In The Upward Spiral: Using Neuroscience to Reverse the Course of Depression, neuroscientist Alex Korb offers a practical, science-based roadmap for overcoming depression. Rather than focusing on a single solution or relying exclusively on medication or therapy, Korb presents a comprehensive, integrated model built around small, everyday actions that reinforce one another to create a positive feedback loop — what he calls the “upward spiral.”
This article explores four key ideas from the book that illustrate how neuroscience can empower individuals to regain control over their emotional well-being. These include: how tiny habits influence brain chemistry, the power of decision-making in restoring agency, the role of exercise and physical activity, and the importance of social connection.
Tiny Habits and Brain Chemistry: Small Actions, Big Impact
At the heart of The Upward Spiral is a compelling argument: you don’t have to completely “fix” your brain all at once to feel better. Instead, tiny, consistent changes in behavior can begin to shift the brain’s neurochemical balance in subtle but powerful ways.
Korb explains how small actions—like getting out of bed at the same time each day, writing down things you’re grateful for, or even smiling—can begin to change the levels of neurotransmitters like serotonin, dopamine, and oxytocin. These chemicals play crucial roles in mood regulation, motivation, and connection. For example, practicing gratitude activates brain regions involved in dopamine production, which enhances feelings of pleasure and motivation.
Even the act of labeling emotions (“I feel anxious” or “I feel sad”) can reduce activity in the amygdala (the brain’s fear center) and activate the prefrontal cortex, which helps with emotional regulation. These are not abstract theories — they’re grounded in real neuroscientific evidence showing how habits and thoughts can shape brain function.
The message is clear: while depression may feel overwhelming, starting with a small, manageable change is not only possible — it’s the most scientifically grounded first step.
The Power of Decision-Making: Regaining Control of the Brain
One of the most debilitating aspects of depression is the sense of helplessness — the belief that nothing you do matters or can make a difference. Korb emphasizes that decision-making, even on a small scale, activates the brain’s reward circuits and helps restore a sense of agency.
Making decisions engages the prefrontal cortex and strengthens its connection to other brain areas responsible for motivation and control. This is crucial because in depression, these connections often weaken, contributing to apathy and lack of drive. By deciding to do something—whether it’s choosing a meal, committing to a short walk, or even picking a new hobby—individuals reassert their ability to influence their world.
Korb suggests that it’s not the quality of the decision that matters most, but the act of making a decision itself. Indecision creates anxiety and reinforces depressive loops, while purposeful choice stimulates the brain’s circuitry to rewire in a more empowering direction.
He introduces the idea of setting “good enough” goals — not perfectionistic ambitions, but achievable targets that allow the brain to experience small wins and build momentum over time.
Movement as Medicine: The Neuroscience of Exercise
Exercise is often recommended as a natural antidepressant, but Korb delves into the neuroscience to explain why it works so effectively. Physical activity boosts levels of brain-derived neurotrophic factor (BDNF), a protein that supports the growth and resilience of brain cells, particularly in the hippocampus — an area linked with memory and emotional regulation.
In depression, the hippocampus often shrinks due to chronic stress and lack of neuroplastic stimulation. Regular exercise reverses this by promoting neurogenesis, reducing inflammation, and enhancing communication between brain regions. Even moderate activity, like walking or yoga, releases endorphins and increases dopamine sensitivity, which improves mood and motivation.
Importantly, Korb underscores that the benefits of exercise don’t require intense regimens. A brisk 20-minute walk or gentle stretching can be enough to initiate the upward spiral. The key is consistency and finding movement that feels rewarding, rather than punishing.
Exercise also offers psychological benefits — it fosters a sense of achievement, provides structure to the day, and can be done in social settings, which leads to the next important element of the upward spiral.
Social Connection: Wiring the Brain for Belonging
Humans are inherently social beings, and our brains are wired for connection. One of the tragic ironies of depression is that it pushes people to isolate themselves, even though social connection is one of the most potent antidepressants available. Korb details how relationships and even casual social interactions activate the brain’s oxytocin system, which enhances trust, reduces fear, and strengthens emotional resilience.
When someone with depression withdraws from others, their brain misses out on the neurochemical rewards of connection. This can deepen the depressive cycle. Conversely, even small social gestures—texting a friend, smiling at a stranger, engaging in a group activity—can stimulate positive brain responses.
Korb encourages readers to seek connection in whatever way feels manageable. This might include support groups, volunteering, therapy, or simply spending time with a pet. The important part is showing the brain, repeatedly, that connection is possible and rewarding.
He also points out that positive social feedback loops develop just like neural ones: small interactions lead to greater openness, which leads to deeper connection, which improves mood — and so the upward spiral continues.
Conclusion: Building Momentum Through Neuroplasticity
The Upward Spiral is not a book that promises quick fixes or miracle cures. Instead, it offers something more realistic — and more empowering: the idea that you can change your brain, one small decision at a time. By leveraging our understanding of neuroscience, Korb provides a hopeful path out of depression that doesn’t require perfection, only progress.
Through small habits, intentional decisions, physical movement, and social engagement, people can create positive feedback loops in the brain. Each small success rewires the brain just a little, creating more space for joy, energy, and purpose. The climb out of depression might not be easy, but with the right tools, it is absolutely possible — and every small step upward truly matters.
Korb’s message is one of compassion and realism: You don’t need to feel great to start; you just need to start to feel a little better. And with each step, the brain begins to learn how to feel well again. That’s the essence of the upward spiral.
