A review of The Depression Cure and Therapeutic Lifestyle Change: Is beating depression REALLY that simple?

I recently finished The Depression Cure by Dr. Stephen Ilardi. It was…interesting. A unique blend of common sense, historical perspective and medical research, boiled into a six-step process which claims to be able to beat depression. My summary? A lot of merit in here, albiet maybe too simplistic. And I plan on incorporating some of what I learned into my life.

For starters, here’s the crux of the book: Depression is a disease of civilization. Ilardi argues that we’ve seen a rise in depression because of the way we have become civilized and socialized. We don’t get enough exercise, enough sunlight, enough of the right kind of food, enough sleep or enough social connections. We have broken away from the way our bodies and minds have evolved, and as a result, we’ve broken down.

Even more interesting: The book came out in 2009, well before iPhones became hugely ingrained in our lives. During that time, depression and rates of mental illness have only increased.

So what’s the cure? According to Ilardi, we need to do six things:

  • Get at least eight hours sleep.
  • Get more sunshine/natural light – including with a lightbox.
  • Improve our social connections.
  • Stop ruminating.
  • Improve our consumption of certain nutrients, like Omega-3s.
  • Get more exercise.

Ilardi claims that these steps combined – which he describes as Therapeutic Lifestyle Change – can dramatically reduce, if not outright eliminate, depression.

What does the research say? Well, that’s the thing, actually: This stuff isn’t psuedo-science. Each and everyone of the six steps above is backed up by real research which shows that these items can help reduce depression. Heck, I’ve written on many of them long before I read this book, including sleep and rumination.

How about the overall TLC package? TLC’s website provides a link which shows the effectiveness of each of these items individually, although I couldn’t find anything which evaluates the package as a whole. Still, it makes sense that they would work when used together, with the effectiveness of each individual element hopefully reinforcing each other.

My greatest issue? It just seems…too easy. Ilardi argues that, in many cases, sunshine can beat depression. I just cannot imagine it’s that simple. I also know how difficult it can be to do some of these items. When you are severely depressed, you may lose the ability to care for yourself or work towards self improvement. To his credit, Ilardi recognizes this: He breaks down each of these steps into small, easy to swallow, achievable items. He also acknowledges that there can be many causes of depression for which TLC is inadequate, including PTSD, brain damage and other medical changes.

If this is all real, I’d argue it could be a paradigm shift in depression. We wouldn’t need therapy or drugs: We’d need sleep or sunshine. It seems too easy and I’m skeptical. I’m very pro-medication (when necessary), and this book just seems to simplistic at times.

Still.

I’m going to give some of this stuff a shot, starting with the Omega 3 supplements, and I highly recognize you do the same (if you’re doing anything physical, like a lightbox or supplements, you should talk with your doctor first – I did!). At the worst, this stuff is harmless or good for you anyway. At the best…who knows.

If you’ve had any experience with TLC, please let us know in the comments below!

Access to guns means higher rates of suicide. What we can do about it is a harder question.

I recently shared this article on my Facebook page. The crux of the article is this: States with higher gun ownership have higher rates of youth suicide, and the gun ownership leads directly to more suicide. According to the article, “For each 10 percentage-point increase in household gun ownership, the youth suicide rate increased by 26.9 percent.”

This study comes in addition to the overwhelming evidence which shows that access to guns leads directly to higher rates of suicide. This isn’t just in terms of youth suicide, but for individuals across the country, regardless of age.

Why is this? While suicidal thoughts and ideation can be a long standing problem, the impulse to actually kill oneself is often a fleeting impulse. That’s why so many advocates – including me – have concentrated on means reduction when it comes to suicide: If we can get someone through that terribly difficult moment, we may be able to get them the help that they need.

Unfortunately, guns are one of the deadliest methods of suicide. If someone attempts suicide with a gun, that method will tragically “work” more than four out of five times. Gun use also explains some of the gender differences of suicide attempts vs. suicide completions: “…women are roughly three times more likely to attempt suicide, though men are around three times more likely to die from suicide.” This is, at least in part, because men are more likely to use a firearm.

While the evidence is overwhelmingly clear that there is a problem, how we address that issue is something else entirely. Like it or not, guns are overwhelmingly pervasive in America, and basic gun ownership is legally protected. Furthermore, it can be difficult for someone who favors gun control methods to advocate for reducing gun-related suicides without seeming like you are actually advocating for more gun control and to take away guns from law abiding citizens (trust me on this – I’ve run into the issue many times!). Any effort to reduce the access of suicidal people to guns has to be balanced with already existing legal protections.

So, what can we do? Many states have enacted so-called “red flag laws” which create a process by which guns can be temporarily removed from someone’s home if there is evidence which shows they can be a danger to themselves or others. Such laws can be effective in reducing suicide: According to a 2016 study of such laws in Connecticut and Indiana, “Indiana’s firearm seizure law was associated with a 7.5% reduction in firearm suicides in the ten years following its enactment, an effect specific to suicides with firearms and larger than that seen in any comparison state by chance alone. Enactment of Connecticut’s law was associated with a 1.6% reduction in firearm suicides immediately after its passage and a 13.7% reduction in firearm suicides in the post–Virginia Tech period, when enforcement of the law substantially increased.”

That’s an amazing number. And that’s a real difference.

But it doesn’t just take a law or official government action to make an impact in this regards. Take New Hampshire, where the Gun Shop Project has encouraged New Hampshire firearms instructors to “show a video about suicide prevention in their classes.” That information, coming from peers, can be powerful. I hope that research is conducted on these efforts in the future.

We have to find a way of respecting the rights of gun owners while protecting those with mental health challenges, but I do have to think there is common ground here. It is my hope we can find that space.

I’m just gonna try to make you smile for a second: Here are seven subreddits you should look at

Does the internet help with depression in the long term? Social media definitely doesn’t.

But, that’s not to say that all social media is evil. Some of it is downright wonderful.

One of the most popular social media/internet forums is Reddit. Reddit, for those of you who don’t know, is one of the longest running internet communities of…anything. And I mean anything.

For those of you who want more info, this video is a good starting point:

Reddit is made up of a series of topic discussion boards, called subreddits, that are organized around certain topics.

Now, just to be clear, like all forms of the internet, Reddit can be absolutely, positively terrible. It’s comment can be insanely abusive and it’s sleuthing “abilities” have led mobs on wild vigilante quests. Thankfully, most of these uses are rare, and if you stick to the right subreddits, you can find some amazing content, guaranteed to make you smile.

So, even if you don’t have a Reddit account (you don’t need one), here are seven subreddits which will absolutely bring a smile to your face.

  1. BeforeNAfterAdoption: Pictures of kitties, puppies and the like, before they are adopted and after. They go from beaten and beaten down to happy and playful.
  2. Aww: It’s just cute things. It’s just cute, cuddly things that will make you go AWWWWWWW.
  3. DadReflexes: If you’re a Dad (or Mom, let’s be real), you know the meaning of this phrase – you get so good at watching your kid that you reflexively can move to keep them out of trouble. These are videos and GIFs which show prime examples of Dad Reflexess saving their kids from trouble.
  4. AnimalsBeingBros: Sounds like you need some more cute animal videos! Here’s animals being friends with each other. Wish humans could get along this well.
  5. Funny: Arguably the most self-descriptive subreddit name ever. Also, yes, it really is funny.
  6. PhotoshopBattles: People will upload great pictures for the purpose of being photoshopped into amazing situations. Examples include cats being kicked in the face by other cats, police officers with two foot differences between them, and more. Words aren’t going to do it justice. Go look!
  7. UpliftingNews: The news is terribly depressing. Here’s a thread of amazing, wonderful news which shows that maybe the world isn’t going to hell in a hand basket at quite the speed it seems like it is.

Any other good subreddits to share? Let us know in the comments below!

 

Why don’t we prioritize self-care?

A good chunk of my life as a public official deals with mental illness as it impacts my constituents. One of the key issues, of course, is that far too many people have access to mental health care – some studies show that only 44% of the mentally ill actually get treatment. That’s a tragedy and a travesty, but it’s reflective of a larger issue:

We do not prioritize how we care for ourselves, or our minds.

And if you need any truer example of this, well…think of yourself. And I mean that seriously. I know everyone is different, but I bet that if you got a bad cough that you couldn’t shake, you’d go to the doctor. If you broke your arm, you run to the ER.

Now, should you run to a therapist every time you get sad? No, of course not. But I will say this: I think there are far too many people out there who simply don’t take the time to take care of themselves. And that may not mean seeking counseling. It may be as simple as taking a walk. Meditating. Building some time into your day to de-stress before your own sadness levels reach a crisis point.

Is that you? It almost certainly is. None of us – and yeah, I know this is me – adequately take care of ourselves. This is true across most sectors of society. How many of us are stressed? How many of us know we should be doing more to watch our for our emotional state of well-being, but don’t?

For example, check out this TED Talk from Guy Winch on emotional first aid, in which he discusses emotional hygiene:

Winch nails it: We know and teach remarkably little on emotional hygiene and well-being. Winch asks the question that I am asking to you now: “Why is it that our physical health is so much more important to us than our psychological health?”

One of the books on my reading list is The Depression Cure by Dr. Stephen Ilardi. The book essentially makes six recommendations for treating depression:

  • Eating more Omega-3 fatty acids
  • Engaging activity
  • Physical exercise
  • Get more sunlight
  • Strong social support network
  • Sleep

Now, serious question: How many of you looked at that and went, “Yeah, right, wouldn’t that be nice?”

I mean, I did. And wouldn’t it be nice to get more of these things?

We’ve got a long way to go in society to combat our rising rates of mental illness, depression and anxiety. Many of those changes have to happen at the cultural and governmental level. But there always has to be individual responsibility taken. And if all of us prioritized taking care of ourselves, I bet we’d be happier.

Just something to think about.

Using creative arts to combat depression

If you follow my Facebook page, you might have noticed that I posted this article the other day. It’s an NPR story about a photographer named Tara Wray who used photography to combat her depression. Said Wray:

“Just forcing myself to get out of my head and using the camera to do that is, in a way, a therapeutic tool. It’s like exercise: You don’t want to do it, you have to make yourself do it, and you feel better after you do.”

According to the story, this effort resulted in Wray launching the Too Tired Project, which bills itself as, “a photo initiative and traveling slideshow series that aims to help those struggling with depression by offering a platform for collective creative expression and community.”

Creative arts have been used to fight depression throughout history; indeed, creative arts and depression are often linked. Many of history’s greatest artists have struggled with their own demons.

So, why is it that creative arts can help people with depression?

Well, I think the quote above is at least a piece of the answer. Engaging into some other hobby – getting into a sense of flow, if you will – can get you out of your head. I firmly believe that escaping yourself is a key part of beating depression. Even if it’s for a little bit, you can trick your brain into thinking you are somewhere else, and when you “return,” things just don’t seem as bad.

Wray also notes that the arts can provide an incredible sense of relief and accomplishment: “When I’ve made what I think is a good picture, I can feel it, and everything else momentarily falls away.”

I’ll add two personal experiences. Redemption started for me during a very down period. I was struggling at work (for those of you who follow Pennsylvania politics, it was 2015 and we were just starting a rather infamous budget impasse which was very stressful). My wife had just started at a new school and she was struggling as well. As a result, I needed an escape. And thus, Redemption was born.

Second is the simple fact that it gives you an alternative perspective that is still within you – one that you can still apply to your normal life. Redemption has a few plot threads going on, but it’s core is a twenty year old named Ash, trying to deal with his inner demons, beat his depression and live his life (and save the world but that’s a whole other story!). The book features a cast of characters who help him cope.

This may be an obvious point but for the purposes of this discussion I have to make it: I wrote all of the characters. They are all my voice, my perspective and my experience. But there was something deeply therapeutic about putting that level of advice and support into another character. It reminded me, in a sense, that all the hope, words and inspiration I need are inside of me to begin with.

Creative arts – writing, drawing, photography, whatever – I think they allow you to expunge and make sense of everything ugly inside of you. They force you to think of a perspective outside of yourself. And in that sense, they can help save you.

If you have any other thoughts or experiences, I’d love to hear them.

Climate change – and a potential climate apocalypse – are contributing to depression

The evidence, unfortunately, is clear: Climate change is here, it is accelerating, and it is going to get worse, with potential cataclysmic changes occurring as soon as 2040.

That, obviously, can and will have massive implications on all of our lives. However, as this NBC article notes, one of those negative impacts from a mental health perspective: The depression which comes as a result of “climate grief.”

I didn’t realize this until this article, but the American Psychological Association released a long report on how climate change is affecting mental health. That’s available here. That report, it seems, concentrates largely on the effects of climate change on the mental health of those who are more directly impacted by the negative impacts of climate change, including some of the enhanced hurricanes and extreme weather events. However, it also notes that personal relationships and psychological can be impacted:

Psychological well-being includes positive emotions, a sense of meaning and
purpose, and strong social connections. Although the psychological impacts of
climate change may not be obvious, they are no less serious because they can lead to
disorders, such as depression, antisocial behavior, and suicide. Therefore, these
disorders must be considered impacts of climate change as are disease, hunger,
and other physical health consequences.

I gotta say, personally, I totally get this, and I bet you do too. Worry about the planet’s health has starting permeating some of my worst fears, and particularly in terms of what we are leaving behind for our children. My children.

The NBC article notes that a woman featured in it, who has three very worried children, enrolled in a ten step program (the Good Grief network), which helps people deal with collective societal problems. I like this strategy a lot because it actually involves doing something – not just sitting and waiting.

I will refer again to an earlier entry I wrote in the aftermath of the Tree of Life shooting – how to have hope in a world filled with darkness. One of the specific items I wrote was this: Find what you can control, and do something about it. Is climate change an issue which is important to you? It should be. The question needs to me this then: What can you do about it? As an individual, there are quite a few things. This involves changing what you buy, what you use and how you take care of yourself. This also means connecting with elected officials and becoming a citizen activist.

On this issue, the best advice I can give is this: You aren’t helpless, and you aren’t powerless. If you are worried about climate change, do something.

My most-read blog entries of the year

I have to say, I really enjoyed the blog this year. After letting it go for months, I picked it up again and have consistently tried to create useful and interesting content. It’s also helped me expand my horizons and think about mental health in a different way.

This year also saw the publication of Redemptionan experience which has given me more joy than I ever could have realized – and an experience which was borne of my own depression. Take note, reader: You can get immeasurable joy out of sadness.

That being said, most importantly, I hope what I wrote has helped you.

So, here’s a look at the five blog entries I wrote which seemed to be the most popular. My year in review, if you will.

5) Ties That Bind: Liberals, Conservatives & Mental Health: This is the only “top five” entry which dealt specifically with public policy. It dealt with the challenges facing Democrats/Republicans, urban/rural areas and how mental health remains a huge challenge in all of these sections of the country.

4) Redemption, by Mike Schlossberg, is Almost Available: Alright, this one was blatantly self-promotional 🙂

3) The Tragic Suicides of Kate Spade & Anthony Bourdain: Within a few days, Kate Spade and Anthony Bourdain killed themselves. I wrote this blog entry just after the news broke about Bourdain, largely motivated by a very real fear about the contingent effect when someone does kill themselves. It was my immediate thoughts on what to do and how to help those who are suffering.

2) How To Stay Hopeful in a World Filled With Darkness: This entry was one of the most painful ones I have ever done, and like the one above, it was in the immediate aftermath of a tragedy – specifically the Tree of Life shooting in Pittsburgh. The crux of this entry was how anyone can stay hopeful and optimistic in a world where gloom and doom have become so powerful.

1) How Vacation Can Make You Depressed, and What You Can Do About It: This entry was inspired by my own upcoming vacation – and the depression which often accompanied it. What was most interesting about this one to me is that this one has seen a slow and steady increase in hits after the entry was posted back in late July. It did okay at first, but then the views just grew and grew. I suppose it’s good to know that I’m not the only one who sometimes feels this way.

It has been a wonderful year, and thank you for giving me the opportunity to talk to you. I wish you a happy, peaceful and restorative New Year. See you in 2019!

Highly recommended mental health reading

As the year comes to an end, I find myself staring at my Goodreads page. I had a pretty good year for reading! Looks like I read 28 books when I wanted to read 20 – I’ll take it!

But, that’s not what I am writing about today, at least, not specifically. I wanted to pass along the books I have read in the mental health genre, both fictional and non-fictional. Some authors just do a remarkably good job of dealing with this realm, and it’s my honor to make a few recommendations. So, without further ado:

Fiction

  • The Summer The World Ended, Matthew Cox: A fantastic book about a young girl who experiences a traumatic loss and has her entire life uprooted. The book takes a close look at trauma, PTSD and more (which I can’t get into without spoiling).
  • Consider and Contribute, Kristy Acevedo: This was the only other book I could find which simultaneously dealt with a young adult, science fiction and mental illness! In the book, portals open, with aliens advising that Earth residents jump in them because the world is about to end. The book follows a young girl with major anxiety challenges and her struggles to deal with the new world. I also interviewed the author, Kristy Acevedo, here.
  • The Memory of Light, Francisco Stork: One of my favorites. It follows a young girl who survives a suicide attempt and her way back into the light. Stork was kind enough to answer an interview from me as well.

Non-Fiction

  • Lost Connections, Johann Hari: A controversial book which I had some issues with. Nonetheless, it offers some interesting insight into the ideas of social, societal and cultural causes behind depression and mental illness in general.
  • How To Break Up With Your Phone, Catherine Price: Okay, this isn’t exactly a mental health book, per se, but I think it is. It helps people learn how to stay away from their phones, and all the benefits that can bring. I also interviewed Price on the blog a few months ago.

And, of course, if you want one more book, allow me to suggest Redemption, my young adult, science fiction tale of depression, anxiety and saving the world.

Any other books to add? Please let us know in the comments. Have a WONDERFUL new year!

Mental Heath & The Holidays

This entry originally appeared in November 2017, and for Thanksgiving, but I think the lessons certainly still apply. To all who celebrate, Merry Christmas, and Happy Holidays!

—-

Gobble gobble!

Now that the obligatory greeting is out of the way, here’s another: Happy Thanksgiving!  I hope that, for whatever struggles you are currently enduring, you are able to find a way to be grateful for all that you do have.

The holidays can be a stressful time, particularly for those who suffer from mental health issues.  This interesting article from Healthline notes two very accurate reasons for depression during this time period:

  • Social isolation, particularly during the holiday season, and particular if you actually don’t have the opportunity to spend time with friends and family.
  • Grieving.  The holidays can be very difficult for those who have lost someone, even more so if that death is a recent one.  After all, since the holidays are usually associated with spending time with people you love.  As such, the loss of those who you are close with can make the pain of the holidays feel virtually unbearable.

This story from a 2014 Huffington Post article adds some additional insight:

  • People tend to set unrealistic expectations for their social interaction and what they can accomplish during the Holidays (pro-tip: You aren’t Martha Stewart).
  • People try to do too much.
  • “Comparing your insides to someone else’s outsides,” particularly thanks to social media (YES this a thousand times!).

That being said, I may as well take this opportunity to dispel a suicide-related myth: Contrary to popular belief, suicides do not increase during the holidays.  In fact, they actually decrease.

On a personal level, I was always relatively okay during the holidaus, even at my most depressed points, though there were some rough patches.  Thanksgiving and Christmas were always nice, but, randomly, what always got me was the 4th of July.  It’s supposed to be a fun, relaxed holiday, but somehow, I always spent it alone, or frequently with people who I didn’t really like and made me feel alone.  There’s something about holidays that can just make you feel like a loser…like, you are supposed to be having fun and aren’t.  Isn’t that the worst?

So, how do you survive?  Some thoughts:

  • First and foremost, don’t even think about talking about Donald Trump.
  • Stay.  The.  Hell.  Off.  Of.  Facebook.  Seriously.  As I’ve discussed previously, social media can be really bad for your mental health, and this can be particularly true for moments when you are already vulnerable from a mental health perspective.  For your own sanity, limit your time on social media.  It will be way, way too easy to, as the note above says, “compare your insides to someone else’s outsides.”
  • It’s Thanksgiving.  Try to be as thankful as you can be.  That’s easier said, than done, of course.  But, to the extent that you are able, think about it.  If you are reading this blog, you have internet access, which is better than the more than three billion people who don’t have internet access. That likely means you live in the developed world, which means you have access to food, clean drinking water, modern sanitation systems and decent medical care.  It’s not much, but try to remember – odds are, you have it better than billions of people across the planet.  That has to count for something.  Challenge yourself to shift your perspective; yeah, you have the racist uncle sitting two seats down, and he’s had one to many Coors, but odds are still better you have it better than billions.
  • Remember – if you are able – actually relax!  The holidays were designed for unwinding.  Need a break?  Take it.  The damn turkey can wait.  You’re more important.
  • If you are someone (like me) who values routine, don’t let the holidays knock you off of it.  I’m still going to the gym.  I’m still gonna go to sleep and wake up at my usual times.  I’d recommend the same for anyone else.

This isn’t much – and it may be woefully inadequate for what you are facing, that I completely understand – but hopefully these little tips can help make your holiday a little better.

Happy holidays, readers!  I am thankful for many things in my life, and that certainly includes those of you who keep coming back to read what I have to say.  I hope you have a great holiday season, and a very happy Thanksgiving!

Two major mental health trends, with one unifying theme

Two articles jumped out at me over this weekend. The first was this extremely long and in-depth look at a major suicide study done decades ago, which showed that even the occasional letter from a therapist can get someone through a crisis and significantly reduce suicide rates. The second touches on the topic you’ve all heard me discuss many times before: The rise of depression and suicide in young adults, and the potential role that smart phones may play.

The commonality here is obvious: The importance of relationships in stopping a mental health crisis and maintaining happy lives.

The Huffington Post article tracks the work of Dr. Jerome Motto, who engaged in a massive suicide study. His team tracked tracked mentally ill patients and found that sending letters to them could dramatically reduce suicide attempts, a study that, according to the article, has been backed up by other, similar studies, including this one by Gregory Carter:

Gregory Carter, who ran a psychiatry service in New South Wales, Australia, orchestrated a study in which Motto’s words were typed onto a postcard illustrated with a cartoon dog clutching an envelope in its mouth. The notes were sent eight times over the course of 12 months to patients who were among the hardest to treat. The majority had histories of trauma, including rape and molestation. Some had made repeated suicide attempts. But Carter found there was a 50 percent reduction in attempts by those who received the postcards. When he checked in on the study’s participants five years later, the letters’ effects were still strong. And the cost per patient was a little over $11.

Meanwhile, the USA Today article I noted above places at least some of the blame of the rise in depression among teenagers and young adults on cell phones:

San Diego State University psychologist Jean Twenge sees a direct link between how much time teens spend on smartphones and troubling signs of mental health distress.

In her 2017 book “iGen,” she cited national health surveys and other statistics to argue that a generation of teens have turned to smartphones as their preferred social outlet, and teens who spend the most time on their screens are more likely to be unhappy.

“What you get is a fundamental shift in how teens spend their leisure time,” Twenge told USA TODAY. “They are spending less time sleeping, less time with their friends face to face. … It is not something that happened to their parents. It is not something that happens as a world event.”

There’s a common connection here, and it’s pretty obvious: People – all of us – need each other.

The simple fact is this: iPhones and social media are build on the premise of building a further connection between people, and while that’s certainly possible, I’d argue that they really just keep us apart. I’m just as guilty of this as anyone else, but when we use our phones instead of talking to people face to face, we’re not building anything. It may increase our surface knowledge of someone’s life, but it’s not a substitute for a real interaction. It’s like heaving sugar for dinner instead of a healthy meal – it may fill you up, but there’s nutritious about what you are eating, and eventually, it rots you from the inside.

The article about sending letters to suicidal people backs up this point, in my opinion. People can, apparently, be brought back from the brink by hearing from someone who truly cares. I will not presume to imagine what is going through the mind of someone who is at the point of a suicide attempt. But from what I’ve read – and what I’ve experienced when I was close to that point – suicide isn’t really about dying, per se. It’s about someone wanting to stop their pain. To know that they have a reason to hope. So, if you get an authentic person sending a real message – hey, how are you doing, I’m thinking about you and I care about you – can that fill a void? Can that bring a person back from the edge? Dr. Motto’s research, and that of others, would certainly seem to imply that the answer to that question is yes.

It seems to me that these two articles detailing the rise in suicide and depression have someone in common – humans are losing their innate ability to connect with others, and doing so can solve many of our mental health issues.

As always, I welcome your thoughts. Let us know your thoughts in the comments below!