Over 260 million people are suffering from depression globally. As depression increases, it is now striking at an earlier age. The major episodes of depression are now occurring frequently by the age of 25, whereas they previously occurred in individuals at about an average age of 40. A staggering two thirds of Americans experiencing depression go through the motions of life without diagnosis and without access to interventions that can powerfully and positively impact health and wellbeing. According to a Boston University study, reported in JAMA, depression rates in the US have tripled following the COVID-19 pandemic.
“Depression should not be tolerated as a lifelong condition with its miserable side effects.”
Depression is almost always a multifactorial disease, and it often has many potential causes. The good news is that recent discoveries in the diagnosis and treatment of depression have increased the opportunity for recovery. Thankfully there are powerful holistic interventions to combat depression. This holistic approach is utilized at the residential Nedley Depression & Anxiety Recovery Program™, and includes exercise, nutrition, adequate rest, deep breathing, classical music therapy, avoidance of negative thinking, daily Bible reading, and as well as other lifestyle measures.
I will highlight several interventions in this article, but you can learn more at the residential Depression & Anxiety Recovery Program™ website. Remember, it takes time to notice the benefit of lifestyle change and interventions in improving depression. Even anti-depressants take up to three weeks to notice a difference; stick with the changes and you will begin to notice a change in how you feel.
Diet and Depression
Evidence clearly shows the relationship between diet and the treatment and prevention of mental health disorders, especially depression. Mental health is strongly and positively correlated with intake of whole grains, olive oil, vegetables, and fruit. More refined grains, sugar and meat are associated with an increased risk of depression. The incidence of both depression and anxiety has been found to be lower in vegetarians when compared to non-vegetarians, which is one reason why I promote a whole food, plant-based diet with my patients.
In 2017, dietary recommendations based on strong evidence from previous studies were published for preventing depression. The Nedley Depression & Anxiety Recovery Programs™ also support these recommendations:
Increase consumption of fruits, vegetables, legumes, nuts, seeds, and whole grains
Include a high consumption of omega-3 fatty acids
Replace unhealthy foods with wholesome, nutritious foods
Limit intake of processed-foods, fast food, and commercially baked goods, and sweets [i]
I want to briefly mention omega-3 fatty acids. Omega-3 fats are emerging as an important nutritional element in brain science. Inadequate omega-3 intake can cause nutritional deficits for the brain and mental capabilities. Due to the risk of biomagnification of toxins in fish, eating a plant-based source of omega-3 fatty acid is recommended, such as from ground flax seed or chia seeds, walnuts, or edamame. For those with depression, I recommend at least 9,000 mg of plant-based omega-3 foods or supplements per day. Depending on the particular symptoms of depression and anxiety, certain supplements may also greatly help.
As important as nutrition is in treating depression, my experience has demonstrated that in most people, other lifestyle treatments for depression are even more important. There are many safe lifestyle treatments that will benefit anyone who practices such an approach, whether or not they are depressed.
Analyze Your Thinking
One of these interventions utilized in the Depression & Anxiety Recovery Program™ is cognitive behavioral therapy (CBT). CBT is an evidence-based, structured psychotherapy effective in treating mental health disorders, such as depression and anxiety. This therapy aims at identifying and correcting erroneous interpretations of events and negative automatic thoughts that may initiate or perpetuate a depressed mood. CBT follows structured steps to change thoughts: If you change your thoughts, you will naturally change your emotions and behaviors. CBT helps develop awareness of triggers, self-talk or automatic thoughts, emotions, and behaviors, focuses on reframing negative automatic thoughts, and results in healthier ways to cope with life stressors. In fact, CBT is just as efficacious, if not more efficacious, in treating depression as drug medications. Learn more with Nedley Health about the steps of CBT, how to identify distorted and irrational thinking, and how to replace those thoughts with true, accurate, and helpful thoughts. I recommend Millie and Her Tangled Thoughts for children and The Lost Art of Thinking for adults.
I also emphasize avoiding negative thinking with my patients. I have found that many depressed patients have a tendency to look at the downside of life. We are all well aware that there will always be things in this imperfect world to complain about. Many of these negative events lie outside of our control. Focusing the mind on enjoying the wonderful blessings of life is not only uplifting, but also therapeutic. The human brain is both flexible and trainable and as rational, positive thoughts become habitual, depression will likely become a thing of the past.
Importance of Aerobic Exercise
It should not be surprising that exercise can help manage depression. Physical activity not only prevents depression but is also a good treatment for those who are depressed. Further, it is useful in treating other mental illnesses including episodes of anxiety, ongoing anxiety, and panic disorder. New evidence indicates that regular workouts may help soothe deep sadness as effectively as antidepressant medications. It is important for the depressed patient to realize that they likely will not feel any better after their first few exercise sessions. This is in contrast to those who are suffering from tension, anxiety anger, or fatigue. Exercise will tend to improve their symptoms even after the first session. In my experience, it takes at least a week of daily exercise before depressive symptoms begin to improve in most individuals. Once the symptoms begin to improve, they usually continue to gradually improve over the course of four to six months. I recommend spending 60 minutes each day engaged in aerobic exercise. Learn more about the benefits of exercise here.
Depression should not be tolerated as a lifelong condition with its miserable side effects. I encourage you to begin the process that will result in a lasting cure for depression. Countless people have found the way to lasting happiness and meaning by changing their lifestyle for the better. You can begin this journey by taking three steps: 1) analyze your life, 2) express a desire to change, and 3) exercise the courage to embark on a new plan for your life. Find the cause or causes of your depression, reverse as many changeable causes as possible through a program such as the community, online, or residential Depression & Anxiety Recovery Program™, that addresses nutrition, lifestyle, social factors, and a renewed spiritual life. “To be in health” means optimal physical, mental, social, and spiritual health. You can have genuine, invigorating health of body, mind, and soul.
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[i] Opie, R. S., Itsiopoulos, C., Parletta, N., Sanchez-Villegas, A., Akbaraly, T. N., Ruusunen, A., & Jacka, F. N. (2017). Dietary recommendations for the prevention of depression. Retrieved July 1, 2019
About the author
Neil Nedley, MD, is a practicing physician in internal medicine. He is the founder and medical director of the Nedley Depression and Anxiety Recovery Programs™. Dr. Nedley has presented and published numerous scientific studies in the medical literature and is well known internationally as a public speaker and teacher. He is author of Proof Positive, Depression—the Way Out, The Lost Art of Thinking, and Optimize Your Brain. Dr. Nedley and his wife Erica have four sons.