Mental health: It’s not “in your head”; it’s actually in the brain

A post about mental health, that might also relate to grief for some people.

I’ll put a little disclaimer here: I’m not medically or scientifically trained, and my understanding of many topics is a layman’s, and also from life experience.  I do however participate quite regularly in training sessions related to grief and bereavement, and along the way there’s been quite a bit to learn.

Recently I took part in two different learning sessions, different venues with different speakers, but in both cases they talked about the hippocampus, that little bit in your brain that looks like a seahorse. (The most I knew about the hippocampus before this was from listening to the BBC Radio Drama “Tracks“!)

The point of both discussions was that the trauma of grief or severe mental illness can result in actual physiological changes in the hippocampus, the part of the brain that is involved in the formation of new memories and is also associated with learning and emotions.

When it comes to mental health – either a long-term condition such as bipolar disorder – or PTSD “Post Traumatic Stress Disorder” as a result of a shocking bereavement or other severe life event – sometimes people think that you can just “pull yourself together”, or that it’s all “in your head”.

The trouble with this attitude is that it can make you feel like a failure if you’re not getting better. This could be about your own mental health, or it could about a loved one who died after struggling with mental illness – as my own daughter did.

Another false implication of this is a belief that the sufferer shouldn’t need to take medication or other treatment. They should be able to take control of their condition.  Put their mind to it. And everything will be okay.

Sometimes those from a religious background will feel that prayer should be sufficient treatment, and/or that the mental health problem is actually a result of sin or some spiritual cause.

It is rare to see the same attitude towards someone who is being treated for cancer or inflammatory arthritis or heart disease or any other obvious physical illness. But when it comes to mental illness, there is still so much stigma and misconceptions about the person having a choice in the matter.

The reality, though, is that it’s not just “in your head.” It’s actually in your brain. Perhaps understanding more about the physical or physiological side will help us move away from those mistaken attitudes.

That doesn’t mean that we can’t do anything to help ourselves, because it’s clear from the article below that we can – but if so, it will be in conjunction with medical attention, not alone. Physical and mental exercise are helpful, as is deep-breathing. And the medications that are prescribed can also help too.

For me the bottom line of this is that if we’re suffering from a severe mental illness or depression, and/or if we are traumatised by our loss and grief, then we should be prepared to accept medical attention, just as we would if we had broken a leg or had some other physical condition.

Along with the medical attention, we should take care of ourselves, try to relieve stress – including through prayer or some other spiritual practice, if we are so inclined – and make sure we exercise physically and mentally.

Breathing deeply is also a good idea. which is why there’s a link here to a short breathing relaxation exercise.


(The following article is a bit technical, but worthwhile reading if this is a topic that interests you. Not everyone will agree with these findings, as it is an evolving science, but this is a point of view I keep coming across in one form or another.)

Remember the hippocampus!: You can protect the brain’s ‘regeneration center’

Stress management, physical and mental exercise, and some medications can keep the hippocampus active, allow neurogenesis.

What part of the brain incorporates our moment-to-moment experiences, weaves them into coherent and interconnected verbal, spatial, and emotional memories, and enables us to be aware of our entire ‘life story’?
It’s the hippocampus, of course. Damage to this portion of the brain—as in seriously mentally ill individuals—severely impairs the ability to form new memories, with subsequent social and vocational impairment.Interestingly, the hippocampus also is the “regeneration center” of the brain, continuously producing progenitor cells that can differentiate into neurons and glia that migrate to brain regions that need replenishment.

What does that have to do with psychiatry? A lot. It is now well established that the hippocampus is structurally and functionally impaired in several severe neuropsychiatric disorders. The hippocampus:

  • fails to develop adequately in schizophrenia
  • shows progressive atrophy in persons with recurrent unipolar or bipolar depression
  • shrivels in severe stress disorders such as posttraumatic stress disorder (PTSD)
  • is damaged by the toxicity of alcohol addiction
  • is rapidly devastated in Alzheimer’s dementia.

It’s no wonder that cognitive functions—especially memory and learning—are seriously impaired in persons suffering from these disorders.

Regeneration and repair

What can psychiatrists do about our patients’ hippocampal dysfunction? There is good news on that front.

Abstinence from alcohol will reverse hippocampal damage within 6 to 12 months. Antidepressants have been found to stimulate production of new brain cells (neurogenesis) and to gradually rebuild the structure of the hippocampus in depressed individuals. Ditto for atypical (but not conventional) antipsychotics, which induce neurotrophic growth factors such as nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF). NGF and BDNF facilitate survival and maturation of new neurons produced in the hippocampus. Some atypicals have been shown to prevent or reverse stress-induced suppression of neurogenesis in the hippocampus and, theoretically, prevent PTSD.

Recent studies demonstrate that antidepressants lose their clinical efficacy if neurogenesis is inhibited. This suggests that hippocampal neurogenesis—rather than neurotransmitters—may be the mechanism by which depression is lifted. Only dementia still defies efforts to halt its ruthless destruction of the hippocampus, with severe cognitive decline and a faded sense of self and the world.

Flexing the memory center

Besides medication, other practical tools can keep the hippocampus healthy (prevention) or restore its health (intervention), whether in psychiatric patients or in mentally healthy but aging individuals. These include:

  • physical exercise, which stimulates neurogenesis
  • stress management to reduce the neurotoxic effects of cortisol on the hippocampus
  • mental exercises—such as memorizing a poem or a list of words or numbers, reading, writing, or retrieving vocabulary—all activate the hippocampus
  • deep breathing several times a day to oxygenate the brain adequately (the hippocampus is the most vascularized brain region and the first to suffer from low oxygen).

We clinicians also should keep our hippocampi healthy through prevention and intervention so we can take good care of our patients.




Brain structure can actually change if we’re suffering from certain mental health conditions. It makes sense to consider accepting treatment, along with taking care of ourselves.

Read more:  “Is the glass half-full, half-empty or something else instead?


Leave a Reply

Please log in using one of these methods to post your comment: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.