The science is in – for mild to moderate depression, pharmaceutical antidepressants are no more effective than placebos. But the science also says that there are four steps you can take that are effective to reduce depression. Reducing or eliminating mild/moderate depression is all about anti-inflammatory foods, supplements, exercise and a shift in cognition (perception).
ONE OF my favorite doctors in the public arena is Dr. Andrew Weil. Among the many reasons that I like him is that he’s joyful, smart, articulate, iconoclastic, has debunked many myths and misrepresentations in the health field, written insightful books, and has promoted “functional medicine”, which seeks to understand and treat a person’s entire body as it relates to the root causes of disease or dysfunction, not simply wrestle with symptoms. (Whew!)
So, when I heard that the good doctor was to be interviewed by Ira Flatow on Talk of the Nation about his new book, Spontaneous Happiness: How to Discover and Embrace Your Body’s Natural Ability to Maintain and Heal Itself, I tuned my dial to KQED and opened my mind to be educated.
Mr. Flatow set the stage before introducing Dr. Weil by citing some ugly statistics: In America, use of medications are up by over 400% since 1988, and one in ten people over the age of 12 take antidepressant drugs according to the CDC.
(Listen to the podcast here.)
For Most, Antidepressant Drugs Don’t Work
Dr. Weil is not the only health practitioner who thinks that this state of affairs is ridiculous. He and others (notably, Dr. Mark Hyman) point out that not only can antidepressant pharmaceutical drugs cause dangerous side effects, but that for mild to moderate depression, they do not work any better than placebos.
The common antidepressant drugs are of a drug classification called “Selective Serotonin Reuptake Inhibitors”, or “SSRI”. Over the years, the pharmaceutical companies with their ubiquitous TV ads have done a good job of convincing too many of us that normal, cyclical (like with the onset of winter) bouts of mild to moderate depression is a big problem that you better not cope with all by yourself, so take this drug.
Problem is, antidepressant drugs don’t work for mild to moderate depression* – you’ll do as well with a sugar pill, on average, but (adding injury to insult), they can cause pernicious side effects, such as:
- Dry mouth
- Nervousness, agitation or restlessness
- Reduced sexual desire or difficulty reaching orgasm
- Inability to maintain an erection (erectile dysfunction)
- Increased sweating
- Weight gain
(*Bi-polar and severe depression is in a completely different category, and those with these conditions need to stay on their meds.)
And there’s another pretty whomping problem with the SSRI class of antidepressant drugs… with long-term use SSRIs can produce the very same problem – depression – that they’re made to alleviate. This situation is described by the “homeostasis effect”, whereby a system, like the body, endeavors to bring itself back to the norm when an outside or unnatural agent is introduced into the system.
Although not often described as such, we hear about this all the time when a doctor or news report describes that some bacteria has become resistant to inoculants, and as such are called, “drug-resistant bacteria”. This also is common with allergy or acid reflex drugs, wherein for some people the more they’re used, the less effective they become.
The Role of Inflammation on Depression
Over the past few years, scientists have been isolating inflammation as a root cause of many degenerative diseases, such as arthritis, diabetes, heart disease, irritable bowel syndrome, Alzheimer’s, Parkinson’s and others. I just got 162,000,000 results from a Google search for “inflammation-based diseases”. Naturally, given this growing understanding of the linkage of inflammation and disease, the marketplace now offers us “Inflammation Diets”, including the spot-on inflammation-reducing tips from Dr. Weil himself.
Inflammation is a prevalent physical and mental health problem because of the poor food choices we make. In the Talk of the Nation radio interview, Dr. Weil briefly describes how processed and manufactured food can cause inflammation, in part by disrupting the right balance between Omega-6 and Omega-3 fatty acids, as well as by dominating the banquet of food choices which consists of poorly grown meat (animals fed grains not grass), simple carbohydrates (white flours, rice, food in boxes) and fats (saturated, trans fat, hydrogenated).
The first clue about the causal link between inflammation markers in the body and depression happened on farms in the 1950s. Farmers recognized that when their cows, sheep and pigs were sick because they exhibited a specific behaviors: they became anti-social, maintained distance from the herd, were listless.
In the 1970s, scientists discovered inflammation markers in the blood supply of sick animals that they termed, “Blood Factor X”. They soon understood that much of the sickness exhibited by farm animals had to do with inflammation. In people, the researchers discovered that inflammation could induce changes in the brain that could instigate depression, leading some very few in the medical field to treat mild to moderate depression via anti-inflammatory foods and treatments.
Four Steps to Reduce Depression
Back now to Dr. Weil’s new book, Spontaneous Happiness. This book presents a step-by-step, week-by-week , scientifically-based road map for improving, or eliminating mild to moderate depression. (There’s a link to it below.)
I have not read the book, but from Dr. Weil’s radio interview, I can summarize what I’ll call “four steps to reduce depression”. Step one is to avoid foods that cause inflammation — those processed, manufactured foods — and to eat instead anti-inflammatory foods. Step two is to take certain, proven supplements proven to reduce mild to moderate depression. Step three is to exercise. Step four is to change one’s perception, a cognitive behavioral shift, if you will.
Step 1 – Eat Anti-inflammatory Foods
Feed animals that eat grass rather than grain (like corn) have substantially more omega-3 fatty acids in their meat. Flaxseed oil, pumpkin seed oil, walnut oil and fish oil are rich in omega-3 fatty acids; wherein corn, safflower, sunflower, soybean, cottonseed oil, and olive oil (olive oil being a perfectly good oil in moderation and appropriate for cooking) contain omega-6 fatty acids.
A healthy diet should consist of roughly 2 – 4 times more omega-6 fatty acids than omega-3 fatty acids. The typical American diet tends to contain 14 – 25 times more omega-6 fatty acids than omega-3 fatty acids, and many researchers believe this imbalance is a significant factor in the rising rate of inflammatory disorders in the United States.
[Want to learn more about healthy and unhealthy fats? Read Eating Fat is Good… Maybe…Could Be… Sometimes.]
Recently, the FDA established a new food pyramid that is no longer a pyramid, but a plate. I describe it in Yes, Choose My Food Plate and The New Food Pyramid is a Plate. Dr. Weil responded by creating a plate of his own, but ahhh, kept it as a pyramid. Confused? Don’t be… be it plate or pyramid, the point is to know what foods to eat, and Dr. Weil conscientiously chooses inflammation-fighting foods.
What is Dr. Weil’s Anti-Inflammatory Food Pyramid?
- It is a practical eating guide that consumers of all ages can use, with tips on how to reduce risks of age-related diseases and improve overall health through diet.
- It is an interactive educational graphic to help today’s families prevent disease while eating well.
- It is a simple tool that promotes optimum health and healthy aging by providing dietary advice that addresses inflammation.
Learn more about it here.
As mentioned, the key foods to avoid are those that are processed and manufactured (in boxes, cans and plastic); grain-fed meat and dairy as opposed to animals raised on grass; simple carbs such as white bread, white rice, potatoes; and unhealthy fats, such as trans fats, saturated fats and partially hydrogenated oils.
Here’s a list of Dr. Weil’s recommended food choices
Step 2 – Take Antidepressant Supplements
The proven supplements to help ameliorate mild to moderate depression include fish oil, vitamin D3, vitamin B12 and SAMe.
Dr. Weil recommends two to four grams of fish oil per day.
Don’t worry about contaminant in your fish oil supplement if manufactured from a reliable brand, as typically they are molecularly distilled and thus free from PCBs and mercury, etc.
Step 3 – Exercise!
Exercise is a proven method to improve mild to moderate depression. Whether you’re doing an aerobic or anaerobic exercise, it does a body, and a mind good. One reason is that exercise decreases the stress hormones such as cortisol, and increases those “feel-good” endorphins, such as epinephrine, serotonin, and dopamine.
I have two rules for beginner exercisers:
1. Recruit a buddy to do it with you, and
2. Begin with an exercise routine that you’re willing to consistently do.
If you’re completely out of shape, walk, and walk quickly. When this becomes comfortable, walk up hills. If you can, begin jogging. In between walking days, learn and do yoga or some strength-producing exercises, such as push-ups and squats. Begin on your knees if you need to for the push-ups, and hold on to a chair for the squats.
Step 4 – Change Your Perception
A teacher once told me and the rest of the class, “Attitude is everything!”. The near-miracle is being able to change it, cause for most of us our attitude is cemented in place, and perhaps it’s not a very good place.
But for those of you that are willing to work on shifting your mind set to improve your mental well being, consider the following information gleaned from Dr. Weil, with a healthy (hopefully) dose of my interpretation.
First, it’s helpful to know that some amount of depression is quite normal. What would be abnormal for all except Buddhist monks is to be always happy. Getting a bit depressed is common during specific times of your life and in seasons of the year. Common times to feel low in life are after child birth, when the kids fly the nest, during menopause, during a career shift, when middle age first hits, during illness, etc. The onset of winter, with its cold and reduced light, can also ignite depression.
Know that when mild to moderate depression happens – the kind that DOES NOT bring you to the highest bridge or building in the neighborhood – there are better methods to combat it than drugs, as this post has been imploring. Along with the three steps already described, working on changing your perception could be very helpful.
Dr. Weil suggests to begin improving your perception/cognition with shutting off the things that make your mind flutter, meaning things that distract you from being present, from being focused on one thing at a time.
Turns out, whether you believe it true for you or not, humans are not good at multi-tasking. This has been studied exhaustively. The brain doesn’t multi-task well, so what it does is shift back and forth between the things you’re doing, trying to focus individually on each thing, and not doing it well. This does not produce calmness – just the opposite.
So, the first thing to awaken to is how you manage your day. If too much multi-tasking is happening, try to simply focus on one thing at a time till it’s as complete as you need it to be for the day. Improve your well-being by turning off the TV and all the electronics that compete for your attention, like every time that “ping” sound happens on your cell phone to alert you to a new text message. That sound and inevitable reaction, takes you from your focus. On a subtle level, it’s stressful if frequently repeated.
There are two things to practice in order to shift perception and improve mild to moderate depression, says Dr. Weil in this radio interview: Meditation and Gratitude.
Meditation takes practice. No one’s good at it immediately. But it’s worth trying because meditation helps you change your reaction to things. As the saying goes, “You can’t change what happens to you, but you can change your reaction to it”.
One basic method to learn to meditate is simply to sit comfortably in a place where there’ll be no distractions for 15 minutes (to start), close your eyes and follow your breath. “Follow your breath” means to stay focused on it, allowing the breath to come in and go out as it will. Soon, just by focusing on it, the inhalation and exhalation will become longer and deeper. When your mind drifts, gently bring it back. If silently reciting some mantra, or affirmation helps, add that. If focusing on an object in your mind’s eye helps, do that. But first get used to following your breath. Over time, you’ll realize that every stress point in your life is being handled with greater ease.
Be grateful. Even those of us in very bad situations can find something day to day to be grateful about. Try… you will find something. The key for this to improve your mindset is to recognize those things for which you’re grateful, and express it. This can be done each evening before bed when you write down the things for which you have gratitude that happened, or were recognized that day.
I close this post with the admonition that all that’s written may be considered helpful tips to help reduce mild to moderate depression, not severe depression. If you’re on a doctor-prescribed antidepressant, you will need to work with your doctor to wean yourself from the drug as you incorporate the suggestions here reported.
Many blessings to you.
Published on December 8, 2011