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The Upward Spiral

Using Neuroscience to Reverse the Course of Depression, One Small Change at a Time

by Alex Korb, PhD

|New Harbinger Publications©2015·240 pages

Alex Korb is a neuroscientist in the department of psychiatry at the University of California, Los Angeles. (Go Bruins!) He’s also a great writer. As per the sub-title, the book is all about “Using Neuroscience to Reverse the Course of Depression, One Small Change at a Time.” It’s REALLY good. Inspiring. Scientifically grounded. Simple. Practical. ← A winning formula for a great book! Big Ideas we explore include the power of exercising your brain (which is the #1 tip, btw), setting goals (and making decisions), developing positive habits (via repetition, repetition, repetition), biofeedback (and how to take advantage of it), and the power of others (rely on it!).


Big Ideas

“You can’t always change where you are, but you can change where you’re going. What if, instead of your life spiraling down, it spiraled up? What if you suddenly had more energy, slept better, hung out with your friends more, felt happier? Your neural circuits have just as much potential for this as they do for depression. It often takes only a few positive emotions to kick-start the process, which then begins to fuel positive changes in other areas of your life—this is the upward spiral, and its incredible efficacy has been proven time and again, in hundreds of scientific studies. The question is, what’s actually happening in the brain, and how does this spiral begin?

It turns out that positive life changes actually cause positive neural changes—in the brain’s electrical activity, its chemical composition, even its ability to produce new neurons. These brain changes alter the tuning of your brain’s circuitry and lead to further positive life changes. For example, exercise changes the electrical activity in your brain during sleep, which then reduces anxiety, improves mood, and gives you more energy to exercise. Similarly, expressing gratitude activates serotonin production, which improves mood and allows you to overcome bad habits, giving you more to be grateful for. Any tiny change can be just the push your brain needs to start spiraling upward.”

~ Alex Korb PhD from The Upward Spiral

I got this book after a number of Optimizers recommended that I check it out. (THANK YOU! And, one more time: If you have a book you’d like me to cover, please let us know here!)

Alex Korb is a neuroscientist in the department of psychiatry at the University of California, Los Angeles. (Go Bruins!) He’s also a great writer.

As per the sub-title, the book is all about “Using Neuroscience to Reverse the Course of Depression, One Small Change at a Time.

Basically: The neuroscience of depression and how to reverse it. It’s REALLY good.

Inspiring. Scientifically grounded. Simple. Practical. ← A winning formula for a great book!

Dan Siegel, a leading neuropsychiatrist (and author of Mindsight) also associated with UCLA, wrote the foreword to the book. As he says, “The Upward Spiral has been a joy for me in its clarity, its cutting-edge science, and its inspiring translation of current research into practical tools for everyday life. Even though this is my field as a neuropsychiatrist, psychotherapist, and mental-health educator who focuses on the brain, I learned a ton and laughed a lot. This book is at the same time informative and fun.

If you or someone you know have suffered from depression I think you’ll love this book as much as I did. (Get a copy here.)

Alex walks us through eight powerful life changes that can get us on an Upward Spiral: exercise, decision making, sleep, habits, biofeedback, gratitude, social support, and professional help.

I’m excited to share some of my favorite Ideas with wisdom we can apply to our lives TODAY, so let’s jump straight in!

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It turns out that just a little change can be enough to push you away from depression and up toward a happier state. That’s because in complex systems like the brain, even a little shift can change the resonance of the whole system. You might have a forecast for rain, but then the wind changes direction, the humidity drops by just 1 percent, and the day is sunny instead.
Alex Korb, PhD
When everything is up in the air, the amygdala becomes more reactive. So if you tend to worry, reduce your options and make quick decisions whenever possible. As soon as you make a decision, however small, everything starts to feel more manageable.
Alex Korb, PhD
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Exercise Your Brain

“I’m sure you’ve heard a million times how good exercise is for you. Well, now it’s time to make it a million and one. Exercise is good for you. And not just for your heart and your waistline, but also for your brain—specifically, for the circuits that keep you depressed. Almost everything that depression causes can be combatted by exercise. For example:

Physically

  • Depression makes you lethargic and tired, but exercise gives you more energy and vitality.

  • Depression often messes up your sleep patterns, but exercise improves your sleep, making it more restorative for your brain.

  • Depression wreaks havoc on your appetite, so you either eat too little or chow down on junk food (in fact, people who eat lots of processed foods are at higher risk for depression). Exercise improves your appetite, leading to more enjoyable eating and better health.

Mentally

  • Depression can make it hard to concentrate, but exercise makes you mentally sharper and better at planning and decision making.

  • Depression makes you… well… depressed, but exercise improves your mood. It also reduces anxiety, decreases stress, and boosts self-esteem.

Socially

  • Depression usually keep

    s you isolated and alone, but exercise tends to bring you out into the world.

Furthermore, all of these effects make it more likely that you’ll engage in other activities and thought processes that also reverse the course of depression. For example, exercise improves sleep, which then reduces pain, improves mood, and increases energy and alertness. The reduction in pain makes you more likely to exercise and increases your enjoyment of exercise. Having more energy also makes it more likely that you’ll exercise. The take-home message is that all these cause and effects intermingle and build on each other in an upward spiral toward feeling better.”

Part 1 of the book is all about the neuroscience of depression. It’s called “Stuck in a Downward Spiral.” Part 2 of the book is all about the neuroscience of REVERSING the course of depression. It’s called “Creating an Upward Spiral.”

That passage is from the very first chapter in Part 2 on how to create the upward spirals. It’s called “Exercise Your Brain.”

We’ve talked about this countless times but I’m always happy to remind myself and to remind you (and your families and colleagues and clients and…) that exercise does a mind, body, and soul good! So… For the million and second time: Exercise is good for you.

Let’s remember that the “upward spiral” Alex is talking about is basically the same thing we’re always talking about with aggregating and compounding tiny gains over an extended period of time. All of our little +1 Optimizations “intermingle and build on each other in an upward spiral toward feeling better.” (Can you FEEL it?!)

Practically speaking: How’s YOUR exercise these days?

Of course, if you haven’t been moving much lately you won’t necessarily *feel* like it. That’s fine. Choose to go move your body in whatever way gives you joy for a minute (Tiny Habits for the win!) and kick start that upward spiral TODAY!

P.S. If you need to be reminded of just how awesome it is, check out our Notes on Kelly McGonigal’s The Joy of Movement and John Ratey’s Spark.

P.P.S. Alex tells us: “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.

Figure out your triggers. It is much easier to avoid temptation than to resist it. If you know what triggers a particular habit, sometimes you can get rid of that habit simply by removing the trigger from your life.
Alex Korb, PhD
Make an anti-laziness rule. Decide ahead of time that you’ll take the stairs for anything less than three floors. Decide that you’ll walk to do any errand that is less than a mile away or bike to any that are less than two miles away. Commit to never taking an escalator if the stairs are right next to it. Don’t circle the parking lot looking for a closer space, just take the first one you see.
Alex Korb, PhD

Set Goals, Make decisions

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 response to stress. 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? What good qualities would you want coworkers or friends to use in describing you?”

That’s from the chapter featuring the second practical tip to help create the upward spiral: “Set Goals, Make Decisions.”

As you may have noticed, when our mood drops and we feel more stressed and anxious and depressed, we have a harder time setting goals and making decisions.

Solution?

Make decisions. However tiny.

When we do that, we regain a sense of agency which is so essential to our well-being. On the other hand, “Indecisiveness is part of the downward spiral because it enhances your feeling of being out of control.”

Alex also talks about the power of reducing choices in our lives and leans on the wisdom from Barry Schwartz’ Paradox of Choice.

Earlier in the book he tells us: “Go for good enough. Worrying is often triggered by wanting to make the perfect choice or by trying to maximize everything. When buying a used car, you want one that is cheap, reliable, safe, sexy, the right color, and fuel efficient. Unfortunately, no single option is likely to be the best in all those dimensions. If you try to have the best of everything, you’re likely to be paralyzed by indecision or dissatisfied with your choice. In fact, this kind of ‘maximizing’ has been proven to increase depression. So don’t try to make the most amazing dinner; start out by just making a good dinner. Don’t try to be the perfect parent; just be a good one. Don’t try to be your happiest; just be happy.

While in this context he tells us: “When your prefrontal cortex has to loop through many potential scenarios, it increases the risk of triggering anxiety or worry. When you decide on one path, then you’ve reduced the number of variables the prefrontal cortex needs to optimize.”

All of which leads us back to the first line of this idea…

Figure out what’s important to you.

Who do you want to be Energy + Work + Love wise? What goals will you pursue and what virtues will you embody in the process?

One more time: Set goals. Make decisions. Take action. TODAY.

Develop positive habits

“Often when we try to start a good habit and then slip up, we describe it as a failure of willpower. But sticking to a good habit is not simply a matter of willpower. You have willpower only insofar as your prefrontal cortex is paying attention and has enough serotonin to work properly. Yes, deciding that you want to do things differently is an important first step, but your striatum doesn’t care much about what you want; it cares about repetition.

You won’t succeed 100 percent of the time—or maybe even most of the time—but getting upset with yourself does not help the process of retraining the brain. It hinders it. Those feelings of frustration and self-judgment are all sources of stress, making it more likely that you’ll keep doing your old habits. The key to change comes in the moment after you realize you didn’t enact your intended habit. That special moment is an opportunity for the prefrontal cortex to reassert itself, to remind yourself of your goal and try again. Yes, you will probably have many slipups, but if you give up after a slipup, you’ve only trained your striatum to give up. You’ll probably hear a little voice inside your head telling you to give up, but the more you listen to that voice, the more it becomes habit and the harder it is to resist. Every time you stick to your goals, the voice gets softer.”

That’s from the chapter on the fourth tip: “Develop Positive Habits.”

For the record, the third tip is “Give Your Brain a Rest” and features wisdom on the power of sleep. One more time: Check out our Notes on Why We Sleep. As Matthew Walker tells us: Sleep is the very foundation on which the other pillars rest.

Short story on Alex’s sleep wisdom? “The key for improving your sleep comes down to two main factors: dealing with your anxieties and stress and improving your sleep hygiene.

So, back to developing positive habits. As we say all the time (specifically in Willpower 101 + Habits 101 + Algorithms 101 and with our Coaches in our Algorithms Module), we need to use our willpower wisely to install habits that run on autopilot.

And, there’s only one way to do that: Repetition.

As Alex says: “Ultimately it comes down to the most cliched but scientifically true maxim: practice, practice, practice. To create new, good habits, you have to repeat them over and over again until your brain rewires itself.

I also love what he has to say about those inevitable “special moments” when we fail to do the thing we said we wanted to do. What do we do in those situations?

First of all, we need to KNOW that they’re going to happen. So we get our Self Compassion on and remember to quit shaming ourselves when we inevitably miss the mark.

Then we run our “Needs Work!” algorithm. “If I miss the mark with an intended behavior, then I’ll take a deep breath, rewind to the moment when I made the decision to go the wrong direction and replay the scene AS IF I had crushed it.

Boom. Done. Carry on.

P.S. Alex tells us: “Be as patient and kind with yourself as you would be with a cute little puppy that you’re trying to house-train. Stressing the puppy out will only make it pee on the floor. When your habit doesn’t take at first, just go for it again. And again… and again—and eventually it will start to stick.

P.P.S. “Resolve to change. Making a resolution to change is more effective than simply wanting to change, and dramatically increases your chance of success. Being specific in what you want to change helps make it more achievable. For example, ‘I resolve to work out more’ is not as effective as ‘I resolve to go to the gym before work on Tuesdays and Thursdays.’

Ultimately it comes down to the most cliched but scientifically true maxim: practice, practice, practice. To create new, good habits, you have to repeat them over and over again until your brain rewires itself.
Alex Korb, PhD

Take Advantage of biofeedback

“This chapter is not just about yoga. It’s about biofeedback, which is simply the fact that the brain changes its activity based on what the body is doing. It just so happens that yoga enhances brain changes through conscious biofeedback. People sometimes think biofeedback requires technology, like a heart-rate monitor or some device that tells you what your body is doing. And while technology can make it easier for you to understand body changes, your brain doesn’t need it. It is perfectly capable of paying attention to your body—your heart rate, your breathing rate, your muscle tension, and dozens of other bodily activities. In fact, your brain is paying attention to all those things all the time, whether or not you’re conscious of it.

We know our brains can control our bodies, particularly when it comes to things like emotions. When you feel scared or excited, your heart beats faster; when you feel frustrated, you clench your jaw. But it turns out, like almost everything else in this book, emotions aren’t a one-way street. They’re a feedback loop. The brain changes its activity based on what the body is doing.

Even actions as simple as changing your posture, relaxing your face, or slowing your breathing can have dramatic effects on your brain activity and, subsequently, your stress, your thoughts, and your mood. These changes are often transient, but they can be long lasting, particularly if they entail changing a habit. You can further improve the biofeedback by increasing your awareness of your body.”

That’s from a chapter on the fifth tip: “Take Advantage of Biofeedback.” Know this: “Your brain constantly receives signals from the rest of the body telling it how to feel. Learning to understand and control these signals is a big part of kick-starting an upward spiral.

Good news: The simplest stuff is also often the most powerful. If you feel so inspired, how about we practice a few little things now?

Let’s start by changing your posture. Sit up or stand up a little taller. Activate that power pose and virtually high five your inner daimon. Now, let’s relax your face. Deliberately soften your eyes and your jaw. Smile. Now, let’s slow down your breathing. Perhaps practice your favorite count. Mine? Inhale for 6. Hold for 1. Exhale for 8. Ahhhh…

Remember: “The brain changes its activity based on what the body is doing.” Let’s help our minds relax by relaxing our bodies as we flip the parasympathetic nervous system switch and make Energized Tranquility our default way of showing up.

P.S. The sixth tip? “Activate a Gratitude Circuit.” As we know, gratitude is huge. Alex tells us: “Importantly, the effect of gratitude is greatest in people with the highest level of hopelessness. When everything appears bleak and meaningless, a little gratitude goes a long way.

The German philosopher Friedrich Nietzsche wrote, ‘He who has a why to live for can bear almost any how.’ Having long-term goals gives you a why.
Alex Korb, PhD

Rely on the Power of Others

“Nobody wants to stick his or her hand in a bucket of ice water and leave it there until the pain is overwhelming, but that’s exactly what participants in one study were asked to do. Some participants had to sit by themselves, while others were allowed to sit with a stranger or even a friend. The participants sitting by themselves experienced much greater levels of pain, while having a friend say supportive things greatly reduced the pain. In fact, even having a total stranger voice support or just passively sit with the participant caused the same benefits.

This same effect is seen in patients with chronic pain. In one study, patients who had their significant other present experienced greatly reduced sensations of pain. Surprisingly, sometimes even just thinking about a loved one is enough to reduce pain. Even more surprisingly, the same is true for talking to a stranger. Pain is an internal sensation and is heightened when you focus on it. Because talking with other people activates prefrontal social circuitry, it can help shift the brain’s focus away from pain.”

That’s from a chapter on the seventh tip called “Rely on the Power of Others.” Alex shares fascinating studies that capture the power of other people to help us create upward spirals.

Like this one: “In addition, holding hands with someone can help comfort you and your brain through painful situations. One fMRI study scanned married women as they were warned that they were about to get a small electric shock. While anticipating the painful shocks, the brain showed a predictable pattern of response in pain and worrying circuits, with activation in the insula, anterior cingulate, and dorsolateral prefrontal cortex. During a separate scan, the women either held their husband’s hands or the hand of the experimenter. When a subject held her husband’s hand, the threat of shock had a smaller effect. The brain showed reduced activation in both the anterior cingulate cortex and dorsolateral prefrontal cortex—that is, less activity in the pain and worrying circuits. In addition, the stronger the marriage, the lower the discomfort-related insula activity. But even just holding the hand of the experimenter—a stranger—reduced activation in the anterior cingulate so that the women felt less distressed about the shocks.

And this one: “One fascinating study allowed mice to recover from a small injury either by themselves or in pairs. Mice recovering by themselves were more likely to develop depressive symptoms and give up easily on difficult tasks, while mice with a partner showed less depression and more fortitude.

When we’re not feeling great, we don’t feel like moving our bodies. But… We know that exercise can give us the nudge on that upward spiral. Same thing with connecting with others. When we’re feeling down, we tend to want to isolate ourselves. But, guess what? That’s when we often most need to connect.

Here’s to embracing the power of exercise, decision making, sleep, habits, biofeedback, gratitude, social support, and professional help as we use neuroscience to reverse the course of depression, one small change at a time. TODAY.

Take a deep breath. When you start to feel antsy or compelled to act on a bad habit, take a deep breath. Let it out slowly, then take another deep breath. Repeat as necessary.
Alex Korb, PhD
Our battered suitcases were piled on the sidewalk again; we had longer ways to go. But no matter, the road is life.
Jack Kerouac, On the Road

About the author

Alex Korb, PhD
Author

Alex Korb, PhD

Neuroscientist, writer and coach. Author of The Upward Spiral: Using Neuroscience to Reverse the Course of Depression