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6 Ways to Combat Depression

6 Ways to Combat Depression

 

According to the latest research, about one in four Americans — more  than 70  million people — will meet the criteria for major depression at  some point in  their lives. The rate of depression in industrialized  societies has been on the  rise for decades — it’s roughly 10 times higher today than it was just two  generations ago.

How can you  make sense of the fact that even though antidepressant use has  skyrocketed in recent years, the rate of depression in the United States hasn’t  declined, but rather increased?

As a clinical psychologist, I believe the answer is rooted in our way of   life. I say this because researchers have assessed modern-day  hunter-gatherer  bands — such as the Kaluli people of the New Guinea  highlands — for the  presence of mental illness, and they found that clinical depression is almost  completely nonexistent among such groups.

Despite being much more likely to experience tragic events like the death of  a child or a crippling illness, and living with none of the material comforts or  medical advances we take for granted, they’re  largely immune to the plague of  depressive illness.

But how are hunter-gatherers able to weather life’s storms so effectively?  Based on the available research, it seems that the  hunter-gatherer lifestyle is  profoundly antidepressant. As they go about  their daily lives, they naturally  wind up doing things that keep them  from getting depressed, things that change  the brain more powerfully  than any medication.

My  colleagues and I at the University of Kansas have developed a treatment   called “Therapeutic Lifestyle Change,” or TLC. It incorporates six major   protective lifestyle elements we need to reclaim from our ancestors: dietary  omega-3 fatty acids, mentally  engaging activity, physical exercise, sunlight  exposure, social support  and adequate sleep.

1. Feed Your Brain

The hunter-gatherer diet typically includes wild game that feed on  grass,  and fish that feed on algae — both abundant sources of omega-3  fatty acids.  Conversely, the extraordinary rise in depression rates over  the last century  has closely mirrored the disappearance of omega-3 fats  from the Western diet,  which has come to rely more on grains (and  grain-fed livestock) than wild game  and plants. In countries where  people still get a better dietary balance of  omega-6s from seeds and  omega-3s from grasses, leaves and algae, depression  tends to be  substantially less common.

But how, exactly, does an imbalance of the fats we eat make us more   vulnerable to depression? Neuroscientists have identified three  mechanisms that  play a role:

Serotonin: Serotonin is a neurotransmitter that helps  turn  off the brain’s stress response. But when brain cells don’t have  enough omega-3  fats, they have trouble understanding the message of  serotonin, increasing a  person’s vulnerability to the kind of  out-of-control stress response that leads  to the onset of depression. Dopamine: Lack of omega-3s  also scrambles the messages of  dopamine, a neurotransmitter that activates the  left frontal cortex — the part of the brain that puts us in a good mood and  pushes us to go  after the things we want.

Inflammation: When unchecked by a balance of omega-3s,   omega-6 fats promote inflammation throughout the body. Over time,  chronic  inflammation triggers a reduction in the production of  tryptophan, the primary  building block of serotonin. It also impairs the  hippocampus, which is critical  to memory function. And it triggers the stress hormone cortisol, which has its  own set of depressive effects on the brain.

A key element of the TLC protocol is to begin taking a daily omega-3   supplement. The easiest source is fish-oil capsules. Fish oil is the  richest  natural source of both EPA and DHA, the two omega-3 molecules  that play an  important role in the brain. I recommend starting a daily  dose of 1,000  milligrams of EPA and 500 milligrams of DHA to all of my  patients.

If you currently have symptoms of depression, or if you want to help  prevent  the onset of illness in the future, this is the dose I suggest  you begin with,  as well. (If you are taking any medications,  particularly blood thinners, check  with your doctor first.)

2. Don’t Think — Do

Unlike hunter-gatherer societies, where people are usually busy  either  chasing dinner or lingering with the community after the meal,  people in  industrialized societies often find themselves alone, without  any kind of  activity that absorbs their full attention — conditions ripe  for  rumination.

Rumination appears to be an instinctive human response when something  goes  wrong. It’s as if we’re hardwired to replay our trials and  tribulations over  and over — perhaps to figure out what might help us  prevent similar negative  outcomes in the future. But after a brief  period of intense pondering, we  usually hit a point of diminishing  returns, when any more dwelling is a waste  of time — and a real source  of stress.

If you find yourself locked in the vise grip of rumination, I can offer  some  words of reassurance — breaking the habit may sound difficult, but  the process  is surprisingly straightforward. The first step involves learning to notice when  it’s happening.

One helpful strategy is to start monitoring your thought process every  hour  or so, just to see where your attention is. Set an alarm on your  watch or phone  to remind you to take note of your state of mind. Then,  when it goes off, jot  down any worries or negative thoughts you were  entertaining at the time.

As you become increasingly tuned in to your mental life, you’ll notice  that  some situations are particularly risk-prone. The research on this  point is  clear: People typically ruminate when they have nothing else to  occupy their  attention.

This leads to the second step: Learn to redirect your attention. In most   cases, it just takes a few minutes of immersion in a good alternative  activity  before the spell is broken.

While there’s no one-size-fits-all formula when it comes to finding  engaging  activities, some things turn out to be anti-ruminative for just  about  everybody. These include participating in shared activities,  whether it’s  building a fence or playing a game of pickup basketball, or  getting involved in  an active conversation — especially if it’s about  something other than what’s  bothering you.

If you’re engaged in a mindless activity that itself leads to  rumination,  listening to upbeat music or books on tape can give your  mind somewhere else to  go.

3. Move Your Body, Shift Your Brain

Even though everyone knows that exercise is a key to maintaining  physical  health, few realize that it’s equally important for preserving  mental health.  Like an antidepressant medication, exercise increases the  activity of brain  chemicals like serotonin and dopamine. It also  stimulates the brain’s release  of a key growth hormone (BDNF) that helps  reverse the toxic, brain-damaging  effects of depression. It even  sharpens memory and concentration, and helps us  think more clearly.

That said, motivation to exercise can be hard to come by. One reason  might  be that our hunter-gatherer forebears got so much physical  activity in the flow  of daily life that they actually avoided extra  exertion whenever possible. They  followed a simple rule: Spend your  energy only on activities that have a clear  purpose or offer immediate  reward. This rule was so important to people’s  survival that it became  part of our genetic legacy.

Many people discover this when they approach a treadmill or stationary  bike  and feel as if a part of their brain is screaming out, “Don’t do  it! You’re not  actually going anywhere on that thing! Conserve the  calories!”

Fortunately, there’s a way out of this dilemma. Yes, we’re genetically  wired  to avoid extraneous exertion, but what about necessary or  pleasure-producing  activity? As it turns out, whenever we’re caught up  in enjoyable, meaningful  activity, our tolerance for exercise goes up  dramatically. So when you make  activity purposeful or pleasant (riding  your bike to work, dancing, playing a  team sport, walking to the store  instead of driving), you’re much more likely  to do it.

When it comes to hitting the gym, it can really help to work out with   someone else. Spending time with others tends to be highly absorbing, so  it  makes the workout pass quickly; it also gives you the mood-elevating  benefits  of social support. Finally, a workout partner can provide the  initiative that  depression steals away.

How much exercise is necessary for an antidepressant effect? Incredibly,  a  Duke University study found that a brisk half-hour walk three times a  week  proved to be more effective than the antidepressant medication  Zoloft. So 90  minutes of heart-rate-elevating exercise is enough to feel  a difference. As one  personal trainer told me, “I don’t think I’ve ever  seen someone leave the gym  in a worse mood than when they arrived.”

4. Let There Be Light

Our hunter-gatherer ancestors were outside all day, every day. As a  result,  our eyes have special light receptors that respond only to the  brightness of  natural outdoor light, which is 100 times brighter than typical indoor lighting.  If you’re like most people who spend most of  their time inside, your eyes’ light receptors simply aren’t getting the  stimulation they need. And that can  have a major effect on both your  brain chemistry and your body clock.

Bright light stimulates the brain’s production of serotonin, that  crucial  chemical emissary that boosts feelings of well-being. According  to the latest  research, people usually feel some elevation of mood  within an hour or two of  exposure to bright light. One recent study  showed that people under the  influence of bright light are less likely  to argue or fight with others.

When we’re deprived of ample light, however, serotonin can fall and the   light-sensitive body clock falters: Hormone levels get out of whack,  sleep  grows erratic, and energy ebbs and flows at all the wrong times.  So resetting  the body clock each day is important, and it all hinges on  those specialized  light sensors at the back of the eyes.

How much bright light is required to keep the clock running on   time? Fortunately, it’s not that much. For people suffering from   depression, 30 minutes of light exposure each day is all it takes to  provide an  antidepressant effect. However, the light needs to match the  brightness of a  sunny day — an intensity of at least 10,000 lux — in  order for the 30 minutes’ worth of exposure to do the trick.

Getting your bright light exposure by spending some time outside has  some  clear advantages. Mere exposure to a natural setting can lower  stress hormones  and reduce feelings of anxiety; this holds true even  when we’re enjoying an  urban park or suburban backyard. We can also  easily combine time outside with  other antidepressant lifestyle  elements, like exercise and social  interaction.

For those in less-than-hospitable climes, however, using a 10,000-lux  light  box during the winter months has advantages of its own. As long as  you have  access to a power supply, it will give you all the light you  need with the  flick of a switch.

5. Get Connected

For hundreds of thousands of years, our ancestors lived in small,  intimate  social bands, facing together the relentless threat of  predators, the forces of  nature and hostile neighboring clans. Such a  clannish sensibility is still  keenly present among modern-day foraging  bands and other traditional,  pre-agrarian societies. According to  anthropologists, “alone time” is virtually  unknown among such groups.

In the industrialized West, on the other hand, we’ve strayed far from  this  sensibility. According to the latest research, 25 percent of  Americans have no  intimate social connection at all, and countless  others spend the bulk of their  time by themselves. One recent study  found that half of all American adults  lack even a single close friend  they can rely on.

Isolation is a major risk factor for depression. Those who lack the  benefit  of a meaningful social connection are highly prone to becoming  depressed,  especially in the face of severe life stress. And, sadly,  once people start  experiencing severe depressive symptoms, they tend to  withdraw even further  from the world around them. In large part, this is  because the brain responds  to depression as it does any other serious  illness, directing us to avoid any  activity, especially social activity,  so the body can focus on getting  well.

Depression can also take an enormous toll on friendships, because the   depressed person feels as if he’s doing his friends a favor by pulling  away,  and his friends, in turn, feel rejected.

It can be helpful to start by disclosing your struggles: Honest  disclosure  is essential to maintaining the health of any friendship. It  can also be  helpful to do a little educating. When your friends  understand that depression  is an illness and withdrawal is a symptom,  it’s easier to take your  disappearance less personally.

The most useful thing for treating depression, by far, is to spend  regular  time together in shared activities: walking, working out,  playing games, going  to a concert, attending a play and so on. Such  activities are especially  effective in combating depressive rumination,  and they promote activity in the  brain’s left frontal cortex, which  itself provides a direct antidepressant  effect.

We ask each patient in the TLC program to adopt the goal of scheduling  at  least three such activities a week with friends or other close   acquaintances.

6. Sleep Well

It’s hard to imagine a hunter-gatherer chasing a lion deep into the  night;  most traditional societies sleep when it’s dark and work when  it’s light.  Meanwhile, the average American stays up well past dark and  gets only 6.7 hours  of sleep a night.

Because sleep is so essential to our well-being, it takes only a few  nights  of deprivation before adverse effects start piling up: Memory and  concentration  wane, mood turns irritable, judgment grows poor,  coordination deteriorates, and  immune function declines.

Sleep disturbance and depression go hand in hand. The loss of slow-wave   sleep — the most restorative type of slumber — can directly account for  many of  depression’s most debilitating features.

Several elements of the TLC program are aimed at enhancing sleep.  Physical  exercise leads to more restorative slow-wave sleep. Daytime  bright-light  exposure strengthens the body clock, making it easier to  fall asleep and stay  asleep. But if you find you’re still not getting  quality sleep because of  insomnia, here are some suggestions:

*Use your bed only for sleeping (not reading, working or watching TV).

*Get up and go to bed at the same time every day. This helps keep your  body  clock on track. Avoid napping during depressive episodes. It can  reduce your  sleep drive, and evidence suggests it can cause a reduction  in slow-wave  sleep.

*Avoid drinking alcohol before bed. Using alcohol (even a drink or two) to  relax and fall asleep can produce frequent awakenings throughout the  night.

*Turn down your thermostat at night. Our remote ancestors always slept   outside or in open huts, where it got noticeably colder around bedtime. A  nighttime dip in temperature sends a primal signal that it’s time to sleep.

If you are currently being treated for depression, consult with your  health  professional before adjusting your regimen or treatment plan. But don’t  underestimate the positive impact that lifestyle shifts like  these can have.  Beating depression may begin with recognizing that we  were simply never  designed for the frenetic pace of modern American  life. By reclaiming the  protective features of the past and integrating  them into the present, I  believe we can overcome depression, once and  for all.

By Stephen Ilardi, PhD, Experience Life

Experience Life magazine is an award-winning health and fitness  publication that aims to empower people to live their best, most authentic  lives, and challenges the conventions of hype, gimmicks and superficiality in  favor of a discerning, whole-person perspective. Visit experiencelife.com   to learn more and to sign  up for the Experience Life newsletter, or to subscribe  to the print or digital version.

 

 

 

By Megan

Megan, selected from Experience  Life

Experience Life magazine is an award-winning health and fitness  publication that aims to empower people to live their best, most authentic  lives, and challenges the conventions of hype, gimmicks and superficiality in  favor of a discerning, whole-person perspective. Visit experiencelife.com   to learn more and to sign  up for the Experience Life newsletter, or to subscribe  to the print or digital version.

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