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

by Alex Korb

there’s nothing inherently wrong with having a more emotional brain. After all, emotion adds spice and excitement to life. However, when increased emotionality is combined with increased

perception of or attention to negative events, that can often spell trouble.

All of this means that to be happy in our daily lives, we need a high ratio of positive to negative. And it turns out, after considerable study, that ratio is three to

While it’s true that everyone’s brain is wired to respond more to emotional information, the type of emotional information that your brain is tuned to—and how it responds—differs across people. Some people’s amygdalas are more reactive to emotional information13

Consciously focusing on the positive can help, but some brain regions may still focus on the negative. The question is, which type of brain do you have?

Take a look at your family tree. Are there a lot of branches suffering from depression or

anxiety? Mood disorders run in families.

They found that the daughters of depressed mothers had a greater bias toward noticing negative facial expressions.

their brains just processed emotional information differently. Unfortunately, paying more attention to the negative puts them at risk for a downward spiral.

For example, one version of the gene that encodes for the serotonin transporter molecule significantly increases your likelihood of developing depression.

this gene also reduces the ventral anterior cingulate’s ability to calm the amygdala, meaning that people with this gene have amygdalas that are more reactive to emotional information.

a process called the mood congruent attentional bias. 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, mentioned in chapter 1, which, in certain contexts, makes you less likely to remember happy event...

After simply looking at negative words, the amygdala subsequently became more emotionally reactive.21 So it doesn’t take a lot to bias your brain.

tend to pay more attention to negative events and emotions22 and to notice more sadness in the world.

When you notice something positive or improve your mood just a tiny bit, your emotion and attention circuits like to keep things rolling.

Ever feel like nothing you do ever comes out right? Well, that’s completely understandable, given that the upper (dorsal) part of the anterior cingulate is specifically tuned to notice your mistakes.

Your brain likes to take shortcuts if it can, and most of the time,

it’s on autopilot. But when your brain notices that you’ve made a mistake, the anterior cingulate alerts the prefrontal cortex,

Time to use a little more proces...

You can’t control the random bits of information that pop into your head. But you can start to notice your biases.

In short, try practicing nonjudgmental awareness. Nonjudgmental awareness is a form of mindfulness that simply means noticing without reacting emotionally,

Awareness does not require emotion, because emotion and awareness are mediated by

Noticing a mistake might automatically trigger the emotional amygdala, but becoming aware of your own reaction activates the prefront...

when they weren’t told about the type of picture, their brains still reacted as if expecting a negative picture. In the face of uncertainty, their brains assumed the worst.

This response to uncertainty can explain why people with depression are more likely to be pessimistic—the past was negative, so the future must be too.28

your brain may automatically interpret the new situation as something bad.

And for almost anything worth having (true love, a great job) you have to pass through some period of uncertainty.

We have to constantly remind ourselves that our brains may be skewing the unknown toward the negative, so we don’t miss out on the potenti...

That’s because your perception of pain is greatly influenced by your mood and motivation.

We don’t just perceive pain objectively (Oh, my hand seems to be stuck in the car door); we have an automatic emotional response to it,

The emotional component is really what puts the pain in the pain sensation.

The important distinction here is between pain signaling and pain perception. Pain signaling is carried out by neurons throughout your body called nocicepto...

The study found that when anticipating pain, people with depression had

increased activation in the insula, amygdala, and dorsal anterior cingulate. Thus, compared to nondepressed people, they had a more visceral and emotional response to the possibility of pain and even considered it more likely to occur.

Lower amygdala reactivity with a hug. A hug, especially a long one, releases a neurotransmitter and hormone called oxytocin, which reduces ...

Their brains had a more emotional response to the pain.

which meant that the pain had a greater impact on their optimism circuitry and lowered their ability to think rationally about the situation.

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.

forgetting the good stuff, which is caused by miscommunication between the amygdala and hippocampus.

When you’re depressed—and thus perceiving more negative events—those negative events are more likely to stimulate the amygdala and be encoded into memory by the hippocampus.

Lastly, you might think your happy memories are safe from the mood bias, but unfortunately, old memories aren’t retrieved like an old email; they’re reconstructed from bits and pieces every time you remember them. Your negative mood influences that reconstruction so that you add a bit more darkness and sadness to them. Recognizing that you’re viewing your own past through the sunglasses of your current depression can help you realize that your life hasn’t always been this bad.

The study found that when the people at risk for depression lost money unexpectedly, they had greater activation in the orbitofrontal cortex, which means losing had a greater impact on their motivation circuit. And when these subjects won money unexpectedly, they had reduced activation of the hippocampus.32 Since the hippocampus is essential for memory, this reduced activity means that they’re less likely to remember winning. Thus both their memories and their future actions are slightly altered by their risk for depression, which creates the potential for a downward spiral.

So just because your brain circuits have a natural inclination toward negativity doesn’t mean they have to stay that way forever. Maybe medication is the answer, or one of many other ways to modify brain circuits,

How to increase norepinephrine. Surprisingly simple things can help increase norepinephrine—and thus decrease the negative bias—such as exercise, a good night’s sleep, and even getting a massage. We’ll discuss these in more detail later in the book

They don’t necessarily directly improve mood, but instead bias the brain toward noticing positive events.

Serotonin and norepinephrine are also important in pain processing.

Chronic pain can be an incessant downward spiral, so reducing pain’s effect on the brain can certainly be a great start to an upward spiral.

To combat pessimism, you can strengthen the brain circuits responsible for optimism. The first step is to simply imagine the possibility of positive future events. You don’t have to believe they will happen, just that they could happen.