Today we’ve got another awesome guest on the show, Dr. Alex Korb. Alex is a neuroscientist at UCLA, and the author of The Upward Spiral: Using Neuroscience to Reverse the Course of Depression, One Small Change at a Time. He’s also the author of Pre-Frontal Nudity, a blog on Psychology Today. Alex, welcome to the Science of Success.
Dr. Korb: Great to be here, thanks for having me.
Matt: We’re super excited to have you on. To kind of kick things off, tell us a little bit about your background, and how specifically you got kind of fascinated with people who struggle with depression and anxiety.
Dr. Korb: Well, I’ve always been interested in Neuroscience. I majored in neuroscience at Brown as an undergrad, and perhaps that originally came from my own examination of myself wondering why I was very emotional sometimes, or why I could be productive at sometimes and found it very difficult to get things done at other times. That probably drove my initial interest in neuroscience. Then I started working at UCLA at the brain mapping center and saw a lot of the great work they were doing there, and that really expanded my interested into neuroscience. At the same time, I was coaching the UCLA women’s ultimate Frisbee team on the side. I really enjoyed that, trying to figure out how to motivate people and unlock their peak potential. Unfortunately, one of the girls that I coached suffered from major depression and had been depressed for three years ever since she was in middle school I think. She was a freshman at the time. And, so, she went through a lot of attempts to get better. She was in therapy, she was on medication, she was getting the best treatment. At the beginning of the sophomore year she ended up committing suicide. And it was extremely tragic, but that really led me to try and want to understand what exactly is happening in the brain in someone with depression that could lead them down that path. So, I decided to pursue a degree in neuroscience, get my PhD at UCLA, and try to figure out what's happening in the brain in depression and what we can do about it.
Matt: Wow. That’s - that definitely hits home. So one of the things you talk about, one of the kind of key components of Upward Spiral is the idea that somebody with depression and somebody with anxiety, can literally remap and sort of change the neurochemistry of their brain. One of the underpinnings of that is kind of the idea of neuroplasticity. Can you talk a little bit about that?
Dr. Korb: Yeah. Well, your brain is constantly being reshaped by the actions that you take and the environment around you, and the degree to which it’s being reshaped varies from time to time. As you’re growing up, it’s very what we would call plastic. Meaning plastic in the sense that something that is easily shaped, or molded. And that process continues as you get older, although a lot of aspects settle and harden and become more rigid. That’s why you say “You can’t teach an old dog new tricks”, but it turns out, the brain is continuing to grow and be reshaped throughout your life. So, through key changes or even unintentional changes in the activities you do or the interactions you have, or the environment that surrounds you, can cause changes in the regions and the chemicals that contribute to either happiness or depression.
Matt: So, can you describe how someone can sort of get stuck in a loop of anxiety or depression?
Dr. Korb: Yeah. Well, it can happen in a bunch of different ways. Like, asking that question is similar to saying “how do traffic jams start?” Anxiety and depression happen in the brain because the brain is a complex dynamic system, like traffic flowing down a busy set of freeways. Now, that analogy I like to use because there’s no one cause for depression. There are many causes that can interact with each other. And that also exposes - there’s no really one big solution, though oftentimes we would like there to be. There are often many small solutions. So, if all you know that someone is depressed, that doesn’t necessarily tell you how they got there, OR what the path forward is. Just says, if you know that there is a traffic jam, that doesn’t tell you how to solve the traffic jam. Because one traffic jam could be caused primarily by weather, whereas another traffic jam could be caused primarily by an accident. So we know the key thing to keep in mind is - what are the forces that are shaping this traffic jam, this pattern of cars being stuck in this certain ways. And what are the different ways to influence the system and get it out of there? In depression or anxiety, it’s this dynamic system of the brain is stuck in this sort of particular pattern of activity and reactivity that it can’t quite get out of. And there’s a whole bunch of different reasons for why it could get stuck, and it’s a whole bunch of small little life changes or medical approaches that we can enact in order to break up that pattern and get people better.
Matt: And in the book you use this amazing analogy which is kind of like - essentially describing how a microphone can get caught with feedback and it just gets loud and louder and louder. Can you elaborate on that idea?
Dr. Korb: Yeah, well, when I was talking about the brain getting stuck in this pattern of activity and reactivity, that’s sort of abstract. And sometimes the traffic analogy works well with people, particularly if they live in place like LA where they have a lot of experience with things like that. But the microphone and speaker analogy because it simplifies it to one simple circuit. So, your brain is composed of dozens and more of circuits that control each aspect of your life. You have a circuit that's devoted to decision-making, and planning, and habits, and every other aspect of your life. Hundreds of different circuits that are often overlapping. Now, if you look at any individual circuit, that’s sort of like a microphone and a speaker that are connected to each other. Because circuits in the brain are dynamic and they have feedback with each other. And we can look at the microphone and speaker and say “oh those are each different independent components”, but when you put them and connect them together, they create this feedback circuit. And if the microphone is oriented in just a particular way, or the speaker is turned up a little too loudly, then just even a soft whisper or a slight tap of the microphone could create this screeching feedback. And that’s important to understand, because a lot of times when people find out I study depression they ask me “ugh, so what’s wrong with the brain and depression?” or they're depressed and they ask me “What’s wrong with my brain?” they want to know what’s wrong. And I don’t think that’s quite the right way to think about it. Because if you look at the analogy of the microphone and a speaker, yes, you’re getting this output, this screeching feedback that’s terrible and undesirable and nobody wanted that intentionally. But there’s nothing wrong with the microphone. There’s nothing wrong with the speaker. Both are working exactly as they're supposed to. It’s just in the dynamic interaction, the elements of that circuit, that it gets caught in this runaway activity. And we might, even though it’s a terrible outcome that’s hard to bare, the solution could be starting with very small changes of moving, reorienting the microphone just a little bit. Or turning down the volume, just a tad on the speaker. And this big problem suddenly disappears.
Matt: You describe the brain as a complex, adaptive system. Which basically, you know, one of the concepts you mention in Upwards Spiral is the idea that the same stimulus can actually have a completely different effect on the brain, based on sort of the kind of mental state, and the kind of place that you’re in. Can you talk a little bit about that?
Dr. Korb: Yeah. It’s relayed to you - this notion of “you can’t step in the same river twice”. All of the actions that you take are causing different changes in the brain, and as you’re moving forward in your life, your brain is constantly shifting and adapting to the previous choices that you made and your current life circumstances. So, a good example is thinking about how setbacks or frustrations can affect us differently at different times in our lives, for a whole number of reasons. That could be including the environment that surrounds you, or the goals that you’re working towards, or the support, the social support that you have. So, for example, if you make a mistake or fail a test in college, where you still have a clear path towards graduation or and you still are living with a bunch of your friends. Then, maybe that wouldn’t have quite the same effect as if you made a big mistake at work when you are in your late 20s, and living by yourself. Because how your brain reacts to that failure is different as your brain chemistry changes with age, it can be different based on you social relationships, the environment around you, the different habits that you’ve continued to develop or strengthen over the time that you’ve been living. So, just because something wasn’t enough to push you into depression early on, doesn't mean that it couldn’t be the reason now, or the primary reason because the reasons are always complex. And similarly, just because you are depressed, one attempt at a solution didn’t work the first time, doesn’t mean it won’t work at another time. And here’s where the analogy to traffic works well. Something that could be used to ease traffic such as a traffic light, or something. Might be very effective, sometimes actually slows people down. But it wouldn't be effective at other times during the day when there are too many cars or things like that. I don't know if that made any sense.
Matt: That makes a lot of sense. Basically the idea that, you know, if you’re struggling - for example. Someone who’s struggling now with depression or anxiety, that just because something hasn’t worked in the past, it may actually be effective now because the brain is so complex and constantly changing that the stimulus might have a completely different effect. It took, to use the traffic analogy, basically the same idea is if you take a route at some time in the day, it might take you five minutes to get somewhere. And if you take it at the wrong time of the day it might take you half an hour.
Dr. Korb: Yes. That’s definitely true. And the thing that’s different from traffic, which makes it even more dynamic, is the fact that your own choices and actions change the actual activity in those brain circuits. So, just because something didn’t work the first time, well, when you do it the second time, the actions you made the first time already had an effect on the brain, so the context in which you’re attempting at the second time, is a totally different context where those brain circuits are now being activated for a second time. Instead of for the first time. And so, that might be enough to be the difference.
Matt: So, for listeners who might not kind of grasp the difference, can you explain the difference between depression and anxiety?
Dr. Korb: Yeah, well, depression and anxiety are very related in terms of their neurocircuitry, but they can have very different effects and appear very differently, and they’re very different syndromes even though they oftentimes occur together. What’s a more common question is I think what people wonder what the difference is between depression and just general sadness, or what the difference is between anxiety and just normal worrying. And it’s not just a matter of degree, because I think a lot of times people think of depression as just being really sad all the time, or anxiety as just worrying a lot. But they both involve a lot more symptoms than that. And I really focus on depression a lot, and it’s, I think it’s even more complex than most people grasp. And so that’s why I like to explain things from that perspective. For example, a lot of times people with depression don’t necessarily feel sad all the time. They can often have an emptiness where emotion should be. They feel like nothing is enjoyable, they don’t have any energy, they have trouble sleeping, often anxiety is a symptom, things feel like they lack meaning and oftentimes it appears like it’s not worth living. And it’s very difficult to understand from the outside because you could look at someone’s life and think “Oh! They have so much going on in their life, what do they have to be depressed about?” But really, the problem with depression is that it robs the brain, it robs the person of their ability to connect or feel a close connection with the people around them, or to enjoy the things that maybe they used to enjoy. And this symptom of anxiety which is often included in depression is a terrible disorder, even when it’s experienced on its own because it’s a lot more than just simple worrying. In fact, worrying and anxiety, they’re sort of related concepts, but worry is thinking about problems, whereas anxiety is much more feeling them. Anxiety is like a trigger of the brain’s fear response, and it includes a lot of physical symptoms that people don’t quite realize. For example, a racing heart, or a queasy stomach, or tense muscles. A lot of times people have these feelings of anxiety, but they’re not even consciously aware that that’s what they’re feeling.
Matt: One of the things you talk about related to that, is kind of the idea that sometimes you can be worried about something or a number of things, but that worry is sort of a surface-level symptom of a much deeper anxiety that may be about something completely different. And that’s something that personally, I found or when I’m feeling really stressed out, when I’m feeling really worried. I’ll often kind of pull back and ask myself ”what’s really stressing me out, what’s really the cause of this anxiety?” and sometimes you have to go to very core fundamental things in your life that are happening as opposed to sort of that surface level thing that it seems like “Oh, I’m stressed out about X”, When really it’s something much deeper that maybe happened, even months ago that you’ve never really dealt with.
Dr. Korb: Right, yeah. I’ve actually experienced this early on in my life. And perhaps it’s useful that my mom is a psychiatrist so she sort of pointed these things out. Not in any mean way. But I realized that I had a lot of stomachaches as a kid, particularly when I was in line at an amusement park for like a scary rollercoaster. My older brother would be like “Ha, you’re scared of going on this rollercoaster?!” and I’m like, “No, I’m not scared! I have a stomachache, I have to go to the bathroom.” I didn’t see a connection between the two. And at another point, when I was learning long division, I just started crying because I couldn’t get it. I just didn’t understand why I couldn’t get it. My mom asked if I was feeling overwhelmed. And it was a strange situation because it didn’t make sense to me why I was crying because I wasn’t sad about anything. I just couldn’t get this mathematical concept. And usually, math had been quite easy for me. And when she asked if I was feeling frustrated or overwhelmed. It took her asking that to have me actually look inside myself and ask myself, “Oh! How am I feeling?” and that’s a very important skill. And I started to realize, “OH! Yes, because I can’t quite grasp this concept, that’s what’s making me upset. It’s not this math problem per-se, it’s this larger problem.” I didn’t fully realize that at the time, but it wasn’t that particular math problem that was making me upset, it was the larger concept of feeling competent in - I was taking a more advanced math class, and feeling like I was able to succeed at it. And you know, that’s an example from childhood, but we have these things going on all the time. For example, you might be worrying about one aspect of a party. I use this example in my book of - for example, when you go through a wedding. Sometimes you obsess over the invitations and all these different aspects of the wedding. But what you’re really worried about at heart, is the social approval of your friends, and they’re about much deeper issues, or any worries that you express about the wedding ceremony per-se, may be reflections of a deeper anxiety that you have about the relationship with the person you’re getting married. So, just because our mind focuses on one aspect of, and thinking “oh this is the problem”, oftentimes that is because dealing with the deeper problem, or acknowledging the deeper problem is more difficult. And so we prefer to focus on these superficial aspects that are actually stand-ins for the deeper problem.
Matt: And that’s something that really hit home for me. In the last six months or so I actually lost both of my remaining grandparents. I found myself struggling and experiencing huge amounts of anxiety with these that were totally normal, totally kind of not an issue for me at all before that. And it really took me a little while to kind of figure out, “Hey this is something that, maybe I haven’t really dealt with, that I need to really think about and kind of go back and drill down a little bit more on.” And so that really resonated with me and hit home deeply, and was the most poignant parts of Upward Spiral.
Dr. Korb: Thank you, yeah. I think a lot of times when certain events happen like that, then we find ourselves at work and we’re trying to finish a report that we’ve done quarterly for the last five years, and just can’t quite seem to finish it or having a lot more difficulties - we realize “oh! Once I finish this, then I’ll have to deal with whether I’m going to get that promotion, and am I really at a job that I value because my grandparents worked at the same job that they valued for all this time”, we don’t like dealing with thinking about those deeper issues but when we, ignoring them doesn’t necessarily make them go away. It just means that we can’t appropriately deal with them.
Matt: Absolutely, yeah. It’s like burying your head in the sand isn’t going to fix the problem.
Dr. Korb: Right.
Matt: We actually have a whole previous episode we did about kind of accepting reality and sort of, you know, really kind of being present and mindful and accepting the way things are. So, for listeners who might be struggling with that, that’d be a good episode to go back and potentially check out.
Dr. Korb: Yeah. And what’s interesting is the very act of introspection, of just asking yourself how you feel and trying to figure out what it is that’s really bothering you. That can actually help reduce its emotional impact. There’s a great study, neuro-imaging study, on people where they were shown emotional pictures and you’re brain has an automatic emotional response when it sees different emotional pictures. But if they ask the people “Name the emotion that you’re seeing”, or “Name the emotion that you’re feeling”, that simple act of introspection actually decreases the brain’s emotional response.
Matt: That’s fascinating. And I think that’s a great segue into some of the strategies for kind of breaking out of that cycle. For somebody that is sort of trapped in a situation of depression or anxiety and they feel like there’s no way out. What are some of the things that you would recommend? I know there’s obviously a broad list that you talk about in Upwards Spiral, but maybe as an initial starting point, or an initial step to sort of make the first shift, or kind of get that upwards spiral started to where they can kind of slowly pull themselves out of it.
Dr. Korb: Well, one of the first things is to recognize that there’s nothing quote-unquote “wrong” with you. A lot of times when people feel stuck in depression or anxiety they spend all this mental effort, chastising themselves for that they’re- or they feel like they can’t address it because there’s something wrong with them, or wrong with their brain. And it’s really just simply recognizing that, now you have different regions of your brain that are supposed to feel anxious, or they’re supposed to make you question your decisions and be indecisive. Those regions are working exactly as they’re supposed to, just as with the microphone and the speaker analogy. Or, there are regions of our brain that are supposed to notice your mistakes and we just need to tweak the activity in those regions a little bit, or change your environment a little bit to tone it down, but there’s nothing inherently wrong with having any of those traits on an individual level or there’s nothing wrong with your brain. And the second thing to realize is that, through intentional action, through - making small life changes in the actions you take, or the interactions you have or the environment around you. You can actually start to shape and change the activity and chemistry in the brain - in the very brain regions that are contributing to you being stuck. And the number of life changes that you can make fall into a whole bunch of different categories. And I’m happy to expand on any of them. But they include small things like, just exercising more, going for a little walk outside because not only does the exercise help, the sunlight absorbed through your skin has benefits, the sunlight absorbed through your eyes has different benefits on a different pathway. Changing some of your habits around sleep can help make it even more restful. Reaching out to people close to you, or even talking to strangers, or getting a massage. These are all small little life changes that have measurable effects in the brain and they can start to change the dynamics i.e., turn down the volume of the speaker of that particular circuit a little bit and push you towards more positive emotions, and feeling more in control.
Matt: So let’s drill down a little bit. One of the first things you recommend is exercise. And I’d love to kind of share with the listeners how exercise can both change your neurochemistry and produce more BDNF, I forget what that stands for but I’m sure you know
Dr. Korb: Neurotropic factor.
Matt: Exactly. So tell us a little bit about that and drill into how exercise can literally change the chemistry of your brain to wire you to be happier.
Dr. Korb: Yeah, well, I’ll start with BDNF since you brought it up. That is a chemical that is sort of like steroids are for your muscles. It helps strengthen and grow new neurons. In a particularly vulnerable part of the brain called the hippocampus which is important in forming new memories, and it’s also part of the emotional circuity of the brain. If you have depression, that can actually start to decrease cell production and kill neurons in the hippocampus. But if you take anti-depressant medication it can increase this chemical BDNF which helps strengthen neurons, keeps them from dying, and grows new neurons. And it turns out that exercise has a lot of the same effects as anti-depressant medication specifically on BDNF because it can actually start to grow new neurons in this key emotional circuit.
Matt: Some of the other neurochemicals that it helps produce are things like norepinephrine, and endorphins, etc. Talk a little bit about why those are important and how those can be mutually reinforcing in terms of improving your brain strength.
Dr. Korb: yeah, so, the three main neurotransmitter systems targeted by anti-depressant medications are serotonin, norepinephrine, and dopamine. And exercise can modulate the activity in all three of those neurotransmitter systems. It can increase the production of serotonin which helps improve willpower and managing your emotions and connecting your present actions to future goals and rewards. The norepinephrine system can help manage stress and help focus. And the dopamine system helps with habits and overriding bad habits and maintaining good habits, and it also is important in a certain spark of joy in life; the enjoyment that you get from eating a chocolate bar, or giving someone a hug. Well, the hug has a lot of other neurochemical effects as well, but, anything - anything that’s naturally pleasing releases dopamine in the brain, which is what makes it rewarding, such as eating or sex, or things like that. Exercise can modulate the dopamine system as well. In fact, a great example of that they took a study of smokers. And one of the reasons smoking is so addicting is because it activates that dopamine system. But they took people who are smokers, they didn’t let them smoke for a day, so they’re really on edge, really wanted that cigarette. One group exercised on a stationary bike for just ten minutes. And then they scanned their brain and see how their brains responded to pictures of cigarettes. And the people who hadn’t exercised had a much bigger drive in their brain for wanting that cigarette. They had a much bigger dopamine response. Whereas the people who had just exercised, that exercised had provided some more dopamine, it modulated the dopamine response so that they didn’t crave the cigarette quite as much.
Matt: So, just ten minutes of stationary bike was able to kind of create some of those changes. So when you talk about exercise, it’s not necessarily going out and running four or five miles. This is something that, you know, can be relatively easy to implement in your life.
Dr. Korb: As I say to a lot of people. The exercise that you do is infinitely more valuable to you than the exercise that you don’t do. And it doesn’t always take a lot because it’s really compared to - well what were you doing in the first place? If you’re feeling depressed and you’re just laying on the couch all day and someone says “Ok! Well run a 5K!” That’s not really going to seem possible. And if that means then you’re not going to do anything, then you’re not going to be able to start to turn things around. So, it really depends on where you are. If you’re just sitting around not doing anything, well, just standing up and walking outside, or walking around the block, that’s going to put you off in a better position than doing nothing at all. And that small amount of exercise will start to put your brain in a better position to make better choices, or it makes it easier to exercise more. That’s why I call my book The Upward Spiral, because these small little life changes, these small little actions, cause changes in the brain which make further positive life changes more possible.
Matt: That’s great. And one of the other topics you talk a lot about is the idea of making decisions, and how making decisions can create sort of some other “upward spirals” and change your neurochemistry. I love the example that you used of - it’s more about making a good decision than making the best decision. This is something that I’ve insistently been trying to teach my wife. I’m sure she doesn’t want to hear that on the podcast. But can you,
Dr. Korb: You should try writing a book about neuroscience then trying to teach your wife every chapter of it. That doesn’t go over as well either.
Matt: Oh I’m sure, I’m sure there was a lot of struggles there.
Dr. Korb: I’d say “You should just read chapter 7 again!”
Matt: yeah, exactly. Well, can you talk a little bit about how decision making can change neurochemistry and specifically why it’s important to sort of settle for a good decision quote-unquote?
Dr. Korb: Well, that has a lot of different aspects to it. One, this notion of trying to pick the best decision causes problems because oftentimes there isn’t a best decision, or you certainly don’t have enough information given where you are right now to be able to decide what that best decision is. And so, we can often feel paralyzed because we don’t actually move forward in any direction, and when you’re given - when you’re not actually moving in a direction, moving in ANY direction feels equally plausible and we can just sit there and do nothing and then gain no more information and therefore we’re not accomplishing anything. Whereas if you just start to move in a particular direction, for example, there’s a study on people who couldn’t decide what job they wanted. What career path they wanted to take, and that can feel very overwhelming. If they just started to research any job, that reduced their anxiety and make it easier for them to move forward. And it didn’t have to be the job that they ended up wanting to take. They just had to start - pick something to start reading about, and then that would give more guidance and more information because now they could say either “oh yes!” from learning about it, “I think that’s a better decision, so I’m going to keep moving in that direction”, or from learning about it, “I realize, eh, that’s the wrong way, I’m going to do something else.” But moving in one direction realizing it’s the wrong thing and coming back to where you started, that is much better for you than sitting there and doing nothing at all. The other aspect of your question that’s important for people to realize is that having a goal, and making one small step or intention towards that goal actually changes the way your brain perceives the world, and is going to start creating opportunities for your brain to just notice solutions all on its own. And that can maybe sound abstract, but think of the feature on your camera that maybe highlights faces when you hold it up to a group of people. It knows that you’re trying to take pictures of faces, so it puts a little box around the faces and it focuses on them. And your brain has that same capability to focus on the parts of your environment, or the parts of your life that are actually important to you and ignore all the rest of the irrelevant details. But in order for your brain to rely on your brain’s automatic processing to do that, you just have to create an intention or a goal and take one little step in that direction, and then that - you start to get the benefits of that brain circuitry.
So the study that’s related to that that’s really interesting, I think, is they asked a group of people to get ready to either point or grab a certain figure, they’re going to show them. Then when they flash an image up on the screen of things that were either easier to point to or to grab, the activity in their visual cortex was actually different based on what their intended action was. Now, the visual cortex, that’s a very low-level thing. That’s the kind of thing that you would think - oh, that should just automatically process the image of whatever is coming in. But based on your intentional and the goals of these people were setting out, the region of their brain that controlled the goals are actually increasing the game sort of in the visual cortex to look for things that were relevant to the goal that they were doing. So, once you start having this idea, once you commit to a particular goal or moving down a certain path and having a specific intention, then these lower level unconscious parts of your brain will start changing your perception of the world to help accomplishing, to make accomplishing that goal easier.
Matt: So one of the things you mentioned is taking that small step, and you talk about a little bit in the book the idea that following through is a critical component and actually has a different impact on your neurochemistry than just sort of deciding you’re going to do something.
Dr. Korb: Yeah, actions speak louder than words. Your brain knows and interprets your goals based on your thoughts, but also on your actions. I experience this myself the first time I signed up for online dating. When I was in my early 20s I felt like “Ah, I don’t have — there’s no one to meet, I can’t get a date with anyone” So I signed up for online dating, and I immediately started going on more dates. But the interesting thing was that the dates that I was going on, wasn’t necessarily through the online dating. But through the act of signing up for the website and paying the money, I sent a signal to myself saying that, “yes, this is something I’m actually interested in”, and that starts to change your perception of the world, and awareness, and the parts of your brain that sees opportunities in everyday situations. On the bus, I would see, make smile with the girl sitting next to me. Then I’d strike up a conversation, and by taking a certain action down the path and committing myself at least somewhat down this path of “oh yes, I’m actually going to try to meet someone”, I was starting to see possibilities in everyday life. And the actual truth is that those possibilities had already been there, but since I hadn’t made a concerted action and to tell myself that “yes, this is, I want to try to meet someone, this is something that’s important to me”, then I’d been missing all of the signs that were around me all along.
Matt: I think that’s so important, it’s one of the reasons that visualization is such a powerful tool as well.
Dr. Korb: And yeah, the problem is it can sound very hokey, I think a lot of that sounds like “The Secret”. Like you send your thoughts out to the university and you change what comes back. But your prefrontal context is responsible for goal-directed actions. And another deeper region, the anterior cingulate cortex, sits as sort of the intersection between your prefrontal cortex and your emotional brain regions. And one of its jobs is to notice goal-relevant stimuli in the world. So, if you don’t have a particular goal, your brain has to spend most of its time ignoring most of the stimuli around in the world, because there’s a million more things than you can ever consciously process. But, if you have a particular goal, then those two brain regions are communicating with each other so the they know, “okay what are the kinds of things I should be looking for”, so when something happens in the world that is close to something that could benefit you, then - boom - the anterior cingulate fires and brings your attention to it, saying “oh this is important, we should pay attention to this”, and by creating those goals and intentions, and moving down that path in a particular path, we’re giving our brain the opportunity to be able to focus on these parts of the world that are important to us. We can’t naturally change the world, per-se, but we can start to change our perception of it and that’s just as important. You can think of the police chief - he can give orders to the lower level officers on patrol, like, ignore drug dealers and start focusing on speeding tickets. And boom, the number of speeding tickets is going to increase. There were just as many people speeding before, but the police department wasn’t paying as much attention to them. And that’s the way a lot of these perceptual systems in the brain work. Your pre-frontal cortex is that police chief that can give the orders to the lower level officers to say “Okay, this is the things that we want to pay attention to, and go out there and look for them.”
Matt: So, everybody who’s listening out there, you heard it from the neuroscientist. That what you perceive in reality can change based on what you tell yourself, and the beliefs that you put into your mind, right? That’s actually something we did a previous episode on as well. About the reality of perception and how literally the world and your world can shift. It’s kind of the same idea that like you said, it sort of sounds like “The Secret”, but the reality is actually rooted in neuroscience, and it’s rooted in the way that your brain is structured.
Dr. Korb: Yeah, and I think, though, starting to take action - even if it’s a small action. Shows that you’re actually committed to that idea as real. Rather than just - you can’t completely change your perception of the world simply by thinking about it. But by taking action as if this thing were true or to show yourself that this is the goal that you are pursuing, then that’s sending feedback to your brain that “oh yes, actually I do believe this is true!” and that’s going to start to have a bigger effect because your thoughts are one thing, and your actions are another thing, and those ideally should be able to support each other. But if you’re trying to have one thought but your actions don’t reflect the thought that you’re having, then they’re going to compete with each other, and you’re not necessarily going to get the same benefit. To continue, very simple actions in your body, in your posture, can have effects on your feelings and your thoughts. You could tell yourself that you’re happy and everything is fine. But if you’re have an anxious facial expression and a sad withdrawn posture, and you’re sitting on your couch not doing anything. Then your brain isn’t going to fully believe those thoughts. Whereas if you tell yourself that everything is fine and you sit up straight and relax your face and you put on a little hint of a smile, take a deep breath and go outside, well then those actions are feeding into those thoughts and those are going to support each other and actually start to make you believe yourself.
Matt: I think that’s incredible piece of advice and wisdom, and something that everybody listening should really take to heart. Changing gears slightly, and something that I’m incredibly passionate about - something that I frequently advocate, is the power of gratitude. I know that’s something you talk about in the book, can you expand on that a little bit, and maybe share some of the research about why gratitude is so powerful?
Dr. Korb: Yeah. Gratitude can actually help improve the quality of your sleep, for example. And that’s a big one because I have a whole chapter in my book on sleep and how important it is, and so many people say to me “Yeah yeah I know, I should get more sleep, I don’t have time for that, give me something else that I can do that doesn’t take up more time.” And the important thing to understand there is - if you just take a couple of minutes before you go to sleep and just write a journal of the things you’re happy for that day, or maybe the things that you’re excited for tomorrow, the things in your life that you’re grateful for, it actually improves the quality of your sleep and makes it more restful, even if you can’t necessarily get more sleep. And focusing on the positive parts of your life can actually, and particularly happy memories, can actually increase the production of serotonin in key regions of the brain such as the anterior cingulate cortex that I mentioned before, which sits at the intersection of the sort of rational and emotional brain. And serotonin as I said before is one of the key system targeted by anti-depressant medications. So, thinking happy memories can actually boost that system. And there are other studies, there was one study that looked at people who underwent psychotherapy. If prior to their psychotherapy they wrote a “thank you” letter to someone they’d been meaning to thank but hadn’t gotten around to yet, then the therapy was actually more effective and there were regions of the brain that had included this anterior cingulate cortex that had changes many weeks later, even from this small act of gratitude.
Matt: That’s amazing. And I know there’s a few other studies too that just demonstrate the incredible power of gratitude.
Dr. Korb: And part of it is because your brain only has a limited ability to focus on things. There’s - the world is so complex that you have to filter out 99% of the things that are floating around you bombarding you every day. And intentional act of gratitude is important, because it tells yourself, it tells your brain that, “Yes, I want to focus more on the things that make me happy”, because evolution didn’t necessarily - wasn’t designed to make you happy. It was designed to make you live and have sex and reproduce. That’s what got us here in the first place. But now that we’re here and we have consciousness, most of us realize that “Oh I actually prefer to be happier”, so evolution didn’t actually design your brain to be the happiest it could be, but through intentional action you can start to shift your perception towards focusing on more positive aspects and therefore increase your happiness.
Matt: Can you elaborate a little bit on the concept of biofeedback? What it is, how it’s important in combating depression and anxiety?
Dr. Korb: Yeah. Biofeedback is simply the idea that the brain changes it’s activity based on what the body is doing. So, I referenced it before, I just didn’t use that name. There’s, for example, when you are feeling anxious, you may have fast breathing, and tense muscles, and a racing heart, if you can slow down your breathing, and stretch out your muscles, then your breathing will not only slow down but deep breathing can also slow down your heart as well. Then that will send different signals back to the brain. We often think of emotion as a one way street, “oh I have this anxiety, and that’s why I’m having all these sensations in my body” such as the breathing, muscle tension, and so forth, but your brain is constantly monitoring your body for how it should feel. So, yes, maybe you felt anxiety, or you had a worried thought or whatever that triggered this anxiety and that caused these bodily symptoms. But now those bodily symptoms are feeding back and making you feel more anxious. And if you can disrupt that feedback cycle by decreasing the body’s anxious response, then you can make yourself feel calmer. Now, it won't necessarily eliminate all of the anxiety, but it’ll keep you from making it worse. And that’s why deep breathing can be so powerful if you’re feeling depressed if sad, if you’re having withdrawn posture and stooped over posture, that can be a feedback signal to your brain saying “oh yes, I’m feeling sad”, or if you have a worried facial expression. You can improve your posture, sit up straight, open your chest to the world, take a deep breath and smile, then that’s going to be sending different signals back to the brain where it’s going to think “oh! Maybe things aren’t quite so bad, because the body is behaving as if I’m happy.”
Matt: So, for listeners out there that might be struggling with depressions or anxiety, or maybe even listeners who aren’t. What would be one piece of homework that you would give them?
Dr. Korb: I think one of the simplest things that I recommend is just going for a walk in the morning, ideally with a friend. That captures a lot of aspects of the upwards spiral including sunlight at the right time, and exercise, and making a habit, and possibly some social inputs as well. And that’s just a very small change that most people feel capable of making. Other simple changes include, the act of introspection. Just, momentarily throughout the day, checking in with yourself and noticing how you’re feeling. Not necessarily making a judgment about it that it’s good or bad, just saying “oh, okay, this is where I’m at”, and that act of introspection can help you feel - can help reduce the emotional impact of your emotions. And, lastly, I would say be present. Whatever you’re doing, just do that at 100%. Pay attention to the things you’re doing, and don’t pay attention to the things you’re not doing. And that - the introspection that I mentioned previously is actually related to that. Because if you’re feeling anxious or if you’re feeling sad, that’s part of who you are at that moment. And being present includes recognizing “Oh, I’m feeling anxious, okay, I’m going to continue to work on this, or focus on that, even though I’m anxious.”
Matt: Where can people find you online for people that want to learn more or do some more research about this?
Dr. Korb: I have a website, AlexKorbPhD.com. I’m including a lot of my blog articles and I offer personal coaching and consultations for people who are interested learning how - more about the brain, or how better to apply it to their life.
Matt: Well, for anybody out there who’s listening that struggles with depression or anxiety, I highly recommend checking out The Upward Spiral. There’s so many different tactics and strategies in the book, we only barely scratched the surface. And we could talk for hours and hours about all the different things that you can do that are often very simple, very easy steps to take to kind of break out of that vicious cycle, break out of that downward spiral and, you know, get into an upward spiral. So, Alex, thank you so much for being a guest on the show. This has been some great feedback and conversation and I really appreciate having you on here.
Dr. Korb: Thanks, it was great to be here and hopefully we reached some people that could use it.