I’m at the University of Cambridge and I’m having a panic attack. I can’t breathe, my head’s spinning, my heart’s going like the clappers and there’s a psychiatrist standing next to me and she’s the one that’s provoked it. Deliberately.
Dr. Annette Bruhl works at the Behavioural and Clinical Neuroscience Institute and she’s examining what happens to our mental functions when we’re under pressure, to try to help those with anxiety. Some stress is vital and we need it to react to threat, but prolonged levels can affect our thinking, our memory and our decision-making processes. Dr. Bruhl’s giving me cognitive tests while I’m inhaling a mixture of oxygen and carbon dioxide. She says the gas is not dangerous but it’s designed to induce feelings of panic. Fifteen minutes later, the results show just how differently my brain works when it’s under acute stress, to when it’s relaxed. Without the gas, a numbers task was straightforward, but with the mask on, I can’t think clearly and make lots of mistakes. The monitors show my pulse is accelerating and my blood pressure’s rocketing.
There is a good reason why I’m sitting in a lab, gasping for breath. I finished an MSc in Psychology at the University of Westminster last year and am still studying, trying to understand how the brain provides consciousness and what affects it. As a journalist, I want to find out if mental decline is inevitable or whether we can rewire our brains and even stimulate growth. It was while doing my academic work that I first met Dr. Catherine Loveday, a neuropsychologist and an expert on the ageing brain. She introduced me to her mother Scilla, a former consultant psychiatrist, for my new R4 series ‘How to Have a Better Brain’.
Scilla tells me how frustrating her memory loss is. She finds the simplest things take her twice as long. When she’s cooking, she forgets what ingredients she’s put in and one family Christmas, the turkey came out of the oven, raw. Scilla is fiercely bright and shows me her computer where she’s got four games of online Scrabble on the go, against her three daughters and a friend in the village. She’s winning every one of them. Sometimes the words come easily, on other days her brain lets her down and she can’t remember where she’s been or what she’s done. Catherine spotted her Mum’s deterioration a few years ago and gave her a series of tests. The results showed Scilla was up to 95% better than those her age in tasks like planning, reasoning and attention. On memory, she was 99% worse. Together, they’re using their combined knowledge of psychiatry and psychology to try to halt further decline. ‘The loss of self is the most difficult’ Catherine says ‘so we’re doing every evidence-based thing we can’.
That includes exercise and when we take Mimi the dog for a walk, Scilla tells me just getting out in the fresh air makes her feel happier and think more clearly. ‘It’s a free space with no distractions, when I can actually discover that I can remember things, that I’m not going completely doolally. If I don’t do it, I can feel myself going into a dark space’.
The science shows that physical activity doesn’t just make us feel better, it also helps protect the brain. Dr. Alan Gow is Associate Professor at Edinburgh’s Heriot-Watt University and part of a team investigating memory loss. He tells me that the simple act of walking can lead to brain functions improving, because it encourages more nerve cells to grow. Tests on people in their seventies suggest the ones who exercised had less brain shrinkage. ‘Those who did a bit more exercise were better in terms of their speed of thinking and their general reasoning’ he says. The team at Edinburgh followed the results with brain scans and found that those who were more physically active had higher grey matter volume and less damage to the white matter, the connective tissues that wire the brain. Dr. Gow is cautious when I ask whether physical activity can halt our mental decline, saying scientists need more long-term research on a greater number of people, but the results so far, he says, are ‘tantalizing’.
Catherine agrees and says when we’re outside we’re getting many benefits. It’s better for our cardiovascular health, so we’re carrying oxygen and glucose to the brain, firing more synapses and creating more connections. That’s why physical activity is one of the many strategies they’re trying to boost Scilla’s brain and their tactics are ones we can all use, to help us function at our best.
Those online word-games she’s playing help too, although the research behind so called ‘brain training’ is mixed. The games are fun and the more you practice anything, the more you’ll improve, but whether we also get better at very different tasks, like attention or comprehension is debatable. Many scientists say your brain is better off being active, learning a new skill or socializing and Catherine thinks it’s that which is having a positive effect, rather than the game itself.
Another key to her brain function is music. Scilla runs a choir and gets great joy from it. ‘I just love music and singing’ she tells me ‘It’s giving voice to something, I’m expressing part of my own soul.’ It’s also helping with her organizational skills and recent research suggests learning music may enhance general cognition. Musical memory is often the last to fade if we’re affected by conditions like dementia.
One of the most fascinating scientific discoveries I made for the Radio 4 series was to do with sleep. I spent eleven years getting up at 4am to present BBC Breakfast and I know how a bad night can affect our mental function for the rest of the day. Going to bed at the same time and not having lie-ins means better quality sleep. The amount? Well, teenagers need 8 to 10 hours, but the rest of us don’t need quite as much. Less than five and we may not be as alert, more than 10 and we can feel jet-lagged. Almost as importantly, is how we wake up. I did an experiment as part of a study into the stress hormone, cortisol. Cortisol affects every cell in our body, if there’s too much or too little over a long time, it can affect our well being and we won’t function properly. When we’re asleep, our cortisol levels need to be low, but a good strong burst of it when we wake, seems to set our brains up for the day and makes us think more clearly. Dr. Angela Clow has been researching this stress hormone for twenty years and when she gives me a battery of reasoning, decision-making and processing tests after a night when I’ve woken to gradual, morning light, I do much better than when I wake in the dark, with an eye mask on. Early research suggests I’m one of many with similar results. Turn computers off at night too. Morning light is blue; evening light falls into the red spectrum. Electronic devices naturally emit the blue light, giving your brain all the wrong signals and priming it to stay awake.
Scilla’s sleep routine is also based on research. Every night, since Catherine first noticed accelerated memory loss, her Mum has kept a diary and she fills it in every night. Catherine says it’s important because sleep helps cement our memories. ‘They so easily slip away, so by writing this regular diary, it means that just before bed, Mum is having to relive her day. It’s not someone delivering those memories to her and saying ‘this is what happened’ either, these are her words and if Mum’s memory does get a lot worse, she’s got her own history to look back on’.
Together, mother and daughter are finding ways, backed up by science, to manage Scilla’s memory loss and so far, there’s been no further deterioration since she was first tested. But Scilla knows what’s happening to her. As a psychiatrist, she helped many people with their mental battles, now she’s fighting one of her own. Despite it, she’s relentlessly, marvelously positive, finding her own ways of coping. ‘The problem is, that it’s not going to go away’ she tells me. ‘The only way to go on with life is to go on with it and to get on with it too.’
I learn a lot from being with Scilla and meeting all these other brilliant minds, coming up with ways to protect ours. Dementia will affect one in three of us over 65. We may not be able to stop it, but like Scilla, there are ways we can better protect our brains, so we can get on with living life.
How to Have a Better Brain – Monday to Friday at 1:45, and available afterwards on the BBC Radio 4 website.
Sian Williams
This article first appeared in the Sunday Telegraph on 15 August 2015.