In his book, “The Depression Cure: The 6-Step Program to Beat Depression without Drugs,” author Stephen Ilardi argues that the rate of depression among Americans is roughly ten times higher today than it was …
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Thanks for the review, Therese.
I do have one point of clarification, however. Although the published evidence suggests that the majority of those suffering from major depressive disorder (unipolar depression) fall into the mild-to-moderate category of individuals who gain no significant advantage of meds vis-a-vis other forms of efficacious treatment (exercise, behavioral activation, phototherapy, etc), I state very clearly in Chapter 11 of the book that individuals suffering from BIPOLAR disorder derive unequivocal benefit from mood stabilizing medications. Thus, I do not believe it’s fair to generalize from your experience of bipolar illness to that of those suffering from unipolar depression, nor does it appear that you’ve accurately characterized my own position on this matter.
Otherwise, I loved the review!
Best wishes,
Steve Ilardi, Ph.D.
University of Kansas
It really is an interesting subject, and indicates that the times have changed dramatically, and now the depression is much stronger than before, is also the lifestyle that we lived for two generations, very different indeed, as to the antidepressants should be very careful as they can be very dangerous if not performed adequately, because we have many cases where people have come to impair their lives by these drugs (as findrxonline, trusted source, and there are more than thousand cases in United States) it is required to be very careful and take an appropriate and prescribed by the doctor, never self that is much more dangerous still.
I posted a Tweet about this article today.
“Feeling depressed? For deep sadness or real depression, here’s 6 simple things you can do to help. http://bit.ly/pllDl”
I also blogged about “lying to your doctor”. Excellent topic.
My focus is on tools for medication compliance. Maybe we can team up to help people. Contact me on my website.
We are in a very interesting place with regard to research on effective treatments for depression. I applaud the approach that Ilardi has taken in breaking a treatment package into manageable chunks. However it seems that a fundamental componant of effective treatment may have been overlooked in the process. I have been conducting trials, over the past 3 years in the UK, with the computerized CBT package Blues Begone http://www.bluesbegone.co.uk. I have accumulated a vast data set on the ability of self help to provide a very powerful intervention. Blues Begone focuses on the combination of behavioural activation, and in that we have common ground with Ilardi, but it also devotes a huge quatity of resources to helping people learn to challenge unhelpful, wrong and negative thinking. This combined approach yeilds a 60% cure rate in clinically depressed individuals and a 50% cure rate in clinically anxious individuals. From properly controlled medical trials we can state with certainty that our combined cognitive and behavioural approach gives a clinical effect equal to 12 hours of face to face CBT therapy. We are left with the conclusion that ordinary people, if given the proper resources and helped to use them, can adequately and successfully treat and cure themselves of depression. This may heralds a revolution in the treatment of common mental health problems. And perhaps may signal the beginning of a reveral in the trend of increasing disability caused by dpression and anxiety disorders.
I’m in complete agreement with Therese’s review. When I first heard of this book, it was during a radio interview with the author. I got a little nervous listening to his skepticism on medication. Much of the ineffectiveness of antidepressants are due to the inconsistent regimen of the patient. And I’m sure the increase in depression has a lot to do with the increase of diagnosis in general. The Amish don’t experience depression as much? Well, the Amish tend to not seek psychotherapy for their symptoms either. I have no evidence to support this – it’s just a hunch. I have suffered from depression my entire adult life, and hopefully soon, I can be rid of the cocktail of pills – once I learn how to feel better on my own. But this is the eternal confusing crisis of depression. How much do I actually have control of?
Hey Dr. Ilardi! How nice to see you’ve commented. Your statistics on the ineffectiveness of antidepressants made me very nervous. Moreover, your description of what suicidal thoughts actually were made me very, very nervous. I always thought suicide was a wish for death, therefore I never saw myself in that category. I was terrified at the description, because I realized the mental anguish you described was what I was experiencing. I’m inspired, mostly by fear, hehe, to get better. Believe me, this is big. I haven’t felt inspired by much in a long, long time. I need to change how I live, and not rely so much on the medication. But I really do need it and I can’t ever see not needing it. Any thoughts?
I think that people who have a lot of external issues, and by that I mean, that they are concerned about feeding their family, and surviving, and keeping safe and warm, have less internal issues, including ‘mental illness’ and Depression as well.
On the other hand, people who have a lot of money, and they are not struggling on the external, or at least are not totally busy with outside stuff, they have more internal problems, and issues.
Having too much is terribly stressful and depressing, in fact. So is too much freedom. So is when you think that life is all about waking up happy every morning, and you make this somehow your goal or purpose in life.
“Oh, I must be ill, because I was not happy today”
Imagine if before you did anything, fun or tedious, a party or a chore or a walk, or getting the mail, that you had to climb over a huge heap of garbage. Imagine that heap of garbage was as big as a house – not impossible to climb over – but a huge pain in the a%$ nonetheless. That party, or walk, or fun thing would not seem as fun to do anymore. Maybe not worth it, and if it was still worth it, it would be hard to do. That chore is that much harder to do. Might make everything seem like a chore.
And work. You’d still get to work on time, but that huge heap of garbage makes it more work, so difficult to get going. And then despair and frustration over how difficult it all is. THAT’s depression. Depression is not simply unhappiness. It’s almost paralysis.
I know, Sara. I have been there. Just paralyzed.
I used to have this aunt, a psychologist, who, whenever she saw me, would urge me to go swimming, and she would insist that this was what I needed to get out of my depression.
I told her to just let me be, and that it was OK, and she did not have to do anything, or try and change me. Then she would say that she just can’t stand looking at me, and that became a problem, not being allowed to even exist without a happy ‘swimmer’s face’.
Then she would get mad that I never visited, and go on and on about my needing to swim.
I am sure you know what I mean. She’s actually still my aunt but has moved to a city a little further away…thank God. (and I never said anything, or complained, or whined, or anything)
Very interesting!!
So, according to the good doctor, the key to curing depression is telling depressed people to stop doing all of those things that are symptomatic of being depressed. Perhaps we ought to tell diabetics to regulate their their blood sugar through positive thinking and cancer patients to stop allowing their cells to divide so fast.
Yes, I am aware I need more sleep and more exercise. Admonishing someone so paralyzed by depression that they are considering ending their own life to “stop ruminating” is borderline irresponsible — especially for a doctor. Someone on the brink of suicide has trouble just getting out of bed in the morning, now we’re going to tell them to exercise? Stop ruminating and go interact socially? You think my brain stops ruminating just because I’m in a social situation? Throw in the strong links between depression and anxiety and this advice sounds even worse.
And once this “engaged activity” is over and it’s time for our mandatory sleep, how do you stop the brain ruminating then? This is a fine article Theresa and I am sure the book addresses some of my concerns, but the overarching message I am getting here is that the cure for the depression is to stop acting depressed. Yeah, I’d love to. How? I understand that Dr. Ilardi is recognized as an expert in his field, but honestly, I am at a loss as to why. So far, from everything I’ve read, his erudition on the subject certainly seems well-hidden.
I see what you mean. The experts might be qualified if they had been there first… feel my pain heal my pain.
Your review of Stephen Ilardi’s book is so very timely. I remember reading an article in the LA Times that stated that about half the population of the US was on some kind of medication for depression!
I don’t know if that figure has changed at this writing, but I found it mind-boggling, as someone who doesn’t take medication of any kind.
This is what I know. Doctors usually want to treat the symptom: the depression itself, rather than look for the origin of the problem. However, depression is usually a sign that there is something wrong somewhere in the body: that there’s an imbalance. I think this is most obvious, in my experience, when someone has just had surgery and he/she is not only recovering from the physical/cutting of tissue, but also trying to recover from the shock of trauma and the overloading of the body with drugs. (I’ve witnessed great levels of depression in people who’ve just had surgery).
I really appreciate the author’s references to Omega-3, sunlight exposure, sufficient sleep, etc.
We were born to be in balance and we need to be on the look-out when we’re not: depression is one of our major clues.
I couldn’t agree with you more Harry LeRoy. As I sit here at 2:30 in the morning, I would love to be able to sleep the night away and get everything back in balance. If only my mind would let me. I stare at my gym clothes and pay the large cost of a membership because I know I should be exercising. The problem is doing it. I’ve tried the SSRIs and I’m frustrated with the side effects of weight gain and insomnia, I almost feel they were contributing to my problems. So now I’m looking for a way to ease this anxiety drug free, however my mind and body won’t do the things I know it should. I make every excuse why not to exercise and eat right (being a mom, busy working, etc.) I’m just so frustrated that I just can’t do it.
I am severely depressed and have been on the brink of suicide many times, several times very recently. There is no possible way I could follow any of this advice when I am having a major depressive episode. I’m lucky if I can make it to the shower, never mind exercise and hang out with friends. Anti-depressants don’t work for me either, but I think it shows a profound lack of compassion for the depressed person to suggest that exercise and conversation will help. Maybe it would, but I can’t leave the house. Severely depressed people are dysfunctional. Now what?
Good on you Steve Ilardi! We need more doctors like you. I empathise with all the above who have been through depressive illness. I have also been there, and yes for five loooong years, you could have thrown all the labels (as many did) at me. Post traumatic stress, depression, agoraphobia.. total and absolute shut down, inertia and paralysis. Call me “crazy” …or not, I came to a point when I had just had enough of the “circus” ..this included one medication after another, and each was as detrimental as the first. I decided to ditch all of it…that is, in one particular moment in time, when I had been so low, for so long, I described it as being locked in a beige room with beige walls and a beige door. I needed to find that door that said…no more. Saying no to victim stance, saying no to the “experts” all trained in keeping me in that stance, saying no to ANYTHING external, to what my heart and my mind were saying.
Saying no to medications that made me like zombie, I would have been happy to feel “something” instead of nothing.. To the question “How are you feeling today?” mmm I don’t know, says I. So..in the lighter periods in the abject darkness of this crappy psychiatric treatment chess game…I got busy. I wanted alternatives…I poured over the net.. I ditched the Lexapro..(disgusting) and did it according to those who had gone before…gradually…and with each step… stronger ,better…more colours began to appear…I saw that door and ran for it. I did not seek the doctors advice because I knew what he would say. I told him long after. He saw me, three months later, when I exercising 6 days a week, got onto the Omega 3′s, changed my diet, disciplined myself to go to bed at the same time each night (instead of staying up all hours and days on end….) routine, followed by grabbing support (that really helps..with likeminded people) I applaud you Doctor Steve, I think you have bucketloads of compassion… I failed to see compassion in the circus of doctors, pharmaceutical companies and the like who keep “us” in the loop. Now be aware… if you try to kick the victim habit… there will be a cast of thousands who will want to keep you down there. I was sick of being on the lounge for 5 years…yep been there..Virginia..couldn’t shower, couldn’t eat..couldn’t sleep, couldn’t work, couldn’t go outside… but I did something far more pertinent. I began to trust me, more than I trusted “them”..the choice was clear…either more of the same and heading down the path that leads to more people telling you what’s wrong with you, or me telling me what was “best” for me. It took months…after 6 months I wnt back to work for one, then two, then three days…after 12 months five days but part time. I changed my environment, internally. I did not see Steve’s book…but I implemented all that he is saying. Simple alternatives to the crazymaking… simply said.. I took complete and utter responsibility for my own welfare. I got my certificate in “untraining the crazymakin’” one baby step at a time…
I remember, years ago, when i was suffering from the unrelenting emotional pain of depression, i read and followed the suggested steps of two books. They helped me tremendously, showing me that my self defeating thinking was the root of my problem. They outlined simple things i could do to help me to correct my thinking and experience some measure of happiness in my life. The books were “Feeling Good” and “Your Erroneous Zones” I still experience minor bouts of depression, but no where near what i did then. When i remember and follow the simple suggestions on how to work on my own thinking, i get better. Just wanted to offer my own personal experience.
I think some of those things may help some people, but crazy in virginia said what I was thinking. I am a rapid cycling, mixed bi-polar type 1. I can’t sleep even with meds, I am tired all the time, am angry and severely depressed all the time with just enough mania thrown in to make me furious at all times. I have taken more meds than you can shake a stick at. They have horrific side effects (that the docs don’t tell you). I have done cognitive and DPT and regular and family counseling. I absolutely hate my life and don’t think it will ever get better. I have been trying to get “un-angry and depressed” for 25 years. So far no luck. Certainly not with the basic stuff listed up there. Some of us are truly suffering and there is no hope, unless they make a medical breakthrough. BTW I’ve been this way since I was a small child. I am also a genius…and I wish I was an idiot-I’d be much happier not being so smart. I hate thinking!!! I hate everything.
I am alone all the time, I derive no satisfaction from anything I do and I don’t want to do anything. That sums it up excet that I have this incredible anger, hatred for my live, my exwife and all my failure. I watch all the people buying their new boats and Cadilacs, and I barely get by. . Maybe the doctors should dispence money because the drugs they give me make me sick. If I had enought money to get, buy especially since I have to pay a huge alimony , but I have to wasch every penny like a pauper, and hoep that there is food money left over, and god forbid if I have a medical episode and thad Dr. Bills. Then I can for get about food. Does this qualify me fom medical mariajauna? Maybe being zombie stoned is the solution, because the only other soolution that I am considering is scionide.
I am sorry to hear that!. I am very smart too but there is a difference between being smart and being wise. I started reading and writing my own poems at the age of 3. I went to the best schools and universities. I got a great family and job. My life was happy but at the end I still got depressed even with my “perfect life”. I do not believe in pills although they may work for some but not for me. I started a relationship with Jesus and that changed my life. I am not talking religion…religion is bad. I am talking about getting to know God through the bible with an open hearth in the intimacy of your room…Just between you and Him. Give Him a chance you don’t have nothing to loose. He is real. It has been proven by science that the bible is true…get to know Him if you will… and detox your body. Get omega 3 and antioxidants. Breath pure air…go nature. Change your life at least that way. Just contact earth end you will feel different. If you can (meaning that you won’t hurt family members)…go away from your life and find your purpose in it by doing something different. Take a challenge. But most of all: Forgive (including yourself) and take the root of bitterness out of your hearth by decision. Take a decision even if you don’t feel like it. Trick you mind and your hearth will follow…try it!
Ps. English is not my first language so forgive any mistakes.
We all get depressed for different reasons. What can help us feel better is also different for different people. I think getting at the root cause for your depression can be helpful just for your own pysche, not to necessarily provide relief, but an understanding of why you are depressed. For some, with therapy, it can be a jumping board for help, and for others, it’s just nice to know why you feel the way you do.
Feeling better can be a passing few hours or a day of doing something that helps, but we all know how it returns and can do so rather quickly. I can be in tears in my car, right after a workout at the gym. I don’t mind exercise so that’s why I used that, but if you’ve never exercised, it may not the be option you choose for that little bit of down time from depression. I think any suggestion is helpful, but again, a huge hurdle and a passing feeling of not being depressed for a short period of time. Maybe this is so for me and others who are more depressed. Not everyone is depressed on the same level.
What helps me in day to day living (sometimes), is to be prepared a day in advance for what I need to do the next day to not make it seem monumental to get whatever it is done.
What lifts my spirits, a talk with a friend who makes me laugh. Yes, laughter can be the best medicine (momentarily). With that said, I will watch more comedy shows. Sure, you can be laughing one moment, then crying the next, but I do find that laughter helps me a little. You’ve got to psychoanalyze yourself to find out what works for you, even if it’s in the short term.
As others have commented, sure, things listed to do to feel less depressed can work, but there’s still that hurdle to do them. I do set small goals, but sometimes I don’t even get them done, but what I don’t do is beat myself up over it. It doesn’t help. Don’t be hard on yourself. Being hard on yourself is like beating yourself up. Now that certainly doesn’t feel good:)
im on three meds-prozac-perpenazine and trazodone-all very small dosage.ive been in a routine of walking-jogging-treadmill-and an overall workout at a local neighbourhood gym everyday-workouts consist of 1-1.5 hrs per day.ive noticed a very very big difference in my mood-i dont yo-yo between my ups and downs-many many things simply do not bother me.i stay away from news and talk radio-i only listen to upbeat music-such as high energy dance music-something aerobic in nature.ive asked my doctor-as i seem to be improving day by day-and feeling noticeably upbeat-to ween me of these meds-its now september-we will try it in november.it also helps that ive lost 70lbs in the last yr-35 lbs to go.im 50-i feel like 30 yrs old.
did not realize that there wasa problem………………I was filling up my life with ” things ” that just got out of hand……It was like waking from a 30yr sleep!!!!! What a revelation……….all my friends knew….and tried to make me realize…….but one day someone said something to me over the telephone…….,and I lost it………I knew she was right,…….and that I had to do something about it…….perhaps it was caused by a need to barricade myself against all the sadness I’d been feeling….from the loss of dear friends……I don’t know……,but I will try my best to get rid of the clutter…do one thing at a time…….who says I have to do the impossible….clean, cook, garden…….,etc work work work……..and never take a break??????? The book from the library…….” Don’t Sweat the Small Stuff” really taught me a lot about myself……..,Who do I think I am………………………..Super Woman??????? I can do a little at a time…………it’s OK…………..nobody is going to judge me………..I do not have to prove anything to anybody…………….just be myself…do the things I like to do…………….even doing nothing………..it’s OK….No more rushing……like a freight train………….I will talk more slowly…….walk more slowly……,.,enjoy the Pandora music tha Vitale set up for me……and just enjoy life….one day at a time………….just go at a slower pace. But most of all………..I will attend Church and receive the sacraments and talk to God………..I know He will help me get through this……..and my Mother will be so happy!!!! Thanks to all my friends…,.especialy to Brigitte…for making me see the LIGHT……..God bless you and ALL my dear friends……so lucky to have you all in my life…..God sent you to me for a reason…,,and I am truly blessed…….Love you all……Marilyn
I am glad I found this I information. I am a first year psychology student and found this article very informative. It backs up idea I have for my assignment. Thanks.
…….I’ve recently discovered Joel Osteen on his TV sermons…………….he truly is an inspiration…..and his sermons really hit home…..for instance, he says by dwelling on the past…..we lose out on what God has given us today…….what a waste!!!!!! The past is past….one cannot dwell on it……,enjoy the day….God has given us…………I feel better allready!!!!!In addition, God has equipped each and everyone of us with “special gifts” to see us through……,if we don’t use them…..it hurts God….we cannot afford to abuse HIS kindness……..He loves us…..but we MUST open our eyes………and not keep rushing so much……otherwise we’ll lose out. In other words………………………SLOW DOWN……ENJOY…….,REALLY ENJOY…….Be aware ALWAYS of GOD’S love……treasue it…..and treasue each and every day He has prepared for us. Ans be sure to let your friends know that you love them….really…….tell them in words….you’re allowed to……………..it’s OK…….they will be happy hearing those words…..My friends are WONDERFUL……I really do love them all…..I’m so fortunate to have them in my life…..I hope they all know that……………..Love you all…..,Good Night
I’ll second Sarah’s statement that being smart is not the same as being wise.
I believe that wisdom requires that we are logically intelligent as well as emotionally intelligent.
The modern society ploughs a lot of money; effort and time into helping people develop logical intelligence since it is often needed for academic excellence and economical growth.
Compare that to the effort put into helping people develop emotional wellbeing. At most we are all left to develop emotionally with very little guidance.
If we are lucky to have parents with some emotional intelligence, they may just pass that down to us, but this is often passed down by accident since very few people are actively thinking of its importance to the wellbeing of the society.
If i consider the history of Africa, where I have my roots. developing emotional values were part and parcel of learning to become a responsible adult. It was important to know how to work with feelings of sadness and fear (although many ideologies were often slightly misguided).
But now most African countries have bought into the rat race to acquire academic knowledge and financial stability. The side effect is that they also now undervalue emotional intelligence.
I believe that the increase in the experience of depression is strongly tied to a widely spread poor knowledge of depression itself
No amount of academic genius is enough to help people secure a resilient ability to beat depression.