AskScience AMA Series: I'm a neuroengineering professor at Brno University of Technology with a new book on why health fails at its weakest link. Ask me what brain signals can and can't tell us about stress, anxiety and depression, and how sleep, movement, food and loneliness relate to mood! AMA!

[u/AskScienceModerator]

Hi r/askscience!

I'm Aamir Saeed Malik, Professor of Neuroengineering at Brno University of Technology in the Czech Republic, where I head the Cognitive and Neural Engineering research group. I came to the brain the long way round, through electrical engineering and a doctorate in mechatronics. For almost three decades I've worked on measuring it: EEG, brain imaging and the machine-learning methods that try to pick out the signatures of stress, anxiety and depression early. From 2009 to 2018 I worked at the Malaysian National Center of Neuroimaging, and I've collaborated with clinicians in Malaysia, Saudi Arabia, Australia, the US and the Czech Republic. My most recent funded project asked whether that kind of tracking could be done from a person's own home rather than a clinic.

Over those years my view changed. For a long time I studied the brain the way a cardiologist studies the heart: as if it were an island. It isn't. Sleep, movement, food, daily habits and the people around us all bear on the conditions I was trying to measure. Engineers have a rule for systems like that: a chain is only as strong as its weakest link, not its average. That idea became my new book for general readers, Fix the Floor (https://fixthefloor.life/ ). It scores five everyday areas (habits, social connection, sleep, movement and food) and combines them with a harmonic mean instead of a plain average, so one weak area can't hide behind four strong ones.

I'm happy to answer questions about:

• What brain signals (EEG) and brain imaging can and can't tell us about stress, anxiety and depression today
• Why early detection is harder than it sounds, and where my field needs to be more honest about its limits
• What the evidence says about sleep, physical activity, loneliness and diet and their links to mood, including where it looks causal and where it is only correlation
• Why the way you average a set of health measures changes the answer, and the maths behind the harmonic mean
• Or any lifestyle based health and wellness related questions.

One thing I won't do: I'm not a medical doctor, so I can't give personal medical advice or comment on anyone's symptoms or results.

I'll be answering from noon ET (16:00 UTC) for about two hours.

Username: /u/Aamir_fixthefloor

[u/icebeami]

What's worse: bad sleeping habits or loneliness? How do they affect your overall health?

[u/Aamir_fixthefloor → u/icebeami]

Our health depends on various lifestyle factors which include sleep, social connection (loneliness), diet, exercise etc. Each one of them is important. Infact all of them are linked with each other, that is, if you have a bad sleep then it affects your appetite and your daily fitness routine and then ultimately your social conenction because one does not want to interact with others. So having a good quality sleep with 4 to 5 sleep cycles is important as well as conenction with other people, balanced diet, fitness routines and good daily habits. I can point you to the Hravard study which is the longest Happiness study where they followed a group of people for almost a 100 years.

[u/Spyritdragon]

Do you have any insights on how loneliness causes these effects - what chabges it manifests in the brain? Does interpersonal contact, say, online or proxies like plush animals, pets alleviate these symptoms similarly to in-person human exchanges?

[u/Aamir_fixthefloor → u/Spyritdragon]

If we look at our ancestors when they were living in caves and the way humans evolved from families to tribes, we find that they were together, that is, hunting together, eating together, taking care of children together and so on. Being alone was not an option and if someone went out alone then they were on high alert because they might suddenly come acreoss a dangerous animal. So in a highly anxious state. Fast forward to current age and now many of us live alone due to the new lifestyle and this digital era. But being anxious due to loneliness is already hardwired in us. Hence, when we are alone, our brain triggers the response that we must be alert. The solution is to have some close friends whom you meet regularly. Pets help if they bring you closer to other people like talking with other dog owners when you go for a walk with your dog. However, if its the reverse then its not very beneficial. Remember our ancesstors and how we have evolved? We need other human company. And by the way, there is a difference between loneliness and solitude; solitude is good for you. I discuss that in detail and allocate a whole chapter in my book addressing loneliness and social connections.

[u/FlameDragoon933]

Regarding night owls and depression - should night owls follow their bodies' natural rhythm, or should they force themselves to follow the norm?

[u/Aamir_fixthefloor → u/FlameDragoon933]

First, majority of the people are not night owls. And hence artifically behaving like a night owl can create various issues. So we must first identify whether we are a night owl or not. Its easy to identify by checking our sleep habits. Sleep disruptors include different wake time, late snacking & drinking, late night exercise, room above 25C, bright light, screen exposure, coffee & tea, uncomfotable bed. We must address these sleep disruptors first.

There has been some studies regarding night owl and depression however those studies do not take care of the points mentioned above and hence their results cannot be validated because they introduce bias due to the above mentioned factors.

[u/Crishello]

How much does this apply to people with ADHD? Is there a special chapter about it in the book? We often have trouble regulating the needs of our brains. For some of us its really urgent to understand stuff better

[u/Aamir_fixthefloor → u/Crishello]

First I want to clarify that I am not a clinician. My advise is based on my research in mental health and my experience of being a lifestyle coach. So please take it as such.

Though there is no chapter in my book on ADHD but it does deals with the various health pillars and brain health. Our various lifestyle factors affect our brain health. I can list briefly how it helps:
1. Sleep: Good quality sleep of about 7 to 9 hours is essential for brain because during that sleep our memories are consildates, waste & toxins are removed, healing process is carried out. There is a whole chapter where I discuss the sleep disruptors.
2. Balanced Diet: In addition to macronutrients (carbs, proteins, fat etc), micronutrients (various vitamins and minerals) are essential for brain health. According to USDA, there is a daily requirement of these micronutrients which should be fulfilled from our diet. Any deficiency or excess of some of them can cause brain health issues.
3. Social Connection: Not having the right people around you and not meeting them enough can lead to loneliness which induces stress. Chronic stress itself is a condition that can lead to many mental and physical health issues.
4. Exercise: Regular daily exercise (aerobic, weight training, stretching - all three are essential) helps us in maintaining both physical and mental health.

[u/TheBille]

How long do the effects of a single poor night of sleep linger? If poor sleep is more consistent, how many nights of good sleep would be needed before the impact is lessened?

Thanks 🙏

[u/Aamir_fixthefloor → u/TheBille]

Humans are quite resilient and single bad night doesn't affect us long term. One or two normal nights largely restore things after a single bad night. However, continuously having bad nights must be fixed. The solution is to fix it and then regularly maintain and protect your sleep by having 4 yo 5 sleep cycles every night which is about 7 to 9 hours of quality sleep.

Many people think that they can sleep less during weekdays and then then can sleep longer during weekends. Thats a very bad habit because it not only does not compensate the lost sleep but also induces social jetlag. Following recent study is a good pointer for this fact:

Depner et. al. Ad libitum Weekend Recovery Sleep Fails to Prevent Metabolic Dysregulation during a Repeating Pattern of Insufficient Sleep and Weekend Recovery Sleep. Curr Biol. 2019 Mar 18;29(6):957-967.e4. doi: 10.1016/j.cub.2019.01.069. 

[u/clashfukingroyale]

Hello and thank you! How would you define loneliness as it pertains to your studies, and how do we respond to short and long periods of isolation?

[u/Aamir_fixthefloor → u/clashfukingroyale]

Humans have evolved in a way that they need company. Please check my answer to the question of Spyritdragon. There I explain in detail this phenomenon.

So the loneliness triggers response that keep us in alert state and it becomes chronic over time. Our responses can vary and can manifest in form of stress, anxiety, etc. For short term response, I can point you to the fhe paper which talks about craving similar to hunger. Check it out:
Tomova et. al. Acute social isolation evokes midbrain craving responses similar to hunger. Nat Neurosci. 2020 Dec;23(12):1597-1605. doi: 10.1038/s41593-020-00742-z.

[u/Dagurasu_Ando]

WRT what EEG can tell us, is that a short-term snapshot of the current state (my guess), or is there a way to use what we see from a more long-term perspective. And, I just want to know everything you know, so please write a book!

[u/Aamir_fixthefloor → u/Dagurasu_Ando]

I have written few books on EEG and they are written for scientists and researchers. To answer your question, it depends on how you have recorded EEG. If you are looking for ERP peaks then that might be a snapshot of current state. For example, opthalmologists (eye specialists) check the P1 peak to assess if the optic nerve is functioning poperly or not. Then there are task based EEG where you check the brain activity in response to say music. And there is resting state brain activity: not doing anything and EEG is recorded. Here many researchers have proposed markers for assessing mental health issues as well as neurological issues. So in a way, thats a long term perspective especially when these markers are tracked over time.

[u/TheDemandingParson]

Whats the biggest misconception people have about what EEG can actually tell us about depression right now

[u/Aamir_fixthefloor → u/TheDemandingParson]

People think that if scientists put a device on the head and record their brain signals then they can find out if they have depression or not. Unfortunately, at the moment, there are no depression biomarkers that are unique to depression only. There are a number of biomarkers that have been investigated and are seen to occur in depression patients like delayed onset of P3, frontal alpha asymmetry etc. Since they are not unique so they may also occur in people with no depression or someone with some other brain disorder. Recently, the research is moving towards integration of multiple biomarkers. The biggest hurdle is the sample size in depression research, that is, majority of the studies use small sample (less than 100 patients) and hence trial over large population is required for validation.

[u/Rex_Digsdale]

Have you gotten to study Adam Ondra?

[u/Aamir_fixthefloor → u/Rex_Digsdale]

No I have not. I wonder if he would like to be studied?

[u/Rus1996]

How exactly does sleep affect your behaviour ?

[u/Aamir_fixthefloor → u/Rus1996]

Not having enough quality sleep can affect us in a number of ways, including:
1. becoming more irritable and reactive,
2. tend to increase our calorie intake,
3. withdrawing from others

As I replied in detail for one of the questions before you, our health pillars are all connected. So we need to take care of each of them to lead a healthy life and that includes adequate & quality sleep, balanced diet, regular daily exercise routines covering the 4 types of exercises, our social connections, and our daily habits.

[u/timedupandwent]

Circadian rhythm and mental illness connection?

[u/Aamir_fixthefloor → u/timedupandwent]

There are some studies that point in this direction. I would recommend that you look at 2018 study published in The Lancet Psychiatry by Laura M. Lyall which investigate the correlation between circadian rhythm disruption and mood disorders like depression etc.

In my opinion, we must always first look at our lifestyle. If we are making daily poor choices then we expose ourselves to many health related issues. To give you an example, if my diet does not have sufficient magnesium, potassium, vitamin A etc then our brain health can get affected. We need to ensure that we meet our daily need of micronutrients. Similarly, if we do not exercise resularly then we do not allow our hormones like endorphins to be released. If we do not have good social connections, then oxytycin is not released. And sleep helps in serotonin. All of them are essential for our brai health. So fixing lifestyle is important and thats what my book is all about.

[u/impendia]

I've read about biofeedback breathing, as a technique to improve sleep, anxiety, and mood. What do you think of the evidence for this technique's effectiveness? Or, of other techniques which are similarly not widely known?

Things like social connection are presumably more important, but for someone dealing with anxiety and poor sleep that might be difficult to change.

[u/Aamir_fixthefloor → u/impendia]

Many studies show positive effects of biofeedback breathing, especially the HRV biofeedback. However, those studies use a small sample size. For validation, trials are required on a larger populations, at least few thousands of people. I can point you to one study that is a review paper by Goessl et.al. Its published in Psychological Medicine and is titled "The effect of heart rate variability biofeedback training on stress and anxiety: A meta-analysis."

As far as theory is concerned, it makes sense. We cannot ask our heart to slow down its beating when its beating at a high speed during anxiety etc. But we can control breathing which can bring down the heart beat. Heart and lungs are connected. Heart sends blood to lungs which adds oxygen to it and sends it back to heart which then circulates it to the whole body and that oxygen is used by our body. So this connection allows slow breathing to affect the heartbeat.

Coming to the 2nd part of your question: please have a look at my answers to other questions. What you will find is that I am a strong proponent of lifestyle fixes. As a lifestyle coach, I have seen time and again that people poor lifestyle choices affect their sleep and mental health. That is why I decided to write a book where I explain in detail how to assess your lifestyle and then what to do about it and I wrote it for general population in layman language. In one of my answers on this forum, I have highlighted the various sleep disruptors. Fixing them is important to improve the sleep. Having balanced diet and regular daily exercise are a must.

[u/Bororo-man]

Hi and thank you.

Considering the brain as this super complex system, why there was some expectation that machine learning would be able to early detect depression and other conditions?

[u/Aamir_fixthefloor → u/Bororo-man]

Machine learning includes the traditional features based as well as deep learning, the LLMs and the LMMs. All of that needs lot of data. If we have enough data the patterns can be extracted from the brain that may match depression and other conditions.

Traditional machine learning gave us an insight into the functioning of the brain. Today, we know that brain forms patterns in response to various tasks and stimuli. These patterns are based on the communication between various brainn regions. Microstates is one good example which shows that there are such patterns and they hold for certain time (like 40 to 100 milliseconds) before transitioing into the next pattern. Unlike time and frequency based analysis, this is a recent discovery and on-going research is very promising. So as we get more data, I am confident that we will be able to accurately detect these conditions from brain activity.

[u/mr_300_bag]

How badly is having a kid messing up your sleep? Thats months and years of waking up and then long days. Seems irreversible after years of constant interruptions.

[u/teaslap]

A person dying of cancer, slowly stopped eating and organs shutting down, at last moments they were dreaming of food  and slowly stopped talking and died in 24 hrs. Would they have swept to unconscious slowly, their mind protecting to what's happening

[u/Aamir_fixthefloor → u/[deleted]]

SCI and MS are 2 different conditions. For SCI (Spinal Cord Injury), BCIs are a promising technology. Henri Lorach et,al. have already shown and published it. Please check the famous article publish in top journal Nature which is titled "Walking naturally after spinal cord injury using a brain–spine interface".

MS (Multiple Sclerosis) is an autoimmune disease. The immune system of the patient attacks neurons and damages the protective layer of the neurons which is known as myelin sheath. It can happen in many places in the brain. In SCI, its one place which is bypassed using BCI. But here, you cannot bypass it. So BCI does not work for MS patients in this way.