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One Doctor’s drugless prescription for depression

Clinical psychologist and University of Kansas professor Dr. Steve Ilardi
was interviewed for a story appearing in the Health and wellbeing section of the UK Guardian, How to beat depression—without drugs. Dr. Ilardi says antidepressants simply don’t work. I’m thinking maybe he’s skyping this message to the Guardian because perhaps the Brits are more receptive to this sort of thing than are Americans, the latter being so much under sway of pharmaceutical company advertising.

The programme has one glaring omission: anti-depressant medication. Because according to Ilardi, the drugs simply don’t work. “Meds have only around a 50% success rate,” he says. “Moreover, of the people who do improve, half experience a relapse. This lowers the recovery rate to only 25%. To make matters worse, the side effects often include emotional numbing, sexual dysfunction and weight gain.”

Uh, did you get that!? “To make matters worse [emphasis added], the side effects often include emotional numbing, sexual dysfunction and weight gain.” Indeed! So if the drugs do anything at all, they might numb you down, take away your mojo, and make you a candidate for being a contestant on the Biggest Loser television show. Depressing consequences, don’t you think?

As a respected clinical psychologist and university professor, Ilardi’s views are hard to dismiss. A research team at his workplace, the University of Kansas, has been testing his system – known as TLC (Therapeutic Lifestyle Change) – in clinical trials. The preliminary results show, he says, that every patient who put the full programme into practice got better.

100% of the patients in clinical trials improved using Dr. Ilardi’s system. Not bad!

His, the TLC, prescription formula involves utilising the 6 measures bulleted below:

▶Take 1,500mg of omega-3 daily (in the form of fish oil capsules), with a multivitamin and 500mg vitamin C.
▶ Don’t dwell on negative thoughts – instead of ruminating start an activity; even conversation counts.
▶ Exercise for 90 minutes a week.
▶ Get 15-30 minutes of sunlight each morning in the summer. In the winter, consider using a lightbox.
▶ Be sociable.
▶ Get eight hours of sleep

All psychiatrists and mental health workers have to do is to pay attention to the evidense, that is, to the results of clinical trials such as those conducted by the University of Kansas. I get the impression that there is not enough of that paying attention to the evidense going on these days.

6 Responses

  1. And for the many people this regimen does not work for, what do you suggest?

    Are you suggesting that there is no place for medication? Or that it is over prescribed?

    Many people spend years trying talk and light therapy, exercise, lifestyle changes, diet and supplements to no avail. By adding medication to the program a lot of good can be gained.

    • The passage of time can work wonders. I don’t have all the answers. You have to find those for yourself. Ditto “the many people”. According to “clinical trials”, Therapeutic Lifestyle Change works much better for many more people than do psych drugs with their, as you should have noted above, 75% failure rate.

      TLC is Dr. Steve Ilardi and U of Kansas associates approach to the “major depressive disorder” label. I’m not saying it’s the best way, or that it’s the only way. I’m just saying it’s a way, and I’m only the messager.

      I wouldn’t say there is no place for psych drugs. I would say there is no place for them in my life. If you think they work well for you, well, that’s you. They don’t necessarily work for everyone. They don’t work for me. I would prefer to face my own demons with my own raw emotions unmasked by any chemical agents.

      The biggest problem with many of these psych drugs is that much of the testing, primarily done by drug companies, only covers the short term. Some psych drugs have been shown to be helpful in the short term. When you look at the long term effects of these psych drugs, the situation grows more grim, and they are much less likely to be seen as leading to a positive outcome.

      Adding psych drugs to the program may help some people. I wouldn’t though like to see any more people maintained on such drugs for the duration of their lives. I think these chemical compounds should be used, if they are to be used at all, in reasonable dosages, and the object should be eventual withdrawal. Reliance on a chemical compound is not self reliance. Drug maintenance, is never, after all, complete recovery of emotional stability.

  2. This is junk science hiding behind a social agenda. The “evidence” Ilardi presents is actually even less compelling than some of the flawed studies the pharmaceutical companies used to justify their drugs. So I am to take the pitch of one snake oil (or this case, fish oil) salesman as evidence against other supposed snake oil salesmen?

    I am not saying I am sure that Ilardi’s treatment doesn’t work, but it is hardly “ignoring evidence” to reject a doctor who calls his treatment a “cure” with no basis for doing so, and recommends using fish oil as a treatment without any study demonstrating actual efficacy. This isn’t depression treatment, it’s depression denial.

    Mindfreevirginia, based on some of your previous posts, I suspect the less said between us, the better. But to acknowledge that drugs may help some people and then say you “would prefer to face [your] own demons with [your] own raw emotions unmasked by any chemical agents” states pretty clearly (and with a smug self-superiority) your belief that depression can (and perhaps should) be overcome through force of will. Feel the same way about a diabetic controlling their blood glucose level? No, that’s physical. Yeah, well, so is the brain.

    And proclaiming that depression meds “mask raw emotions?” Kinda the way insulin “masks” a person’s inability to regulate their blood glucose levels, or the way crutches “mask” a person’s “raw” compound fracture? Just because depression occurs in a part of the body we don’t understand as well as we do bones and blood doesn’t mean that problems that occur in the brain are “demons.”

    “Self reliance” doesn’t work so well when the “self” is damaged. And for those people for whom “self reliance” results in suicide, I guess we’re just thinning the herd? The fact that they may actually have several parts of their brain malfunctioning and causing severe emotional trauma and cognitive impairment is irrelevant, to you I guess, because there is no blood test for it. Leeches, anyone?

    • Obviously we have a difference of opinion here. I don’t think any University in the country, let alone the University of Kansas, would put up with a Professor proven to be a quack or a confidense man. Making the allegation then that Professor Ilardi is practicing junk science just doesn’t make it so. When you have a failure rate approaching 75% with conventional treatment for depression using psychiatric drugs, I think perhaps the time has come to look for a method that might work instead.

      Depression was once not the chronic condition that it is seen as being today. This is to say that there was once a time when complete recovery from clinical depression was a commonplace phenomenom. This was before, of course, the development of SSRI antidepressant drugs to treat the condition. The fact is that these antidepressant drugs may have a great deal to do with why depression has come to be seen as a lifelong condition. When these drugs work little better than a sugar pill, the much touted placebo effect, what other conclusion is to be drawn?

      I have seen a study with results that showed physical exercise worked better than antidepressants alone, and antidepressants with physical exercise, in alleviating depression. Hmmm. Curious, wouldn’t you say? Maybe this depression business has a little bit more to do with lifestyle issues than it has to do with physiological disease, or genetic predisposition. We shouldn’t pretend like the issue has been resolved when it simply hasn’t been resolved. People being different, we can’t draw the same conclusion for everybody that has developed the blues either for that matter.

      Most people are pretty resilient, and able to bounce back when misfortune strikes home. When people haven’t developed this ability to bounce back, we have to ask why this is so, but we don’t have to automatically assume that there is something intrinsically different about them, or innately “wrong” with them. We are, after all, united by species specific traits. By making such an assumption we could be “throwing out the baby with the bathwater” as I think I have heard you put it at another time. Is it better to have “wrong” genes, or merely to be less skilled in certain areas? You tell me. As far as I’m concerned, I think there is less difference between any two people than there is between any one person and a chimpanzee let us say. If this difference is so slight, maybe a few of these people who are so down on themselves, can bounce back, and be up on themselves, without being resigned to a lifetime regimen of pill taking.

  3. Hey, I’ve tried countless depression meds and only a few have every helped, so I am hardly advocating that pills are the answer. And no doubt the focus on SSRIs has stunted development of other avenues of treatment. As one researcher said, SSRIs are about as advanced as trying to top off a patient who seems to be a quart low on serotonin. And my assessment of Dr. Ilardi’s treatment is as much based on the lack of repeatable successes by other clinicians at other universities using the same protocol. So far as I am aware, only his team has had success with it. Taking that limited success and touting it as a cure smacks of junk science. That it is being done at a major university proves nothing. After all, weren’t all those depression meds based on the research from some prestigious university also?

    I’ve seen the same studies with respect to exercise. And I myself have suggested that depression is poorly defined as an illness. We ask what is wrong with people who appear to lack resiliency for the same reason we try to resuscitate a person having a heart attack. Your logic suggests that we shouldn’t be too quick to label differences as flaws. I agree. We are trying to alleviate severe pain and suffering here, not sever people from their personalities. Perhaps you’ve seen instances where that is exactly what psychiatric science has tried to do. All science can be misused. That is not an argument against further research.

    And I think we have to get past the “feeling blue” crap. That is not what depression is. No matter how lacking the definition for depression may be, that ain’t it. I didn’t suffer some personal setback and go into a funk. This is a pain I’ve known most of my life — even before I knew what “depression” was. Losing the will to live is not merely “my personality.” And overcoming that, such as I have, required a realization that my brain is malfunctioning. Life would be easier if the tool I used to try to understand my affliction wasn’t also the source of that affliction, trust me.

    The worst part of your argument, however, is your willingness to embrace pills for other “real” afflictions, like taking a pill for Malaria. Or do you think we should allow people who have heart disease to die? How about diabetes? Hey, if your body can’t regulate your blood glucose level, who’s to say that’s “wrong” or “bad?” It’s just different. Parsing definitions and drawing a line between “different” and “sick” is difficult and it will continue to raise huge ethical and philosophical issues. I am not convinced that is the meat of your argument, though.

    Mine is clearly wasted breath. You’ve made up your mind that I am not sick. Whether you view me as weak or a liar is another matter. I’d hope you’d least entertain the possibility that my inability to vigorously exercise away my blues may not be a character flaw. And as for “lifestyle” change as treatment. Lifestyle is a component in almost every illness. When you start advocating denying angioplasty for people who’ve eaten too many cheeseburgers, then I will respect that you’ve at least made a consistent argument. A reprehensible one. But consistent, nonetheless.

    • 1. I am not against the use of pills in treating physical afflictions. Malaria, diabetes, etc. Nor am I against angioplasty for people who have eaten too many cheeseburgers as you so succinctly put it.

      2. If you’d really lost the will to live, you are under no obligation to live. You can take your own life, and nobody can prevent you from doing so. Should you fail at taking your life, you are likely to spend a little time on the psycho ward. Should you confess to losing your will to live, perhaps some portion of your being still desires to live. Confession, as well as failure, can get you put on the psych ward in such a case.

      3. I can’t speak for you. You do that pretty well for yourself. I can speak for myself. I have no oppressive depression, and so I would have no need for antidepressants even if they did work. I have had all sorts of psychiatrists come up with all sorts of labels for what they thought was “wrong” with me. Some of these doctors would see depression as the root cause for any other label they would come up with. They needn’t have bothered to do so. I’m not depressed.

      4. I think that when the number of people on antidepressant drugs in the USA approaches 10% that something is dreadfully wrong. Way too many people are being labeled ‘sick’, and being put on these psychiatric drugs. I feel that putting people on these drugs is a way for the psychiatric business to try to look more legit than it actually is, and for the drug companies to profit at other peoples expense and misery. That is my opinion, and I’m sticking to it. Although that is my opinion, I am no idealogue. I welcome difference of opinion, discourse, and debate.

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