Not long ago, renowned integrative physician Dr. Andrew Weil noticed that “depression” had been the number-one search term on his website for the past few years. Weil, founder and director of the Arizona Center for Integrative Medicine at the University of Arizona and director of integrative health at Miraval Arizona, had himself struggled with mild-to-moderate depression until his mid-50s. In his new book, Spontaneous Happiness (Little, Brown, 2011), he outlines what was most effective at lifting his own depression.
Delicious Living: Are people more depressed now, or are they just searching for alternatives to conventional treatments for depression?
Dr. Weil: Although depression occurs everywhere, nowhere does it affect as many people as in affluent, technologically advanced countries. Life in the developed world has gone from hard and generally content to relatively easy and often depressed. We eat manufactured food, are largely sedentary, rarely venture outdoors, and are overwhelmed by an overload of information, stimulation and noise. We are also more isolated than ever before—even though contact is now just a mouse click away. The social isolation associated with modern day living is both a central symptom of depression and a factor that contributes to its development; spontaneous happiness is incompatible with social isolation.
DL: What other factors contribute most to common depression?
Dr. Weil: Prescription medication use is on the rise, and drugs such as sleep aids, anti-anxiety medications, pain relievers, and steroids can worsen mood. But I believe there is a darker association between pharmaceuticals and depression. I feel strongly that the medical-industrial complex has contributed significantly to the depression epidemic. We have been led to believe that ordinary emotional states, such as sadness or anxiety of any duration, are due to biochemical abnormalities that require treatment.
Consider instead that it may be normal, healthy, and even productive to experience mild to moderate depression from time to time as part of the human emotional spectrum, and that drug therapy might only be indicated when we get stuck in a particular mode for a prolonged period of time, or suffer from major depression. Pervasive marketing by the pharmaceutical industry has created the perception amongst doctors and patients alike that relief from any mood disturbance comes primarily in the form of a pill.
DL: What are your thoughts on antidepressants, pro and con?
Dr. Weil: The majority of conventional medical doctors believe that all emotional problems stem from imbalances in brain chemistry; thus their total commitment to drug therapy. It is likely that some cases of depression result from deficiencies or an excess of neurotransmitters such as serotonin, but it makes equal sense to suggest that mood disorders actually result in disordered brain biochemistry.
In my view, prescribing antidepressant drugs is too often a quick and easy substitute for developing treatment plans that address the totality of health concerns and lifestyle factors that impact health, including emotional wellness. Using the diagnosis of depression has become a common way to explain and manage the complaints of those with vague or confounding symptoms.
Although many treatment options exist for mild to moderate depression, people with major depressive disorders often benefit from conventional medical therapy. A 2010 study published in the Journal of the American Medical Association concluded that prescription antidepressants typically offer little relief for patients with mild or moderate depression, but may be of significant help to those experiencing very severe depression.
DL: Which actions were most effective in lifting your own mild depression?
Dr. Weil: A significant emotional shift in my life occurred when I learned to reinterpret rejections and criticism of my creative work as simple annoyances that should have no impact on my self-esteem. I began to consider negative reviews in a dispassionate way to see if anything useful could be gleaned from the comments. I also used to withdraw when depressed, thinking that my moods were to be endured alone and not inflicted on others. That way of thinking increased my tendency to be antisocial and isolated, and it increased depressive rumination.
Now I value my occasional periods of depressed mood as sources of intuitive knowledge and inspiration, even creative energy. I do not look forward to these times, of course; I simply accept them in a more positive light. I also remain socially active when depressed because my sense of contentment and balance return more quickly when I interact with my family and friends.
DL: For most people, healthy nutritional and lifestyle changes can be a great start. Which steps do you recommend most?
Dr. Weil: Of all the body interventions I recommend to help prevent and treat depression, the two I prescribe most often are regular physical activity and supplemental fish oil. Research asserts that moderate exercise, such as a brisk 30-minute walk each day, can help prevent depression and is as effective for the treatment of mild to moderate depression as antidepressant medication. People who are fit and exercise regularly have less inflammation than others, and inflammation appears to play a significant role in depression. People who walk outdoors get the added benefit of connecting with nature.
Most of us do not get enough omega-3 fats; both EPA and DHA reduce inflammation, may protect brain cells from injury and improve communications between them. I believe an adequate intake of omega-3s from diet and supplements can help move your emotional set point away from sadness and toward contentment.
General health recommendations can help optimize emotional as well as physical health. Don’t smoke, and if you do, quit; follow an anti-inflammatory diet that emphasizes a wide variety of brightly colored fruits and vegetables, cold water fish, plant-based protein, healthy fats and slow-digesting carbohydrates; avoid highly processed, manufactured and fast foods; supplement with a good multivitamin, vitamin D3 (2,000 IU daily), and fish oil (use molecularly distilled products and start with a combined dose of 2,000 mg of EPA and DHA); make clean water and green tea your beverages of choice; regularly practice healthy means of stress management such as breath work, laughter, and meditation; get at least 7 hours of sleep each night; and maintain a strong community of family and friends.
In addition, keep in mind that happiness does not depend on external factors; work to cultivate the kind of happiness that comes from within: Volunteer your time to help those less fortunate, practice forgiveness to calm your spirit, limit time spent on the Internet, and embrace an attitude of gratitude.