Last week I started writing about the book, The Upward Spiral, by Dr. Alex Korb. We didn’t get terribly far into the book, and I’d like to dive a little deeper into the next chapters of it. Dr. Korb begins this section of the book talking about bad habits. Interestingly, decisions about what we should do are made in the highest-thinking part of the brain, the prefrontal cortex, but our habits are controlled by an area that isn’t quite as conscious (the striatum), and it doesn’t care whether our habits are good or bad. Essentially, it helps us do things just because we’ve done them so often before. Plus, if we have decided that something is pleasurable, we get a little dose of dopamine when we do it, which rewards the behavior and makes it more likely to happen again. We can help ourselves to some extent if we can avoid triggers of our bad habits (like avoiding bars if you have a drinking problem). Our prefrontal cortex is capable of overriding our impulses and habits; however, when it does this it requires a lot of serotonin, which isn’t unlimited. We can improve our chances by doing serotonin-boosting activities (see last week’s blog) and by setting goals. When we complete our goals, we also get a little dopamine boost, which helps reinforce them. Creating new habits is hard work, but if we diligently do this, over and over again, we can create a new pathway in the brain that will be strengthened every time we do it.
He discusses exercise next. Exercise can sound like a rigid term if we are locked into thinking of it as lifting weights, running, biking, etc. However, exercises are also pickleball, yoga, hiking, basketball, swimming, and just going for a walk. Exercise, for mental health purposes, is movement. Exercise is scientifically shown to give us energy, help us sleep better, regulate our appetite, improve decision-making abilities, decrease anxiety and stress, and it brings us into the world. This one change can positively affect other areas that contribute to depression and mental illness, causing the upward spiral that Dr. Korb refers to in his book. Think about it; exercise can improve your sleep, expose you to sunlight, and increase your motivation to do things, and all of these together begin to have an even stronger impact. It also has a strong impact on boosting serotonin, and this neurotransmitter is what many antidepressants are designed to affect.
Many people with depression also struggle with feeling indecisive. Dr. Korb suggests focusing less on making a perfect decision, and instead to just try to make a good decision. Any small step that we take toward action (once we’ve made a decision) can also create a domino effect toward completion. The act of making a decision can actually focus our attention and alter the way that we perceive things with our senses because we start to focus on what we’re looking for and drowning out the rest of the noise. When we make a decision to do something good for ourselves, we’re also setting ourselves up for another dopamine rush when we achieve it. The act of making decisions actually reduces anxiety, and the act of making decisions will actually strengthen those brain pathways so that future decisions will be easier to make. If you struggle with making decisions, start with clarifying your values. Ask yourself, “At the end of my life, what do I want said about me?” If you know this, you know what is important and valuable to you, and you can make your decisions according to those values.
Sleep is the focus of the next chapter. Poor sleep is both a common symptom of depression and a factor that keeps people depressed. Poor sleep also has a negative effect on weight, the heart, immune system, and it even increases the likelihood of addictions. Light is one factor in sleep that has an effect on how tired we actually are. Our hypothalamus detects light coming in from the eyes to help decide if it is time to start getting sleepy. This means that staring at the phone before bed can mess with your tiredness. Even small noise disturbances can mess with the quality of our sleep, so I tend to suggest alternatives like fans or white noise machines when clients tell me that they need to sleep with the tv on. Ways to improve overall sleep include:
Create a routine that will lead toward sleeping for 8 hours straight. This means avoid napping, and go to bed and wake up at consistent times. Understand that it may take time and patience to actually get to the point of sleeping the full night through, especially if your sleep cycle is really out of whack.
Only use your bedroom for sleep and being with your significant other. When the bed is used for lounging, the brain associates it with another place to lay. If it is used for sleep, the brain will cause you to feel sleepy when you lay down.
Have a routine that prepares you for sleep, like brushing your teeth and reading.
Avoid caffeine in the hours before sleep.
Don’t eat large meals less than 3 hours before bedtime.
Don’t drink alcohol as a way of going to sleep. It can mess with your body’s natural sleep rhythm and cause you to not feel tired without drinking.
Exercise regularly as a way of increasing available melatonin, but don’t exercise right before bed.
Instead of trying to cram in a bunch of information, I think it would be best to end this section here. Come back next week, and we’ll finish the rest of the book.