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

by Alex Korb

We now know that what you do with your mind—how you focus your attention, intentionally shape your thoughts, and purposefully calm your emotions—can directly change your brain.

Amazingly, science now affirms that you can use your knowledge and understanding to change the way you harness the power of your mind to create wellness, joy, and connection in your life. And this book will show you how.

Just fifteen minutes of biking is sufficient to

increase activity in circuits responsible for emotional control and to raise levels of the neurotransmitter serotonin.

They find that the patients moved to sunny rooms suddenly have a higher tolerance for pain and need less medication.3

the studies described above—and dozens of others—beautifully illustrate how small life changes actually change the activity and chemistry in specific circuits.

As brain activity and chemistry begin to change, so does the course of depression.

Downward spirals occur because the events that happen to you and the decisions you make change your brain activity.

The big problem with the downward spiral of depression is that it doesn’t just get you down, it keeps you down. Depression is a very stable state—your brain tends to think and act in ways that keep you depressed.

Depression is caused by the tuning of various brain circuits and their interactions with the world and with each other. Think of a simple circuit, like a microphone and a speaker.

but depression generally involves a problem with how the thinking and feeling circuits in the brain get out of whack.

Two parts of the brain in particular are to blame: the prefrontal cortex and the limbic system.

The thinking prefrontal cortex is supposed to help regulate the feeling limbic system, but it’s not doing a good job. Fortunately, it’s possible to change the way they act and communicate,

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

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.

exercise changes the electrical activity in your brain during sleep, which then reduces anxiety, improves mood, and gives you more energy to exercise.

expressing gratitude activates serotonin production, which improves your 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 ...

Your brain is a positive feedback system—often, all it takes to see effects is a tiny change,

As you’ll find out later in the book, exercise, sunlight, specific sleep patterns, certain muscle movements, and even gratitude all alter activity in specific neural circuits, reversing the course of depression.

It has to do with the way the brain deals with stress, planning, habits, decision making, and a dozen other things—the dynamic interaction of all those circuits. And once the pattern starts to form, it causes dozens of tiny changes throughout the brain that create a downward spiral.

Luckily, decades of scientific inquiry have shown us how to modify different brain circuits, change the levels of various neurochemicals, and even grow new brain cells.

By changing the firing rate of neurons in a few key regions, you can influence the pattern of activity in the entire brain.

Serotonin—improves willpower, motivation, and mood Norepinephrine—enhances thinking, focus, and dealing with stress

Dopamine—increases enjoyment and is necessary for changing bad habits Oxytocin—promotes feelings of trust, love, and connection, and reduces anxiety GABA—increases feelings of relaxation and reduces anxiety Melatonin—enhances the quality of sleep Endorphins—provide pain relief and feelings of elation Endocannabinoids—improve your appetite and increase feelings of peacefulness and well-being

Bright sunlight helps boost the production of serotonin. It also improves the release of melatonin, which helps you get a better night’s sleep

dysfunctional serotonin system is responsible for the lack of willpower and motivation. The difficulty in concentration and thinking is probably due to problems with norepinephrine. Dysfunction in the dopamine system leads to bad habits and lack of enjoyment.

Boosting serotonin leads to a better mood and a greater ability to set goals and avoid bad habits. Increasing norepinephrine means better concentration and lower stress. And more dopamine generally means more enjoyment.

Changing any one of these factors can increase serotonin activity.

As I mentioned in the introduction, depression is primarily a result of poor communication between the thinking prefrontal cortex and the emotional limbic system.

The prefrontal cortex gets its name from the fact that it is the front-most part of your brain. Basically, it is the whole surface of the front third of your brain, sitting just behind your forehead. It is the CEO of the brain—the center of your planning and decision-making circuits. It is also responsible for controlling impulses and motivation.

In depression, it is responsible for worrying, guilt, shame, problems with thinking clearly, and indecisiveness. Changing activity in the prefrontal cortex can help with these problems, and it can change bad habits and improve willpower.

Similarly, the specific tuning of your decision-making circuit can contribute to your brain getting stuck in depression—as can the specific tuning of your habit circuit, your stress circuit, your social circuit, your memory circuit, and on and on—they can all potentially contribute to a downward spiral of depression, when the conditions are right.

depending on the excitability of the worrying circuit, some people worry more, and some worry less. And depending on the neural connections in the decision-making circuit, some people are more decisive than others.

Sometimes the best solution is not always the most straightforward one. It turns out that other activities—like hanging out with friends, getting a better night’s sleep, or even expressing more gratitude—could all help

The trick is finding the right one for you, and hopefully this book will help with that.

So your genes can give you brain circuitry that is more likely to get depressed.

Early childhood experiences also shape the tuning of your circuits, even including the stress your mother experienced while pregnant with you,

And given that the prefrontal cortex takes the longest to mature, it’s susceptible to stress for a long time. Stressful life events throughout childhood and adolescence can alter the development of neural circuits and change the levels of various neurotransmitters.

The third big factor that shapes the tuning of your circuits is the current stress level in your life.

The fourth factor is the amount of social support in your life. Humans are social animals. We need each other, and we’re meant to be around other people.

Lastly, random luck also plays a role. That might be hard to hear, but it’s true.

There is not always an explanation for every little variation in your mood, so don’t drive yourself crazy looking for one.

The overarching reason your brain circuits act the way they do is evolution.

It turns out that just a little change can be enough to push you away from depression and up toward a happier state. That’s because in complex systems like the brain, even a little shift can change the resonance of the whole system.

Worrying and anxiety are two big symptoms of—and causes of—depression. Worrying is mediated mainly by connections between several parts of the prefrontal cortex and the anterior cingulate. By comparison, anxiety is mediated by circuits within the limbic system.

The circuits that helpfully allow us to plan, solve problems, and make decisions are the same circuits that lead to worrying. And the circuits that keep us out of danger are the same circuits that cause anxiety.

So if you tend to worry, reduce your options and

make quick decisions whenever possible. As soon as you make a decision, however small, everything starts to feel more manageable—we’ll

So what’s the difference between planning and worrying? The answer is really just the amount of emotional and self-oriented processing in the medial prefrontal cortex and anterior cingulate—how vigorously these regions react to potential future scenarios.