Camilla Nord book: The Balanced Brain author on pain

Camilla Nord book: The Balanced Brain author on pain

Deciphering the connection between chronic pain and depression

by Suswati Basu
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Camilla Nord, the acclaimed author of “The Balanced Brain,” recently joined The Trouble Club in London, as she delved into the intriguing arena of neuroscience and its intersections with mental health. Dr Nord’s expertise in the field led to a compelling discussion that highlighted the intricate relationship between chronic pain and depression.

Who is Camilla Nord?

Camilla Nord leads the Mental Health Neuroscience Lab, situated within the University of Cambridge's MRC Cognition and Brain Sciences Unit. Additionally, she holds a dual appointment as an Assistant Professor of Cognitive Neuroscience within the Department of Psychiatry. At her lab, Nord and her team delve into the complex interactions between the brain and the body in neuropsychiatric disorders, employing techniques from both cognitive and computational neuroscience.

Their research encompasses a broad spectrum, ranging from fundamental explorations in neuroscience, which includes pinpointing the brain's role in mental health disorders, as well as examining potential immune or metabolic mechanisms. Their pursuits extend to practical translational science, encompassing experimental medicine investigations into innovative treatment approaches.

Moreover, Nord is the esteemed author of a widely acclaimed neuroscience publication, "The Balanced Brain: The Science of Mental Health," published by Penguin in 2023.

What is ‘The Balanced Brain’ about?

In her book, Nord delves into the notion of a well-balanced brain and its deep connection to mental health. She conducts a thorough exploration of diverse approaches to addressing mental health issues, ranging from conventional therapies and medications to unconventional methods like recreational drugs and electrical brain stimulation.

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Nord contends that mental health is a labyrinthine journey, uniquely experienced by each individual. She underscores the multitude of paths leading to mental well-being. To illustrate the mechanics and occasional limitations of these various treatments, Nord scrutinises an extensive array of interventions, encompassing traditional therapies and medications, as well as less conventional options like recreational drugs and electrical brain stimulation.

Camilla Nord unveils the brain’s multifaceted role

She commenced by addressing the question of why she chose to specialise in the brain, responding with a resounding assertion that “the brain is for everyone.” She elaborated, emphasising that neuroscience can shed light on even seemingly intangible and subjective phenomena like mental health and well-being.

The discussion soon delved into the relationship between pleasure and pain, with Nord underscoring the surprising connection between chronic pain and depression.

Chronic pain and depression: a significant connection

Chronic pain, as Nord explained, shares more similarities with mental health issues like depression than with acute pain. She shed light on the fact that individuals suffering from chronic pain are not only more prone to depression but are also more likely to develop chronic pain following an injury if they’ve experienced depression in the past.

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Nord proceeded to unveil the fascinating phenomenon of “stress-induced analgesia.” This intriguing concept explores how the body releases opioids, pleasure-enhancing chemicals, in response to certain types of physical stress, ultimately suppressing pain. She explained that this phenomenon has been observed in both animals and humans, citing skydiving as a real-world example.

“I think this link between physical health and mental health gets overlooked […] But actually, the two cannot be decoupled. And we know that even at the level of the brain, something experienced physically like chronic pain, has more in common with mental health problems like depression than it does with acute pain, which we call nociception sort of immediate pain.”

Dr Camilla Nord, ‘The Balanced Brain’ Author

The discussion then turned towards the intricate relationship between chronic pain and mental health. Nord emphasised that chronic pain, while physically experienced, triggers changes in the brain that closely resemble those seen in individuals with depression. This connection, she argued, underscores the inseparable nature of mental and physical health.

From placebos to predictions

Nord’s personal experience with chronic pain served as a poignant example of this connection. She detailed how a steroid injection, aimed at reducing inflammation, led to a significant improvement in her chronic pain—a remarkable placebo response that highlighted the brain’s influence on physical health.

“I think the placebo is a really important mechanism for both mental and physical health treatment, something we already use and rely on […] So that means that even the drugs we rely on, the medications that we know work compared to placebo. They work better than placebo. They [actually] work partially because of placebo.”

Dr Camilla Nord, ‘The Balanced Brain’ Author

The conversation then shifted towards hedonic hotspots in the brain, areas associated with pleasure and reward. Nord discussed their role in maintaining well-being and touched on the challenges of treating pathological fears and disgust, noting the differences between these emotional responses.

The concept of prediction errors was also explored, with Nord elaborating on how our brains respond to unexpected outcomes and how this can affect our moods throughout the day. The audience was intrigued by the discussion of antidepressants and their role in shifting perceptions of events towards a more positive domain.

“[What] antidepressants seem to do is shift this emotional tipping point, whether you judge something as positive, negative, or neutral towards the neutral to positive domain. And that happens right away.”

Dr Camilla Nord, ‘The Balanced Brain’ Author
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Nord concluded the discussion with an in-depth exploration of placebos, emphasising their importance in both mental and physical health treatments. She highlighted that even established medications work partially because of the placebo effect, underscoring the nuanced nature of treatment in the realm of neuroscience.

In a world where the boundaries between physical and mental health are increasingly blurred, Camilla Nord’s insights shed light on the interconnectedness of our brain and well-being. Hence her engaging discussion left the audience with a newfound appreciation for the profound impact the brain has on our lives and the promise of future discoveries in neuroscience.

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