A Better Reset: The Neurology Behind Building Habits That Last
Have you ever wondered why reaching for your phone in the morning feels so effortless? You’re half asleep, the sun hasn’t even come out yet, and your brain has already begun working on autopilot. This phenomenon is called “automaticity”. This is where the brain has effectively created a mental shortcut by cutting out the task of decision-making, carving out a neural pathway for efficiency.
The key here? Repetition.
Whether automating late-night scrolls on social media or brisk morning walks, your brain will automate whatever you program it through consistency. Studies show that all it takes is around 66 days for the brain to strengthen neural pathways to form a habit. With each repetition, new behaviors can become truly automatic.
If your brain has been doing less-than-ideal repetitions in the areas of diet, health, and exercise, the good news is that when you work WITH your brain’s design instead of against it, building lasting change becomes simpler than you think.
For patients managing neurological conditions, building consistent habits isn’t just about self-improvement. It’s fundamental to how well your brain heals, adapts, and manages symptoms. Whether you’re dealing with chronic pain, migraines, cognitive concerns, or recovery from neurological injury, your daily habits directly impact treatment effectiveness.
How Your Brain Builds Habits
We have often heard the phrase, “you can’t teach an old dog new tricks”, but the truth is, habit-forming through repetition, even in older age, can form strong neurological pathways. You actually can teach an old dog (or person) new tricks!
“Myelination”, the process in which a habit becomes automatic, happens through a 3-step loop known as the Cue-Routine-Reward loop. Your brain follows a simple three-step process: a cue triggers the behavior, you perform the routine, and a reward reinforces the loop. Once this pattern proves reliable, your brain shifts into autopilot mode.
Think of your brain like a forest with well-worn paths. Every time you walk the same route, that path becomes clearer and easier to follow. Your brain isn’t being stubborn when it defaults to old patterns—it’s being efficient. The established trail requires less energy than forging through undergrowth.
We often talk about strategies that help us in the moment, like taking a deep breath during a tense conversation or pausing to reset between tasks. These work, and they matter. But here’s what’s fascinating: when you practice these same techniques mindfully and repeatedly, something remarkable happens. Your practices become second nature! You will do this automatically, without even thinking about it.
I tell my patients: Your brain is like a very efficient assistant. It’s constantly asking, “What do you want me to automate?” The habits you repeat most often are the ones it prioritizes. So, the question isn’t whether your brain can change, it’s which pathways you want it to strengthen.
Four Ways to Build Lasting Habits
Here are four proven strategies to help you build brain-healthy habits that last.
1) Start With One Keystone Habit
Oftentimes, it’s easy to get caught up in a long list of goals that we want to achieve, and we end up missing out on all of them.
The first step to building a lasting habit is knowing exactly which one you want to create. Some habits create a ripple effect… when you establish one, others naturally follow.
For example, if getting better sleep is on your resolution list, start by focusing on that one single goal. Some ways to achieve this can look like:
- Establishing the same bedtime every night (this is especially important for migraine patients)
- 15-minute walk right or stretching exercise after waking (helps with pain management and mood regulation)… more about exercise later!
- Glass of water first thing each morning (supports medication effectiveness)
Dr. Kandel’s Tip: Choose ONE habit and commit to it for 21 days before adding another. I’ve seen too many patients try to overhaul everything at once, only to feel overwhelmed and quit. One strong habit is worth more than five weak ones.
I had a patient with chronic migraines who was using rescue medication 15-20 times per month. Her sleep schedule was chaotic. Sometimes in bed at 10 PM, sometimes at 2 AM. We focused on just one thing: lights out at 10:30 PM every night, no exceptions. Within four weeks, her migraine frequency dropped to 6 per month. She wasn’t just sleeping better, but her brain finally had the consistency it needed to regulate properly.
2) Stack Your Habits
Another way to increase your chances of building lasting habits is by creating a routine around them. Your brain already has dozens of automatic behaviors stored in an area called the basal ganglia, which acts as your “habit headquarters.” Using a technique called habit stacking, you can piggyback new habits onto these existing pathways instead of building from scratch. The formula is simple: “After I [EXISTING HABIT], I will [NEW HABIT].”
For example:
- After I pour my morning coffee (decaf!) → I take my medications (helps with adherence)
- After I brush my teeth at night → I do 2 minutes of neck stretches (helps with tension headaches)
- After I sit down at my desk → I take three deep breaths (reduces stress-related symptoms)
The existing habit serves as a built-in cue. Your brain already recognizes “morning coffee” as a signal, so you’re piggybacking on an established neural pathway rather than creating one from zero.
Habit stacking works especially well for medication adherence. Instead of trying to remember to take medication at a specific time, link it to something you already do automatically every day.
Dr. Kandel’s Tip: Write your formula on a sticky note where you’ll see it. For the first week, say it out loud: “After I pour my coffee, I take my medication.” This verbal repetition strengthens the connection.
3) Make It Ridiculously Easy
Most of the time, what really prevents us from achieving our goals is resistance to getting started. When starting a task, your prefrontal cortex works hardest, and that’s where all the resistance lives. If initiating the task takes more steps than ideal, the brain will perceive it as difficult, and the chances of follow-through become lower.
One of the keys to successfully initiating any new habit is time. Ideally, it should take less than 2 minutes to start. Getting your shoes on is the hardest part of exercise. Sitting on the cushion is the hardest part of meditation. Once you’ve started, continuing is much easier.
This is especially important for patients managing fatigue or pain. The key is consistency, rather than perfection.
Try this trick! Instead of “exercise 30 minutes,” start with “put on workout shoes.” Instead of “meditate 20 minutes,” start with “sit on a meditation cushion.” Instead of “follow a perfect diet,” start with “add one vegetable to dinner.”
Dr. Kandel’s Tip: Set up your environment to support your desired habit. Put your walking shoes by the coffee maker. Place medications next to your toothbrush. Keep a water bottle on your nightstand. If you have to search for what you need, you’ve already lost the battle.
4) Track Your Progress
One easy way to do this is to use a simple paper calendar. Every day you complete your habit, mark an X. Your only goal: don’t break the chain.
After about two weeks, you’ll notice a shift. You’re no longer doing it for the reasons you started, but you’re doing it because you don’t want to ruin your streak. That’s dopamine, your brain’s reward chemical, at work. The brain positively perceives and rewards accomplishment, accordingly.
For patients managing chronic conditions, visual tracking provides something else too: evidence that you’re taking control. When symptoms flare despite your best efforts, that calendar shows you’re doing your part. That matters psychologically.
Dr. Kandel’s Tip: Miss a day? Don’t spiral. Just start again tomorrow. Two missed days is a hiccup. Three means your system needs adjustment.
What to Expect When Building Habits
Building a habit takes about 66 days, but what does that really look like?
Weeks 1-2: Everything feels exciting. Motivation is high.
Weeks 3-4: The novelty wears off. Your brain starts pushing back. You’re building the pathway, and that takes effort. This is also when patients often stop physical therapy exercises, abandon medication schedules, or give up on lifestyle changes. Neurologically, this is exactly when it’s working, so be sure to push through and don’t quit! Hitting the 21-day mark is really essential in the beginning of forming a habit.
Weeks 5-8: The habit starts feeling more natural. You notice when you DON’T do it. The neural pathway is strengthening.
Week 9+: The habit requires minimal conscious effort. It’s become part of who you are.
Discomfort during weeks 3-5 isn’t a sign you’re failing. It’s proof that neuroplasticity is happening. Just remember that after the temporary discomfort, your brain is building healthy habits that will last for years.
Building Rhythms That Last
Your brain is designed to create automatic patterns, and you get to decide which patterns become automatic. It is not about perfection or all-or-nothing overhauls.
For patients managing neurological conditions, the right habits can mean the difference between simply managing symptoms and significantly improving function. You don’t need to change everything at once. Start with one habit.
Give it 30 days. Walk that path consistently enough for your brain to say, “I’ve got this now.”
If you’re managing a neurological condition and aren’t sure which habit would best support your treatment, don’t hesitate to contact your healthcare team. Building the proper habits in the correct order can make a significant difference in how you feel day to day.
A Message From Dr. Kandel
“It is never about being perfect; it is always about being better. We’ve all heard it: every journey starts with a single step. This is your opportunity to become a new and improved you; it just takes one single step
And now, let’s get back to that little teaser above, about exercise. If you’ve been following along, you know that last month some of the staff gave little blurbs on how to de-stress during the holiday by revving up your vagal nerve, activating your parasympathetic (calm) nervous system.
Well, it’s a new year, and everyone makes the same resolution… I’m going to exercise more… I’m going to get healthy. In the next few weeks, more of my staff will be posting a series of exercise activities. From simple stretches that can alleviate joint stiffness, to targeted exercises that affect problem zones like the neck, back, and maybe a large waistline… keep following to see which exercises are right for you!”
Joseph Kandel, MD
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