Thalamus-Depression / Basal Ganglia-Anxiety
FUNCTIONS OF THE LIMBIC SYSTEM (LS)
Sets the emotional tone of the mind
Filters external events through internal states
Tags events as internally important
Stores highly charged emotional memories
Modulates motivation
Controls appetite and sleep cycles
Promotes bonding
Directly process the sense of smell
Modulates libido
In a paper published in 1878, French neurologist Paul Broca noted that deep in the middle of the brain all mammals possess a group of areas that are different from the surrounding cerebral cortex. Using the Latin word for “border,” limbus, Broca named this collection of areas the limbic lobe. They form a ring around the brain stem below the cortex.
From an evolutionary standpoint, this is an “older” part of the mammalian brainthat enabled animals to experience and express emotions. It freed them from the primitive behaviors dictated by the brain stem found in the older “reptilian” brain.
The subsequent development of the surrounding cerebral cortex in higher animals, especially humans, gave us the capacity for problem solving, organization, and rational thought. Yet in order for these functions to have an effect in the world, one must have passion, emotion, drive, and the desire to make something happen. The limbic brain adds the emotional fuel in this process.
The limbic system (LS) typically includes:
Thalamus - relays information to and from the outside world and the cerebral cortex. A large structure deep in the center.
Amygdala - involves in emotional and fear responses. An almond shaped structure in the temporal lobes.
Hippocampus - helps memories get into long-term storage. A seahorse-shaped structure.
Hypothalamus - important emotional center, controlling the chemicals that make you feel hungry, sexual, sleepy, exhilarated, angry, or unhappy.
Olfactory cortex - or sense of smell, which connects to emotional and memory centers.
In our experience at Amen Clinics, when the LS is less active, there is generally a positive, more hopeful state of mind. When it is overactive, sadness and negativity can take over. Overactivity in the LS is associated with lowered motivation and drive, which is often seen in depression.
The hippocampus, located on the medial side of temporal lobes, has also been reported to be involved in storing highly charged emotional memories, both positive and negative.
The LS structures are also intimately involved with bonding and social connectedness. When the LS of animals is damaged, they do not properly bond with their young.
PROBLEMS IN THE LIMBIC SYSTEM
Sadness
Clinical depression
Increased negative thinking
Flood of negative emotions, such as hopelessness, helplessness, and guilt
Appetite and sleep problems
Decreased or increased sexual responsiveness
Social isolation
Pain
BONDING DISRUPTION
Death
The death of a family member causes intense sadness and grief. In this relationship, there is often a tight neurochemical bond. When it is broken, the activity of the LS is disrupted. Many who experience grief say the pain actually feels physical. This sensation is not imaginary. Grief often activate the pain centers in the brain, which are housed near the limbic system. It is interesting to note that the people who had a good relationship with the deceased often heal their grief much more easily than those whose relationship was filled with turmoil, bitterness, or disappointment. When people who had a bad relationship with the deceased person reflect, they have to relive the pain. In their mind, they may still be trying to fix what was wrong and to heal the wound, but they can’t. In addition, the guilt they may carry with them impairs the healing process.
Divorce
Divorce can be a source of the most severe kind of stress possible for a human being to experience. For many, it actually causes more anguish to lose a spouse through divorce that it does through death. People who are “limbic ally connected” have a very powerful bond, and I believe this phenomenon may be one of the major reasons women often don’t leave abusive men. To break that bond, which is at the core of their limbic brain, causes a severe rupture that can make the woman feel fragmented. She may be plagued by sleep and appetite problems, depression, irritability, and social isolation.
DEPRESSION
Lack of bonding and depression are frequently related. People who are depressed often do not feel like being around others and consequently isolate themselves. The social isolation tends to perpetuate itself: The more isolated a person becomes the less bonding activity occurs. This worsens the depression and increases the likelihood of further isolation. Depression is associated with low levels of certain neurotransmitters, especially norepinephrine, dopamine, and serotonin. On our experience, these deficits can cause increased activity in the LS.
PAIN
In my experience, people who experience chronic pain often have high activity in the thalamus, which is part of the limbic system. This is especially true with issues like fibromyalgia. A number of antidepressants, such as duloxetine (Cymbalta) and amitriptyline (Elavil), have been found to be successful in alleviating pain syndromes, as have mood-supporting supplements like S-adenosylmethionine (SAMe) and fish oil.
PSYCHOLOGICAL LIMBIC PRESCRIPTIONS
ANT Therapy – Learning how to kill the ANTs (Automatic Negative Thoughts). Here are the actual “ANT killng” principles that we use at Amen Clinics with people of all ages.
1. Did you know every time you have a thought, your brain releases chemicals? That’s how our brain work: You have a thought --- your brain releases chemicals --- an electrical transmission goes across our brain and you become aware of what you’re thinking.
Thoughts are real and they have a direct impact on how you feel and how you behave.
Every time you have an unkind thought, a sad thought, or a cranky thought, your brain releases negative chemicals that activate your limbic system and make your mind and body feel bad. When most people are mad, their muscles get tense, their heart beats faster, their hands start to sweat, and they may even begin to feel a little dizzy. Your body reacts to every negative thought you have.
3. Every time you have a good thought, a happy thought, a hopeful thought, or a kind thought, your brain releases chemicals that make your body feel good. When most people are happy their muscles relax, their heartbeat and breath slow. Your body reacts to your good thoughts.
4. Your body reacts to every thought you have!
We know this from polygraphs or lie detector tests. The tester asks questions such as “Did you do that thing?” If you did the bad thing, your body is likely to have a “stress” response that might manifest in the following ways:
Hands get colder
Heart goes faster
Blood pressure goes up
Breathing gets faster
Muscles get tight
Hands sweat more
5. Thoughts are very powerful. Every cell in your body is affected by every thought you have. That is why when people get emotionally upset they often develop physical symptoms. Did you know that Abraham Lincoln had periods of bad depression well into adulthood? He even though about killing himself and had some days when he didn’t get out of bed. In his later life, however, he learned to treat his bad feelings with laughter. He became a very good storyteller and loved to tell jokes. He learned that when he laughed, he felt better.
6. Your automatic thoughts do not always tell you the truth. It’s important to think about your thoughts to see if they help you or they hurt you. Unfortunately, if you never challenge your thoughts, you just “believe them” as if they were true. These negative thoughts invade your mind like ants at a picnic.
7. You can train your thoughts to be positive and hopeful or you can just allow them to be negative and upset you. Learning how to not believe every stupid thought you have is a critical skill to ending unnecessary suffering. ANTs pup up in your brain automatically, seemingly out of nowhere. When ANTs are left unchecked they steal your happiness and literally make you feel old, fat, depressed, and feeble-minded. Notice and exterminate ANTs whenever possible.
ANT #1: All–or–nothing thinking
These thoughts happen when you make something out to be all good or all bad. There’s nothing in between. If a baseball player strikes out, he may think he’s the worst player, rather than saying to himself, “The best baseball players make an out seven times out of ten. Next time will be better.”
ANT #2: “Always” thinking
This happens when you think something that happened will “always” repeat itself. For example, if your wife is irritable and she gets upset you might think, “She’s always yelling at me,” even though she yells only once in a while. Whenever you think in words like always, never, no one, everyone, every time, or everything, you’re falling prey to “always” thinking, which isn’t usually accurate. There are many examples of “always” thinking: “No one ever calls me.” “Everyone is always picking on me at work.” “You never listen to me.” This type of ANT is very common. Watch out for it.
ANT #3 (dangerous): Focusing on the negative
This occurs when your thoughts only see the bad in a situation and ignore any of the good that might happen. For example, let’s say you gave a presentation at work. Most of your coworkers told you that you did a great job, but one person fell asleep during the talk and now all you can think about was how boring it must have been. If you want to keep your mind healthy, it’s very important to focus on the good parts of your life more than you do the bad patrs.
ANT #4 (dangerous): Fortune telling
This is where you predict the worst possible outcome to a situation. For example let’s say you just started a vacation and the hotel had trouble checking you in. You immediately think that this is a sign that everything else will go wrong. The first negative thing that happens can put you into a depression spiral.
ANT #5 (dangerous): Mind reading
This happens when you believe that you know what another person is thinking when they haven’t even told you. Many people do this, and more often than not it gets them into trouble. It’s a major reason why people have trouble in relationships. I tell people, “Please don’t read my mind; I have enough trouble reading it myself.” You know you’re mind reading when you have thoughts such as “Those people are mad at me. They’re talking about me.”
ANT #6: Thinking with your feelings
This occurs when you believe your negative feelings without ever questioning them. Feelings are very complex and they sometimes lie to you. But many people believe their feelings even if there’s no evidence for them. Whenever you have a strong negative feeling check it out. Do you have a real reason to feel that way? Or are your feelings based on insecurities, or things from the past?
ANT #7: Guilt beatings
Guilt is typically not a helpful emotion. Guilt beating happens when you think with words like should, must, ought to. Because of human nature, whenever we think that we “must” do something, we don’t want to do it. It’s better to replace guilt beatings with phrases like “ want to do this,” “It fits my goals to do that,” “It would be helpful to do this,” etc.
ANT #8: Labeling
Whenever you attach a negative label to yourself or to someone else you inhibit your ability to take a clear look at the situation. Some examples of negative labels are "nerd," "jerk," "idiot," "spoiled brat," and "clown". Negative labels are very harmful. Whenever you call yourself or someone an idiot, you lump that person in your mind that you become unable to deal with them in a reasonable way.
ANT #9 (most dangerous): Blaming
Typically, you’ll hear yourself thinking:
“It wasn’t my fault that…”
“That wouldn’t have happened if you had…”
“How was I supposed to know…”
“It’s your fault that…”
Blaming others starts early in life. Whenever you blame someone else for the problems in your life, you become powerless to change anything. Many of us play the blame game, but it rarely helps us.
The Work in 4 Questions - Another technique that I teach all of my patients is called the Work. It was developed by my friend Byron Katie and is explained so well in her book Loving What Is. Katie describes her own experience suffering from suicidal depression. For ten years, she sank deeper and deeper into self-loathing, rage, and despair. The one morning in 1986, out of nowhere, Katie woke up in a state of amazement, transformed by the realization that when she believed her thoughts, she suffered, but when she questioned her thoughts, she didn’t suffer.
Katie’s great insight is that it is not life or other people that make us feel depressed, angry, stressed, abandoned, and despairing: it is our own thoughts that make us feel that way. Katie developed a simple method of inquiry to help people question their thoughts. It consists of writing down any thoughts that are bothering us, or any in which we are judging other people. Then we ask ourselves four questions, and do what Katie calls a “turnaround.” The goal is not so much positive thinking as accurate thinking. The four questions are:
"Is it true?"
"Can I absolutely know that it’s true?"
"How do I react when I believe that thought?"
"Who would I be without the thought” Or, "how would I feel if I didn’t have the thought?"
After you answer the four questions, take the original thought and completely turn it around to its opposite, and ask yourself whether this new version of the thought that is not true, or even truer than the original thought.
Gratitude and Appreciation
Psychologist Noelle Nelson and I did a study on gratitude and appreciation. While she was working on a book called The Power of Appreciation, she underwent two SPECT scans. The first time, she was scanned after 30 minutes of meditating on all the things she was thankful for in her life. Her brain looked very healthy. Then she was scanned several days later after focusing on the major fears in her life. Noelle took the exercise very seriously, and let flow a string of frightening thoughts. Then I scanned her brain. Her frightened brain looked very different from her gratitude brain. Her cerebellum was completely shut down.
If you recall, the cerebellum is known to be involved in physical coordination, such as walking or playing sports. New research also suggests that the cerebellum is involved in processing speed --- in other words, how quickly we can integrate new information. When the cerebellum is low in activity people tend to be clumsier and less likely to think their ways out of problems. They think and process information more slowly and they get confused more easily.
When I saw Noelle’s second scan, I thought, “This is why negative thinking is involved in athletic slumps.” If an athlete thinks he will fail, likely he will. I now had proof that negative thinking actually shuts down the coordination part of the brain.
SOCIAL LIMBIC PRESCRIPTIONS
Surround Yourself with People Who Provide Positive Bonding
Have you ever picked up a container that had ants crawling on it? Within seconds they’ve crawled onto your body and you are hurriedly trying to brush them off. If you spend a lot of time with negative people, the same thing will happen. Look at your life as it is now. What kind of people are around you? Do they believe in you and make you feel good about yourself, or are they constantly putting you down denigrating your ideas, hopes, and dreams?
I cannot overemphasize how contagious the attitudes of others are and how much hidden influence they can exert. The reason so many people feel good about attending a positive-thinking seminar is that they have been in a room full of people who were all reaffirming the best in one another. But let one of those people go home and walk into a house where someone makes fun of his efforts and says he’s wasting his time and will never get anywhere anyway, and watch how fast the positive effects of the seminar wear off!
Deciding that you don’t want to spend time with people who are going to have an adverse effect on you doesn’t mean you have to blame them for the way they are. It simply means that you have the right to choose a better life for yourself.
Source: Book Change Your Brain Change Your Life - chapter 6
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FUNCTIONS OF THE BASAL GANGLIA
Integrates feeling and movement
Shifts and steadies the motor movements
Suppresses unwanted motor behaviors
Helps to set the body’s anxiety level
Involved in forming habits
Modulates motivation and drive
Mediates pleasure/ecstasy
The basal ganglia are a set of large structures toward the center of the brain that surrounds the limbic system.
The integration of feelings, thoughts, and movement in the basal ganglia causes you to jump when you get excited, tremble when you’re nervous, freeze when you’re scared, or get tongue-tied when the boss is chewing you out. The basal ganglia allow for a smooth integration of emotions, thoughts, and physical movement, and when there is too much input, they tend to lock up.
When the basal ganglia are overactive (anxiety), people are more likely to be overwhelmed and have a tendency to freeze. When the basal ganglia are underactive (ADD), often a stressful situation moves them to action. People with ADD are frequently the first ones on the scene of an accident, and they respond at stressful situations without fear.
Shifting and smoothing fine motor behavior is another function of the basal ganglia and is essential to handwriting and motor coordination. Let’s use the example of ADD, which tends to show low activity in the basal ganglia, as well as the prefrontal cortex and cerebellum. Many people with ADD have very poor handwriting. The act of handwriting is difficult and often stressful for them. Many people with ADD also complain that they have trouble getting their thoughts out of their head and onto paper, a term called finger agnosia (the fingers cannot tell what the brain is thinking).
We know that the medications that help ADD, such as the psychostimulants Ritalin, Dexedrine, and Adderall work by enhancing the production of the neurotransmitter dopamine in the basal ganglia. These medications sometimes improve handwriting and enhance a person’s ability to get his thoughts onto paper to an amazing extent. In addition, many people with ADD say that their overall motor coordination is improved by these medications.
In our brain-imaging work, we have seen that the basal ganglia re also involved in setting your anxiety level. Overactive basal ganglia are often associated with anxiety, tension, increased awareness, and heightened fear. Underactive basal ganglia can cause problems with motivation and energy. In our research, one of the strongest statistical findings associated with increased activity in the basal ganglia is nail biting, which is usually a habitual expression of anxiety.
Interestingly, some of the most highly motivated individuals we’ve scanned, such as entrepreneurs and corporate CEOs, have significant increased activity in this part of the brain. We theorize that some people can use this increased activity in the form of motivation to become “movers” in society.
Cocaine is a powerful enhancer of dopamine availability in the brain, and it has both very fast uptake and clearance from the brain. It comes on strong in a powerful wave, and then it’s gone. The user gets a high, and when it’s gone, he wants more. In contrast, while Ritalin also increases the availability of dopamine to the basal ganglia, its effects are less powerful and it clears from the brain at a much slower rate. Dr. Volkow’s group postulated that activation of the basal ganglia by cocaine perpetuates the compulsive desire for the drug. Ritalin, on the other hand, enhances motivation, focus, and follow-through, but does not give users a high or an intense desire to use more. In fact, one of the biggest clinical problems I have with teenagers who have ADD is that they forget to take their medication.
Intense romantic love can also have a cocaine-like effect on the brain robustly releasing dopamine in the basal ganglia. Love has real physical effects. I had the opportunity to scan a close friend, Bill, shortly after he had met a new woman. He was head over heels for her. I decided we’d scan him and get a look at the brain of new love. To my amazement, his brain looked as if he had just taken a lot of cocaine. The activity in both the right and left basal ganglia was very intense, almost to the point of resembling seizure activity. Love has real effects on the brain that are as powerful as addictive drugs.
PROBLEMS WITH THE BASAL GANGLIA
Anxiety, nervousness
Physical sensations of anxiety
Tendency to predict the worst
Conflict avoidance
Risk aversion
Tourette’s syndrome/tics
Muscle tension, soreness
Tremors
Fine motor problems
Low motivation/Excessive motivation
Sensitivity to rejection
Social anxiety
ANXIETY
Any discussion about anxiety must start with the good aspects of it. People with really low levels of anxiety are constantly late, often die early from preventable health-related problems, and are more likely to go to jail. As you can see, some anxiety is good. Appropriate levels of anxiety prevent you from driving too fast on a rainy night, get you to pay your taxes on time, and stop you from having an affair when you want to stay married.
In one of the most important studies, in 1921, researchers from Stanford University evaluated 1,548 ten-year-old children, looking for the traits that were associated with health, success, and longevity. They then continued to follow them over the next ninety years. There results were fascinating. Longevity was not associated with happiness or a lack of worry. In fact, the don’t-worry-be-happy people died the earliest from accidents and preventable illness, because they tended to underestimate risks. The trait most associated with longevity was conscientiousness, which means if you said you were going to do something – and you actually consistently followed through. Of course, balance is important. You want to have enough anxiety to do the right things, but not so much that it causes you to suffer.
CONFLICT AVOIDANCE
Anxiety is, by definition, very uncomfortable. Thus, people who are anxious tend to avoid any situations that might make them more uncomfortable, especially dealing with conflict. People who have basal ganglia problems tend to be frozen by conflict, and consequently do what they can to avoid it. Unfortunately, conflict avoidance can have a serious negative impact on your life.
Loren
Loren, the owner of a neighborhood deli hated conflict. He also had problems with chronic feelings of tension and anxiety. His fear of confrontation prevented him from firing employees who were not good for his business. It also caused him to be overly nice to people who were negative to him, so Loren grew to resent his own lack of assertiveness. His problems even caused marital difficulties. For years Loren wouldn’t talk about the things in his marriage that made him unhappy. He would just hold them in until he finally exploded. Learning to deal with conflict was the centerpiece of his treatment.
TOURETTE’S SNDROME (TS)
TS is a very interesting disorder that provides the bridge between the basal ganglia and two seemingly opposite disorders, ADD and OCD. TS is characterized by motor and vocal tics lasting more than a year. Motor tics are involuntary physical movements such as eye blinking, head jerking, shoulder shrugging, and arm or leg jerking. Vocal tics typically involve making involuntary noises such as coughing, puffing, blowing, barking, and sometimes swearing (coprolalia).
One of the most fascinating aspects of TS is its high association with both ADD and OCD. It is estimated that 60% of people with TS have ADD and 50% have OCD. On the surface it would appear that these are opposing disorders. People with ADD have trouble paying attention, while people with OCD pay too much attention to their negative thoughts (obsessions) or behaviors (compulsions).
A crash course in the neurotransmitters dopamine and serotonin is necessary here. In the brain there tends to be a balancing mechanism between dopamine and serotonin. This balance, however, tends to be played out in the basal ganglia. Dopamine is involved with motor movements, motivation, attention span, and setting the body’s idle speed, while serotonin is more involved with mood control, shifting attention, and cognitive flexibility. When dopamine levels are raised, serotonin become less effective; and when serotonin levels are raised, dopamine becomes less effective.
For example, when I give someone a psychostimulants to treat ADD, it works by effectively raising the availability of dopamine in the basal ganglia. This helps with focus, follow-through, and motivation. If I give him too much, he may become obsessive, moody, and inflexible (symptoms of too little serotonin). Likewise, if I five someone who has ADD a medication that enhances serotonin availability in the brain, such as a selective serotonin reuptake inhibitor (SSRI), his ADD symptoms are likely to become worse.
Since the basal ganglia are involved with dopamine production and have been found to be overactive in OCD (and low in ADD), the basal ganglia are likely significantly involved in all three of these disorders. An interference mechanism in the basal ganglia is likely to be part of the picture, upsetting the dopamine-serotonin balance in the brain.
FINE MOTOR PROBLEMS
Another interesting connection that is probably related to basal ganglia hyperactivity is the development of fine motor tremors when we become anxious. When I was a young lecturer in front of an audience, I didn’t hold papers in my hands because I was concerned the paper might start to rattle or shake in response to the anxiety I felt. When the basal ganglia are overactive, we are more at risk for increased muscle tension or tremors. In my practice I have often prescribed medication to calm the tremors musicians get during a performance.
Increased muscle tension related to overactive basal ganglia activity is often associated with headaches. I have noticed that a number of people with resistant headaches have intense focal areas of increased activity in the basal ganglia. This seems to occur with both muscle contraction headaches (often described as a pain in the back of the neck or as a tight band around the forehead) and migraines (usually one-sided throbbing headaches that may be preceded by a visual aura or other warning phenomena). Interestingly, anticonvulsant medication such as topiramate (Topamax), which decreases areas of overactivity in the brain, is often helpful in decreasing some types of headaches.
LOW AND HIGH MOTIVATION
Motivation tends to be low in dopamine-deficient states, such as in ADD. However, when serotonin levels are raised too high, decreased motivation also becomes a problem. Physicians know that if a dose of serotonin-enhancing antidepressants is too high, lowered motivation is often the result. Many people have told me they stopped these medications because they stopped doing thins that were important to their business or home life. One CEO told me he had stopped taking his SSRI because he realized he wasn’t keeping up with his paperwork and he really didn’t care. “That’s not like me,: he said.
Heightened dopamine or basal ganglia states may also cause increased or even excessive motivation. Many CEOs of corporations have enhanced basal ganglia activity. They also tend to work excessive hours. In fact, weekends tend to be the hardest time for these people. During the week, they charge through each, day getting things done. On the weekend, during unstructured time, they often complain of feeling restless, anxious, and out of sorts. Relaxation is foreign to them. In fact, it is downright uncomfortable. Workaholics may be made in the basal ganglia. Their internal idle speed or energy level doesn’t allow them to rest. Of course, there is a positive correlate. Many of the people in society who make things happen are driven by basal ganglia that keep them working for long periods of time.
BSAL GANGLIA CHECKLIST
Use the following scale and place the appropriate number next to the item. Five or more symptoms marked 3 or 4 indicate a high likelihood of basal ganglia issues.
0=never ; 1=rarely ; 2=occasionally ; 3=frequently ; 4=very frequently
___ Feelings of nervousness or anxiety
___ Heightened muscle tension (headaches, sore muscles, hand tremor)
___ Feeling keyed up or on edge
___ Quick to startle
___ Tendency to freeze in anxiety-provoking situations
___ Excessive fear of being judged or scrutinized by others
___ Conflict avoidance
___ Lacking confidence
___ Sensitive to criticism
___ Biting fingernails or picking at skin
___ Always watching for bad things to happen
___ Excessive motivation
___ Tics
___ Poor handwriting
Supplements for high basal ganglia + anxiety
Many supplements have antianxiety properties. Some of my favorites include magnesium, theanine from green tea, the calming amino acid GAVA, Ashwagandha, Relora, and valerian root. B vitamins, especially vitamin B6 in doses of 25 to 100mg, have also been found by some to be helpful. If you take B6 at these doses, it is important to take a B complex supplement as well.
Nutritional Interventions
In my experience, people with high anxiety do better eating small meals throughout the day so they do not get hungry. Hypoglycemia is a major cause of anxiety disorders, and includes the following symptoms: periods of feeling confused, dizzy, light-headed, irritable, anxious, panicky, or shaky; sweating; or feeling faint. If you have a three or more of the above nine symptoms, it is a good idea to have a two-hour glucose tolerance test to see if hypoglycemia is an issue for you.
If you have low basal ganglia activity and low motivation you will likely do better with a high protein low carbohydrate diet that gives you more energy during the day. It is also often helpful to eliminate caffeine, as it may worsen anxiety.
Source: Book Change Your Brain Change Your Life - Chapter 8