The Depression Cure
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cover of The Depression Cure Introduction to The Depression Cure

Depression is a devastating illness. It robs people of their energy, their sleep, their memory, their concentration, their vitality, their joy, their ability to love and work and play, and—sometimes—even their will to live. As a clinical psychologist, I’ve worked with hundreds of patients to help heal depression’s debilitating effects, so I will never underestimate this treacherous foe. From the day I first walked onto a psychiatric unit at Duke Medical Center two decades ago, I’ve devoted my career to fighting the disorder: I know it far too well to make any blanket promises of a one-size-fits-all cure.

Yet here’s what I can say with complete confidence: Depression is beatable. And the six-step program outlined in The Depression Cure is the most promising treatment for depression I’ve ever witnessed in my years of clinical research and practice. Admittedly, this is a bold claim—one I never would have imagined making when I began developing the program a few years ago.* But it’s based on three important observations:

• The program—Therapeutic Lifestyle Change (TLC)—has proven remarkably effective in a large treatment study at my university. Patients were randomly assigned to receive either TLC or treatment-as-usual in the community (mostly medication), and fewer than 25% of those in community-based treatment got better.** But the response rate among TLC patients was over three times higher. In fact, every single patient who put the full program into practice got better, even though most had already failed to get well on antidepressant medications.

• All six components of the TLC program—omega-3 fatty acids, engaging activity, physical exercise, sunlight exposure, social connection, and enhanced sleep—have antidepressant properties. We know this from mountains of published research. But TLC is the only approach that combines these separate elements into an integrated package—a comprehensive, step-by-step program that’s more potent than any single component used on its own.

• Most important, TLC addresses the modern depression epidemic at its source: the fact that human beings were never designed for the poorly nourished, sedentary, indoor, sleep-deprived, socially isolated, frenzied pace of twenty-first-century life. The program provides a long-overdue, common sense remedy for a contemporary American lifestyle that’s drifted dangerously off course.

In recent years, I’ve been invited to speak with thousands of people—patients, therapists, psychiatrists, students, and many others—about this lifestyle-based approach to healing depression. The question I’m most frequently asked is: Who might benefit from the program?

My reply: Everyone. This usually draws some laughter, as most people think I’m joking—a bit of ironic, self-mocking exaggeration. But I’m actually quite serious. At least four groups of people can benefit from the TLC program, and together they include just about everyone.

• The program was initially designed to help those suffering from clinical depression—whether or not they’re already receiving some other form of treatment. TLC is highly effective when used on its own, but the program can also be combined with antidepressant medication or traditional psychotherapy.

• Then again, you don’t have to be diagnosed with full-blown depression to benefit from TLC. The protocol can also help those who are simply feeling blue or fighting milder symptoms of the disorder.

• Likewise, the program offers protection to anyone who wants to minimize the risk of depression in the future.

• A few years ago, psychologist Harriet Lerner—the bestselling author of influential books like The Dance of Anger—observed something else about the TLC program that I had never considered: Each step involves something that’s good for us, no matter how well we may be doing already. As Harriet put it, “Your program isn’t just about depression. It’s something everyone can use to their benefit.”

She’s right, of course. There’s a wealth of research on the physical and psychological benefits of the program’s core elements: weight loss, increased energy, lower blood pressure, improved cardiac health, better immune function, reduced inflammation, greater mental clarity, and an enhanced sense of well-being. These are treatment “side effects” worth signing up for, and they represent another important reason for embracing the TLC program.

Despite the treatment’s beneficial effects, it’s still advisable to get a physical exam before you start putting the protocol into practice. In my own clinical research at the University of Kansas, I don’t let anyone begin the full program until they’ve first seen a doctor. This policy may surprise you, but it’s based on sound reasoning. For one thing, it’s always a good idea to check with a physician before embarking on a new exercise program. The same goes for taking high-dose nutritional supplements or increasing sun exposure. Since these are all core elements of the TLC program, it’s important to get your doctor’s okay before you begin.

In addition, depression can be triggered by many common medical conditions—diabetes, sleep apnea, thyroid disorder, heart disease, chronic infection, and hormonal imbalance, to name a few—and the disorder can be very difficult to treat effectively until such underlying medical problems are addressed. Finally, several drugs carry the potential to cause depression (ironically, even some common psychiatric drugs), and your doctor can help you consider this possibility, as well.

In the chapters that follow, I’ll describe the Therapeutic Lifestyle Change program in clear, step-by-step detail. And I’ll share countless stories of those who’ve used the program to overcome depression and find their way to lasting recovery. My hope is that by putting TLC into practice in your own life—one step at a time—you, too, will begin living the depression cure.



* With the help of several talented graduate students.

** "Getting better" was defined in the study as: experiencing at least a 50% reduction in depressive symptoms and no longer meeting diagnostic criteria for major depressive disorder by the end of treatment.