Dr Steve Ilardi is slim and enthusiastic, with intense eyes. The
clinical psychologist is 4,400 miles away, in Kansas, and we are
chatting about his new book via Skype, the online videophone service.
"I've spent a lot of time pondering Skype," he says. "On the one hand it
provides a degree of social connectedness. On the other, you're still
essentially by yourself." But, he concludes, "a large part of the human
cortex is devoted to the processing of visual information, so I guess
Skype is less alienating than voice calls."
Social connectedness is important to Ilardi. In The Depression
Cure, he argues that the brain mistakenly interprets the pain of
depression as an infection. Thinking that isolation is needed, it sends
messages to the sufferer to "crawl into a hole and wait for it all to go
away". This can be disastrous because what depressed people really need
is the opposite: more human contact.
Which is why social connectedness forms one-sixth of his "lifestyle
based" cure for depression. The other five elements are meaningful
activity (to prevent "ruminating" on negative thoughts); regular
exercise; a diet rich in omega-3 fatty acids; daily exposure to
sunlight; and good quality, restorative sleep.
The programme has one glaring omission: anti-depressant medication.
Because according to Ilardi, the drugs simply don't work. "Meds have
only around a 50% success rate," he says. "Moreover, of the people who
do improve, half experience a relapse. This lowers the recovery rate to
only 25%. To make matters worse, the side effects often include
emotional numbing, sexual dysfunction and weight gain."
As a respected clinical psychologist and university professor,
Ilardi's views are hard to dismiss. A research team at his workplace,
the University of Kansas, has been testing his system – known as TLC
(Therapeutic Lifestyle Change) – in clinical trials. The preliminary
results show, he says, that every patient who put the full programme
into practice got better.
Ilardi is convinced that the medical profession's readiness to
prescribe anti-depression medication is obscuring an important debate.
Up to 20% of the UK population will have clinical depression at some
point, he says – twice as many as 30 years ago. Where has this
depression epidemic come from?
The answer, he suggests, lies in our lifestyle. "Our standard of
living is better now than ever before, but technological progress comes
with a dark underbelly. Human beings were not designed for this poorly
nourished, sedentary, indoor, sleep-deprived, socially isolated,
frenzied pace of life. So depression continues its relentless march."
Our
environment may have evolved rapidly but our physical evolution hasn't
kept up. "Our genome hasn't moved on since 12,000 years ago, when
everyone on the planet were hunter- gatherers," he says. "Biologically,
we still have Stone Age bodies. And when Stone Age body meets modern
environment, the health consequences can be disastrous."
To counteract this Ilardi focuses on the aspects of a primitive
lifestyle that militate against depression. "Hunter- gatherer tribes
still exist today in some parts of the world," he says, "and their level
of depression is almost zero. The reasons? They're too busy to sit
around brooding. They get lots of physical activity and sunlight. Their
diet is rich in omega-3, their level of social connection is
extraordinary, and they regularly have as much as 10 hours of sleep."
Ten hours? "We need eight. At the moment we average 6.7."
So we should all burn our possessions and head out into the forest?
"Of course not," Iladi shudders. "That would be like a lifelong camping
trip with 30 close relatives for company. Nobody would recommend that."
Instead we can adapt our modern lifestyle to match our genome by
harnessing modern technology, such as fish oil supplements to increase
our intake of omega-3. All well and good. But I can't escape the feeling
that the six-step programme seems like common sense. Isn't it obvious
that more sleep, exercise and social connectedness are good for you?
"The devil is in the detail," replies Ilardi. "People need to know
how much sunlight is most effective, and at which time of day. And
taking supplements, for example, is a complex business. You need
anti-oxidants to ensure that the fish oil is effective, as well as a
multivitamin. Without someone spelling it out, most people would never
do it." Ilardi practises the programme himself. He's never been
depressed, he tells me, but it increases his sense of wellbeing and
reduces his absentmindedness (his college nickname was "Spaced").
It all makes sense, but will I try it myself? I don't suffer from
depression, but wellbeing sounds nice. I'm not so sure about the fish
oil, but I might just give it a go.
Enjoy the sunshine, get plenty of sleep – and be sociable
▶ Take 1,500mg of omega-3 daily (in the form of fish oil capsules), with a multivitamin and 500mg vitamin C.
▶ Don't dwell on negative thoughts – instead of ruminating start an activity; even conversation counts.
▶ Exercise for 90 minutes a week.
▶ Get 15-30 minutes of sunlight each morning in the summer. In the winter, consider using a lightbox.
▶ Be sociable.
▶ Get eight hours of sleep
Source: http://www.theguardian.com/lifeandstyle/2010/jul/19/beat-depression-without-drugs
