Rewiring Brain

Today, one of my patients asked me what actually happens when we talk about “rewiring” the brain. Let me take him as a generic example: a person on lamotrigine (a mood stabilizer) and Prozac (an antidepressant) to address a range of symptoms that stem from trauma.

Pharmacological explanation
Lamotrigine has been shown to increase blood flow in the prefrontal cortex. Prozac increases serotonin signaling between neurons. Medicines in some ways comparable to neurosurgery, for restoring brain function.

Psychological explanation
No single strategy is sufficient. Here are four examples that are used together:
1. Reframing. To be frank, trauma or serious abuse in childhood came from a sick adult person. As a child, you were pure as a lotus. You simply happened to be in that situation. You are golden.
2. Explaining to Build Self-esteem. You are navigating life beautifully now. Your God-given intelligence, kindness and thoughtfulness are the building blocks of your psyche. Hold all of these together and shift toward the belief that you have enough, and you are more than enough.
3. New Knowledge. Often this looks like mentorship, which many people never had while growing up. Focusing on intimacy with your partner matters more than spreading yourself thin across many friendships.
4. Creative Activity and Hope. It might be your work or meditation or dinner parties, respectively immersing in regenerating all that is cognitively, emotionally and socially rich.

Neuroscience explanation
Brain rewiring happens constantly. It draws on all of the above, to help the brain reset toward health.

The dorsolateral prefrontal cortex, working with the anterior and posterior cingulate and other regions, directs attention. The medial prefrontal cortex, anterior cingulate and insula work together to quiet ruminations and bring calmness from arousal. Further, this allows the ventrolateral prefrontal cortex to bring in emotion regulation, calm the amygdala, and help form new healthy memories that integrate into the hippocampus. Connecting all of these gray matter regions is white matter, the brain’s fiber-optic cabling, which keeps them working in sync.

To be honest, the science is still at a rudimentary stage, and these are basic facts. You can find references for each of them on Perplexity. Medication opens the door and meaning, connection, and action walk you through it.