best mental and physical health possible. May you find yourself in your true element, smiling and shining in the days to come. I wish that what you do today remains to inspire you as an ode to the hardest of times.