Восходящая спираль. Как нейрофизиология помогает справиться с негативом и депрессией — шаг за шагом

by Alex Korb

В этой книге нейрофизиолог объясняет процессы в мозге, стоящие за депрессией, и предлагает практичный и эффективный подход для избавления от нее.

Научные эксперименты, проведенные за последние десятилетия, коренным образом изменили наши представления о механизме работы нейронных связей в мозге человека, которые отвечают за возникновение депрессий.

Наш мозг полон нейронных цепочек, между которыми происходит очень сложное взаимодействие. Есть цепочки, в которых рождаются наши тревоги. А есть цепочки, в которых «живут» наши привычки. Есть нейронные пути, которые участвуют в принятии решений. А есть такие же пути, информирующие нас о боли. Есть цепочки, которые определяют наш сон, память, настроения, способность к планированию своей деятельности, удовольствия. И все они взаимодействуют друг с другом. У всех одни и те же группы нейронов, независимо от того, находитесь вы в состоянии депрессии или нет. Хотя «настройка» каждой нейронной цепи у разных людей может отличаться. Депрессии возникают из особого характера взаимодействия нейронов. Они могут иметь очень сильное воздействие на поведение человека.

К счастью, научные исследования показали, как небольшие коррекции в образе жизни и поведении человека могут изменить работу и нейрохимическую составляющую деятельности тех или других наборов нейронов. А по мере того, как меняется работа мозга и продуцируемых им нейрохимических веществ, меняется и течение депрессии.

В этой структурированной и доступной книге нейрофизиолог Алекс Корб рассказывает, как вы можете применить на практике достижения наук о мозге, чтобы обратить свою депрессию вспять.

Genres: Psychology, Nonfiction, Self Help, Mental Health, Neuroscience, Science, Health

256 pages, Unknown Binding

First published March 1, 2015

About the author

Alex Korb, PhD is a neuroscientist who has studied the brain for over fifteen years. Outside of the lab, he is a speaker, consultant, personal coach, and is also head coach of the UCLA Women’s Ultimate Frisbee team. He has a wealth of experience in yoga and mindfulness, physical fitness, and even stand-up comedy.

Reviews

[Morgan Blackledge · Rating 5 out of 5]

This is the most comprehensive yet economical overview of the biological, psychological and social factors that contribute to depression that I have come across yet.

Of course, there is much, much more to be said on each subject. But author Alex Korb touches on just about all of the important stuff.

All of the advice he gives on how to pull out of a depressive "downward spiral" is spot on. Totally clinically sound.

Of course, implementing all of the various interventions (i.e. doing all the shit he says) is the the challenging and important part.

But if you were to (a) basically read and understand the reasons for depression that he is providing, and (b) do all the shit he's telling you to do, you will (c) be doing about as good as anyone could expect to do when they are recovering from depression.

And that incidentally, is actually pretty darn good. As it turns out, depression is very treatable. Of course there are allot of different types of depression, but generally speaking, it's treatable, and this book nails the treatment plan about as good as any I've read so far.

There is so much information in this short book, that a reasonable synopsis would be almost as long as the book. But let me attempt to break it down to some bullet points:

The book begins with a (very) brief but minimally sufficient tour of neurochemistry and brain structure and function.

Brain Structure:
The brain structures important to a discussion about depression are the evolutionarily recent (thinking-deciding) prefrontal cortex (PFC) and the "primitive" evolutionarily ancient (feeling-motivating) limbic system including (most significantly) the Amygdala (your lil' almond shaped emotional computers) the thalamus and hypothalamus (the switchboard operator) and the hippocampus (your brains "save" button).

Depression is largely a result of these (and other) brain structures, not playing well together.

Neurochemistry:
These brain structures function and communicate via chemical "messengers" (neurotransmitters and hormones), including serotonin, dopamine, oxytocin, endorphins, norepinephrine, GABA, and endocannabinoids to name but a few.

Imbalances in neurochemistry can contribute to brain structures not playing well together, and brain structures not playing well together contributes to imbalances in neurochemistry.

It's impossible (and not important) to go into detail in this review. But suffice it to say, your brain is an extremely complex system (much like a global weather system) and sometimes it gets "stuck" in maladaptive patterns, what the author refers to as "Downward Spirals" (think global climate instability e.g. global warming).

Although the system is complex. The solutions are fairly straight forward. In essence, we need to "jump start" our brains (and extended nervous system) in to an "Upward Spiral" i.e. a virtuous cycle of adaptive functionality.

This process of going from a Downward to an Upward Spiral is achieved via numerous behavioral modifications including:
• restful sleep
• sufficient exercise
• healthy diet
• adequate social support
• practicing mindfulness
• values clarification
• meaningful goal setting and accomplishment
• changing maladaptive thinking habits
• receiving adequate medical attention
• receiving professional psychotherapy

The author's main point is, you don't have to be perfect, you don't have to know exactly what you to do, you just have to take a step.

And the right step(s) prime the pump for more good steps, and Papua New Guinea (a place and a magic word) your pulling out of your nose dive.

The Deliciously Dark Subtext:
I love neuroscience, evolutionary theory, and behavioral psychology because it strips human behavior of just about all of its "magical mystery".

That is not to say that all (or even most) of the secrets of human behavior and wellbeing have been discovered.

No!

Way not!

Not even close!

All I'm saying is that these ways of investigating and understanding human behavior and wellbeing are rapidly approaching the tipping point of being minimally sufficient to the task of eliminating the need for non-naturalistic explanations.

In other words, we may not know exactly how this shit works, but it's a pretty safe bet it ain't magic.

When we ban magical explanations in favor of naturalistic explanations, we trade naïve bliss for some serious handles on how to do shit.

When we went from a geocentric cosmology (the earth is at the center of the universe), to a heliocentric model (the sun is at the center of our solar system), we lost our "gods golden kids" status, but we gained the ability to navigate the globe and eventually stick a dude on the moon.

Similarly, when we abandon our naïve spirituality and folk psychology e.g. the assumption that our consciousness is a disembodied, non-physical "magical spirit" and our conscious awareness is the important source of our behavioral choices and wellbeing. We trade out our "comforting" assumption that our immortal, immaterial soul is in charge, for some real handles on how to achieve extraordinary resilience and wellbeing.

The "bad" (actually good) news is we can't just pray or think our way to resilience and well-being. We have to (primarily) behave our way to it.

The good news is, it's actually possible to do that. Or at least achieve our best approximation of what ever that is for each of us.

So again. As I mentioned, I love neuroscience, evolutionary theory and behavioral psychology.

But it's not for everyone.

It's actually very destabilizing for some folks.

If you're one of them, you may wish to stop reading right now, and you may also be wise to skip this book.

For you, I might recommend something by Louise Hay. And good luck with that by the way.

But if you're ready for a highly functional, robust, naturalistic explanation for depression. Than get this book, and read on.

The powerful subtext of this book and every other significant contribution to a naturalistic exclamation for human behavior is this:

Your conscious awareness is an emergent property of your embodied brain and extended nervous system.

Every experience you have comes as a result of neurochemicals e.g. neurotransmitters and hormones interacting with your brain and extended nervous system.

Everything you think, feel or otherwise perceive emerges as a result of neurochemicals acting on your brain and extended nervous system.

You can change your brain and modulate your neurochemistry with effective cognitive and behavioral training and (as a last resort) psychopharmacology.

It's far from perfect, but it's the best solution for recovery from depression (and every other form of psychopathology for that matter) that we currently have.

If that information sits well with you. Than you are ready for this book. If this information provokes an existential or spiritual crisis. Go ahead and have it. We all have to go through that one at some point. And comeback when your finished.

Just remember, all of the specialness and magic of living that you sense and know to be true, is real. It's just not magic. It's nature. And that's ok.

This may seem depressing at first, but trust me, it is the most reliable pathway out of depression currently available.

My advice to you is to keep an open mind, entertain the possibility that recovery is possible, get professional and peer support, roll up your sleeves and get to work.

Reading this book is an excellent place to begin.

Loved It!!!!!!

[Caroline · Rating 5 out of 5]

This book was recommended to me as being of interest to anyone, rather than just people with depression - and indeed I found it so.

The author is a neuroscientist, and all the points he makes about positive and negative behaviours are backed up with descriptions of what is going on in the brain. I rather skimmed these technical details, and concentrated instead on the practical advice he was giving. The book is well designed, with grey boxes for suggestions that can be put into action. At the end of reading the book you could just flick back and pick out these boxes.

I found his knowledge about research relating to depression extremely interesting. I was familiar with some of the ground he covered, but some of it was new, and some of it I needed to hear again.

I learnt some valuable lessons from this book. All in all I thought it was an excellent read. I end with my usual smattering of notes

Different neural connections = different vulnerabilities in each person

*When a circuit in your brain is activated more easily we say it is more reactive or excitable. For example, depending on the excitability of the worrying circuit, some people worry more and some people worry less. Also depending on the neural connections in the decision-making circuit, some people are more decisive than others. Other people's social circuitry will make them experiences loneliness more than others.

The different tendencies of our various brain circuits means that everyone has different downward spirals they're likely to get stuck in, and thus need different upward spirals to make them feel better. For example someone prone to loneliness might do well to spend time at the library or in a coffee shop, whereas someone prone to worry might do well to practice mindfulness.

Depression

Your genes can give you brain circuitry that is more prone to depression. Mood disorders run in families.

Our brains are wired to pay more attention to emotional events, and emotions are more easily activated by the negative. Plus, some people's brains automatically focus even more on the negative than others, eg they have a bias towards pain, loss, the emotional toll of mistakes, distorted memories of the past & distorted expectations of the future. In truth, reality is almost certainly better than it appears.

Negative events carry more weight with our brains than positive ones. We are more unhappy at losing $5 than we are happy at finding $5.

In the face of uncertainty, depressed people assume the worst. But uncertainty is just uncertainty. It's not bad, it's just unknown.

Antidepressants will help 30 out of 100 people feel 100% better. Another 20 people will get substantially better but will still be somewhat depressed. If the last 50 people are put on a different medication, 15 will get better.

Psychotheraphy by itself will help about 50% of people get better, combined with antidepressants and almost all of them will improve.


Character traits

A lot of our negative behaviours/traits are just the downside of positive behaviours/traits.

eg
Planning, solving problems...........Worrying
Keeping us safe................................Anxiety


Good behaviours for anxious or worrying people

Reduce your options and make quick decisions wherever possible. As soon as you make a decision, however small, everything starts to feel more manageable.

Pay more attention to what you CAN control. Feeling in control reduces anxiety.

Breathe deeply. Take a deep breath and let it out slowly.

A splash of cold water can slow down the heart rate. If you are feeling overwhelmed or stressed find a sink & splash some cold water on your face.

Get support from friends.

Go for "good enough". Worrying is often triggered by wanting to make the perfect choice. If you try and have the best of everything you're likely to be paralysed by indecision, or dissatisfied with your choice..

Avoid catastrophising (ie imagining the worst case scenario). Remind yourself of possible positive outcomes.

Make a plan to deal with the issue facing you, don't just worry about it.

Mindfulness: stay in the now. Pay attention to things that are happening now, and don't pay attention to things that aren't happening now.

Practice non-judgemental awareness about your negative or negatively-biased thinking.


Temptation

It is much easier to avoid temptation that it is to resist temptations. Get unwanted temptations out of your life where possible.

Habits

Resisting impulses is like fighting an army of zombies with a limited number of bullets. Eventually you will run out of bullets. But you can create better habits. With habits you are using a different part of the brain. Ultimately it comes down to practice, practice, practice. To create new, good habits you have to repeat them over and over again, until your brain rewires itself.

Regrettably bad habits don't need much repetition, because they often release a lot of dopamine, so you easily get hooked.

When you first try a new habit it requires a lot of effort. Starting a new habit requires the intervention of the prefrontal cortex, and that take mental effort. The good news is that the dorsal striatum responds to repetition - every time you do something it gets further wired into this part of the brain (which governs habits.)

Changing your habits while stressed will have a more powerful effect than when you are not stressed.

Changing habits means that you will make mistakes. You won't succeed 100% of the time, maybe you won't even succeed most of the time. You may have many slip-ups. Be as patient and kind with yourself as you would be with a puppy you were trying to house train. Keep trying, and eventually the new habit will stick.


Exercise

Exercise if very good for your brain and psychological well-being. You may not want to exercise, in which case save more pleasurable pastimes as rewards for doing so. Exercise alters your dopamine circuits and releases endorphins. If you can't aim for the runners' high, go for the walkers' buzz.

Decisions

These are important. It's better to make a decision than to do nothing. It's better to do something partly-right, than do nothing at all.

Making decisions includes setting goals.

It helps you find solutions to your problems and calms your limbic system

Indecisiveness gets in the way of happiness.

A decision with an action is a robust way to start an upward spiral.

One of the most important consequences of decision-making is that it guides our attention to the things that matter most - just as Google biases your research towards the things that matter most.

Making a decision, even a tiny one, starts shedding light on ways to improve your life.

It also helps us a lot to have control over our decisions, rather than having them made for us.

We don't just choose the things we like - we like the things we choose.

It is okay to change your mind. It's much better to make a decision and then change direction than it is to do nothing. You are still in control of your life.

Every time you make a decision instead of procrastinating, worrying or acting impulsively, you strengthen your decision-making circuit for the future.

If you have to make a lot of decisions in a row, the decision-making circuit gets fatigued and the brain falls back into indecisiveness or impulsivity...but that's okay...as with physical exercise, you're training your brain for the future.

Goals

Deciding on a goal and achieving it feels more rewarding than if something good happens to you by chance.

It is better to decide to DO a positive than to decide to AVOID a negative. eg 'I want to do a great job', not 'I don't want to do a bad job.'

People are often at their best when working towards a long-term meaningful goal.

Goals have to be clearly defined, not nebulous. Be specific.

We also need to set goals we believe we can achieve. If necessary break them down into smaller goals.

Sleep

Getting enough sleep is very important.

If you are worrying and can't sleep, write down your thoughts. Get them out of your head and onto a piece of paper, and be done with it.

Yoga

This is incredibly helpful and does a particularly good job in increasing positive emotions.

Music

This can be motivating and enjoyable & can help you regulate your emotions. It can also lower blood pressure. So sing along with the radio, or even better, go dancing.

Posture

Stand up straight and put your shoulders back. Your posture is an important source of sending messages to the brain. People with confident postures are more decisive & confident. It can also increase your energy.

Muscles

The interesting thing about muscles is that they don't tense on their own. When they are tight it's because the brain is telling them to be tight.

To remind your brain to relax your muscles it's sometimes helpful to clench them first, just for a few seconds.

The most important muscles to relax are your facial muscles, and they have the largest effect on emotion. Relaxing your hands, butt and stomach are also important.

Gratitude

This is a potent antidote to negativity because it doesn't depend on your life circumstances. Gratitude is a state of mind. The effect of gratitude is greatest in people with the highest levels of hopelessness. When everything appears bleak and meaningless, a little gratitude goes a long way.

Gratitude also reduces anxiety. The brain can only focus on so many things at once, so gratitude replaces those negative feelings and the worry evaporates

Try keeping a gratitude journal and noting 3 things every day, even 1 thing a day would be helpful.

Even if a situation is 90% what you don't want, you can still be grateful for the other 10%

Gratitude for the future.....Optimism combats negativity and is a form of gratitude, because we are grateful for the possibility of good things to come. You don't have to believe that good things will happen - you just have to believe that they could happen, or that no matter what happens, you will be okay.

Gratitude that involves social comparisons isn't helpful. It means you are more likely to assume other people are engaging in social comparisons about you, and that can make you feel judged and excluded. On the other hand, showing gratitude, kindness and compassion towards others activates more positive social circuits. And when you feel those emotions towards other people you are more likely to feel that other people are feeling the same about you.

With gratitude, it is often the searching for things to be grateful for that triggers the positive brain response - actually finding something to be grateful for is a bonus.

People

We need them. Social interactions change the activities of numerous brain circuits.

As has been demonstrated in an fMRI experiment, social exclusion activates the same brain circuitry as physical pain.

A good social network even improves the effects of antidepressant medications.

Social support can come in many forms - a church, following a football team, joining an activity group....even text messages, social media comments and emails.

Levels of happiness are contagious

After examining 4000 people over 20 years, Harvard researches found that if you have a friend nearby who becomes happy, your chances of becoming happy increase by 25%

Pets are good

This is partly due to companionship, partly due to looking after another creature..

[Yamini Kashyap · Rating 5 out of 5]

Being a chronic depression and anxiety patient myself, I started reading this book without much hope and expectations. I never believed when people said a book could change lives, until I read this one myself.
Alex Korb gives a lot of hope to every patient stuck in a downward spiral through this book. A lot of theories that we discard because they're just overly romanticised or clichéd have been backed with adequate scientific evidences in this book- "Biofeedback" is one of them. The best takeaway fact from this book is that depression manifests itself as physically as most diseases in the human body, and so it's very much treatable. And what's better, you can exit your downward spiral through multiple avenues, each one of which has been elaborated enough for a layman to understand and more importantly, execute. You may need not have access to medication and professional help to start with. I could go on and on praising this book but I'll stop here with a strong recommendation for everyone to give it a read.

[Zitroneneis · Rating 2 out of 5]

Executive Summary:
A book that manages to lay out a captivating hypothesis about depression which sadly falls short in delivering a coherent approach to addressing the problem and instead rehashes many old pieces of wisdom in tone-deaf writing style.

Review:
The core message of the upward spiral is pretty simple: the human brain is a highly complex interconnected system which can get caught in a downward or upward spiral that can lead into or out of depression.

In depression the brain has been caught in negative feedback loops that reinforce themselves making it harder and harder to get out of this state.  But just as the brain can get stuck in a downward spiral it is possible to positively influence different parts of the brain to provide new impulses and break the negative loop and change it to an upward spiral instead.

The brain system is too complex, dynamic and interconnected to figure out exactly how the many parts of each individual brain work together to create to the problem of depression. But it is understood which parts of the brain are involved and how they effect each other. This knowledge can be used to address the different parts individually and hope that the system will end up in a more favourable working point.

After establishing this hypothesis the book goes through the different parts of the brain that are effected by / and that have an effect on the underlying cause for depression. For each of these parts the book offers suggestions and techniques on how to positively influence that area to support the activation of an upward spiral.

While the underlying hypothesis of the book is very appealing in its simplicity I struggled to relate to the book. It mostly comes down to two aspects - the tone of the writing and the buffet style presentation of the factors that might have a positive effect on the depressed brain in a downward spiral.

The tone of the writing makes it is pretty obvious that the author has a background in Neuroscience and has not worked much with real patients. The book does not transport the feeling that the author tested his suggestions with actual people suffering from depression. Instead the book just gives the results of hundreds of different studies and a plethora on tips and suggestions that often end up sounding condescending  if you have ever struggled with a depression (so you're depressed and don't manage to get out of bed - have you tried to do some exercise and smile more regularly for a few weeks, studies have shown that this can help some people). 

On top of that it is very clear that he has not suffered from a severe depression himself. The examples he uses to showcase how to get caught in a downward spiral and how to get out of it again actually downplay the severity of a depression. He lists a difficult time after a breakup in college and getting anxious while preparing a dinner for guests under time pressure as examples. Not that it is a requirement to have suffered from depression to be able to write a book about it, but some prolonged exposure to the problem (direct or indirect) might have helped to generate a tone of writing where it feels like the struggles are being taken serious.

The other issue is the outline of the book - it is structured in chapters which focus on the different areas of the brain that are involved in the problem of depression. But what is lacking is a thread that ties all the different advice and techniques together. Instead the reader is left with hundreds of tips and solutions but no guidance on where to get started.

The author is obviously very knowledgeable in the field and he manages to tie together results from different scientific fields into a framework to explain depression but it does not become clear to me who this book is aimed at. It is too simplified for a reader with a scientific background, it is too vague/condescending to be of help for readers struggling with actual depression and it is not helpful for people that want to get a better understanding of a loved-ones struggle with depression because of the tone deaf writing from a scientific perspective.

[Vui Lên · Rating 5 out of 5]

4.5. Bản dịch tiếng việt là Vòng xoáy đi lên

Cuốn sách thực hành tốt nhất về điều trị trầm cảm mà mình đọc gần đây.

Nếu như CBT, ACT, EFT bạn đa phần cần có nhà trị liệu hỗ trợ thì trong Vòng xoáy đi lên, bạn chỉ cần nghiêm túc đọc và thực hành, kết quả sẽ xuất hiện.

Những khái niệm về não bộ, thần kinh không phải là chủ đề dễ hiểu, dễ giải thích. Vậy nên mình rất trân trọng lối viết đơn giản, dễ hiểu và khả năng thấu hiểu người đọc của tác giả (chứ đã trầm cảm rồi mà đọc sách dày cộm, thuật ngữ khó nhằn thì chắc... còn nản hơn)

Những bài tập, chủ đề trong sách cũng phù hợp để nâng cao sức khỏe tinh thần. Ít tốn kém, hiệu quả cao. Một cuốn sách mà ai ở thời đại này cũng nên đọc.

[el · Rating 3 out of 5]

“Be as patient and kind with yourself as you would be with a cute little puppy that you’re trying to house-train.”

Well. I am now seriously considering a PhD in neuroscience.

Blog | Bloglovin’ | Instagram | Tumblr | Twitter

[Amy · Rating 4 out of 5]

I've been curious about this one, and so have my patients. I wrote a paper a couple of years ago speaking about neuroscience and psychotherapy, and about the possibilities within psychology and also integrative medicine and our alternative world, for re-encoding, re-working our neural pathways. That's in these days, and not just the cutting edge of therapy these days, but the driving force. How do we get our brains to "unlock?" How do we rewire for happiness, intimacy, trust? I have never been a quick fix therapist. Leery of that, I have always been a deep affect, psychodynamic psychoanalytic talk therapist - and I always will be, In fact, a main point of my paper was that I believe this rewiring happens within our deep therapies. I have seen EMDR work, and it works far better within deep existentially held relationships. But I have also seen that in deeply known and trusted relationships, even talking about EMDR seems to help loosen and rewire, without even having to enact the protocol. And everything from the alternative world supports that process as well. Its an enhancement of what we know works from our deep work. And that in 2021, our psychotherapy should reflect what is going on in these other fields to support our good work.

So while I thought my neuroscience explantation catered to the knowldegeable and the lay, this book does and even better job of simplifying it for the lay person. Its non-shaming and non-judgemental, and it makes the point that some of us just got unlucky wiring. Its twice as hard, and definitely unfair. But what it does do, even if its suggestions feel simple, is offer hope that re-wiring is possible. It lays out that there are things we can do to re-code and re-wire and open new neural pathways. And offers many success stories including the author's own. It also appears to have a workbook with it, which I am considering getting for my patients who are looking to make this a daily practice. But I have seen it work, so I am excited. This really is the new path, and gives much hope for folks whose entrenched pathways would feel closed out. I think if it calls to you, its worth a read. But definitely do the therapy part as well. Its hand and glove, in my best opinion.

[Michael Shulman · Rating 5 out of 5]

Very straightforward and easy to understand. Alex Korb does a great job explaining difficult neuroscience concepts for the layperson in plain English.

[OKSANA ATAMANIUK · Rating 4 out of 5]

“The Upward Spiral: Using Neuroscience to Reverse the Course of Depression, One Small Change at a Time”
Alex Korb, 2015
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“У пастці депресії. Як подолати тривожність і радіти життю”
Алекс Корб
@nashformat.ua 2019
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Мені не подобається, коли спрощують проблеми інших!
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Коли про проблеми не говорять, а якщо говорять, то так, ніби людина сама винна у всіх своїх бідах!
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Це стосується і депресії!
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Можливо щасливчикам, які ніколи не чули про депресію, просто пощастило мати інші гени, структуру мозку чи більше серотоніну?
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Хочете знати більше і допомагати іншим, хоча би розумінням проблеми - читайте!
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Цитата:
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«Серотонін - підтримує силу волі, мотивацію та настрій.
Норепінефрин - допомагає мислити, зосередитися й дати раду стресу.
Дофамін - підсилює задоволення й є необхідним для зміни шкідливих звичок.
Окситоцин - поглиблює почуття довіри, любові та близькості, знижує тривожність.
ГАМК - допомагає розслабитись і знижує тривожність.
Малатонін - покращує сон.
Ендорфіни - полегшують біль і покращують настрій.
Ендоканабіоїди - покращують апетит, підсилюють відчуття спокою та комфорту.»
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«Це надмірне спрощення, але загалом кожен нейромедіатор причетний до окремого симптому депресії. Дисфункція серотонінової системи відповідає за відсутність сили волі та мотивації. Проблеми з концентрацією і мисленням, імовірно, мають стосунок до проблем із норепінефрином. Дисфункція дофамінової системи зумовлює появу шкідливих звичок і відсутність задоволення. Усі ці нейромедіатори необхідні для коректної роботи десятків нейронних ланцюгів; ускладнює ситуацію те, що всі вони взаємодіють між собою. На жаль, депресія - це не тільки нестача норепінефрину, серотоніну й дофаміну, тому її не можна подолати, просто підвищивши рівень цих нейромедіаторів. Утім це частковий розв‘язок проблеми.»
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Анотація:
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«Депресія — це не просто поганий настрій. Люди з депресією можуть і не бути пригніченими. Там, де мала би бути якась емоція, вони часто відчувають порожнечу. Те, що колись дарувало задоволення, більше не тішить. Усе здається складним, і ніщо не вартує зусиль. Найгірше, що депресія не просто тягне на дно, а й міцно утримує там. Проблема полягає у фізіології...»
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#примхливачитака

[Gaelen · Rating 3 out of 5]

This is very much an entry-level book for people who have never explored the neuroscience of mood or tried to explore behavioral therapy for depression, either in conjunction with therapy or independently. If a direction like “Avoid catastrophizing” is as simple to follow as realizing, “gosh, I hadn’t thought of that before,” then this book may have some utility. For those of us who have engaged in many years of CBT, meditation, and other more advanced strategies, this book won’t impart much insight. Further, at least a third of it is taken up with extolling the benefits of exercise, so if you already work out every day and understand the anti-depressant effects of exercise, you can skip a significant portion.

I’m also concerned it may help cultivate a feeling of defeat among newbies, because so much of the oversimplified advice makes it sound impossibly easy. For example: “If you can remove the trigger from your life (for example, avoiding a bar if you’re an alcoholic, you can evade the habit.” Sure, it’s that easy (eyeroll)!

On the other hand, there is a lot of helpful, actionable advice here for newbies, and I can see someone getting a lot out of this if they’ve never tried any sort of behavioral therapy before. For this reason, I’ve given the book a 3-star rating.

[Joy D · Rating 4 out of 5]

This book addresses the ways people can create an “upward spiral” to avoid the well-known downward spiral into anxiety and depression. It is particularly helpful for those actively experiencing depression but can also be an excellent resource for those who simply want to understand mental health more fully. It includes scientific explanations of the biochemical and neurological processes and does so in a way that is understandable to a person without a deep scientific background. It is told in two parts. The first explains the sources of depression, neurotransmitters, and the parts of the brain involved. The second contains many useful steps to be taken to stop or reverse negative thoughts. Some of these we have heard before, such as exercise, but they bear repeating. It also contains tips on getting better sleep, which I found helpful. I think the material in this book could be useful to anyone, regardless of whether they suffer from chronic depression, since everyone feels down or anxious occasionally, and there are positive ways to keep from descending into despair or hopelessness.

[Felicia · Rating 5 out of 5]

A great book for anyone dealing with depression or for someone who knows of someone dealing with depression. A must read book that has helpful hints within the book!

[Katrusya · Rating 4 out of 5]

"Мої вітання! Ви дочитали цю книжку до кінця. Навіть якщо ви геть нічого не запам'ятали, з погляду нейробіології ви все одно отримали користь. У вашому мозку виділяється дофамін навіть після того, як ви, у передчутті завершення, читаєте ці слова; а коли ви дочитаєте і закрийте цю книжку, мозок виділить ще трішки дофаміну, аби ви змогли повернутися до дійсності".

Хороше й різностороннє дослідження, багато порад по саморегуляції тривожності, щоб не допустити депресії, пояснення фізичних та психологічних процесів простою мовою. Загалом корисна практична книжка, автор прикольний і самокритичний, але для мене особисто мало що було новим. Хоча, приємно іноді почитати й підтвердити те, що знаєш)

Від мене 3,5

[Book Princess (Anastasia) · Rating 4 out of 5]

Дуже толкова книжка про депресію. Дуже мені сподобалося, як автор пояснює, за що яка ділянка мозку відповідає і що робиться з кожною з них під час депресії. Згрубша ця книга - селф-гелп бук з багатьма порадами, що можна зробити самим, якщо у вас депресія. Але й про медикаменти чи психотерапію автор теж не забуває. І все це чітко і лаконічно.

З мінусів - є повтори, але в нон-фішні це норма, бо як інакше запам‘ятати корисну інформацію?) Але мене це дратує, така вже я) А ще мало яка інформація була для мене новою, проте повторити ніколи не зашкодить)

[Kathy · Rating 5 out of 5]

Dr. Korb does an outstanding job of making the neuroscience of depression understandable to the common person. In the first part of the book, he explains the neuroscientific reasons for depression, and how we unintentionally can keep "feeding" that depression by our actions, inactions, and thoughts. The second part of the book gives realistic suggestions for how to build on small, positive changes and keep them going.

Depression is a difficult beast, and at first I thought he was saying "just snap out of it!", but on closer reading, I got that he "gets" depression, not only the science of it, but the dark reality of it, and his suggestions were then taken in a more appreciative light. An excellent and very helpful book for anyone who cares to know more about this difficult subject, and/or wants to do all they can to escape the beast.

I was provided a copy of this book by Goodreads in exchange for an honest opinion.

[Netta · Rating 4 out of 5]

Бодренькая книжка (впрочем, все же не про депрессию, а про негатив), которая не вгоняет в уныние бесконечными примерами о неудачниках, выбравшихся из отчаяния и тлена и заработавших первый миллион, а достаточно просто и нескучно поясняет, что когда нам кажется, что наша жизнь не удалась и никогда не удастся, потому что с утра пригорел омлет, наорал начальник и наступили на ногу в метро, мы совершенно не одиноки, и спускаться по этой уходящей вниз лестнице вовсе не обязательно - по ней с тем же успехом можно забраться наверх, пройдя пешком после работы до дома, выспавшись и поблагодарив себя за то, какой ты, в общем-то, замечательный, уже сейчас, без всяких мотивирующих книжек, миллионов и блестящих карьер.

[Laurens · Rating 5 out of 5]

Perfect mix of neuroscientific principles underlying depression and anxiety, and practical advice to escape these processes with "upward spirals".

Good introduction, and helpful handbook to make a start with treating your own depression in small steps.

(Second "read" is the audiobook version)

[Hákon Gunnarsson · Rating 4 out of 5]

Pretty interesting, and for most parts understandable book on depression. I think the central idea of the upward spiral is quite doable, but I may have to read it again to get it fully.

[Trace · Rating 5 out of 5]

December 26, 2017 - Fantastic - very informative with a huge amount of suggestions and things to do to get one on an upward spiral again.

December 21, 2017: Fascinating book so far. I'm only on page 79. Already I've learned so much. For instance - the circuits in some people's brain attach more importance to negative events. They have a skewed "positivity ratio" in that they will often need 3-5 (or even more) positive events to counteract or balance out a negative event. Sometimes their brains will not even register positive events. Ie - on the way to work, late - a person will encounter 6 green lights and one red light. The green lights go unnoticed but they will get highly agitated at the one red light that is "making them late".
This explains so much. Have you ever had people in your life who will seemingly forget ALL of the many ways that you blessed and nurtured them, but will become extremely annoyed at the one thing you could have done better?? Knowing this bit of information doesn't make it any easier but it helps give me insight into why some people act the way they do!! I wish I had known this information years and years ago! And the author gives fabulous tips on redirecting your brain to counteract these circuits and begin an upward spiral.
So far - very, very good book!!

[Abby Garrett · Rating 4 out of 5]

I’ve struggled with depression for the past couple months and my friend, Hannah, recommended this to me. I found it interesting and helpful! I loved all the tips for changing the patterns in your brain by using things like exercise, talking with people and keeping a gratitude journal. It’s informational, without being to heady and it’s practical without simplifying the impact that depression can have on ones life. I’d recommend.

[Monkey · Rating 5 out of 5]

This is the kind of depression literature that we need: Practical, optimistic without the typical shallowness. Just the act of reading this was a small boost to my mood.

A rare five star review from me because I can wholeheartedly recommend this to anyone who deals with depression or with someone with depression.

[Sneha · Rating 2 out of 5]

Appreciate the advice- exercise, get sleep, etc. But this sounds very trite to someone in the thick of depression. This book kind of comes off like a lecture and spewing of facts and studies that are good to know, but not what you really care to hear when depressed. Sounds like a researcher who has never really had or fully understands what depression is like

[Brian · Rating 4 out of 5]

I took Greg Lukianoff’s advice and picked up this audiobook. Korb does a great job explaining brain science and providing modest but tangible steps to combat depression.

[Gianluca Fiore · Rating 2 out of 5]

I will save you a read: if you are expecting new insights into curing depression, there won't be any in this book.

Most of the book is practical and optimistic, but in a very simplistic way. It's full of "if you do x you'll get y" and "this part of the brain influences that behavior" and yet "doing x will cause y". Useful to understand where's neuroscience at in terms of understanding depression and little else. It may be what you are looking for, just understanding more, and if so it's a good book.

So why the few stars? Because it is optimistic to the point of being dismissively simplistic towards depression. I was left with the idea that a few positive steps in the right direction, if kept for months, could cure my depression forever. Which is not the case. There's nothing about trauma, situational depression, and ineffective drugs. It may appears that Dr. Korb has taken the stance of depression not being a long lasting disease but one that is more connected to bad habits, and therefore easily curable. Perhaps in his career he was lucky to meet mostly patients that showed immediate progresses in curing their depression, and thus got the idea that it isn't such a deep mental disorder. I found the book excessively focusing on the positive results of neuroscience and barely instead on how debilitating and hard to treat depression can be.

Ultimately, I learned very little, nor earned much hope. More a self-help book than a scientific one.

[Richard · Rating 4 out of 5]

I'm struggling to figure out how to rate this.

I want to rate it highly, because it was my expectation that a better understanding of what my brain is doing deep inside me would make it easier to change those patterns.

But just as I was finishing the book, life corrected my enthusiasm by handing me an insight that overwhelmed — in a bad way — the motivation to apply Korb's lessons. Whomp: more depression.

I still recommend it pretty highly, because I'm an empiricist who very much values scientific understanding. The book doesn't promise rainbows and unicorns, and doesn't deliver them, but it does a very good job at the more limited goal of giving us tools to nudge ourselves in a better direction.

[CUONG TRAN · Rating 4 out of 5]

Không chỉ nói sâu về khía cạnh khoa học mà tác giả còn đưa ra nhiều hướng dẫn thực hành dựa trên khoa học thần kinh ứng dụng để cải thiện sức khoẻ tinh thần.

Để tạo ra vòng xoáy đi lên, những chuyển biến nho nhỏ từ việc tập thể dục, cách đặt mục tiêu ra quyết định, cách nghỉ ngơi, xây dựng thói quen và lòng biết ơn,...được trình bày rất cụ thể và có thể áp dụng được cho bất kì ai chứ không chỉ là những người mắc bệnh trầm cảm.

[Ihor Kolesnyk · Rating 4 out of 5]

Дуже спрощене пояснення на основі наукових досліджень (299 позицій!) поведінки мозку під час депресії, біохімії мозку та методів, які допомагають полегшити або вирішити цю проблему. Насправді це ряд проблем, які називають депресією, але автор не надто витрачає час на дефініції - це дещо засмучує.

[Mehrsa · Rating 4 out of 5]

There is some great advice in here for when you get in a funk or start to have anxiety. He explains a little of the mechanics of the downward loop in emotion and feeling and he gives a few helpful pointers (none of which are groundbreaking) to stop the doom loop/

[Lia · Rating 5 out of 5]

Автор у своїй книзі порівнює депресію зі спіраллю, по якій людина спускається на дно та розповідає, як наші дії, навіть маленькі кроки, допомагають поступово рухатися цією спіраллю вгору і долати депресію.
Спираючись на різні наукові дослідження, він пояснює, які зміни відбуваються в мозку людини при депресії та які під час виконання тих чи інших дій, спрямованих на покращення самопочуття.

Я часто чула та просто приймала як факт, що рух, сон, корисні звички, дихальні вправи тощо можуть допомогти якісно змінити життя і почуватися краще. Але після прочитання цієї книги я глибше зрозуміла, чому це корисно і які саме зміни відбуваються в мозку разом зі змінами в житті. Тепер я усвідомлюю, що конкретно отримаю, якщо, до прикладу, почну займатися спортом. У моєму випадку такі знання допомагають вибудувати правильну мотивацію для впровадження нових звичок у життя.
Думаю ця книга буде корисна кожному, незалежно від того чи бореться людина з депресією чи тривогою. Хоча б для кращого розуміння, як працює наш мозок та як ми можемо використовувати доступні нам методи впливу на нього, щоб змінювати свій стан і настрій.

В книзі присутні медичні терміни і мені складно сказати, чи буде ця книга легкою для всіх читачів (мені здається, що не дуже). Але точно можу стверджувати, що вважаю її корисною і вартою часу витраченого на читання.

Книга зосереджується переважно на методах самодопомоги й не приділяє багато уваги психотерапії чи медикаментозній терапії. Особисто я думаю, що у випадку депресії варто починати саме з цього, а методи самодопомоги застосовувати як допоміжні. 
Людині в депресії нелегко почати самостійно змінювати все і допомога ззовні може виявитися необхідною. Не з усім можна впоратися самостійно і про це важливо пам’ятати. Звернутися по допомогу - це прояв сили та сміливості.

[Brian Johnson · Rating 5 out of 5]

Inspiring. Scientifically grounded. Simple. Practical. ← A winning formula for a great book!

“You can’t always change where you are, but you can change where you’re going. What if, instead of your life spiraling down, it spiraled up? What if you suddenly had more energy, slept better, hung out with your friends more, felt happier? Your neural circuits have just as much potential for this as they do for depression. It often takes only a few positive emotions to kick-start the process, which then begins to fuel positive changes in other areas of your life—this is the upward spiral, and its incredible efficacy has been proven time and again, in hundreds of scientific studies. The question is, what’s actually happening in the brain, and how does this spiral begin?

It turns out that positive life changes actually cause positive neural changes—in the brain’s electrical activity, its chemical composition, even its ability to produce new neurons. These brain changes alter the tuning of your brain’s circuitry and lead to further positive life changes. For example, exercise changes the electrical activity in your brain during sleep, which then reduces anxiety, improves mood, and gives you more energy to exercise. Similarly, expressing gratitude activates serotonin production, which improves mood and allows you to overcome bad habits, giving you more to be grateful for. Any tiny change can be just the push your brain needs to start spiraling upward.”

~ Alex Korb PhD from The Upward Spiral

Alex Korb is a neuroscientist in the department of psychiatry at the University of California, Los Angeles. (Go Bruins!) He’s also a great writer.

As per the sub-title, the book is all about “Using Neuroscience to Reverse the Course of Depression, One Small Change at a Time.”

Basically: The neuroscience of depression and how to reverse it. It’s REALLY good.

Inspiring. Scientifically grounded. Simple. Practical. ← A winning formula for a great book!

Dan Siegel, a leading neuropsychiatrist (and author of Mindsight ) also associated with UCLA, wrote the foreword to the book. As he says, “The Upward Spiral has been a joy for me in its clarity, its cutting-edge science, and its inspiring translation of current research into practical tools for everyday life. Even though this is my field as a neuropsychiatrist, psychotherapist, and mental-health educator who focuses on the brain, I learned a ton and laughed a lot. This book is at the same time informative and fun.”

If you or someone you know have suffered from depression I think you’ll love this book as much as I did. (Get a copy here.)

Alex walks us through eight powerful life changes that can get us on an Upward Spiral: exercise, decision making, sleep, habits, biofeedback, gratitude, social support, and professional help.

Some of my favorite big ideas from this book include:

1. Exercise Your Brain - It does a mind, body and soul good.
2. Set Goals - Make decisions.
3. Develop Positive Habits - Repetition, repetition, repetition.
4. Biofeedback - Take advantage of it.
5. The Power of Others - Rely on it.

I’ve summarized those Big Ideas in a video review that you can watch here: https://youtu.be/vlfda_doSd4?feature=...

I’ve also added The Upward Spiral by Alex Korb, PhD to my collection of Philosopher’s Notes--distilling the Big Ideas into 6-page PDF and 20-minute MP3s on 600+ of the BEST self-development books ever. You can get access to all of those plus a TON more over at https://heroic.us.