[robg]

"When you say "brain health" do you mean actual neurological changes taking place in the brain, or underlying mental health issues like depression and anxiety?"

I've been looking closely at this distinction between mind and brain for over a decade and I have to say the evidence is very thin as to nature vs. nurture wrt anxiety and depression. Moreover, ask any professed expert about the differences between chronic stress and "generalized" or otherwise anxiety, on the one hand, and sleep disturbances and depression on the other. The more certain they seem of the answer you more you know they are not honest arbiters.

The most recent work on sleep suggests a glymphatic system that washes toxins from the brain especially well during sleep. More to your question, the best work I've seen suggests that many mental health concerns can not be treated well if there's an underlying sleep disorder.

Taking a step back, if any person is under a lot of stress AND not sleeping well, and for years on end, the distinction between mind and brain and body would seem to matter little. They are suffering and in need of serious help and likely to self-medicate. However, doctors still today do not know how to treat sleep or stress concerns and specialists are all over the place, from therapists to neurologists to psychiatrists and behavioral health specialists.

Feel free to reach out to me personally. My contact info is in my profile.

[Eilene]

I will reach out, thank you. This is very helpful. Your last paragraph describes Peter accurately. At some point, all the years of chronic stress, too little sleep, too many stimulants (even before IV drug abuse) changed him somehow. I'm not a doctor, but I knew him for almost 30 years and over the course of a decade or so something profound changed.

[robg]

That's the truly crazy thing to me - over a decade if someone was gaining a lot of weight or had a heart attack or drinking more and more maybe the people who care would try to stage an intervention. But if it's lack of sleep and/or too much stress, it's shrugged off as they are so hard working and productive and dedicated. It's a culture of Type A people and the rewards that go with that professionally. And now we're raising generations to act the same way. I'm of the belief that the obesity epidemic is a symptom not a cause. Food is naturally rewarding and de-stressing.

Back to telomerase (Blackburn won the Nobel) and the glymphatic system (Nedergaard will win the Nobel). In short, chronic stress causes significant damage across the body and down to the cellular level. Sleep is the body's way to recover and the glymphatic system appears to be the cleaning process in the brain, down to the cellular level. When you have much more damage and insufficient recovery, something really has changed, like a car driven too fast, too hard, without oil changes for a decade.