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

by Alex Korb

Think about how your life would improve. How would your life be better if your bad habit was gone?

Try yoga. Yoga utilizes almost every suggestion in this chapter, including stretching, breathing, relaxation, and posture changes, and it can, in fact, help treat depression.1 Yoga poses that incorporate back bends and opening the chest do a particularly good job at increasing positive emotions.

Are you hungry or stressed? Unfortunately, emotional sensations are not very precise, and your brain often misinterprets them. For example, your brain receives a signal that something is happening in your stomach. It may interpret it as hunger, but in fact, it might just be that you’re stressed, or vice versa. These types of signals are like your car’s check-engine light—alerting you that something is happening, but not being very helpful in telling you what. Calmly doing a self-assessment of your feelings can help distinguish the signals.

A splash of cold water. Sudden cold water on your face slows down your heart rate by indirectly stimulating the vagus nerve. If you’re feeling overwhelmed, stressed, or anxious, find a sink, fill your hands with cold water, and splash it on your face.

Use the power of music. Whether playing an instrument or listening to the radio, music increases heart-rate variability, though making music has a stronger effect.4 Music engages most of the limbic system, including the hippocampus, anterior cingulate, and nucleus accumbens, which is why it can be motivating and enjoyable and can help regulate your emotions.5 It can also be soothing, lowering blood pressure6 and reducing stress.

So sing along with the radio or just make a playlist of your favorite songs. Better yet, go dancing. Dancing combines music, exercise, and being social, so you get a triple boost to an upward spiral.

Smile. It’s simple and improves your mood;

Laugh. If you want to get the biggest facial feedback benefit, laugh. Even if nothing is funny, just open your mouth and let out a “ha-ha-ha.” The brain doesn’t distinguish much between genuine laughter and fake laughter,9 and fake laughing can often lead to laughing at yourself for real.

Wear sunglasses. On bright days, we often contract our corrugator supercilii while squinting to reduce glare from the sun. So while it might be a beautiful day, you’re sending signals to your brain that you’re slightly upset. Sunglasses reduce glare so you don’t have to squint. So they not only make you look cool, but also, thanks to facial feedback, they help you feel calmer.

Relax your jaw. Often, when stressed, we inadvertently clench our teeth, which increases overall tension. So let your jaw hang loose, wiggle it around, and then open wide. This may make you yawn, which will also increase your calmness.

Take a deep breath. When anxious or overwhelmed, slow breathing can help. Breathe in slowly through your nose while counting slowly to six (or even eight). Pause for a couple seconds at the top of your inhalation and then exhale slowly through your nose for the same count.

Breathe faster for energy. Sometimes you feel that you need more energy. Try quick, shallow breaths for twenty to thirty seconds. Don’t do it for too long, however, or you may start to feel light-headed.

Clench and relax. To remind your brain to relax your muscles, sometimes it’s helpful to clench them first. Take a deep breath in and then flex a tight muscle for a few seconds. After holding for a few seconds, exhale with a sigh and relax. The most important muscles to relax are your facial muscles, since those have the largest effect on emotion, but relaxing your hands, butt, and stomach are also important.

In depression, life is full of disappointments and lacking in things you sorely need—a good night’s sleep, a job well done, a friendly face. While the gap between what you want and what you have may seem large, it is never as wide as it appears when you’re weighed down by depression.

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. Conversely, you could be rich and powerful and still be annoyed at the sound your husband makes when he’s chewing. Gratitude is a state of mind—in fact, there’s a gratitude circuit in your brain, badly in need of a workout. Strengthening that circuit brings the power to elevate your physical and mental health, boost happiness, improve sleep, and help you feel more connected to other people.

Write a detailed thank-you letter. Think of someone who has been especially kind to you—a friend, a teacher, a coworker—whom you’ve never properly thanked. Write a letter thanking this person, being specific about what he or she did that affected your life. Then schedule a meeting, maybe over coffee or a drink, and deliver the letter in person. Don’t tell the person what the meeting is about; let it be a surprise. This form of gratitude can have a long-lasting effect. One study showed that after writing and delivering a thank-you letter, people had increased levels of happiness even two months later.3

Ask for help. Sometimes when you’re feeling crappy, it’s hard to focus on—or even remember—happier times. 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.

Keep a gratitude journal. Take a few minutes every day to write down three things you’re grateful for. To make it a better habit, try doing it at the same time every day. If you can’t think of three things, just write one. If you can’t think of even one thing, just write, “I’m grateful for the food I ate today” or “I’m grateful for the clothes I’m wearing.” Even if a situation is 90 percent what you don’t want, you can still be grateful for the other 10 percent.

Be grateful when you wake up. When you wake up in the morning, try to think of one thing you are looking forward to that day, even if it’s just breakfast.

An old Cherokee legend tells of a battle between two wolves. One wolf represents anger, jealousy, self-pity, sorrow, guilt, and resentment. The other stands for joy, peace, love, hope, kindness, and truth. It is a battle raging inside us all. Which wolf wins? The one you feed.

Take a deep breath. A nice long one, through your nose. At the top of your breath, pause for a moment to think, “I am grateful for this breath,” then let it out slowly.

Depression is an isolating disease. It makes you feel separate and alone, even around other people, and this often makes people want to be physically separate. But that desire for solitude is just a symptom of the depressed brain, and it perpetuates the disease, just as the desire to not exercise perpetuates it. One of the most important neuroscience principles to take from this book is that even though you may feel like being alone, the cure to depression often lies in other people.

Be around people. Downward spirals are more likely when you’re alone. If you start to feel your mood sliding downhill, try going somewhere where there are other people around, like a library or coffee shop. You don’t need to interact with others; just being in the same physical space can help.

We avoid social exclusion for the same reason we avoid touching a hot stove: it hurts!

Social support comes in many forms—even text messages, Facebook comments, and emails can help counteract feelings of social rejection.

Turn up the heat. Feeling warm can boost oxytocin—or at least mimic its effects, increasing feelings of trust and generosity.33 So if you can’t get a hug, try wrapping yourself in a blanket and holding a mug of hot tea. Taking a warm shower can also help.

Talk to people you care about. That doesn’t mean stalk them on Facebook. Email them. Call them. Even better, go for a walk with them or meet for coffee—do something fun.

Root for a sports team. One of the most powerful ways to combat depression is a sense of belonging. Winning is fun, even if you’re just a spectator. Cheering for a winning sports team increases testosterone,41 which boosts energy and sex drive. A sports team also provides a community, so even after losses, you have the camaraderie—and there’s always the hope that your team will win next time.

Find a community where you feel like you belong—a church, a team, or an activity group. Keep seeking interactions with others, and be patient with yourself—allow your brain time to rewire.

Go see a professional. Make an appointment with a psychiatrist, psychologist, or therapist. They’ve undergone years of training to help people like you. Maybe you doubt that a professional will help; but like almost every other aspect of the upward spiral, while you can’t be certain that any solution will definitely work, you can be certain that if you don’t try, nothing is likely to change.

Do what you used to enjoy. It can be stressful if you don’t enjoy hobbies or activities anymore, but you can overcome this with your own form of BAT. 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.

Everything is interconnected. 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.