A scientist’s opinion: Interview with Professor Barbara Sahakian about brain changes during COVID-19

Interview with Professor Barbara Sahakian, Professor of Clinical Neuropsychology at the University of Cambridge, Department of Psychiatry and Behavioural and Clinical Neuroscience Institute, UK.

How is the pandemic changing our brains, in situations when we haven’t contracted the virus itself? How is it impacting it both physically and psychologically, and are these long-term changes?

Barbara J. Sahakian ESMH scientistBarbara Sahakian: When the virus gets into the brain, you get these neurological and psychiatric symptoms, but it is true that it’s not just people who have contracted the coronavirus who have suffered increased anxiety and depression during the pandemic. Surveys have shown that anxiety and depression is increased in many people. This has mainly been caused by excessive worry over contracting or spreading the virus to other family members, as well as the isolation and loneliness partially caused by the lockdowns where people have to shield, which can change brain chemistry. We’ve also been under a lot of stress during this pandemic; for example, some people are worried about their jobs or about managing childcare. The repeated stress is a major trigger for persistent inflammation in the body, which can also affect the brain. Over the long term, it can shrink the hippocampus and subsequently affect our memory and emotions. Stress can also affect levels of brain serotonin and cortisol, which can alter our mood. Serotonin is important for our normal mood regulation, and the Selective Serotonin Reuptake Inhibitors (SSRIs) are the drugs used as treatment for people with depression and anxiety, so when we alter brain serotonin in a negative way, it can affect mood quite seriously. High, prolonged levels of cortisol have been linked with mood disorders as well as shrinkage of the hippocampus, and it can also cause many physical problems such as irregular menstrual cycles in women. Eventually these changes can cause symptoms of depression and anxiety. We know and hope that some of these will dissolve in people, but some of them may be more permanent changes. We will have to look at that in surveys to see what’s happening.

Barbara Sahakian: We published a recent study, with Amy Bland from Manchester Metropolitan University and other colleagues, where we looked at people who were isolating during the first UK lockdown amid the pandemic. We found that those who did not stay socially connected were showing signs of negative bias, so they were focusing more on negative faces and sad faces, rather than happy faces or happy information. It became clear that these were the same symptoms seen in people with depression and that isolation was really affecting them. Conversely, we found that people who managed to stay more socially connected during the pandemic didn’t have those strong effects. So the social interaction and connectedness — even if it’s by telephone or zoom — is very important for people, while social isolation can have a very negative effect on the brain and on people’s behaviour as well.

Barbara Sahakian: I have noticed that researchers haven’t talked much about the impact that might be occurring in younger ages, in terms of their early social cognition development. You’ll be somewhat protected if you’ve got siblings but not everybody will have siblings, and play groups or nurseries haven’t been able to continue because of the lockdowns. I’m quite worried about what might happen at younger ages because normally they have a support system; for example, when a mother has a child, they might go to a mother and baby group or a toddler group, and they interact with other mums and children play together. But we’ve had so much disruption that people have had to stay isolated. During this critical time of social cognitive development, these children haven’t had the normal play and interaction experience they should have had. These are building blocks, not only for our social interactions in the future but also for what I call the “cold cognition” as well. This implies cognitive processing of information that is independent of emotional involvement, so more logic, planning and problem solving. I’m worried about adolescents too, where they have had their schooling disrupted enormously. Adolescence is a time when they’re becoming independent in the world, into adulthood, and engaging with their peers. It’s so important to have that peer-to-peer interaction. So I’m concerned about what the effects will be, of this forced isolation and restricted interaction that we’ve had to have over this very long period of time.

How can we overcome the negative brain changes linked to the pandemic due to the continued stress?

Barbara Sahakian: The brain is incredibly plastic, which means it is changeable and can compensate for damage, and so we can alter the brain function and its chemistry. I have come up with six ways we might be able to overcome negative changes and reboot our brains, but you have to act early — before these become serious, when one should seek help with a psychologist or psychiatrist:

Interestingly, the first way is being kind and helpful to others; kindness, altruism and empathy affect the brain. For example, a neuron-imaging study showed that when people make a charitable donation, it activates the brain’s reward system — so helping somebody else affects your ability to experience positivity and reward, which also helps in terms of resilience. Volunteering can also give a sense of meaning in life and it promotes happiness, health and wellbeing, while reducing depression and anxiety.

Barbara Sahakian : One of my favourites is exercise. Exercise positively affects both your physical and mental health — people who exercise actually live longer. Exercise has been linked to better school performance in children, in young adults it promotes better cognition and job performance, while in older adults it maintains cognitive performance and provides resilience against ageing issues, such as memory loss and dementia. Exercise also generates new cells in some brain areas, and those with high levels of fitness have been found to have increased brain volumes, which is also linked to better cognitive performance. So go out and get some fresh air, while walking, running, or cycling — anything that you enjoy to make sure you get into a routine!

Eating well can help with the mental and physical fatigue we are currently experiencing with the pandemic; good nutrition is the building blocks for our brain that fuels both our body and brains. Avoid sugary foods and saturated fats, and have a well-balanced diet filled with fruits, vegetables, and cereals.

Social isolation is very detrimental to physical, cognitive and mental health, so it is important to keep socially connected with people, even if you have to do it remotely. Social interaction is associated with positive feelings and an increased activation in the brain reward system — in a similar way to receiving money. It gives you that sense of positivity about the world around you and about the future.

I was a Lead on the UK Government Foresight Project on Mental Capital and Wellbeing, and learning something new is incredibly important to keep your brain and neural networks active. It also helps prevent any cognitive decline. So don’t sit passively all day long, like in front of a TV, but try to read a book or get on the internet to learn how to do something you’ve always wanted to do.

Lastly, getting enough and good sleep is essential because, during sleep, the brain reorganises and recharges itself, stores our memories, and helps us maintain our normal brain function by removing toxic waste byproducts. Sleep deprivation causes problems with our memories and attention span.

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