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Archive for the ‘Depression’ Category

Having suffered from depression in my early twenties and having since found ways to fight it, I feel that the above book is well worth a read for its inventive use of evolutionary psychology to fight depression. Although it provides some very good advice, my main qualm is that it fails to provide much enough information on existential crises as a cause of depression. For this reason, although I think that the advice is sound, I would also combine it with theories brought to light in Frankl’s ‘Logotherapy’ or Camus’ The Myth of Sisyphus (providing that you also are seeking some sort of meaning to your life). I have outlined the main tenets of the book below, followed by a short critique.

 

What is depression?

Depression is a word bandied about a lot nowadays, and may be incorrectly used by someone who is just a bit down. In technical language, depression is called a ‘major depressive episode’. According to the criteria laid out in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV) (apparently frequently used by those working in the mental health field), the diagnostic criteria are the following (excerpt taken from Iliardi’s book).

There are nine core diagnostic symptoms:

1. Depressed mood

2. Loss of interest or pleasure in all (or nearly all) activities

3. A large increase or decrease in appetite/weight

4. Insomnia or hypersomnia (greatly increased sleep)

5. Slowing of physical movements, or severe agitation

6. Intense fatigue

7. Excessive feelings of guilt or worthlessness

8. Difficulty concentrating or making decisions

9. Frequent thoughts of death, or suicidality

 

A diagnosis requires at least five of these hallmark symptoms to be present most of the day, nearly every day, for two weeks or more.

These core symptoms also have to cause functional impairment or severe distress.

 

What causes depression?

Ilardi blames much of depression today on our maladaptation to the modern environment. Humans adapted to be successful in the EEA (Environment of Evolutionary Adaptedness) and have not had time to evolve to fit the modern environment (the development of modern, settled societies happened relatively quickly when compared to a human evolutionary timescale).

According to Ilardi’s book, the human body was never designed for the post-modern industrial environment. This is demonstrated by cross-cultural studies that show an increased rate of depression in more ‘modern’ societies. Until about 12,000 years ago – when people invented farming and began domesticating livestock – everyone on the planet made their living by hunting and foraging for food. People lived as hunter-gatherers for the vast majority of human history.

An example of our maladaption to our modern environment is provided by the obesity epidemic. Our hunter-gatherer ancestors faced a fluctuating, seasonal food supply – with the prospect of hunger and starvation around the corner. It therefore made sense for them to crave sweets, starches and fatty foods, and to binge whenever those rare fatty foods were on hand. Now that high calorie foods have become available 24/7 it has caused no end of trouble. In addition, as we take less exercise than we once did, we tend to burn off fewer calories – hence lots of overweight people.

 

Ilardi’s Six Step Cure

Many of the features found in the EEA (the environment that humans evolved in) are not present in modern society. Iliad has identified a number of these features (which tend also to be found in modern day tribes who experience little depression) and suggests that we incorporate them into our lives as a preventative measure against depression.

The features are as follows:

  • Dietary omega-3 fatty acids
  • Engaging activity
  • Physical exercise
  • Sunlight exposure
  • Social support
  • Sleep

Fat molecules play an essential role in the construction of brain cells and the insulation of nerve fibres. However, whilst the body can make of many these fat molecules that it needs, it is unable to make some that it requires, and we must therefore obtain the remainder from our diet. One of the most important of these fats is omega-3 fatty acids. These are found in fish, wild-game, nuts, seeds and leafy vegetables. Unfortunately, these have gradually disappeared from the American diet over the past century. For example, much of the beef, cattle and fish are mostly grain fed today and therefore have little omega-3 content. Countries with the highest levels of omega-3 consumption typically have the lowest rates of depression.

Depressed patients tend to ruminate (dwelling on negative thoughts, turning them over in your mind) for hours each day. People only ruminate when they have free time on their hands, when their minds aren’t occupied with some reasonably engaging activity. The biggest risk factor for rumination is simply spending time alone. When you’re interacting with another person, your mind doesn’t have a chance to dwell on repetitive negative thoughts.

Exercise changes the brain. It increases the activity level of important brain chemicals such as dopamine and serotonin. Exercise also increases the brain’s production of a key growth hormone BDNF. Because levels of this hormone plummet in depression, some parts of the brain start to shrink over time, and learning and memory are impaired. But exercise reverses this trend, protecting the brain in a way nothing else can.

Sunlight is important because the brain gauges the amount of light you get each day and uses that information to reset your body clock. Without enough light exposure, the body clock eventually gets out of sync, and when that happens, it throws off important circadian rhythms that regulate energy, sleep, appetite and hormone levels – these disruptions can trigger depression.

We spend much less time than previous generations interacting with our friends, neighbours and extended family. Technology has promoted our increasing social isolation. Many are oblivious to the social world around them as they march along to the beat of an iPod.

After a few nights of poor sleep, people tend to get cranky. When sleep deprivation continues for a long time it can lead to health problems. We certainly average less sleep than our forbearers, having to deal with the stresses of work, the permanent twilight of modern cities, distractions from nightlife to television and, in general, less physical tiredness. Sleep is therefore a vital part of the 6 step programme.

 

My Take on the Programme

In my opinion, the programme is remarkably effective, and makes a lot of sense. In my experience, most difficult thing about depression is that one normally lacks motivation to do anything. A slight encouragement from a friend or family member wouldn’t go amiss here. However, once that first step has been taken it becomes much easier. For example, going on a bike ride or going for a jog should help to improve your mood (exercise and sunlight); in addition, it can bring you into closer contact with nature which some studies have shown to be beneficial.

Look back on my time with depression, I can see many of the problems that I faced at the time. For me, the principal cause was social anxiety, which lead to me to be incredibly reclusive and cut off from the rest of the world socially. In addition, I lacked the motivation to get exercise and my diet was appalling.

Currently, although I haven’t implemented all of the steps of the programme, I have made a number of improvements. I force myself to get some exercise 5 days a week, normally jogging in the park but also cycling, climbing and kayaking. This not only helps to keep my body healthy, it also improves my mood. In addition, most of the activities take place outside, providing me with my daily dose of sunlight! I would also suggest that enough physical exercise improves sleep at night, as your body is physically exhausted.

Socially, whilst I am never going to turn into some sort of extrovert (being an INTP), I tend to meet regularly with people to practice my French and Chinese. Again, forcing oneself to meet these commitments is well worthwhile. There are many times when I wish to cancel a meetup but I know that if I do so I will probably end up ruminating and feeling isolated due to lack of social contact!

Food-wise, I tend to eat quite healthily, avoiding fast food as well as sweets/desserts in general. The only part of the programme that I fall short on is the intake of omega 3 fatty acids.

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