Last week I briefly referenced a book called The Upward Spiral by Dr. Alex Korb. I have found that many of the books I recommend to clients go unread because people live busy lives, some people just don’t enjoy reading, and frankly, most people aren’t mental health nerds like me who find this stuff fascinating. This means that when I come across a particularly good book I sometimes want to share it on this blog. The ideas and points that I will be sharing today come from Dr. Korb, and while I’m happy to be a messenger, I don’t want to take credit for his work, so assume that anything particularly helpful comes from him.
First of all, this book is centered on the idea that an event or couple of events can trigger a downward spiral into deep depression. I think it’s safe to say that most people who have dealt with depression in their lives would agree with that. Just like something can trigger this downward spiral, though, we can do things that will cause an upward spiral as well. Not only this, if people can figure out what contributes to their negative spirals, they can take steps to avoid them. He calls depression a communication and regulation problem between the thinking and feeling parts of the brain. Dr. Korb spends some time discussing different regions of the brain, and while it is very interesting and helpful, I’m not going to include that for the sake of space. However, the takeaway is that our brains are complex and not everything happening in the brain is at a conscious level. When we have bad habits or we’re stuck in a rut, there are parts of the brain that might be working against us. While we can consciously overrule our desires and impulses, it takes a lot of effort, and sometimes we can legitimately run out of willpower.
I will mention some of the neurotransmitters and brain chemicals that Dr. Korb brings up because we can actually change the levels of them with our actions.
Serotonin: involved in willpower and regulating moods, and we can increase it with exercise, gratitude, and sunlight.
Dopamine: involved with habits and enjoyment, and it can be increased through enjoyable activities, exercise, gratitude, and social connection.
Norepinephrine: helps with regulating stress, and it is increased through exercise, sleep, and increased sense of control.
Oxytocin: key in building connections with others, and it is increased through gratitude, physical touch, social supports, and music.
Endorphins: help with euphoria and pain reduction, and they are increased through exercise, stretching, massage and physical touch, and social connections.
Endocannabinoids: involved in peacefulness and pain reduction, and increased through exercise.
Melatonin: helps us sleep, and it is increased through sunlight and exercise.
GABA: helps reduce anxiety and is, interestingly, increased with yoga.
BDNF: is responsible for strengthening and growing neurons, and it is increased with exercise.
Cortisol: the stress hormone, and it is decreased (this is a good thing) through exercise, deep breathing, relaxing music, good sleep, and mindfulness.
You may have noticed that many of the ways to positively impact our brain chemistry are the same: exercise, sunlight, gratitude, social connections, etc. By making positive changes, we can actually change (for the better) the structure of our brains. I think this is important because telling someone that exercise can help adjust their brain chemistry so that their mood is altered is different from saying that exercise will make them feel better.
Anxiety often accompanies depression. It isn’t uncommon for people to have a diagnosis of Major Depressive Disorder and Generalized Anxiety Disorder. On the surface, they might seem like opposites, but they are definitely related. Anxiety isn’t necessarily a bad thing, though. The brain’s primary objective is survival, and anxiety does actually make us more aware and keeps us safe. Recommendations for reducing anxiety when it feels overwhelming are:
When struggling with indecision, accept that even the wrong decision will be more helpful than not making any choice at all. (The band Rush taught us that, “If you choose not to decide you still have made a choice.”)
Focus on what you can control in a situation, not what you can’t.
Take slow deep breaths to activate the parasympathetic nervous system for calming.
Aim for “good enough” and don’t expect perfection. (We have the chance to learn and grow through our whole lives, and while we can’t be perfect, we can alway continue to improve).
Don’t catastrophize situations. We may be programmed to think of the worst-case-scenario, but that isn’t usually reality.
Be mindfully present in the here and now.
The next thing discussed in the book is focusing on the negative. First of all, our brains are all wired in a way that the negative stands out more than the positive. This is probably a survival strategy that humans developed in order to notice danger. It is definitely true, though, that some people have more of a bias toward the negative than others, and when one’s mood becomes more negative, they are even more likely to notice negative events. Not only that, they are more likely to have an easier time recalling painful memories than happy ones. They may pay extra attention to their mistakes and beat themselves up for them. It’s also interesting to note that the reason we all notice our mistakes so much more than our successes is that part of our brain is trying to help us learn, and it isn’t necessarily a conscious part. To combat this tendency toward pessimism, Dr. Korb recommends beginning to imagine that things could get better. I’m aware that this seems a little too simple, but the areas of the brain that are activated by this process help regulate the “alarm” area of the brain. Activities that increase serotonin and norepinephrine (see above) will be especially helpful in becoming less negative-focused.
This book has a lot of good information. Too much, in fact, to be able to cover it all in a single blog. Come back next week and we will continue to dive into the book.