This is the third and final week of letting everyone know some of the very helpful information in the book, The Upward Spiral, by Dr. Alex Korb. It is a fascinating book that I highly recommend reading, and it is all about making small changes that can start a chain reaction toward a better mood. It is written, primarily, for people with depression; however, anyone can give themselves a boost following the suggestions in the book.

Dr. Korb’s next chapter is about biofeedback. He says, “Your brain constantly receives signals from the rest of the body telling it how to feel.” There are things that we do automatically with our bodies based on our feelings. When we feel happy, we smile. When we’re angry, we bring our eyebrows together. When we are confident, we pull our shoulders back and our heads up. The thing is, that these pathways between our feelings and our bodies become so strong and connected that they end up working in reverse too. If you push your eyebrows together for a few minutes, your brain will get the message that you’re supposed to be in a bad mood, If you curl the corners of your mouth upward, your brain will figure you’re supposed to be happy, and if you put your shoulders back and your head high, your brain will assume you’re feeling confident. Splashing cold water on your face or listening to music will also have a positive effect on your mood when you’re feeling down and stuck. Deep breathing and muscle relaxation can also relieve stress and help you calm your brain. The point is, your mood doesn’t have to be fixed, and you can change it through your physical actions.

Gratitude is a highly underrated method for improving one’s mood. Thinking about and expressing gratitude has been shown to reduce the likelihood of suicidal thoughts, reduce anxiety, improve physical health, and it creates a sense of connection to others. Gratitude gives us a boost of dopamine and serotonin, and it can help improve sleep. One important note is that gratitude isn’t about telling yourself, “Well, at least I don’t have…like….” Social comparisons can, almost inevitably, lead to noticing when others have it better. It is just about being grateful for what you have, regardless of whether others have more or less than us. We can be grateful for anything: your most recent meal, a good night’s sleep, the laugh you had when your dog did something silly, or even the breath you just took.

The next thing mentioned is having social support. Many people who have depression will tell me that they have periods of time where they isolate themselves. This common symptom does reinforce depression, though, and it generally makes their moods worse. Whether we like it or not, our species is very social. Our ancestors weren’t the strongest or scariest on the planet, but humans became the top of the food chain because we were smarter than other animals and we kept each other safe. For people who are anxious in social situations, they will often desire connections while simultaneously fearing them. The region of our brain that registers rejection is the same one that registers physical pain, hence the feeling of “hurt” when we feel rejected. I’m aware that socializing, for some, can feel terrifying. Consider starting small by just being in places where other people are located, even if you don’t wish to socialize. Dr. Korb mentioned that studies have shown, “Interacting with others can help reduce your pain, anxiety, and stress, and it can improve your mood.” Even though folks with depression might feel compelled to be alone, spending time with friends and family actually makes them feel better. Volunteering is a way of being social and helping others, which doubles up the “feel-good” effects.

All of the tips mentioned throughout the book can be very helpful. Sometimes, though, professional assistance is needed. Going to a counselor for therapy creates an opportunity for actual changes in the brain that can alter moods and negative thinking patterns. It can also help people learn to find enjoyment again. In many cases, medication can also be very helpful for people dealing with depression and other disorders. Counseling and medication both create brain changes, but they do so differently, so often it is recommended for people to try both avenues because it creates more opportunity for growth and relief of symptoms.

Well, there you have it. Three blog posts later, we’ve reviewed an entire book. Obviously, there is a lot that I’ve left out. It is a very worthwhile read, so if this blog gives you any curiosity about the book, please go check it out. The point of the book is simple, though. There are many different things that we can do with the intention of helping ourselves. Any positive change that you make allows you to be better off today than you were yesterday. It doesn’t matter how small the change is, it just matters that we take the steps. If you have a goal of being 1% better off today than you were yesterday, and you keep making that goal each day after, you can be in a significantly better place in a relatively short amount of time.

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.