Monday, October 15, 2007

Taking on the Depression Epidemic: A Promising New Treatment Approach

According to a sweeping epidemiological survey, roughly one in four Americans will now succomb to debilitating depressive illness by the age of 75. Sadly, the risk of depression is even higher among young adults (see chart below); it now looks like over half of all 18-29 year-olds will become clinically depressed at some point!


And we're talking about a disorder that robs people of their energy, their sleep, their memory, their concentration, their ability to love and work and play. It robs over 500,000 people each year of their very lives (via depression-linked suicide).

Bizarrely, the depression epidemic keeps getting worse, despite the fact that antidepressant use has gone up over 400% in the past two decades (150 million antidepressant prescriptions are written each year in the U.S. alone). The rate of depression in the U.S. is now 10 times higher than it was in the 1940s, before the advent of antidepressants. (And, no, this is not merely an artifact of greater public awareness or people's willingness to admit their symptoms; it's a genuine scientific finding.)

What's going on? I believe the answer lies in the fact that we were never designed for the modern sedentary, socially isolated, sleep-deprived, fast food-laden, indoor, frenetic pace of modern life. In fact, because the vast majority of human history was lived out in a hunter-gatherer context, it appears that humans are best adapted to that ancient way of life. There are many features of the hunter-gatherer lifestyle that - according to the best available research - confer powerful protective benefit against the experience of depression: abundant exercise, ample dietary omega-3 fatty acids, extensive social support and connectedness, sunlight exposure, 8+ hours of sleep each night, and engaging activity that prevents against the psychologically toxic process of rumination (i.e., dwelling on negative thoughts).

These antidepressant lifestyle elements not only fight depression, but they are capable of changing the brain as effectively as any medication.

Over the past few years, clinical research group of Dr. Steve Ilardi (aka, Psych Pundit) at the University of Kansas has worked hard to help depressed patients find a lasting cure by reclaiming these protective lifestyle elements from the past. We call the approach Therapeutic Lifestyle Change (TLC) for Depression. The preliminary results thus far (to be presented at next month's ABCT Conference in Philadelphia) have been enormously encouraging: 76% of TLC patients have experienced a favorable treatment response, in comparison with only 27% of patients on a waitlist who received 'treatment as usual' (mostly meds or therapy) in the community.

This work has recently received considerable attention in the national press, including an in-depth story in the November/December issue of AARP Magazine (readership: 30 million). As a clinical researcher, of course, I am eager to see the results of this work published in a peer-reviewed journal, and my research team currently has 4 articles at various stages in the publication pipeline.

In upcoming posts, I'll plan to give more details about the treatment program, as well as updates about scholarly publication as they become available.

24 comments:

Dr. Deb said...

It is rather "bizarre" as you say about the antidepressant prescriptions & depression epidemic. I do believe that lifestyle change is important. Keep on going with this one!

Psych Pundit said...

Thanks, Deb. As I'm sure many of your patients can attest (and mine certainly do), simply popping a pill - without making any other changes in one's life - is not a high probability path to a longterm cure from depressive illness.

Rajesh said...
This comment has been removed by a blog administrator.
Anonymous said...

Hey,

Not to be provocative, but why are you citing a study that is 2 years old?

Also, I'm curious to know where you go the statistic 25% of the US population will be at some point in time clinically depressed.

Was that an average of the 2 statistics of anxiety disorders (28%) and mood disorders (20.8%)?

Is that depression?

I'm curious to understand your rationale, or if I'm not reading the right data (totally possible).

Thanks.

Psych Pundit said...

Anonymous,

That particular epidemiological study - The National Comorbidity Survey - represents the methodological gold-standard for the field, but it's only conducted every decade or so. Thus, it's by far the best citation I'm aware of for obtaining an estimate of current prevalence rates of Axis I disorders. Surely you don't think they've changed that much in just a two-year span, do you?

And the estimate of lifetime prevalence "roughly 1 in 4" was taken from the study's actuarial projection of the current population out to age 75. (The actuarial methodology is quite similar to that employed by life insurance companies in projecting life expectancy based on present mortality rates at each age distribution).

Given that 25% of all 18-29 year olds have ALREADY been clinicall depressed (Kessler et al., 2003), it seems reasonable to assume that the lifetime risk for the youngest Americans will be considerably higher.

Sean said...

A recent study has shown that people who are under the medication of anti depressants drive worse than the people who do not take anti depressants. Antidepressants have been seen to lower the driving skills of even experienced drivers after they have started taking depression pills. http://www.xanax-effects.com

xanax said...

The anti-anxiety medicine xanax is wholly capable of facilitating your war against anxiety as it is the most widely recognized medication to treat anxiety disorders, especially generalized anxiety disorders and altogether Xanax can treat a whole lot of anxieties related to panic disorders and depression. Before you move on to administer Xanax and treat your anxiety, get hold of Xanax tidbits from the site http://www.pill-care.com

Anonymous said...

Xanax is NOT an anti depressant it is a benzodiazepine, ( a sedative drug ) which, of course will alter driving ability.

Modern SSRI's are a useful and mostly safe *adjunct* to the seriously depressed and in some cases life saving.

respectfully, please dont muddy the waters sean

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Kathy R. said...

it seems that anxiety and depression is a major that most teens never signed up for, is this assumption wrong ?
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Hip said...

Here is an angle on the cause of the depression epidemic that probably very few people will have even considered: many cases may be caused by an infectious agent.

I myself caught a virus (that also spread around my social connections), and without any doubt, precipitated mental state change in many of those who caught it. Increased susceptibly to stress occurred in many of the infectees. Fatigue, lethargy and depression were also common, as were increased memory problems. All suddenly appearing, in many people, soon after catching this infection.

For those interested in this, see here:

Epidemic Depression Virus

Viruses in Perspective


I suspect that this virus I caught is a new enterovirus. Enteroviruses are very hard to detect once they have formed a long term infection in the host.

Hip said...

By the way, I would recommend that everyone with depression test to see if their depression is caused by chronic brain inflammation.

To test this, you can simply try out the anti-inflammatory treatments detailed here:

http://chronicsorethroat.wordpress.com/site-map/chronic-fatigue-syndrome-research-chronic-fatigue-syndrome/

Generic Cialis said...

It's true that depression has to be with some substances that your body doesn't produce like dopamine or serotonine and that's why they have to take pill to help them with that but i think that take the therapy it's very helpful too.

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Since long time ago there are many people with depression problems. Consequently, depression become an epidemic around the world.Generic Viagra I have an aunt she has been suffering a terrible depression since she got blind. According to psychologist she has to break her own mirror and continue her life normal as possible.

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