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

by Alex Korb

exercise, sunlight, specific sleep patterns, certain muscle movements, and even gratitude all alter activity in specific neural circuits, reversing the course of depression.

Happy memories boost serotonin in the anterior cingulate (chapter 8). Try to think of one happy memory before you go to sleep—write it in a journal or just reflect on it.

Depression is often accompanied by bad habits such as impulsiveness, poor coping skills, addiction, and procrastination.

an ancient Hindu saying: “For the first thirty years of your life you make your habits. For the last thirty years of your life, your habits make you.”

Routines often cause downward spirals because we act them out even though we don’t derive any pleasure from them.

To get rid of a destructive coping habit, you can’t just stop doing it, because then you’re left with the stress. Instead, you have to replace it with another habit.

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create new, good habits, you have to repeat them over and over again until your brain rewires itself.

exercise also has many of the same effects on the brain as antidepressant medications and even mimics the buzz of recreational drugs.

exercise is natural, it causes more nuanced and targeted brain changes, and its benefits can exceed even those of medication.

One of the greatest obstacles to exercise is that people with depression don’t feel like doing it.

stop worrying about whether each step will make you feel better. Stop asking, Am I feeling better yet? Just absorb yourself in the task of living your life.

it’s better to do something only partly right than do nothing at all.

A decision without action is just a thought,

Google biases your search results

when you decide on a goal, the prefrontal cortex changes the way you see and smell and hear the world in front of you.

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

people with depression tend to create nebulous goals that are poorly defined, which makes progress and achievement difficult.

Write down at least one or two specific goals that you could achieve that align with what’s important to you.

write down your thoughts. Get them out of your head and onto a piece of paper and be done with it.

Melatonin release and sleep are both improved by exposure to sunlight.

you have neurons that stretch from your eye to the brainstem region that produces serotonin, which are stimulated by ambient levels of light.24 Another reason to make sure you get plenty of bright light during the day.

don’t take regular naps. And if you consistently get quality sleep, you won’t even feel that you need them.

Sunlight

Exercise

Remembering Happy Memories

“He who has a why to live for can bear almost any how.”

How would your life be better if your bad habit was gone?

try randomly changing anything you don’t like about your environment. Maybe just hang a different picture in the living room, or paint your bedroom, or even move to a new apartment. Start a new job. Go on vacation. Get a new hobby. Buy some new clothes. This may sound like strange advice, but the limbic system is very good at picking up subtle environmental cues, and because it has a lot of connections with the striatum, even subtle changes can have a big effect.

just start doing something productive—anything productive—even if it’s not the thing you’re supposed to be doing.

Sudden cold water on your face slows down your heart rate by indirectly stimulating the vagus nerve.

standing or sitting in an open, expansive posture increases testosterone and decreases the stress hormone cortisol.

Gratitude is a potent antidote to negativity, because it doesn’t depend on your life circumstances. You could be poor and starving and yet still grateful for a warm breeze.

If you’re having difficulty remembering happy events, talk to an old friend, look at photographs, or read older entries from your diary. This is another reason to keep a gratitude journal; it’s something to look back on when things get tough.

you don’t even have to believe good things will happen; you just have to believe that they could happen or that no matter what happens, you’ll be okay.

Gratitude is powerful because it decreases envy and increases how much you value what you already have, which improves life satisfaction.

Make a list of things you used to enjoy (playing tennis, going to the movies with friends, and so on). Recognize that your lack of enjoyment is only a temporary situation and keep doing the things you used to enjoy, even if they don’t seem as fun.

Gratitude improves sleep. Sleep reduces pain. Reduced pain improves your mood. Improved mood reduces anxiety, which improves focus and planning. Focus and planning help with decision making. Decision making further reduces anxiety and improves enjoyment. Enjoyment gives you more to be grateful for, which keeps that loop of the upward spiral going. Enjoyment also makes it more likely you’ll exercise and be social, which, in turn, will make you happier.

Don’t feel like hanging out with people? Go for a run. Don’t feel like doing work? Go outside. Can’t sleep? Think about what you’re grateful for. Worrying too much? Stretch.

Do something to change the pattern—anything. Can’t find a reason to get out of bed? Stop looking for a reason; just get out of bed.