In my last post I mentioned a brilliant book, “The Upward Spiral” from Alex Korb, neuroscientist specialised in mood disorders, which has given me a real understanding of the neurological mechanics of depression and how to reserve it. So as promised here is a little more on this topic: the 8 actions recommended by Dr Alex Korb to reverse the downward spiral of depression.
But let’s just remind ourselves of the basics first.
The neurological mechanics of depression
This is how Dr Alex Korb describes depression: “Essentially, your brain is full of intricate, interacting neural circuits. […] There are circuits for sleep, memory, mood, planning, enjoyment, and more, and they all communicate with each other. […] The disease of depression is a pattern of activity that arises from the interactions of these circuits.”
Dr Alex Korb then goes through the different chemicals coming into play when you suffer from depression:
- Serotonin – improves willpower, motivation and mood
- Norepinephrine – enhance thinking, focus and dealing with stress
- Dopamine – increases enjoyment and is necessary for changing bad habits
- Oxytocin – promotes feelings of trust, love, and connection, and reduces anxiety
- GABA – increases feelings of relaxation and reduces anxiety
- Melatonin – enhances the quality of sleep
- Endorphins – provide pain relief and feelings of elation
- Endocannabinoids – improve your appetite and increase feelings of peacefulness and wellbeing
So what happens in the brain when you starts feeling depressed? You get stuck in a downward spiral because things that happen to you and decisions you make change your brain activity. If your brain activity changes in the wrong way (as in a negative way), things will soon snowball.
There are things you could do to make yourself feel better but you won’t feel like doing them and so instead you will continue to feel worse. And this is the biggest problem with depression. Depression doesn’t just get you down, it keeps you down.
This is why you need to take action now. And below is how you do it.
How to reverse depression
The good news is anyone can get out of depression by creating an upward spiral to reverse the cycle. In the second part of the book Dr Alex Korb goes through the 8 actions that you can take to reverse the effects of depression naturally.
By the way most of these actions are actions that I have previously recommended on this blog. Just saying.
Action #1: Exercise
I dedicated a whole article on the effects of exercising on the brain: You cannot be depressed while you exercise.
The key take-away points are below:
- Out of the 8 main chemicals that are involved in the mechanics of depression, 6 of them are positively impacted by exercising
- Exercising help activate 3 of the chemicals that are targeted by antidepressant medication
- Exercising activates 3 “natural drug” responsible for making you feel good
- The more intensive the exercise, the bigger the benefits
Action #2: Set goals and make decisions
Being unable to make decisions is a symptom of depression
When you are depressed you find it hard to make decisions. Even the smallest decision seems overwhelming.
I remember one day when I was in Denmark and at my lowest which is the perfect example. A friend called me and asked me if I wanted to go for a walk or grab a coffee (we had previously agreed to meet up but not what we would do). I simply couldn’t answer the question. I couldn’t even put a meaningful sentence together. I couldn’t explain what I was feeling and thinking. My friend was there within 5 minutes telling me how scared he was and took me for a walk and a coffee afterwards.
If that sounds familiar, do not worry. This is not you, it is just your depression playing tricks on your brain and you can fight it.
The benefits of making decisions for your brain
- engages the prefrontal cortex
- focuses attention and enhances perception
- increases enjoyment
- increase dopamine (through goals setting)
- override and utilise habits
- creates perceived control
- reduces worry and anxiety
- helps make more decisions – and thus creates an upward spiral
Let’s get you started
- Make a good decision, not the best decision
Do not let yourself become overwhelmed with the details and the pros and cons of each option. Just make a decision and you will slowly start getting better
- Take a step in the right direction
The decision-making process isn’t complete until you start implementing the decision you have made. So once you have made the decision, take the first step towards it. If you have decided to go for a walk, just start by putting on your trainers.
- Figure out what is important to you
Studies have shown that focusing on your values reduces the brain’s stress response. So focus on what is really important to you. What makes you feel happy? What achievements are you proud of? What qualities do you want others to see in you?
- Decide for something you want, not against something you do not want
The point here is to focus on something positive, not negative. Thinking about something in a positive way activate the right circuits in your brain and help reverse the depression cycle.
- Create specific long-term goals
If you start thinking about what is important to you and your values, your goals should come to you easily. I always have 3 main goals centred on health, relationships with others and wealth. I adjust them regularly. If you do not know where to start, I would suggest you start with your health and set as your goals to act on one of the action listed in this post.
Action #3: Sleep
The benefits of good sleep for your brain
After exercise, sleep is the next best tool to fight depression as it impacts 5 out of the 8 chemicals involved in the depression circuits.
Good quality sleep will:
– Restore clear thinking and improve your attention
– Reduce prefrontal worrying
– Improve frontal-limbic communication
– Enhance learning and memory
– Prepare your Melatonin
– Improve your mood with Serotonin
– Reduce your stress with Norepinephrine
– Reward your Dopamine system
– Reduce pain with Endorphins
– Cleanse the brain
Let’s get you started
- Write down your worries – Worrying prevents you from falling asleep or getting good quality sleep. So write everything that is on your mind before going to bed. It will help you clear your mind.
- Make your environment comfortable – Quality sleep requires calming the brain but being uncomfortable activates the brain’s stress response. So make sure the condition of your bedroom is right for you before going to bed.
- Brighten your day – Getting sun exposure during the day will help Melatonin release (which improve your sleep), boost your Serotonin and reduce pain so try and get outside in the middle of day even if just for 10 minutes.
- Sleep for 8 hours straight
- Use your bedroom only for sleeping (and sex of course which also helps reverse the cycle of depression)
- Create a routine for preparing or sleep
- Avoid caffeine near bedtime
- Do not eat a large meal less than 3 hours before bedtime
- Do not use alcohol as a sleep aid
For more on sleep see previous article: How getting a good night’s sleep can help fight depression
Action #4: Develop positive habits
Habits are the things you do when you’re not thinking about what to do.
The benefits of developing good habits for your brain
Developing good habits can be a powerful boost to an upward spiral because once you set those habits in motion, you can start to change your life without any additional effort. Good habits impact your Serotonin and Dopamine levels as explained in more detail below.
Let’s get you started
- How we create habits
Habits are created by repetition. Some habits require less repetition than others because some actions release more dopamine than others. When you first try to start a new habit it requires efforts, which is particularly difficult when you have depression. But powering through it will be worth it as the more you do the action the more dopamine will be released and the easier it will become.
- Self-affirmation can help you change your habits
Studies show that thinking about your positives qualities makes it easier to change your habits. That’s because happy memories boost Serotonin and so does positive self-reflection. So here is how to use self-affirmation. Before thinking about which habit you’d like to change, answer this list of question with a yes or no. If you answer yes, elaborate.
o Have you ever forgiven another person when he or she has hurt you?
o Have you ever been considerate of another person’s feelings?
o Have you ever given money or items to someone less fortunate than you?
o Have you ever tried to cheer someone up who had had a bad day?
o Have you ever encouraged a friend to pursue a goal?
- Reduce your stress
Stress biases the brain toward old habits over intentional actions, which is why it is so hard to change habits that we have put in place to cope with stress (such as smoking). And those coping habits are feeding your stress and your depression. So the best way forward is to reduce your stress level first rather than attacking the coping habit with full force.
You can reduce your stress levels through:
o Exercise – see action #1 above
o Decision making – see action #2 above
o Improving your sleep – see action #3 above
o Biofeedback – see action #5 (8 actions that will reverse the cycle of depression – Part 2)
o Gratitude – see action #6 (8 actions that will reverse the cycle of depression – Part 2)
o Social interactions – see action #7 (8 actions that will reverse the cycle of depression – Part 2)
- Accept that you won’t be perfect
Habits are created by repetition, i.e. by practice. And when you practice you make mistakes, it’s the way it goes. So just accept it and beat yourself up about it. As always, just remember to be kind to yourself.
- Increase your Serotonin level
The higher your levels of Serotonin, the more likely it is that you will stick to your good habits. The following actions help produce Serotonin so go for it:
o Get some sun
o Get a massage
o Remember happy memories
- Activate your prefrontal cortex
In depression the prefrontal cortex doesn’t work as it should, which is why it is so hard to create good habits. You can help redress this by:
o Keeping long-term goals in mind – see action #2 above
o Having some self-awareness, i.e. become more aware of your emotions, practice mindfulness. For more on that see How meditation can help relieve your depression
- Change your environment
Once habits are stored in your brain, they are triggered by a thought, a feeling or something in your environment. So to change a habit, you should try to change your environment. Example: if you want to stop eating cookies, don’t walk through the cookies aisle in the supermarket.
- Productive procrastination
If you are struggling to do what you need to do and it starts to increase your anxiety, do something. What I mean is do something that is on your to do list even if it isn’t the most urgent task. It still needs to get done and it will keep you moving forward. Once you start being productive, dopamine is released and you will have more energy and motivation to do tackle the thing you really should be doing.
In the next post we will look at the remaining 4 actions recommended by Alex Korb:
- Social interactions
In the meantime, I would love to hear your thoughts on the first 4 actions: exercise, decision-making, sleep and developing good habits. Have you tried any of them? How did it work out for you?