Hippocampus shrinkage
November 29, 2009 8:22 PM   Subscribe

I'm am massively depressed right now. I have my Masters dissertation to hand in next month but cannot do anything at the moment involving complex thought and haven't been able to for at least the past year. I have awful memory recall - I can read something, put the book down and cannot tell you a thing I have read - I can barely string sentences together, I cannot think abstractly; in short, I'm a mess. I'm petrified that after two episodes of pretty intense depression, my hippocampus is permanently damaged.

I'm petrified that after two episodes of pretty intense depression, my hippocampus is permanently damaged. A lot of studies I have read on the subject seem to indicate that exposure of the brain to huge quantities of stress hormones over prolonged periods atrophy the two sides of the hippocamus responsible for memory and declarative learning. It appears such changes are permanent.

The thought that my hippocampus is damaged beyond repair is making me even more depressed. I am, or at least was, a very cerebral and creative person. Even if I can take some happy pills to convince my brain everything is okay, I don't want to if I'm going to remain stupid like this forever.

So, any neurologists able to tell me if these changes are indeed permanent?

I apologise for the messiness of this post. I really can't think at the moment.... Before anyone starts to worry, I'm not suicidal. I would never kill myself. I desperately want to live, but this is really getting me down at the moment.
posted by anonymous to Health & Fitness (15 answers total) 11 users marked this as a favorite
The worry that you are permanently damaged is a symptom of the depression, not a rational belief. Please, seek help from a psychiatrist or other mental health professional for your depression.
posted by decathecting at 8:33 PM on November 29, 2009 [2 favorites]

One hypothesis: Hippocampal neurogenesis has been linked with learning and memory skills. Stress and depression are known to reduce hippocampal neurogenesis. You can read more here and here if you like.

Things that increase hippocampal neurogenesis:
- antidepressants
- exercise
- probably a whole lot of other things-- e.g., rodents living in "enriched environments" have higher rates of neurogenesis, which for humans may include social, creative, or academic stimulation, but who knows

So exercise. Take meds if you like. Do all of the other things that people tell you to do when you're depressed. I really doubt the changes are permanent (or at least they can be mitigated to some degree). Brains are plastic and recover pretty nicely if treated well.
posted by dino might at 8:46 PM on November 29, 2009

All of the things you described are extremely common symptoms of depression, not necessarily damage resulting from it.
posted by so_gracefully at 9:03 PM on November 29, 2009

One step at a time. Is your Masters dissertation a thesis/paper you are writing? Can you break it down into smaller manageable tasks? Focus on this first. If you are also simultaneously studying for an oral exam, try to schedule study times, and try to work in some time to meditate, go for walks, and maybe do some yoga. Prepping for grad school written + oral exams is extremely stressful, and besides depression you have anxiety getting in the way here. Do your best to break your school work down into manageable tasks and take it one day at a time.

In regard to your actual question: Now is not the time to give yourself anxiety over your depression giving you permanent neurological damage. Not only is it highly HIGHLY unlikely that you have severe, irreversible brain damage, but this thought is distracting you from working on the problem by adding a bit of a hypochondriacity on top of depression and anxiety. I hope that doesn't sound mean, I'm just trying to point out that you seem to be experiencing very strong anxiety in combination with depression, and you should talk to your doctor about ways to alleviate the anxiety symptoms, do what dino might suggests above to be nice to your brain/reduce stress levels, and be well.
posted by NikitaNikita at 9:15 PM on November 29, 2009 [2 favorites]

I am a microbiologist not a neurologist but I find it extremely unlikely (impossible, to be honest) that you have permanently damaged your hippocampus. Your worrying about it is a symptom of anxiety. I think you should talk to a therapist (you're a student, right? you can go for free at your student health services. almost every grad student i knew ended up in therapy at some point)

NikitaNikita's advice is good- break down your task into small, manageable components. Start by writing an outline or a rough table of contents. The next day, find and organize your references. That might take a couple of days. Then, start with your introduction- even if you just get a few paragraphs down and they're crappy, don't stress. You're making progress and can edit later.

Really, though- talk to your doctor and find a therapist.
posted by emd3737 at 9:34 PM on November 29, 2009

I am not a neurologist but I am familiar with your situation. I am also about to hand in my master thesis and suffered from severe depression the past year. Thanks to a residential therapy I can go without antidepressants now. But I still feel like I am not as a quick thinker as I used to be. Especially since I read that medication for epilepsy (another problem of mine) might be associated with lowering your IQ level. On the other hand I once got a prescription for methylphenidate and felt extremly smart on it. However, it turned out that I did better in tests without med. Selfsuggestion is a powerful thing either way. Once you believe that you have become stupid, you sure will feel and act stupid.

The only way out I see is to keep on working on your thesis. And if you start with writing only one paragraph a day. The brain works like a muscle. You need to start working out again.
posted by jfricke at 10:26 PM on November 29, 2009 [2 favorites]

I'm petrified that after two episodes of pretty intense depression, my hippocampus is permanently damaged.

You have no evidence this has happened. You have no direct imaging of your hippocampus. Therefore, analytically, you have no factual basis whatsoever for coming to this conclusion. You also mention issues with your mental health. You must therefore consider the possibility that your fear may be generated by those issues and therefore may not be rational. Observe yourself to find out.

Usually we would obsess on these issues when we would rather not think about something else. What also makes this whole line suspicious is that it wouldn't matter if your hippocampus had shrunk or not, your logical course of action does not change--your job is finish the degree now. Additionaly suspicious is that for all of your inability to retain information or think complex thoughts, you sure know a lot about the literature on shrinking the hippocampus. Can I just point out that you're doing plenty of complex thinking here, just not on your thesis.

So is there some issue facing you that you might not want to think about? I'm going to put my money on its the fact you are graduating and that means: "what's next?" That is a whole lot of questions you don't want to think about. If you could only hold off graduating, you could avoid dealing with the emotional aspect of dealing with your changing circumstances.

Well you're just too damn close and it serves you no purpose to stop now. Set your alarm for 7 AM, get organized and get to work.
posted by Ironmouth at 11:30 PM on November 29, 2009

is it possibly entirely just panic at the prospect of finishing your Masters on time? Severe anxiety is common for people in this situation, even when they're actually quite close to finishing. If you've been putting your thesis off this whole time and are now realizing you've got no chance of finishing it within a month, I can understand why you'd be in a petrified state. Depression is a real illness and you might be able to get an extension on medical grounds. You just need to finish it as soon as you can, because you'll probably return to normal once it is off your shoulders.
posted by moorooka at 12:29 AM on November 30, 2009

Quit it! Back off. Take up photography. Learn to play guitar. Do something else stimulating. Lay off the gas pedal, you'll get your mojo back, but not if you're freaking out about it. Seek treatment for your depression, get a thesis extension.

My wife was in the same place. She gave up for a few months, did something else with her life then came back to the fold and knocked it out. You can't drive a car that's got no gas.
posted by GilloD at 12:48 AM on November 30, 2009

If you're a woman, get your iron levels checked.
posted by Jacqueline at 2:11 AM on November 30, 2009

I smoked too much strong hashish and ate quite a bit of other drugs. In the end, I had a nervous breakdown, sank into depression and the cognitive deficit was obvious. Now, some years later, I'm as smart as I ever was, and have matured so I'm simultaneously much more organized and spontaneous.

I have a friend who was abused as a child, got pregnant in a haze of drugs at the age of 19, her shitty boyfriend cheated on her in the 8th month, she had a full-scale nervous breakdown and teetered for a couple of years on the verge of schizophrenia. She left the guy with the child in her belly, moved abroad, lived alone, worked her way out of it, got a college degree and today is an incredibly mature, beautiful-from-the-inside woman and a completely wonderful mother with a really smart and well-raised little 10-year-old guy.

You can work on anything, and you will see results. I'd advise you to listen to some really hardcore experiences from various 12-Step Internet radio programs. These guys have lived in sewage-filled swamps by gas stations, eating scavenged potato peels to buffer the alcohol. Turn around, work on it, become upstanding citizens.

You can do this. It is possible. It doesn't matter how you feel now, it matters what you do now. Consider this - it a promise.
posted by krilli at 2:26 AM on November 30, 2009

I have awful memory recall - I can read something, put the book down and cannot tell you a thing I have read

A lot of studies I have read on the subject seem to indicate...

Not to be a jerk, but are you sure your memory recall is that awful?

I think you're panicking about your thesis and you're looking for an excuse for not having finished it/not being able to finish it. Your post is intelligent and well written and not nearly the mess you make it out to be.

It also sounds like you're just overwhelmed by the whole process. You haven't done anything for a year and if you think about doing it at this stage of the game, you can't, so you give up. What you need to do is pick the smallest chunk of your thesis you can think of and just do that. Write a paragraph, write the dedication, write anything. And when you're done with that, pick something else and do that.

Seek help for your depression, or as others have said, get an extension, or just knuckle down and see how far you can get with it. The sooner you do something other than just sitting around worrying if you have brain damage, the better off you'll be.
posted by cali59 at 4:20 AM on November 30, 2009 [1 favorite]

IANAD, but I work in a neuropsychology laboratory that does cognitive testing to evaluate brain functioning.

I've typed up hundreds of neuropsych reports in my time here and I can tell you it is very, very, very common for people with depression to have cognitive difficulties. Exactly as you've described in yourself: they have no attention span, their memory is shot, they can't keep track of anything or finish a book. A lot of them swear up and down that they must have ADHD or early dementia or some other sort of brain damage, but it almost always comes down to a textbook case of depression.

Not only that, but the cognitive testing usually reveals only mild deficits. The depressed person perceives that their functioning is a LOT worse than it actually is. This is more common in very intelligent people (like you)...they are used to mentally operating at a very high level and that makes them sensitive to even a small decline in their abilities.

The neuropsychologist always recommends therapy and a visit to a psychiatrist for antidepressants, reassuring the patient that their cognitive problems will clear up once the depression issue is resolved.

And that's what I recommend you do. You are not brain damaged. Stop reading those studies and freaking yourself out. Go make an appointment with a psychiatrist and best of luck to you. It will get better, honest.
posted by castlebravo at 7:36 AM on November 30, 2009 [6 favorites]

If you're a woman on hormonal birth control, consider getting off of it. It has the known side effect of causing depression and feeling stupid. These both go away pretty quickly when the pills are stopped. Also consider getting your thyroid levels checked (a full panel). Low thyroid causes "brain fog" and depression. Both of which are reversed with medication (which can take up to six weeks to reach full effect).
posted by stoneweaver at 8:23 AM on November 30, 2009

Go to a doctor, get checked out. Talk to your adviser and see if you can take a couple of weeks off. Go someplace where you don't have to do anything stressful, maybe a friend's house, for at least a week. Then reassess.
posted by theora55 at 6:03 PM on November 30, 2009

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