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

by Alex Korb

The Trouble with Other People The poet Emily Dickinson once wrote, “It might be lonelier without the loneliness.” She famously kept to herself and yet was scared of being alone. This apparent paradox is common, because the people who most yearn for closeness are often the most sensitive to rejection. Whether you have depression or not, other people can often be a source of stress and anxiety. Our brains are wired to care what people think about us, which is why feeling judged or rejected is so distressing. In fact, as demonstrated in an fMRI experiment, social exclusion activates the same circuitry as physical pain.1 In the experiment, participants were scanned while playing a virtual ball-tossing game with two other players. They were told the others were real people, but in fact, it was computer controlled. At first the “other players” played nicely, sharing the ball with the participant. But at one point they stopped sharing, only throwing back and forth to each other, ignoring the participant. This small change was enough to elicit feelings of social exclusion, and it activated the anterior cingulate and insula, just like physical pain would. We avoid social exclusion for the same reason we avoid touching a hot stove: it hurts! Reflecting on rejection. We often experience something as rejection when it’s really just a misunderstanding. For example, maybe you leave a message for a friend, and he or she doesn’t call you back. It’s easy to assume the intention was to hurt...