Science shows that community changes our brain chemistry. But before I deep dive into what happens with neurotransmitters and dendrites, I’ll be honest with you about why this is heavily on my mind right now.
Over the past several weeks, my communities showed up for me on incredibly short notice. People jumped in as advance readers, rallied to get Goodreads reviews posted at the last minute when I urgently needed them, and carried me through a high-stress bottleneck when my pre-order timeline jumped up by two months from the original plan. I want to honor that generosity honestly, because it means the world to me.
But I also want to be vulnerable about the other side of it: I’ve realized that I’m currently not naturally great at community.
Is it because of childhood trauma, where I could never rely on my parents? Is it because I’m deeply introverted and neurodivergent (AuDHD), meaning I overthink all my replies too hard, and receiving support can feel just as exhausting as giving it? Is it being overstretched by childcare, eldercare, and healthcare giving? Or is it because the very first important community I was in (my church) rejected anyone who questioned things, and I’ve never quite gotten over that first heartbreak?
Maybe my relationship with ambition needs a scale-back. Maybe I’ve simply bitten off more than I can chew. Despite the subtitle of my book using the word healed, I still have deep-seated trust issues after all these years. All of these things probably hold some degree of truth, and I’m not sure which ones weigh more than the others.
But what I do know is that in my current season of life, my communities are carrying me—hard. I am actively working to become more community-minded, because connection isn’t just a personality trait you either have or you don’t; it’s a skill you can build, even when your wiring makes it harder. And I am really looking forward to the day that I can consistently be the one they depend on, because they have truly shown up for me.
Last month, I launched a brain health group program through the Aroga Lifestyle Medicine clinic in Toronto, so I did some extra research into the literature on how connection shapes the brain.
It turns out that social isolation acts as a chronic stressor that physically alters our neural architecture. One of the most striking human datasets comes from an unlikely place: Antarctica. Researchers scanned a crew who spent fourteen months at the German Neumayer III station, and found roughly a 7% reduction in the volume of the dentate gyrus—the part of the hippocampus responsible for forming new memories and generating new neurons.
What’s most interesting isn’t the shrinkage itself but what also happened to brain neurochemistry. The volume loss correlated with falling levels of BDNF, brain-derived neurotrophic factor— the growth signal that tells your brain to build and maintain synapses. Their BDNF dropped within three months of arrival and stayed low even six weeks after they came home.
(Two major caveats though: 1) the study had only nine participants, and the authors themselves said to interpret it cautiously, 2) Antarctic overwintering isn’t just social isolation—it’s also cold, darkness, confinement, and relentless monotony.)
But here’s the part that’s genuinely hopeful: newer work suggests these gray matter changes are largely transient. The brain appears to recover when the conditions do. This isn’t a one-way door.
On the flip side, social engagement is profoundly protective. The largest analysis to date, pooling twenty-one longitudinal cohorts and more than 600,000 people, found that loneliness raises the risk of dementia by about 31%. To put that in perspective, the authors noted it sits in the same magnitude range as physical inactivity or smoking 15 cigarettes.
Systematic review data suggests that participating in even one regular social activity is associated with a substantially lower risk of cognitive impairment. (These are observational findings, so some of the effect likely runs in both directions—people with early cognitive changes withdraw socially. But the signal is consistent and it is large.)
Belonging isn’t just a warm, fuzzy feeling; it builds what neurologists call cognitive resilience. Being part of a supportive community creates a biological buffer, helping your brain maintain its function and protect its synapses even when there’s underlying aging or pathology happening on a microscopic level.
One of my favorite writing partners challenged me last fall with the opening chapter of my second book: “But Anne, you don’t explain what is RADICAL about your Radical Brain Health approach?”
After letting that sit in the back of my brain for six months, I realized part of the answer: the biggest brain health improvements come from radical structural life changes, not from slightly optimizing one more habit. (Don’t get me wrong—every small change gradually bends your brain health trajectory in a better direction.)
For most of us, making radical life shifts feels impossible. I have patients who say, “I just can’t make it to the gym once a week,” or “I just can’t stop eating out,” or “I just can’t resist ruining my bedtime every night by scrolling for an hour.”
My “I just can’t” is this: I just can’t stop being an ambitious loner who compulsively works on her projects all the time.
My goal is to challenge myself to actually enjoy my life and connect with the people I love. I have already achieved so much; why do I try to take everything to the maximum? Why can’t I decide to take community and social connection to the maximum, when the evidence says it is exactly what my brain needs?
We all have our Achilles heels. Because my mother was unemployed and my father harmed others and was convicted, it is very hard for me to shake the feeling that I must constantly be producing, helping, progressing, and making the world a better place. My brain is often in “survivor” mode—just get through this thing, and then this next thing, and then we’ll be okay—rather than stopping to smell the roses and remembering to focus on “we.”
When I grew up, I didn’t play any sports or do any extracurricular activities other than church. And now? I am a daily gym freak. I built that from scratch. So I am hopeful that I’m going to get there in being more community-minded.
I know that if you’ve read this far, you’re in my community—at least in terms of this online writing space I’m creating. So thank you. I can’t promise to be socially normal until after this book is launched, but learning how to lean on others, and to be available for others to lean on me, is very high on my list.
Which brings me to a confession.
I am aware that an essay about scaling back ambition is about to end with me asking you to buy a book within a specific window of days. The irony is not lost on me. Please consider it a live demonstration of the problem.
Here’s the thing I’ve learned watching this industry from the inside: a book launch runs on momentum, and momentum is built almost entirely in the first few days. It’s the same logic as a film’s opening weekend, or those crowdfunding campaigns where hitting a third of the goal in the first 48 hours decides the whole thing. Early commitment is a signal. When a book gets early reviews and sells in a tight, concentrated burst right at launch, the people who decide what gets stocked, featured, and recommended all notice. A slow, loyal trickle—however loving—doesn’t move the same needle.
Which is why the readers who showed up early for me, with minimal notice, did something genuinely structural. They weren’t just being kind, though they were. They were laying the foundation the whole launch stands on.
I’ve got two kicks at the can:
Preorder phase -- pre-orders are what drive interest in stores & libraries deciding to stock it in their shelves. It also gives a signal to media as to whether to review/cover my book.
Launch week in October -- this is what determines whether I have a chance at having a bestselling book. For the Canadian bestseller lists, pre-orders generally count in the launch week (Oct 6-11). For Amazon’s algorithm, it will be best to plan to buy a copy on launch day (Oct 6).
So here is my one real ask: the Indigo paperback pre-order is finally live. If you’ve been waiting for a reason, this is it. A pre-order placed today with shipment to your local store counts toward launch week, helps the book reach physical shelves, and gets it into the hands of readers who’d never otherwise find it.
I’m at 58 Goodreads reviews right now, and I return to them when I feel like giving up, which is most days. I’m told that 100–200+ reviews is where a book starts to get taken seriously by both algorithms and the literary community. If you’d like to join the early review team, reply to this email or sign up on NetGalley for a free advanced Kobo or Kindle copy.
A generation ago, books lived or died on a single newspaper review. Now it’s word of mouth—the quiet recommendation, the review posted at 11pm because a friend asked.
Which brings the whole thing full circle. The force that carries a book is the same one that protects a brain: other people, showing up.
With so much gratitude for both my in-person and online community,
xo Dr. Anne
Rise After Silence: An ER Doctor and the Patients Who Healed Her — launching October 6.
Canada: Indigo paperback pre-order ← the one that helps most right now
Canada, Independent: Ben McNally · Book City · Another Story Bookshop · Audrey’s · The Next Page · Pages Kensington, or Shop your Local Store
United States: Barnes & Noble
Launch week, October 6–11: in stores across twenty Canadian locations.
📚 Hugh’s Room Launch Show and End Violence Everywhere Fundraiser in collaboration with Ben McNally’s Bookstore.
📚 Chapters Woodbridge — Family Friendly Q&A, Thursday, October 8, 7–9PM
📚 Indigo Eaton Centre — Friday, October 9, 4–7PM
📚 Indigo Sherway Gardens — Saturday, October 10, 12–3PM
📚 Indigo West Edmonton Mall — Sunday, October 11, 12–5PM
I’d rather not tell you what I think of my own book. Here are recent readers instead—people who read it cover to cover, and to whom I’m eternally grateful.
“One of the most compelling medical memoirs of our time.”
“One of, if not the best, autobiographies I have ever read.”
“I started it less than 48 hours ago and had trouble putting it down.”
“Witty, insightful, self-deprecating, honest, and brave. The author has a remarkable ability to tell hard truths without losing sight of the humour, absurdity, and humanity that exist alongside them.”
“I loved every stitch of this book.”
“SO GOOD!”
“If you read one book this year, make it this one.”
References
Fishman, A., Grinin, P., & Riljak, V. (2025). The (Un-)Social Brain in Isolation. Physiological Research.
Stahn, A. C., Gunga, H. C., Kohlberg, E., et al. (2019). Brain Changes in Response to Long Antarctic Expeditions. The New England Journal of Medicine.
Wang, S., Molassiotis, A., Guo, C., et al. (2023). Association Between Social Integration and Risk of Dementia: A Systematic Review and Meta-Analysis of Longitudinal Studies. Journal of the American Geriatrics Society;
Li, J., Shi, L., Jiang, N., et al. (2026). Associations Between Social Relationships and Cognitive Impairment in Older Adults. Medicine.
Powell, A., Chan, K., Shepherd, C. E., & Brodaty, H. (2026). Cognitive Resilience in Ageing: Determinants and Interventions. The Lancet Neurology.
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