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The Upward Spiral: Using Neuroscience to Reverse the Course of Depression

At first I wasn’t sure how I felt about the word neuroscience popping out at me from The Upward Spiral’s front cover. I’ve never been science oriented, and reading how Alex Korb was going to be “using neuroscience to reverse the course of depression, one small change at a time” made me apprehensive. But then, a few pages in, my anxieties began to diminish — especially since the entire second chapter is dedicated to reducing worry.

Korb, a neuroscientist who earned his doctorate at UCLA, flawlessly explains complex brain functions and neurotransmitters and their roles in depression. On top of his easy-to-understand analogies and personal stories, his light humor makes the book not just informative, but uplifting.

And up is where we want to go. As Korb puts it, “the big problem with the downward spiral of depression is it doesn’t just get you down, it keeps you down.” To explain what happens in a depressed person’s brain, Korb explores the research. Scientists don’t fully understand what depression is, he acknowledges, but they do know that it relates to neurotransmitters the brain produces, and that it relates to different parts of the brain. In particular, the prefrontal cortex, used for thinking, and the limbic system, used for feeling, are involved, as well as neurotransmitters like serotonin, norepinephrine, and dopamine. (Don’t worry too much if you have no idea what I’m talking about: Korb has friendly illustrations of the brain to make the learning process much easier.)

Korb goes on to describe how anxiety and worry, negative thoughts, and bad habits can keep us in our downward spiral. A depressed brain has a bias toward negativity, bringing bad memories and self-criticism to light much more easily. Controlling bad habits, he explains, is all about putting our prefrontal cortex to use. When we want to stop a habit, we use our prefrontal cortex to think about what we’re doing, and use the neurotransmitter serotonin to inhibit impulses. Depression prevents the production of serotonin, making it harder to stop the habits.

After he describes the downward spiral, Korb helps us start moving in the other direction. He encourages readers to take small steps, since any change, no matter how tiny it seems, can have big effects. Making small, even somewhat trivial decisions when we are indecisive can help us feel productive, he writes, and is one step in the process of reversing depression.

In addition to setting goals and making decisions, Korb advocates getting adequate rest, exercising, and developing positive habits. Most of his advice seems straightforward, but what surprised me was his emphasis on gratitude. Research suggests that opening a so-called gratitude circuit can have great positive effects on our brain. It not only decreases symptoms of depression, but also improves physical health, improves sleep, and boosts serotonin. Gratitude also plays a role in the production of dopamine, Korb explains, the neurotransmitter that increases enjoyment. And so, by activating our gratitude circuit, it’s easier for us to feel positive emotions.

I thoroughly enjoyed reading this book, and not just because it deftly explains the science in clear terms. I also enjoyed it because I could feel Korb’s little bursts of encouragement along the way. For instance, in the chapter on anxiety and worrying, he motivates us to stay in the now.

“Focusing on the present helps reduce anxiety and worry,” he writes, “because it decreases emotional, self-focused processing in the ventromedial prefrontal cortex.” And, he reminds us: “There’s nothing wrong with your brain.” Reading lines like that inspired me to incorporate some of his techniques into my own life.

Although he does use scientific terminology at times, Korb redeems himself to non-science-oriented readers by using humor and relatable situations. His reassuring tone and tidbits on his own experience with depression are just what readers need to power through their struggle.

The Upward Spiral: Using Neuroscience to Reverse the Course of Depression, One Small Change at a Time

New Harbinger Publications, March 2015

Paperback, 240 pages


The Upward Spiral: Using Neuroscience to Reverse the Course of Depression

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Samantha Munoz

APA Reference
Munoz, S. (2016). The Upward Spiral: Using Neuroscience to Reverse the Course of Depression. Psych Central. Retrieved on September 27, 2020, from
Scientifically Reviewed
Last updated: 17 May 2016
Last reviewed: By a member of our scientific advisory board on 17 May 2016
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