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771 Dealing with Depression (archive)

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Depression is a debilitating disease that affects as many as 20 million Americans in a year. It can take a terrible toll on health as well as on family and work relationships. Many drugs are prescribed to treat depression, but the evidence is not impressive that they offer most patients great benefit.

Our guest, Dr. Stephen Ilardi, has come up with a number of non-drug approaches that may work at least as well as antidepressants for mild to moderate depression. These lifestyle modifications require effort, but they are inexpensive and don't have dangerous side effects. Could the cure to depression be within your grasp?

Guest: Stephen S. Ilardi, PhD, is associate professor of clinical psychology at the University of Kansas. His book is The Depression Cure: The 6-Step Program to Beat Depression without Drugs.

Links for Dr. Ilardi:
The Depression Cure/ Amazon page:

The book's homepage:
His university homepage:
The page for Therapeutic Lifestyle Change:
His Psychology Today blog page:

The podcast of this program will be available the Monday after the broadcast date. Podcasts can be downloaded for free for six weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.

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I am currently going through a bout of depression like I never have before due to the loss of a Girlfriend I knew for 20 years & the loss of income from my job.

The 2 doctors I talked to it about right away wanted to put me on ANTI-DEPRESSANTS which I refuse to take due almost killing myself when I was on them one time before.

Does anyone know of a supplement or any other idea that might help?

Greetings Joe, Terry and Dr. Ilardi,

Thank you for this hopeful program about depression. If I may, I would add another very effective tool to defeating depression; and it's so simple.

Consciousness, regular deep breathing, as in meditation. Before you dismiss me, please hear me out. The enteric nervous system, which runs the length of our digestive systems from mouth to anus, does more than process our food. It has more neurotransmitters and as many neurons as the spinal cord. It is called the second brain, and is the seat of our emotions. Langley's codification of the nervous system in the 1920s included this often neglected part of the nervous system.

So, the breath. Consistent periods of deep meditative breathing massage the enteric nervous system, relaxing and soothing the nerves and relieving accumulated stress. See the Anatomy of Hatha Yoga by David Coulter for more detailed information.

I have proven the efficacy this technique with my own depression. I and other meditators report actually feeling stress lift from the heart. A deep, sustained feeling of well-being ensues; one that is accessible simply by being conscious of the breath and using this powerful tool to take volitional control of the nervous system.

I was at the verge of running back to the doctor when I broke through my depression with this technique. I feel liberated and empowered knowing that I can take control of my nervous system with the breath.

Thanks again for your consistently excellent program!

Tim K.

I was excited to see that you were dealing with depression on the show when I received my weekly email on Friday. I was awed by what I listened to this morning. You were describing me. Although I have had, in the past, a major clinical depression, treatment with therapy and medication really helped. I found that after very difficult therapy sessions I wanted to exercise. I would spend time in the car crying out what I had just went through and then work really hard at the gym. It felt good to push against the weights.

I am now struggling with this overall sadness. There are reasons for it, but I now see that there are things I can do. I take Prozac but wonder if my dependence on it is of fear of what would happen if I stopped. My weight is terrible, my mood blue and my house is this constant state of mild chaos. To the drug store I go for Omega 3 and to the neighborhood street I take for a walk.

Thank you, Joe and Terry, for the knowledge you share. I am a big fan of your show, books and website. Although I have learned much from you this show really hit home with me. I wrote down the steps to end the depression and with yours' and God's help I will defeat this. My family deserves this. I deserve this.

I stopped everything this morning to listen to the report on Dr. IIardi's book on beating depression. I have a 19 year old granddaughter who suffers from anxiety and depression connected to Asperger's syndrome. She has been taking antidepressants for years and I have always been uncomfortable with that. Recent news about these drugs indicate complications with brain changes and addiction which adversely affect the sufferer's life.

I would love to see this child stop medication and try, in a supervised, controlled environment, to move forward without these drugs. I wonder if anyone has been successful in "coming off" years of taking these drugs. And, having read, Anatomy of an Epidemic, which slams the use of Prozac and other anti-depressants, I wonder when our population will simply stop using, replacing drugs for simple life enhancing behaviors as suggested at the end of the show. Grandma's home remedies actually work.

My wife died of depression and HIV in 2005 at the age of 37. After her death, I asked myself many questions about what was depression and how serious it was. She only told me once that she suffered from depression yet her behavior over the years yelled loudly that this was her main problem.

For 5 1/2 years after she moved in with me she stayed in her room for 18 hours a day watching TV - never holding down a job or doing anything at all. I watched her doing this and did not understand what was going on. Coincidentally, my father who was 50 years her senior also was doing the same thing - refusing to come out of his room and locked in a state of depression (ultimately dying of a heart attack in his room).

I now realize that their two causes of depression were immensely different. My wife probably had her causes of depression from causes that were with her when she was born but my father probably had his depression caused by the drugs he was taking for his heart bypass operation. I now deeply regret not forcing my wife to exercise every day with me.

The doctor expressed my thinking at the time - asking my wife to exercise with me was too much. Thanks very much for your show today it was immensely helpful. My girlfriend's daughter suffers from the same problem and I am trying to move my girlfriend in the direction away from drugs and into non-drug therapies to help her.

I am an expert on Depression not because I have an MD or PHD. But from actual experience of suffering from it from the age of 11. I am 50 now. Being someone who is less inclined towards modern medicines quick pill popping fixes and being physically healthy I didn't go to Dr's.

As a result of having it from childhood, and going undiagnosed and being called a lazy unmotivated, not driven, problematic, angry. I accepted all those and that became my self-concept. At 45 After watching a TV show, I slowly began to realize I had Bipolar-II, ADHD, generalized anxiety. Before I learned the science I had one term for all this: "Basket case" or "Mess". T

Being poor I educated myself and went looking for treatment through publicly funded psychiatric clinics. Well a that is radio show in itself. Ever since then I have been happy to pop pills. Even with pills it was long 5 years before I went though a year without debilitating depression even for a short time. Last year was my first. And you if you are too deeply ill you cannot even make the lifestyle changes till you come to higher level of functioning.

Talk about dysfunctional, surprisingly throughout this period, I was a highly paid and well respected network engineer. But the rest of my life was an empty black hole....

I agree wholeheartedly with everything this Dr said on his radio interview. I unfortunately had to learn it through lot of reading and trial and error and support groups.

But I do have one problem with the message that came across, from the title of the book and the way the Dr gave the interview. Because Dr didn't mention any disclaimers or exceptions.

The message seems to say " Anyone who has depression, you don't need medicine, you can fix through life style changes. Well that is a dangerous stretch to make that conclusion from neuro-science research up to date. In fact other experts who were on this program who talked about the same subject would agree with me.

I've seen plenty people around in my life (depressed seems to attract the same type), and from support groups, people who have completely given to this idea of "We don't need to pop pills to get better". And they are spinning their wheels and running around searching for this and that therapy or improvement in life without getting it together. I did too.

Well the reality is some have to take medication irrelevant of their belief. May be for life or for a period or just to get life style changes jump started. Depending on how deeply and how long you have been depressed. That is what this Dr and his radio didn't get across enough.

Well I am compelled to write this because My sister died ignoring psychiatry and my ex-wife a brilliant woman is wasting her life away trying this or that alternative therapy without any improvement and life that is spiraling down.

Loved this show. I am kind of "anti-drug", so it was great to hear that even a doctor who is not, offering effective alternatives. It really seems like common sense. Thank you for your show. I really enjoy it.

Just in time. - J...

My alarm woke me to hear the news that I had long suspected: The anti-depressents I had been prescribed were long on expectation, very short on results. Dr. Ilardi's summation was as accurate as can be, as I had found out in my own life as to how best to combat (a play on words) this syndrome. Suicide runs in my fathers (to include him) family. While in the US military (22 years) there were more than eight suicides in the various units I belonged. Leaving the military I was diagnosed with "clinical depression," and prescribed paxil, zoloft, to combat what the doctors had viewed as me, a potential suicide.

The reason they thought this was that I had moved to Minnesota without family there or support, and the issues of my fathers suicide, and the members of my units who had "self destructed." What was overlooked in all of this was I had a wife and family I cared deeply about, I was involved in my family, and I needed to walk 45 minutes each day (my wife needed the car). There were also field studies I needed to complete, and with a family I belonged to the PTA.

The drugs had a devastating effect on me. The drugs caused me to have massive personality changes. I was bouncing off the wall. A dear friend, when his med for depression was changed committed suicide, leaving a wake of broken lives (not to mention a twin brother) and unanswered questions. My dear friend, my wife, in realizing my changes were not in the best keeping for our family, in a rage threw the paxil and zoloft and flushed them in the toilet and made an appointment for "group counseling" (not exactly the way "it" happened. We are both much happier now, as we work out doors, and exercise, and participate in the community. We are both retired, and more happy now than ever.

Thank deeply, Dr. Ilardi for his affirmation to us and what his research showed (we are doing the right things) I appreciate his research as if I could not express this enough!

Dear Terry and Joe,

Thank you for the wonderful work you do every week to inform and educate us on the critically important health issues of our time.

I found today's program on Depression most interesting because of my own suspicions at different periods in my life when, because of divorce and health issues, I thought I might be clinically depressed. Although I was prescribed antidepressants more than once, I took only a one week dose of an antidepressant many years ago, which seemed to interfere with my ability to swallow! When I asked my doctor about this, he seemed indifferent, so I never took another antidepressant, and determined that I would help myself and bring myself out of it. And I did. Bottom line, I was afraid of the powerful drugs and I'm glad I did not continue along that path.

I am 67 years old now, working full time as a successful advertising executive, and enjoying life in spite of its ups and downs as I grow older. By listening to your program and interviews with some of the top physicians and specialists in the nation, I always learn something new related to health and benefit greatly from the preventative measures your guests offer up weekly. Anything than can help me with the transition into the next chapter of my life is a WIN WIN! And that is YOU!

This was a very informative interview and everything Dr. Illardi talks about concerning our lifestyle changes is so powerful and so true. Thank you for this wonderful show. I will be purchasing the CD of this show, as well as the book for a dear friend of mine who is suffering from depression.

On another note, I just want to let you know that I am a long time listener - weekly since 2001, when I was diagnosed with early stage breast cancer. This was at the suggestion of my husband who has probably been a listener of yours since the day you started broadcasting! I am a 10 year breast cancer survivor now, and have tuned into to your show every Saturday morning at 7 a.m. since 2001! I would not miss it! I even set my alarm the night before so I will awake in time to hear you! I am never disappointed!

You are providing such an important message to your listeners. Thank you, Terry and Joe, for the gift of good health advice you share with us every week!


Vicki W.

I thoroughly enjoyed the show but wondered if you have some tips on how to be supportive of a spouse who suffers from depression and constantly talks of the negative aspects of their life! I can't seem to say anything that will change the subject.

Love your show.

It is extremely irresponsible to present this program without a serious discussion about the overwhelming majority of people on antidepressants who would be dead without them. The "six steps" the doctor presents are common sense maintenance issues that are only the beginning. I come from a long line of people who inherited depression and the sometimes result, alcoholism. I would have driven off a bridge in my 20s if it had not been for antidepressants. Rumination--there is no escape from it! It is a result of anxiety and isolation--one cannot just decide to stop. Shame on you!

This is such an exciting program in a personal way! My twin was on Zoloft for years and gained lots of weight, which made her more depressed. I suggested that she exercise for a natural form of anti-depressants ie endorphins. She got into a cycling class and when her meds ran out she found that she didn't need them anymore! She has never had to take another anti depressant now for 10 yrs.

I heard your program today. My mother is 94 years old and has Alzheimer's and severe depression. I am trying to help her but she won't help herself. She's taking Aricept for the Alzheimer's but I can't see where it's helping any and, of course, if it isn't, there's nothing that can be done about Alzheimer's.

She's been on anti-depressant medicine for a couple years or so for depression (first one I don't remember, then Prozac, now Paxil) but I can't see where they're doing anything either except keeping her from crying, and the Paxil has maybe given her a little bit of an appetite (she didn't have any before) but it's not helping her otherwise that I can tell.

She has probably had depression all of her life but she has always had good physical health and isn't now paralyzed or in pain but all she wants to do is sit in her chair with her hands in her lap and stare at the TV when she isn't falling asleep. She won't get up and do some marching steps in front of her chair holding on to her walker, or walk back and forth through the house a couple times a day as she was advised to do by a home care nurse and therapist.

The nurse told her that if she didn't move around at least once an hour that she's going to get bed sores on her behind. And I told her that if that happens, she will have to go to the nursing home because I won't be able to take care of her any more. She's very head strong and contrary, so in spite of being told that, she still only gets up when she has to go to the toilet, the table, or the bed. She used to go sit in her "sun room" and listen to CDs or tapes when there wasn't anything on TV that she was interested in but she doesn't want to do that any more (I made her do it today).

She says it's "too hard" to get out there (she has to use a walker now or hold onto something). She can always ask me to help her but that's just an excuse (she's big on excuses) because it's easier to just sit with her hands in her lap. She gets no socialization at all and doesn't want any.

She never did want friends or to talk with people. She never did talk much and now talking is almost non-existent. She doesn't make any response when I talk to her. She couldn't care less about what I'm saying so she just stares straight ahead. No wonder she's depressed.

According to what the man said this morning, she's doing everything that she shouldn't do and nothing that she should. There is nothing or no one, including me, that she cares about. How do you go about helping someone like that when they don't care enough to help themselves?

How does one get off the many drugs that have been prescribed and go to the six step program when the doctor you're seeing thinks you MUST take said drugs. I know it's dangerous to just stop the drugs, and every time my 19 year old stops the drugs on her own, there's a minor suicide attempt. Just finding another doctor doesn't seem to be possible. She's told me she intends to stop all the drugs.

It is said that "all roads lead to Rome". What is it going to take for people to realize that living an utterly unnatural life leads to endless diseases, conditions, great suffering and great expense. The advice Dr. Ilardi gives to individuals suffering from depression, boils down to simply living a healthier, more natural life, the way our minds/bodies were designed to function.

Nothing that Dr. Ilardi has come up with is new, certainly not earth-shaking. Any responsible therapist would agree that exercise, diet, and human (and/or animal) company--sometimes in conjunction with medication--are useful tools in the amelioration of depression. These ideas have been around for at least 20 years.

As far as his suggestion that previous generations have had few instances of depression, one needs to take into account that for centuries, no one had the vocabulary to describe what was happening to him or her, and it's taken a long time to develop that vocabulary.

Don't forget that Freudians, for the longest time, attributed women's depression and anxiety as "hysteria." Moreover, the social stigma and misunderstanding of mental conditions was, and is, still present in Western cultures, and to a greater extent in some other cultures. These conditions weren't--and in some cases still aren't--talked about.

Hi. I listened to your show and got depressed from the announcement that anti-depression pills might not be as effective as previously thought. I've been on Bupropion since December and haven't seen any change for the better. Before that I was on Paxil. Nada on that one, too.

In fact, on some days I feel worse and cry hour after hour. I'd been walking a mile since summer, too and thought I was feeling good, but the side effects from Bupropion in December made me so sick I couldn't even walk. Ah well.

It is a smart strategy. People can implement it themselves, though doctors, school personnel and others should also encourage use of it.

Paul, I also hated my time on anti-depressants and was so glad to wean them out of my body for good. I have recently tried SAMe and then 5-HTP. Personally, I've been having better results with 5-HTP. Best wishes to you.

Thank you for this episode! This was an hour-long "NPR Driveway Moment" for me, as I grabbed a clipboard and made copious notes.
And really, I have been aware of all of these approaches, but to have Dr. Ilardi lay them out succinctly in your discussion is invaluable. I've always been someone to ignore "Grandma's wisdom", but I come around when there is some science laid down behind it.

I'm in Western NC for the last few years, rendering me rather socially isolated (compared to years in Durham); my most enjoyable exercise (swimming) is somewhat inaccessible; good, trust-worthy food is not always at hand; and the last two winters have been savage for this region. (I've known I'm prone to SAD, beginning with a year spent in Michigan 20+ years ago.) Add to all that the stress of starting a business. So I've recognized many of the "6 Steps", but haven't put it all together.

I had a short stint on Serzone (sp?) in the mid '90's, but I couldn't detect any effect, positive or negative. But I am very anti-drug on this topic. I've just never trusted the assertion that afflictions such as depression can be completely chemical, at least to the extent of treatment. So I thank Dr. Ilardi for his work.

Thank you Joe and Terry for this thoughtful discussion. I will re-read my notes, listen to the show again, and maybe I can pull all of this together into a road-map out of funk.


ps Ms Terry, it is *always* so good to hear your voice! I used to ring up your grocery orders at Whole Foods/Durham (circa 1995-2002). I'm not sure I've ever had another customer who could change the ambient light with a smile! Keep up the good work, and I hope you are all well! Regards!

I was diagnosed with clinical depression about 7 years ago. I was treated by a psychologist, psychiatrist (who offered me anti-depressants, which I refused), and participated in group therapy.

More or less by accident, I ended up following a path similar to what Dr. Ilardi recommends. I know own his book and consider it excellent.

I was prescribed an anti-depressant several years ago when I had reached an all-time low in my life. I was depressed and anxious, no doubt about it. People don't know what it means to be depressed because the word is such common-place banter. But it is a fog that engulfs your head and won't lift. When I went to get the prescription filled, the pharmacist discussed the drug with me and by the end of the discussion I declined the prescription.

I would consult a pharmacist first thing, if I had reservations about any drug. (And although the medical profession doesn't believe in anecdotal experiences, but rather "scientific outcomes", I believe that googling the drug's name with "negative" in the search string is also a good way to discover the drug's impact on other people.) I overcame my depression a day at a time, a goal at a time. But, I believe depression is like alcoholism--it can always return if you are not diligently, consciously keeping it at bay.

I listened to the podcast last night. I thought Ilardi described some excellent ideas for combating depression without drugs. In rank order, I was impressed by his case for the effectiveness of making social connections with family, friends, and relatives (#1), activities preventing rumination (#2.5), exercise (#2.5), adequate sleep (#4), and sunlight (#5) for those who stay inside a lot. However, it’s hard to believe that the omega 3 supplement is more than a placebo without seeing the evidence.

Although Joe kept bringing up the few people who proclaim that an antidepressant drug "saved their lives," Ilardi cited the evidence about the ineffectiveness of antidepressant drugs for the overwhelming majority (85%) of depressed people. It was suggested that, for most people, antidepressants are probably expensive placebos with side effects.

I enjoyed the show. However, I have a couple of concerns about the information presented.

First, Dr. Ilardi implied that the ratio of omega-6 to omega-3 is important. I did not hear anything about how a person might have some idea of what ratio is "good" for him, nor anything about absolute concentrations of omega-3/6 in the body. Are there simple routine tests to determine this?

More critically (I am a mathematician), we know there is more than one way to change a ratio. I did not hear anything about changing the amount of omega-6, nor where it usually comes from in modern American diets.

Secondly, the discussion of fish oil, may be just "drug treatment" under an alias. Does anyone know anything/much about the effects of fish oil beyond the useful fatty acids, long term effects, or respectable doses? I recently quit taking fish oil because of stomach discomfort, but I intend to try to get back on the regime. I just wish that I had more information about the effects, but short term or long, both desirable or un-.

Thirdly, is the impact of fatty acids more directly related to the concentration in the blood, or the concentration in one's body fat, or the long term concentration in what one eats? Those numbers might be different.

I do have some "mild" hypertension, maybe 140/65, generally, after 70 years of bp far lower than that. I trust and respect my doctor, but I fear she does not know much more than what I read on the web about these questions.

I appreciate your perspective on this topic. Why then do Phd Psychologists seek prescriptive authority for psychoactive medications including antidepressants?

I am a mental health professional, and although I haven't heard the podcast yet, I am glad to hear people suggesting non-medical treatments for depression. I have felt for years that I see too many patients who only want new pills and seem to make no attempt to find other solutions for their depression. I think depression is an extremely complex concept that has multiple causes, and thus multiple treatments. Reducing it to a simple "chemical imbalance" is grossly oversimplifying a very complicated process.

Having said that, for many people depression is a neuropsychiatric illness and medication should be part of their treatment-but even then, research is confirming that meds are not as successful as we would like to think, and many if not most people have residual symptoms. So adding lifestyle changes and non-medication approaches should be done by everyone. Thanks as always for your great shows.

Loved this radio program. What a great message. But I do agree with Deepal's comments: "And you if you are too deeply ill you cannot even make the lifestyle changes till you come to higher level of functioning. "

Nothing the Dr. suggests would hurt anyone, and the steps would certainly help everyone, on some level. Thanks for such a timely and important message. This program probably offered hope for a lot of hopeless people!

Fine show.
The numbers of depression tell a slightly different story than Dr. Ilardi discusses. First of all, my psychologist more than any other outside resource in the last few years has helped my mood, optimism and activity levels so I am really on Dr. Ilardi's page and a poster boy for his book.

"Depression affects up to 20 million Americans" - but those numbers are from computer billings from doctors. The number of Americans on prescription and non-prescription meds is probably more than double and more like 50 or 60 million. Our lifestyle is obviously as Dr. Ilardi discusses making many ill and insurances punish coding for depression.

SSRI's and Bupropion work better than discussed in your show. Family doctors with no access to psychologists do brief counseling and use the antidepressants with pretty good success given the side effect problems which are real and harmful. We older docs really appreciate the improvement of SSRI's over using higher dose tricyclics which were even more toxic and less effective.

My favorite psychiatrist used medications as a bridge/crutch to non-medication therapy which he preferred for the long term in typical depression.

100 lb. weight gain with SSRI's effect on dopamine receptors or triggering mania in bipolar patients are real problems which temper the urge to treat patients with drugs.

I am a service connected DV and the VA has prescribed me a generic Clonazepam, that is different then what I have previously been prescribed that is not the same, instead of helping my anxiety so I can function they knock me out, has anyone had the same issue? I know that they (VA) purchase medications in bulk and am sure this is not the same medication.

I have been listening to your radio show for years and it is always so interesting and informative.

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