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

by Alex Korb

Understanding also provides a step toward acceptance, and until you accept how things are now, it is difficult, if not impossible, to change.

And the more out of shape I got, the more I lost interest in getting back in shape. 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.

Have fun (a.k.a. don’t “exercise”). When you don’t think of it as “exercise” but rather as “being active” or “having fun,” you’re more likely to do it, and it will have a bigger emotional benefit. If you bike to work three days a week or play Frisbee with friends in the park, it won’t feel like you’re exercising, but it’ll add up to a lot of activity.

Exercise is possibly the most straightforward and powerful way to start an upward spiral.

Depression is a stable state, which means that your brain tends to think and act in ways that keep you depressed. To overcome depression, your brain needs to get off its lazy butt, and you’ve got to make it.

Almost everything that depression causes can be combatted by exercise. For example: Physically Depression makes you lethargic and tired, but exercise gives you more energy and vitality. Depression often messes up your sleep patterns, but exercise improves your sleep, making it more restorative for your brain (chapter 7). Depression wreaks havoc on your appetite, so you either eat too little or chow down on junk food (in fact, people who eat lots of processed foods are at higher risk for depression1). Exercise improves your appetite, leading to more enjoyable eating and better health.

Mentally Depression can make it hard to concentrate, but exercise makes you mentally sharper and better at planning and decision making.2 Depression makes you…well…depressed, but exercise improves your mood.3 It also reduces anxiety,4 decreases stress,5 and boosts self-esteem. Socially Depression usually keeps you isolated and alone, but exercise tends to bring you out into the world.

Enjoy the view. Exercising in pleasant environments, whether urban or rural—or while looking at images of pleasant environments—boosts the benefits of exercise.8 In fact, irrespective of exercise, being in nature or even just looking at views of trees or lakes can have a big impact on your mood and can reduce depressive symptoms.9 So try going for a run in a park, or pick a treadmill near a window.

but it will seem even cooler when I tell you that BDNF is also increased by antidepressant medication, particularly in the frontal lobe.11 Thus, exercise has an effect on the brain similar to that of antidepressants.

Exercise helps create the conditions for growth, but you’ve got to keep it up and give it time to work.

Think about what’s important to you. When you connect your exercise to a long-term goal, it helps your brain overlook momentary discomfort and makes your exercise more satisfying (chapter 6). In my case, I reminded myself that being in better shape made playing sports more fun. Maybe you’ll do it for your kids. Maybe you’ll do it because you value hard work. Only you know what’s most important to you.

Movement increases the firing rate of serotonin neurons, which causes them to release more serotonin. And when more serotonin is released, more is produced to keep up with demand.

Reward Yourself with Dopamine Dopamine is your brain’s version of methamphetamines. The dopamine circuit in the brain controls aspects of pleasure, decision making, and focus. It’s the primary neurotransmitter behind addiction. All those addictive drugs called “uppers,” like crystal meth or cocaine, are basically jacking up your dopamine.

Exercise before you reward yourself. Let’s face it: you’re going to watch television. You’re going to eat ice cream. You’re going to waste time on Facebook. No big deal. But the next time you do, make it a reward for something. Exercise beforehand. Walk up and down the stairs twice. Do ten sit-ups. Jog around the block. You were going to have the reward anyway, so just insert a little activity into your inactivity. And when you feel that you earned that television show or that ice cream, it’s even more enjoyable.

Keep an exercise plan. Add exercise on your to-do list or calendar and check it off when you complete it. Planning activates the prefrontal cortex, and checking it off the list releases dopamine. Win-win.

Exercise causes your brain to release endorphins, neurotransmitters that act on your neurons like opiates (such as morphine or Vicodin) by sending a neural signal to reduce pain and provide anxiety relief.

Endorphin release is highest during intense exercise.19 So if you can manage to push yourself through a hard workout, you’ll get a bigger endorphin boost. But if you can’t get the runner’s high, it’s fine to settle for the walker’s buzz.

Exercise also increases activation of the endocannabinoid system.20 You may not have heard of endocannabinoids before, but they are a naturally occurring chemical in your brain that was named after cannabis (marijuana). The active ingredient in marijuana (tetrahydrocannabinol, or THC) activates this same system, causing reduced pain sensitivity and an improved sense of well-being.

The relationship between stress and depression is a two-way street: depression is stressful, and stress pushes you toward depression. Yes, it’s another freakin’ downward spiral.

In REM sleep, your brain is a lot more active than in other phases of sleep. We’ll go into this more in chapter 7, but basically, people with depression show increased amounts of REM sleep, which means their sleep is not as restful.24 Antidepressant medications reduce REM sleep,25 as does exercise. So…exercise, sleep more deeply, feel happier and more energetic, want to exercise more, rinse, repeat.

Make an anti-laziness rule. Decide ahead of time that you’ll take the stairs for anything less than three floors. Decide that you’ll walk to do any errand that is less than a mile away or bike to any that are less than two miles away. Commit to never taking an escalator if the stairs are right next to it. Don’t circle the parking lot looking for a closer space, just take the first one you see.