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

by Alex Korb

but exercise improves your mood.3 It also reduces anxiety,4 decreases stress,5 and boosts self-esteem.

For example, exercise improves sleep, which then reduces pain, improves mood, and increases energy and alertness. Then

Having more energy also makes it more likely that you’ll exercise.

Just as exercise strengthens your muscles, it also strengthens your brain. Exercise increases nerve growth factors, such as brain-derived neurotrophic factor (BDNF), which are like steroids for your brain. BDNF makes your brain stronger, so it’s more resistant to all kinds of problems, not only depression.

Numerous studies have demonstrated that exercise causes growth of new neurons.

voluntary group had more new neurons than the forced group, which suggests that actively choosing to exercise provides more benefits than being forced to.

And to start an upward spiral, all you need is something, no matter how small, that’s better than what you’re doing right now.

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.

when I tell you that BDNF is also increased by antidepressant medication, particularly in the frontal lobe.11

The relationship between exercise and antidepressants doesn’t end with neuron-strengthening BDNF. Most antidepressants target the serotonin system and elevate serotonin levels, which increases motivation and willpower. Well, it turns out that exercise can also boost serotonin activity.

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.

meaning that even vacuuming, gardening, or walking to a faraway parking spot will benefit your brain.

Importantly, serotonin and BDNF are particularly good at creating an upward spiral, because serotonin stimulates the production of BDNF, and BDNF strengthens serotonin neurons.14 Exercise sets the snowball in motion, and the brain’s dynamic interactions keep it going.

The difficulties with concentration and deep thinking that often accompany depression are mainly the fault of a lagging norepinephrine system, which is why, next to serotonin, norepinephrine’s the neurotransmitter most commonly targeted by antidepressant medications. Fortunately, exercise increases norepinephrine as well.

While all exercise increased norepinephrine, intense exercise was particularly helpful.

The dopamine circuit in the brain controls aspects of pleasure, decision making, and focus.

In fact, any addiction—not just to drugs, but also to risk taking, emotional drama, or whatever turns you on—simply hijacks the brain’s natural capacity to enjoy things.

Fortunately—you guessed it—the dopamine system is also positively affected by exercise.16

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.

And when you feel that you earned that television show or that ice cream, it’s even more enjoyable.

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.

And yet after biking, the exercise group showed decreased activity in those brain areas—their brains wanted the cigarettes less. Just ten minutes of exercise had significantly altered their dopamine circuits and increased their willpower.

it’s a heckuva lot better than just sitting there, and it’s a great kick start to an upward spiral.

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.

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. Luckily, exercise can help.

Make it simple. It’s much easier to convince yourself to do simple, easy activities. Try starting with one push-up after you check your email in the morning. If you start feeling better and want to do more, go for it. But if all you ever do is one push-up, that’s better than nothing.

The study showed that exercise dramatically reduced their stress hormones (such as, cortisol and adrenaline) and depression, and improved their physical health and social relationships.21 This exemplifies the upward spiral: one life change can have multiple, seemingly unrelated effects.

Sitting is the new smoking. In other words, it’s bad for you. If you sit at a computer all day (like me), get up and walk around at least once every hour. And every twenty minutes, briefly stretch your hands, arms, and back. Try working at a standing desk or replace your chair with an exercise ball. Walk while you’re on the phone.

That’s one of the interesting things about exercise. When you start doing it, you might be more tired, but after a while, you end up with more energy overall to do other fun things.

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.

My brain was juicing up on all those good neurochemicals—all that serotonin, dopamine, and norepinephrine began making things happen. The BDNF was silently working away.

Yes, you often need to give it a few pushes, but you’ll be surprised sometimes by how your brain just starts to make things easier all on its own. While I hadn’t liked distance running before, I found after a few slow jogs that I enjoyed the simple freedom of stepping out of my door and going.

Decision making in the prefrontal cortex, which is a high-level brain process, affects the lower-level sensory processes.

Figure out what’s important to you. To help reduce irrelevant details in your life, focus on what’s really important to you. Studies have found that focusing on your values reduces the brain’s stress response.

So think about the times in your life when you were happiest. What were you doing then, and what factors contributed to your happiness? What activities make you feel most fulfilled? What achievements are you most proud of?

This study may seem strange, but it proves that making a decision changes your brain’s perceptual processing of the world.

Of course, changing the way your brain perceives the world is not going to solve all your problems.

But turning on the light will sure as heck improve your chances of finding them. Making a decision, even a tiny decision, starts shedding light on ways to improve your life.

We are often under the impression that we are happy when good things happen to us. But in actuality, we are happiest when we decide to pursue a particular goal and then achieve it.

So deciding on a goal and then achieving it feels more rewarding than if something good happens to you by chance.

If you decide to get out of bed, it will be more empowering than waiting until you have to go to the bathroom.

Actively choosing a particular goal you want to pursue—rather than basing your decision on

avoiding something you don’t want—forces you to focus on the positive, at least briefly. For example,

This type of positive thinking is more effective at chang...

that deciding for yourself is associated with greater importance placed on winning, more emotional engagement, more likely changes in behavior, and enhanced memory.10

Actively choosing a painting they would like in their own home caused its preference rank to go up, and actively rejecting a painting caused its preference rank to go down.

We don’t just choose the things we like; we also like the things we choose.