Brain atrophy, delirium and depression

Brain atrophy involves the loss of neurons. Some degree of atrophy and subsequent brain shrinkage is common with old age, even in people who are cognitively healthy. However, this atrophy is accelerated in people with mild cognitive impairment and even faster in those who ultimately progress from mild cognitive impairment to Alzheimer’s disease. Brain Atrophy and B Vitamins September 22, 2010

Cell Atrophy and Loss in Depression: Reversal by Antidepressant Treatment

Mounira BanasrJason M. Dwyer, and  Ronald S. Duman Curr Opin Cell Biol. 2011 Dec; 23(6): 730–737. Published online 2011 Oct 11. doi: 10.1016/


Depression is associated with structural alterations in limbic brain regions that control emotion and mood. Studies of chronic stress in animal models and postmortem tissue from depressed subjects demonstrate that these structural alterations result from atrophy and loss of neurons and glial cells. These findings indicate that depression and stress-related mood disorders can be considered mild neurodegenerative disorders. Importantly, there is evidence that these structural alterations can be blocked or even reversed by elimination of stress and by antidepressant treatments. A major focus of current investigations is to characterize the molecular signaling pathways and factors that underlie these effects of stress, depression, and antidepressant treatment. Recent advances in this research area are discussed and potential novel targets for antidepressant development are highlighted.

Physical Effects of Depression on the Brain 

Reviewed by Smitha Bhandari, MD on July 28, 2020

Brain Size

There’s some debate about which areas are affected and how much. There’s growing evidence that several parts of the brain shrink in people with depression. Specifically, these areas lose gray matter volume (GMV). That’s tissue with a lot of brain cells. GMV loss seems to be higher in people who have regular or ongoing depression with serious symptoms.

Studies show depression can lower GMV in these areas: 

Hippocampus. That part of your brain is important for learning and memory. It connects to other parts of your brain that control emotion and is responsive to stress hormones. That makes it vulnerable to depression.

Prefrontal cortex. This area plays a role in your higher-level thinking and planning.

There’s also evidence these parts of your brain get smaller: 

  • Thalamus
  • Caudate nucleus
  • Insula

Results are mixed on how depression affects the amygdala. That’s your fear center. Some studies show it gets smaller. Others found that stress and depression might boost its GMV. The more severe the depression, the higher the GMV.

When these areas don’t work the right way, you might have:

  • Memory problems
  • Trouble thinking clearly
  • Guilt or hopelessness
  • No motivation
  • Sleep or appetite problems
  • Anxiety

You might also move or talk slowly, or overreact to negative emotions. – see last blog discussing psychomotor retardation.

Brain Inflammation

Experts aren’t sure if depression or inflammation comes first. But people who have a major depressive episode have higher levels of translocator proteins. Those are chemicals linked to brain inflammation. Studies show these proteins are even higher in people who’ve had untreated major depressive disorder for 10 years or longer.

Uncontrolled brain inflammation can:

  • Hurt or kill brain cells
  • Prevent new brain cells from growing
  • Cause thinking problems
  • Speed up brain aging

Are the Changes Permanent?

Scientists are still trying to answer that question. Ongoing depression likely causes long-term changes to the brain, especially in the hippocampus. That might be why depression is so hard to treat in some people. But researchers also found less gray matter volume in people who were diagnosed with lifelong major depressive disorder but hadn’t had depression in years.

While more research is needed, there’s hope that current or new treatments might help reverse or ward off some brain changes.

Atrophy of brain cells! Brain inflammation! Loss of Grey Matter Volume in the brain!

Hey this is very serious! This is no joke!

Paula’s brain cells shrank? She had brain inflammation? She lost grey matter volume!

And no one looked into this?

No one did modern tests to see if she had metabolic dysfunction like Kraepelin suggested? No one even checked her vital signs to see if something was amiss?

That is the first step, is it not, to check vital signs to see if the pattern of respiratory rate, blood pressure, heart rate and body temperature was normal? [We already know that her vital signs were not normal and pointed to possible hypercapnia, which if it resolves spontaneously or is treated with supportive mostly non invasive medical care is reversible? If it does not kill you, that is.


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