Skip to main content
Move the World.
Mental Training Can Heal Traumatic Brain Injuries (and Reduce Depression)

Millions of Americans are dealing with depression caused by traumatic brain injuries (TBIs), but current therapies are limited by our incomplete understanding of the causes of (and treatments for) depression. But scientists are gradually tying together information from brain scans, self-reported symptoms, and therapeutic treatments that may help us learn how to better heal the brain.

A new study shows that cognitive training classes—basically, teaching new information or strategic thinking—are associated with reduced depression, thickening in the cortex, and regrowth of neural connections damaged by TBIs. In other words, cognitive therapy like this can literally heal brain damage. It's the first study to tie all of these factors together, but it's part of a growing body of research that is changing how we think about psychological disorders.

Fragile, Resilient Jell-O: The human brain is (scientifically speaking) a bunch of Jell-O squished into a ceramic jar, so it doesn't take a lot of shaking to mess with it. And, given our tendency to drive around at high speeds, hit each other, fall down, and do other risky things with our jars, it's no surprise there are a lot of brain injuries. The CDC estimates that 2.8 million Americans suffer a traumatic brain injury every year, mostly in concussions from accidents and falls.

But despite how sensitive the brain is, it is also by design quite resilient: 75% of TBIs result in only a brief loss of consciousness or disorientation, and over 90% recover without a long-term disability. That's a remarkable recovery rate for a serious injury to a sensitive organ. But even if a brain injury doesn't result in permanent disability, it often carries lasting consequences, including chronic depression and PTSD.

The Treatment: Researchers at the Center for BrainHealth at UT-Dallas used psychological tests and fMRI scans to see how people with long-term depression from a TBI could benefit from cognitive training. Participants were assigned to classes that either taught simple information or "strategic thinking"—ways to focus, think abstractly, and so on. Subjects attended a dozen 90-minute classes, completed tests and homework, and worked on projects in small social groups. Researchers scanned their brains before the course, immediately after, and then again three months later.

The Results: The treatment resulted in significant improvement in depression, PTSD, and daily functioning. Average scores on a "depression index" were reduced by almost a third, and nearly 60% of the treatment group transitioned from severe to "minimal" depressive symptoms. The different content of the classes (factual learning vs. cognitive strategies) didn't make a difference in this case, and neither did the fact the cognitive training wasn't directly designed to control depression (unlike some other cognitive therapies). Even better, the improvement in depression continued even after the treatment ended.

Brain scans showed that less depression was correlated with thickening of the cortex and restoring neural network connectivity. This builds on studies showing that major depression is connected to thinning in the cortex, and other effective treatments for depression (including drugs, electroconvulsive therapy, and cognitive behavioral therapy) also increase cortical thickness.

Okay… So What's Going On? There's a lot of moving parts here, but the basic theory looks like this:

1. Brain trauma can scramble your neural networks and cause thinning in your cortex, resulting in depression, PTSD, and trouble functioning in daily life. Psychological problems often persist for years after recovery the initial injury.

2. Cognitive training classes (it doesn't seem to matter what they're about) can reduce symptoms of depression. These improvements in wellbeing are correlated (in time and degree) with physical growth and thickening in the prefrontal cortex.

The prefrontal cortex is strongly associated with the ability to suppress unwanted thoughts and regulate mood, so it makes sense that if it's healthy, depression and PTSD are easier to control. But how does step two work, exactly? You just do a class about whatever, and then you get better?

The truth is that there isn't direct evidence of what specifically patients' brains responded to, but researchers have a few ideas about why the cognitive therapy makes a difference (even if the content doesn't). The study's lead author speculates that "social engagements, cognitive stimulation from new learning opportunities and hope of improvement afforded by both programs may help explain the reductions in depressive symptoms."

That's not a satisfying answer, and it's tempting to read him as saying cognitive training is "just a placebo." But what does it mean to call something a placebo for a psychological problem? If therapy, socializing, and a hopeful outlook work to repair physical damage and psychological harm, that just sounds like regular old medicine. What we're learning from brain scans is that mental exercises and social interactions have physical, quantifiable effects on the brain, and those effects can lead to improvements in subjective mental health. But it's possible that you have to be "bought in," mentally, for them to be most effective.

The Upshot: People are natural dualists, so we tend to divide stuff into things that are "real" (like chemicals, electricity, physical trauma) and stuff that's "just in your head." But given our increasing scientific knowledge about how the mind works, this just isn't a useful way to think about it anymore. Antidepressants can change your brain chemistry and therefore affect your mental state. But brain studies are showing us that the brain can be dramatically altered by stuff that feels more ephemeral, like thoughts, conversations, and human interactions. It turns out what's "just in your head" is, literally, what's in your head.

This matters for how we approach mental health. Connecting psychology and neurology in more concrete ways will help us measure and improve our cognitive therapies the same we can with pharmaceutical treatments. As Dr. Sandra Bond Chapman, founder of the Center for BrainHealth, put it, "Identifying what changes are happening in the brain when interventions successfully reduce depressive symptoms could allow us to create more effective, pharmaceutical-free approaches to help alleviate depression." And on that front, too, things are looking up.

Up Next

Biblical Plagues
Scientists Have Found the Locust Swarm Pheromone
locust swarm
Biblical Plagues
Scientists Have Found the Locust Swarm Pheromone
A locust swarm is flying famine, devouring millions of pounds of crops. Researchers have found the swarming trigger — and perhaps an answer to stopping it.

A locust swarm is flying famine, devouring millions of pounds of crops. Researchers have found the swarming trigger — and perhaps an answer to stopping it.

Building Community
“Community Fridges” Are Helping Fight Food Insecurity
Community Fridges
Building Community
“Community Fridges” Are Helping Fight Food Insecurity
Community fridges stocked with donated food that’s free for the taking are helping neighborhoods across the U.S. overcome food insecurity.

Community fridges stocked with donated food that’s free for the taking are helping neighborhoods across the U.S. overcome food insecurity.

Father's Day
This Gang is Breaking the Stereotype of the Absent Black Father
the dad gang
Father's Day
This Gang is Breaking the Stereotype of the Absent Black Father
These dads are on a mission to change the way the world views black parenthood.

These dads are on a mission to change the way the world views black parenthood.

Criminal Justice
Fighting to Get Breast Pumps to Mothers in Prison
Mothers in Prison
Criminal Justice
Fighting to Get Breast Pumps to Mothers in Prison
Breastfeeding isn’t a right afforded to mothers in prison. One former inmate wants to change that.

Breastfeeding isn’t a right afforded to mothers in prison. One former inmate wants to change that.

Music
Chance the Rapper is Bringing Music Back to Chicago Schools
Chance the Rapper is Bringing Music Back to Chicago Schools
Music
Chance the Rapper is Bringing Music Back to Chicago Schools
On the far South Side of Chicago, as far south as you can get — a traffic light away from neighboring Riverdale —...

On the far South Side of Chicago, as far south as you can get — a traffic light away from neighboring Riverdale — the Ira F. Aldridge Elementary School is offering its students something rare in the forever-strapped Chicago public school system: opportunity. With a grant from Chance the Rapper's charity SocialWorks, the school can now offer a more robust music program, ensuring an instrument in every student's hands. "I...

Global Health
The Next Pandemic Is Out There. Is the Private Sector Ready?
Event 201 works with private sector for global pandemic preparedness.
Global Health
The Next Pandemic Is Out There. Is the Private Sector Ready?
Johns Hopkins' simulated, international catastrophe is helping business, government, and public health leaders improve global pandemic preparedness.

Johns Hopkins' simulated, international catastrophe is helping business, government, and public health leaders improve global pandemic preparedness.

Building Community
This Chicago Urban Farm Grows Opportunity, Jobs
This Chicago Urban Farm Grows Opportunity, Jobs
Building Community
This Chicago Urban Farm Grows Opportunity, Jobs
Growing Home’s organic urban farms use agriculture as a vehicle for providing job training for people with...

Growing Home’s organic urban farms use agriculture as a vehicle for providing job training for people with employment barriers, whether due to prior convictions, medical concerns, poverty, homelessness, or any other issues which make gainful employment difficult.

#fixingjustice - Policing
Civilian Oversight Is a Solution to Police Misconduct. But is it Effective?
civilian oversight
#fixingjustice - Policing
Civilian Oversight Is a Solution to Police Misconduct. But is it Effective?
Creating a civilian review board to oversee police conduct seems like a straightforward solution to disciplinary...
By Andrew Denney

Creating a civilian review board to oversee police conduct seems like a straightforward solution to disciplinary issues on the force. But why is it so hard to implement?

Dispatches
Unlike Smoking, Vaping Won't Mess With Your Microbiome
Unlike Smoking, Vaping Won't Mess With Your Microbiome
Dispatches
Unlike Smoking, Vaping Won't Mess With Your Microbiome
Smoking kills off good bacteria and upsets the balance of power your gut.

Smoking kills off good bacteria and upsets the balance of power your gut.