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

by Alex Korb

Similarly, during actual painful stimulation, people with depression had greater increases in amygdala activity than nondepressed people. Their brains had a more emotional response to the pain. And the more helpless they felt, the greater the brain’s emotional response. Furthermore, they had decreased activation in the region of the brainstem that produces painkilling endorphins, so their brains did not try to suppress the pain as much. They also had decreased activity in the ventral anterior cingulate and prefrontal cortex, which meant that the pain had a greater impact on their optimism circuitry and lowered their ability to think rationally about the situation. Thus, if a depressed person and a nondepressed person both burn their hand on the stove, the depressed person is more affected by the pain. The brain’s response to pain is one reason that people with chronic pain are more likely to develop depression, and vice versa.