Any small change we make to treat depression has to be an act of faith because built into depression is doubt in its cure.
Faith Without Doubt
Before a Qigong/Tai Chi practice session last Thursday, the instructor asked me if I had other spiritual practices. I mentioned that I meditate daily and participate in a mindfulness discussion group on Saturday mornings.
He said that he had been reading an article about one of the world’s major religious figures and was trying to understand the difference between faith and faith without doubt.
Though I couldn’t put the difference into words on the spot, it’s something that the authors of the original mindfulness manual had addressed as well.
The next day I took a shot at an answer. The instructor had done enough research on the work of Roger Jahnke to muster the faith he needed to give Integral Qigong and Tai Chi a try. As he practiced it, he experienced the benefits of the movements for himself. By the time he decided to train so that he could teach the technique, he had arrived at faith without doubt.
Doubt Without Faith
In The Upward Spiral: Using Neuroscience to Reverse the Course of Depression, One Small Change at a Time, Alex Korb writes, “The big problem with the downward spiral of depression is that it doesn’t just get you down, it keeps you down. All the life changes that could help your depression just seem too difficult. Exercise would help, but you don’t feel like exercising. Getting a good night’s sleep would help, but you’ve got insomnia. Doing something fun with friends would help, but nothing seems fun, and you don’t feel like bothering people.”
I’ve written about my own seasonal tendency toward a downward spiral in “Depression’s Early Warning System” and “Help to Make it Through the Night.” My sleep cycle gets out of whack, I perceive simple exercise to be much more daunting than it actually is, and I’m less inclined to socialize.
Habit and Neuroscience
Two things keep me doing what’s good for me in the absence of tangible reward. Habit and neuroscience. I’ve made a conscious effort to form habits around sleep, taking walks, and scheduling social connection because neuroscience tells me how and why they’re so beneficial.
Korb’s neuroscience does a good job calling out the culprits of depression. “The prefrontal cortex worries too much, and the emotional limbic system is too reactive. The insula makes things feel worse, and the anterior cingulate isn’t helping by focusing on the negative. On top of that, the prefrontal cortex has a hard time inhibiting the bad habits of the dorsal striatum and nucleus accumbens. Depression is so hard to overcome because each circuit pulls the others downward.”
Ironically, it’s understanding why what I’m doing isn’t making me feel better that helps me stick with it…until I feel better.
The Upward Spiral
Korb writes, “It turns out that positive life changes actually cause positive neural changes—in the brain’s electrical activity, its chemical composition, even its ability to produce new neurons. These brain changes alter the tuning of your brain’s circuitry and lead to further positive life changes. For example, exercise changes the electrical activity in your brain during sleep, which then reduces anxiety, improves mood, and gives you more energy to exercise. Similarly, expressing gratitude activates serotonin production, which improves your mood and allows you to overcome bad habits, giving you more to be grateful for. Any tiny change can be just the push your brain needs to start spiraling upward.”
Ten Minute Exercise
In the Upward Spiral section of the book, Korb offers enough scientific information on the effects of each small change (or well-being practice) to give you faith in trying it.
Since most can be achieved with little effort, read through these small changes and decide which you’d like to try first.
Choose a Small Change
The circuits that allow us to plan and solve problems when we’re not depressed are the same ones that lead to anxiety and worry when we are. The simple act of making a decision, any decision, makes things begin to feel more manageable.
None of these small changes are silver bullets for depression, so there’s no need to worry about choosing the perfect small change to make.
Soak Up Some Sun
Getting at least a few minutes of mid-day sunshine helps boost the production of serotonin, which improves willpower, motivation, and mood. It also improves the release of melatonin, which helps regulate your circadian rhythm and improves sleep, which improves just about everything.
When I mentioned my seasonal (winter) malaise to a friend, he loaned me his light therapy lamp, and the tiny amount of faith I had in it based on hearsay from folks who use them overrode the doubt I had in trying it. I needed only enough willpower to carry it home, set it up, and plug it in. I noticed enough improvement in my energy and sleep cycle to give me faith to buy my own. Stay tuned.
Move Your Body
I have faith without doubt that moving my body is my most effective tool for battling depression. It helps with energy levels, makes decision making easier, reduces stress, and I’ll be devoting a separate post to the laundry list of other well-being benefits soon.
Notice that I didn’t use the word exercise. I do a few minutes of push-ups, sit-ups, and stretches every morning that I consider exercise, but, perhaps based on how much my gym clothes stank when I’d forget to bring them home to launder on weekends, I still think of exercise as a duty rather than a pleasure.
By contrast, for most of the year, I enjoy my daily outdoor walks, which is a way to get exercise without thinking of it as exercise. Only when it’s cold and rainy do I think of walking as exercise.
Over the last several months, I’ve also added Qigong/Tai Chi to move different parts of my body than I move during my walks.
I wrote about the importance of (and tips for) sleeping better in “7 Shocking Links Between Sleep and Depression.”
This one is so basic that you don’t have to decide to do it. But, if you decide to breathe to alter energy and mood, remember that breathing slowly and lengthening exhales reduces anxiety. Sharper inhales and faster breathing increase energy.
I had one of my biggest a-ha/duh moments when Korb explained that while we might need a biofeedback device to understand our respiration, heart-rate, etc. our brain doesn’t. Monitoring these things is literally what our brain does for a living. A-ha! Duh!
Given that, here are some biofeedback techniques he recommends.
Splashing cold water on your face quickly calms you down.
Want to improve your mood? Try singing along with your favorite playlist, smiling, or laughing. The brain doesn’t distinguish between real and fake laughter. (I guess that explains how the laugh tracks on old sitcoms tricked me into thinking that the shows were actually funny.)
Wearing sunglasses can prevent squinting, which keeps our brow from furrowing, which tricks our brain into thinking we’re slightly upset. (I suspect that this has to be balanced with getting enough sunlight.) Other tips include relaxing your jaw if you store tension there, or clenching and deliberately relaxing muscles.
Spend Time with Others
Though I can and do meditate and practice Qigong/Tai Chi on my own, there’s a benefit to spending time with other people. This reduces pain, anxiety, and stress, and improves mood.
Conversations with friends and family are great, but if you’re really not up for it, scheduling time to engage in a shared weekly activity with others is small change.
If all you’re up for is surfing the web or drinking a cup of coffee, doing it at a library or coffee shop can be beneficial.
According to Korb, one of the best things about gratitude is that the more hopeless you feel, the better it works. It also greases those social dopamine circuits to make interactions with others more pleasant.
Other Small Change
Developing positive habits or breaking negative ones is also helpful, but I’ll save some habit tips and tricks for another post.
And seeing a therapist can help you pinpoint areas to work and a wider range of therapies when the small changes aren’t enough.
Alex Korb’s TedX Talk “Simple Steps for Strengthening Your Brain’s Circuits of Resilience” clocks in at under 10 minutes.