SCIENTISTS CONFIRM THAT EXCESSIVE WORRY SHRINKS YOUR BRAIN

While there is no such thing as “the lawyer personality,” many lawyers are tense, moody, irritable and engage in frequent worry at work. Scientific research has now confirmed that personality type affects the tissue volume of key brain structures as we age. It turns out that conscientiousness (a positive quality which can make you a better lawyer and enhance many aspects of your life) preserves brain volume, while neuroticism measurably decreases it as early as middle age. We all know that worrying can’t help you protect the people you care about or solve any problems, but now we know it can shrink your brain as you age. Lawyers who worry all the time need to heed these findings and initiate changes in their attitude before it’s too late.

Personality theory has been around a long time. All of us remember terms like warm, cold, introvert, extrovert, thinking type, intuitive type, and so forth. Over the years different psychologists proposed different models for human personality. The current thinking is that there are no fixed personality “types,” but rather clusters of personality traits associated with particular behavior patterns which are stable over time. Psychologists also agree that personality traits exist on a continuum, that individuals are a mix of these traits (displaying more of some than others), that traits dispose people to act in certain ways rather than absolutely determine how they will act, and that changing life circumstances can temporarily push certain traits into the foreground and others into the background.

There is some consensus that NIH psychologist Robert McCrae’s Five Factor Model most accurately captures basic differences in enduring personality features. McCrae refers to them as “the five basic ways in which individuals differ in their enduring emotional, interpersonal, experiential, attitudinal and emotional styles.” The five different factors in McCrae’s model are extraversion, agreeableness, conscientiousness, neuroticism and openness.

Extraversion equates with being energetic, enthusiastic, outgoing, talkative, trusting, playful and gregarious. Agreeable people are generous, kind, warm, sympathetic forgiving and altruistic. Conscientiousness equates with being competent, efficient, organized, self-disciplined, orderly, reliable, responsible, dependable and thorough. People with neuroticism are tense, worried, anxious, thin-skinned, touchy, self-conscious, overly concerned with adequacy, self-pitying, depressed, hostile and self-defeating. Openness equates with being curious, imaginative, insightful, original, having a wide range of interests, valuing feelings, valuing aesthetics, enjoying fantasy and having or accepting unconventional viewpoints.

Personality is related to stress in many ways. On the most fundamental level your personality can make you more prone to the biological effects of stress or it can effectively insulate you from those effects. During the second half of the 20th century stress medicine research showed that stress can have many deleterious effects on animals and humans. These included dwarfism, immune system suppression, mood disorders (anxiety, depression), insomnia, stomach ulcers, and increased rates of diabetes, hypertension, heart attacks and strokes.

In the 1990s neurophysiologist Robert Sapolsky, Ph.D. (author of Why Zebras Don’t Get Ulcers) discovered that unremitting stress on monkeys caused them to suffer significant shrinkage in the tissue volume of a key brain structure called the hippocampus that lies in the medial temporal lobe. The hippocampus is the most important module in the brain for encoding long term memories and a healthy hippocampus is necessary for learning new information.

One way that Dr. Sapolsky induced the stress was by keeping younger, weaker males in constant, close contact with an older, stronger, dominant male who kept tormenting them because they had no means of escape. The younger males became visibly nervous, anxious and withdrawn. When Dr. Sapolsky tried to these highly stressed monkeys new tricks for acquiring food he saw that they were learning impaired (which could equate with being too distracted by anxiety to learn or with having a shrunken hippocampus). When he sacrificed them and measured the tissue volume of their hippocampi he determined they had significant shrinkage relative to male monkeys in the control group who had not been continually stressed.

What’s the mechanism? When a monkey’s survival is threatened he goes into a fight-flight response which prompts his hypothalamus to tell his pituitary to tell his adrenal glands to pump out the stress hormones adrenalin and cortisol. While adrenalin is quickly cleared from the system, cortisol is slow to dissipate. If a monkey is subjected too frequently to attacks, or credible threats of attacks, his blood cortisol level remains high.

In high amounts cortisol is neurotoxic. The hippocampus has more cortisol receptors than any other organ in the human body. Normally the hippocampus can tell the pituitary to put the brakes on cortisol production by the adrenal glands, but if it gets overwhelmed by too much cortisol over too long a period it loses its ability to do this. The cortisol build up from continuous stress kills off cells in the hippocampus which gradually shrinks and this leads to poor memory with learning impairment.

On May 19, 2009, Johnathan Jackson (a psychologist), David A. Balota (a radiologist) and Denise Head (who works in psychology and radiology) at the University of St. Louis published a paper titled Exploring the relationship between personality and regional brain volume in healthy aging in the journal The Neurobiology of Aging. The purpose of their research was to determine what effect, if any, three targeted personality traits (extraversion, conscientiousness and neuroticism) had on brain volume in healthy people as they aged. Virtually all persons have some degree of brain shrinkage as they age. The researchers postulated that personality might correlate with and even causally impact the rate of brain shrinkage as people aged.

The researchers selected 79 cognitively intact adult males and females aged 44-88 who had no history of neurological disease, stroke, head injury, hypertension, drug or alcohol abuse or depression. They had all study participants complete the NEO Five-Factor Inventory, a validated measure of McCrae’s five personality trends. The researchers also had all study participants undergo brain imaging using an MRI with software that performs quantitative volumetric analysis. This means the MRI can identify neuroanatomic structures within each study participant’s brain and measure their volume in cubic centimeters.

The results were rather dramatic. Individuals with neuroticism had smaller cerebral gray matter generally with the most decrease in the ventrolateral prefrontal cortex (VLPFC), the dorsolateral prefrontal cortex (DLPFC)and the orbito-frontal cortex. The hippocampi of these individuals was normal for their age, which reflected the fact that these individuals - although neurotic - had not been subjected to lengthy periods of extreme stress akin to being sexually abused, fighting in a war, and so forth. The individuals who were high in conscientiousness had normal brain volume for their age in their VLPFC and DLPFC but higher than normal brain volume in their orbito-frontal cortex. The individuals high in extraversion had normal brain volume for their age in all three structures. The researchers concluded that personality may not only relate to, but may also moderate, age-related decline in the volume of certain key brain structures.

In plain English what this research indicates is that neurotic people (those who are generally tense, worried, anxious, moody and irritable) have a chronically elevated stress level, with chronically elevated levels of stress hormones, and they pay for it by experiencing accelerated shrinkage of key brain areas in their frontal lobes.

The VLPFC, the DLPFC and the orbito-frontal cortex are all frontal lobe structures that play key roles in “executive functioning.” This refers to the ability to plan behavior in accord with one’s goals, to keep one’s goal in mind in the face of distractions, to monitor one’s behavior for errors in task execution and correct them, to shift one’s attention if circumstances dictate and to complete tasks in a flexible manner in response to changing circumstances. These structures enable us to coordinate our cognitive resources to carry out complex tasks like multi-tasking.

Of the three structures the one that has the most to do with emotions is the orbito-frontal cortex. It’s the orbito-frontal cortex that carries out emotional self-regulation based on our awareness of other people’s expectations and reactions and our sensitivity to social rewards and punishment. People with damage to their orbito-frontal cortex experience problems with inhibiting impulses toward anger, rage, violence and substance use. The most famous example of this was Phinneas Gage, a foreman for the Rutland and Burlington Railway in Vermont. In 1848 Gage accidentally exploded a dynamite cap which sent a 3 foot seven inch long iron tamping rocketing upward from the ground. It went through his cheek bone below his left eye and continued out the top of the head, piercing his brain and obliterating his orbito-frontal cortex on it’s way.

Prior to the incident Gage was a reliable, dependable employee who never drank, cursed or fought and who served as a leader in his church. Afterwards Gage was often late for work or missed work. He was cantankerous. He cursed and spat at people and got into lots of fistfights. He was fired from his job and kicked out of his church. He ended up in a freak show where he displayed the iron rod. He died of seizures. Remember that Gage is an extreme example, and someone who changed by virtue of severe brain trauma rather than someone who affected his brain on a cellular level by the daily stress of his own neuroticism while practicing law. Although the researchers in this study did not perform neuropsychological testing on the study participants to see if they manifested impairment of brain functions such as executive functions or social intelligence, one can infer they would have picked it up to varying degrees. Why? Because measurable shrinkage of cerebral gray matter is associated in the medical literature with decline in brain function.

What to do with this information

In Dr. Seuss’ wonderful story How The Grinch Stole Christmas he talks about how the Grinch’s heart shrank from a life of isolation, vengeful thoughts and scowling without kindness, friendship or giving. Can hearts literally shrink from such a life? I don’t know. But it’s clear that our brains can and do shrink in some very important places from spending too much time fussing, fretting, imagining the worst, worrying and handwringing. Genes are predispositions not destiny - the child of a depressed parent or an alcoholic parent can grow up free of depression or alcoholism. Personalities are the same. Personality represents a customary pattern of relating to oneself and one’s world but personality is not fixed and frozen.

A lawyer who tenses up, starts churning out worst case scenarios in his head and begins to fret and worry, whenever he faces an unanticipated challenge or a spot of bad news, can learn to relax, breathe and ground himself. There are a huge variety of techniques including seated meditation, walking meditation, yoga, slow and deep abdominal breathing, taking a walk in the nearest park, the Relaxation Response and the Body Scan that I have talked about in my book The Upward Spiral and in other blog articles, which can break the circuit between experiencing difficulty and automatically going into fight-flight. If you have a tendency toward neuroticism (from genes, your upraising or both), I strongly encourage you to begin using these techniques to overcome stress and keep your mind from being a stress factory which can literally shrink your brain.

The fewer brain cells you have as you age the greater your risk of dementia and the more prone you are to become disabled by a stroke or concussion from a fall. Stress reduction is important for all of us who want to stay healthy, active and mentally sharp our whole lives. For those of us in whom neuroticism is their dominant personality trend, stress reduction is absolutely crucial to prevent brain shrinkage and impairment of brain function. Although it’s never too late to start life long habits of stress reduction, you’re better off starting them in your forties than in your sixties or seventies when neuroticism may have done some irreversible damage. Many is the lawyer who changes the oil of his car every 3,000 miles but who doesn’t pay much attention to what’s under his own hood. For your health and wellbeing as you age, please remember to take good care of your brain by managing your stress.

Meditation, smiling and laughter have all been clinically proven to reduce blood cortisol. Meditation has been proven, through the use of volumetric brain MRI studies on Buddhist monks, to increase the thickness of the cerebral cortex, in particular frontal lobe structures dedicated to concentration and the insula (which enables us to have empathy for others).