The Upward Spiral: Using Neuroscience to Reverse the Course of Depression, One Small Change at a Time

by Alex Korb

Your early childhood experiences, current life stress, and level of social support can influence your circuitry toward or away from depression.

It’s uncomfortable to feel the weight of the future pushing down on you, to be caught in the brief moment between the mistakes you made in the past and the mistakes you’re about to make in the future. Perhaps you understand the feeling.

Since the hippocampus is responsible for memory, when something bad happens, your limbic system tries to connect the bad thing to something in your recent memory that might have predicted it. That way, in the future, it can predict the bad thing before it happens.

In depression, the brain’s negative bias is responsible for making bad situations seem a lot worse than they actually are. In truth, the reality is almost certainly better than it appears: your relationships not as broken, your job not as pointless, and your abilities greater than you realize.

It turns out that when your mood gets worse, so does your brain’s negative bias. Feeling down means you’re more likely to notice negative things about the world and about yourself. This includes context-dependent memory,

markets history also

When starting a new relationship or changing jobs, your brain may automatically interpret the new situation as something bad. But it’s not bad; it’s just unknown. And for almost anything worth having (true love, a great job) you have to pass through some period of uncertainty.

Thus, in depression, you’re more likely to store more bad memories than good ones. On top of that, because of context-dependent memory, depression makes it harder to remember happy memories and easier to remember bad ones.

Unfortunately, most of us have bad habits that are just as obvious—just not to us. For example, I have terrible problems with procrastination, and I end up watching television instead of writing or exercising. Maybe you’ve got a habit of giving up when things get difficult, and it keeps you from accomplishing meaningful goals. Maybe you have anger issues or organization problems. Maybe you push people away when you start to feel close, or just spend too much time alone. Maybe you never met a cookie you didn’t like, or a cigarette or a can of beer. And in addition to the bad habits you know about, you probably have several others that are negatively impacting your life that you aren’t even aware of.

If you were a caveman, your impulses wouldn’t be such a problem. Life would be pretty simple. If something tastes good, you eat as much as possible, and if something feels good, you do it as much as possible. Nowadays, though, there are too many easily obtainable pleasures, which hijack dopamine in the nucleus accumbens and create a tendency to act for immediate gratification.

It becomes even more problematic in depression, because there’s less dopamine activity in the nucleus accumbens. First, that means things that used to be enjoyable no longer are. Second, with reduced dopamine activity, the only things that motivate the nucleus accumbens are things that release lots of dopamine, such as junk food, drugs, gambling, and porn. All these impulses mean your actions are guided only by what’s most immediately pleasurable, which is not usually good for you in the long term. And while most impulses are easy to recognize, the most insidious bad habits are often routines.

The important thing to understand about a pattern in the dorsal striatum is that once it’s there, it’s pretty much there for good. That’s why you never forget how to ride a bike. This is one of the reasons that bad habits are so hard to change. You don’t actually eliminate old habits—they just get weaker as you create newer, stronger ones. Furthermore, once habits are in the dorsal striatum, they no longer care about pleasure.

That’s also how addictions work. Addictions start out as pleasurable impulses in the nucleus accumbens. But over time, the nucleus accumbens stops responding, and the addictions no longer feel pleasurable. But because they are engrained in the dorsal striatum, you feel compelled to have another drink or another cigarette anyway. Because of these changes in dopamine, addictions increase your risk of developing depression, and depression increases your risk of developing an addiction. Another downward spiral.

Everyone has coping habits; they are some of the deepest, most ingrained routines we have. They make us feel better, at least for the time being, by reducing amygdala activity and the body’s stress response. Good coping habits can pull you out of an impending downward spiral, because the dorsal striatum takes over and sets your life back on course. But bad coping habits don’t stabilize your mood in the long term, so acting them out just creates more stress later on, and down the rabbit hole you go.

I’d been caught in a downward spiral and hadn’t realized it. It’s a bit silly that it started with a laptop, but there you go. In fact, that’s usually how downward spirals start. A small change leads to unintended consequences that build on each other.

a small change can lead to a downward spiral. like me in 2015 with BT

While all exercise increased norepinephrine, intense exercise was particularly helpful. So if you can find the energy to push yourself, your brain will make it worth your while.

It’s at this point in the book that Joe explains an important aspect of surviving in the wilderness, “You gotta keep making decisions, even if they’re wrong decisions, you know. If you don’t make decisions, you’re stuffed.” In mountaineering, if you’re stuck in a bad situation and you don’t know the right way out, you just have to pick a direction and go. It doesn’t have to be the best direction; there may not even be a best direction.

Perhaps that is like the situation you find yourself in. Every decision feels wrong. But that’s just because your limbic system is overwhelming your prefrontal cortex. It is a symptom of depression. In fact, it’s one of the symptoms that makes depression so stable.

But remember, it’s better to do something only partly right than do nothing at all. Trying for the best, instead of good enough, brings too much emotional ventromedial prefrontal activity into the decision-making process.2

do not overthink?

A decision without action is just a thought, and while thoughts can be helpful, they won’t have as powerful an impact on your brain. A decision with action is something else entirely: it’s a robust way to start an upward spiral.

decision means action!

To help reduce irrelevant details in your life, focus on what’s really important to you.

Unfortunately, people with depression tend to create nebulous goals that are poorly defined, which makes progress and achievement difficult.14 For example, a nebulous goal might be “Spend more time with my kids,” whereas “Play board games with my kids every Sunday” is a specific one. When goals are poorly defined, it becomes difficult for the brain to determine whether you’ve actually accomplished them or are even moving toward them. Not only does that mean less dopamine, but the lack of perceived progress can be de-motivating.

be specific about goals

For example, if the goal of finding a job seems too daunting, try setting a smaller goal of sending out two resumes a week, or spending ten minutes every day look for a job online.

When you’re stalled and paralyzed, things feel out of your control. But the good news is that you don’t have to start with the big decisions. You can start small. Choose what to have for lunch, or what television show to watch. Research shows that decisiveness in one part of your life can improve your decisiveness in other parts of your life.22 Pick one thing, go with it, and don’t question it. When you exercise a muscle, it gets stronger, and the exercise makes it easier to work out the next time. Similarly, every time you make a decision instead of procrastinating, worrying, or acting impulsively, you strengthen your decision-making circuit for the future.

If you’re worrying or planning while trying to fall asleep, write down your thoughts. Get them out of your head and onto a piece of paper and be done with it.

If your bedroom is too cold or hot, too bright, noisy, or even smelly, your sleep could be disrupted without your conscious awareness. So do something about it.

And here are some more concrete tips to prepare your brain for a great night’s sleep.

Stress biases the brain toward old habits over intentional actions, which is one of the reasons it is so hard to change coping habits—the things we do to deal with stress. One of the problems with coping habits is that if you don’t do them, you stay stressed. And if you try to suppress a coping habit, you’re more stressed, which makes your brain want to do that coping habit even more. Clearly this is a downward spiral, and the best solution is to find other ways to reduce your stress. Reducing your stress levels can be accomplished through many means: exercise (chapter 5), decision making (chapter 6), improving sleep hygiene (chapter 7), biofeedback (chapter 9), gratitude (chapter 10), and social interactions (chapter 11). Even if you can’t reduce your stress as much as you’d like to, a little stress has some benefits: habits are learned more deeply when you’re stressed.6 So if you can manage to change your habits, even a little bit, your efforts will have a more powerful effect than trying to change your habits when not stressed.

stress-coping by bad habits downward spiral

Those feelings of frustration or self-judgment are all sources of stress, making it more likely that you’ll keep doing your old habits. The key to change comes in the moment after you realize you didn’t enact your intended habit. That special moment is an opportunity for the prefrontal cortex to reassert itself, to remind yourself of your goal and try again. Yes, you will probably have many slipups, but if you give up after a slipup, you’ve only trained your striatum to give up. You’ll probably hear a little voice inside your head telling you to give up, but the more you listen to that voice, the more it becomes habit and the harder it is to resist. Every time you stick to your goals, the voice gets softer.

never give up seems to apply to brain also

As we discussed in chapter 4, we often get stuck in habits because our environment keeps triggering them. Ideally, then, we should identify the specific environmental cue that’s triggering the habit (for more insight, see Charles Duhigg’s The Power of Habit) and just avoid or change that cue.

But for now, just sit up straight and take a deep breath. Allow your face to relax and the corners of your mouth to drift up, and let biofeedback works its magic.

Write a detailed thank-you letter. Think of someone who has been especially kind to you—a friend, a teacher, a coworker—whom you’ve never properly thanked. Write a letter thanking this person, being specific about what he or she did that affected your life. Then schedule a meeting, maybe over coffee or a drink, and deliver the letter in person. Don’t tell the person what the meeting is about; let it be a surprise.

i had this impulse in dec2015. it was natural and something that i wanted to do but didn't. allthough when i am buying gifts fe for grandmas i think this is it

In another study, a group of British researchers looked at people going through life transitions (in this case, starting college).7 Life transitions mean uncertainty, which revs up the limbic system. And when your environment changes, your habits change, so if you’re not careful, you can fall into a routine that isn’t optimal.

Keep a gratitude journal. Take a few minutes every day to write down three things you’re grateful for.

weekly better

The Powerful Pull of Guilt

my central theme now

An old Cherokee legend tells of a battle between two wolves. One wolf represents anger, jealousy, self-pity, sorrow, guilt, and resentment. The other stands for joy, peace, love, hope, kindness, and truth. It is a battle raging inside us all. Which wolf wins? The one you feed.

Gratitude is powerful because it decreases envy and increases how much you value what you already have, which improves life satisfaction.

The interaction of oxytocin and dopamine also helps explain one of the problems with addiction. Over time, drugs of abuse, such as cocaine, dramatically lower oxytocin levels in several key areas, including the hippocampus, hypothalamus, and nucleus accumbens.29 These reductions explain why addiction gets in the way of forming and maintaining close, healthy relationships. In fact, oxytocin can help reduce addiction. Oxytocin reduces the nucleus accumbens response to drugs of abuse30—that is, oxytocin makes them less addicting. It can also reduce alcohol consumption.31

Interestingly, the text-message group had cortisol and oxytocin levels similar to the no-contact group. Thus, there is something comforting about verbal speech that is not always captured in a text message.