Where the heck was Dr. Marisa M. Silveri when I was 14 years old and I needed someone to smack me upside the head with a really good reason not to drink and smoke pot?

(Wait a minute. I just did the math. Dr. Silveri hadn’t even been born when I was 14 years old! Forget I asked that question.)

I spent last Thursday afternoon with Dr. Silveri at the Brain Imaging Center at McLean Hospital, just outside of Boston. Dr. Silveri teaches at Harvard Medical School, like most of the doctors at McLean. She is brilliant, like most of the other doctors at McLean. And she is completely, thoroughly and totally into her research: The adolescent brain.

She showed me the lab’s three MRI machines like they were Aston Martins and then she showed me what I had done to my poor little 14-year-old brain when I started drinking and drugging.

Susan Tapert Ph.D., Univ. of California - San Diego

It wasn’t pretty.

The top scan shows the brain of a 15-year-old non-drinker performing a memory test. The bottom scan shows the brain of a 15-year-old heavy drinker taking the same test. Even scarier, the heavy drinker was not drunk when he took the test.

Here is how Dr. Silveri explained it: The prefrontal cortex of the brain — the region which regulates decision making, learning and memory — is not fully developed in teens. An undeveloped prefrontal cortex does not mean teens will make poor choices but an undeveloped frontal lobe makes it more difficult for teens to filter out the bad choices, Dr. Silveri said.

You really do not want to interfere with the development of your prefrontal cortex, which is the part of your brain that will prevent you from behaving like Britney Spears. Alcohol damages the ability of the prefrontal cortex to develop. Teens who drink have reduced brain activity and score worse on vocabulary, general information and memory tests — even when they are not drunk.

Dr. Silveri is not against drinking – “Absolutely not.” She merely wants teens to delay drinking as long as possible to allow their frontal lobe to fully develop. “Help your frontal lobe help you!” she proclaims.

Dr. Silveri, who is 36-years-old but looks a dozen years younger, often takes her brain scans and message to teens: “I’m not here telling you to “just say no.” I am here telling you to delay.”

“Delay” isn’t nearly as offensive  as “Just say “NO”.”

What does any of this have to do with depression? Everything. The onset of my depression and mania began in my early teens. I used drugs and alcohol to self-medicate. Alcohol is a depressant; like throwing gasoline on a fire and tossing a match.

Would the “delay” message have worked on me when I was a teen? I don’t know. The “Just say “NO”" mantra certainly did not.  I do know that studies have shown that the earlier you start drinking, the more likely you are to become an alcoholic. I am living proof. It took decades for me to put down the drugs and alcohol  and get a handle on my depression.

“I’m about doing science that is real for people,” Dr. Silveri said. “Is there something I can do with science to make life better for teens?”

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    Last reviewed: 12 May 2010