The Depression Cure: The 6-Step Program to Beat Depression without Drugs

by Stephen S. Ilardi

Based on the highly effective, proven Therapeutic Lifestyle Change (TLC) a practical plan for natural ways to treat depression -- without medicationIn the past decade, depression rates have skyrocketed, and one in four Americans suffer from major depression at some point in their lives. Where have we gone wrong? Dr. Stephen Ilardi sheds light on our current predicament and reminds us that our bodies were never designed for the sleep-deprived, poorly nourished, frenzied pace of twenty-first century life. Inspired by the extraordinary resilience of aboriginal groups like the Kaluli of Papua New Guinea, Dr. Ilardi prescribes an easy-to-follow, clinically proven program that harks back to what our bodies were originally made for and what they continue to need with these six FoodDon't Think, DoAntidepressant ExerciseLet There Be LightGet ConnectedHabits of Healthy SleepThe Depression Cure's holistic approach has been met with great success rates, helping even those who have failed to respond to traditional medications. For anyone looking to supplement their treatment, The Depression Cure offers hope and a practical path to wellness for anyone.

Genres: Self Help, Nonfiction, Psychology, Health, Mental Health, Audiobook, Science

310 pages, Kindle Edition

First published July 6, 2010

About the author

Stephen Ilardi received his Ph.D. in clinical psychology from Duke University, and has spent the past two decades as an active researcher, university professor, and clinician. He has treated several hundred patients suffering from depressive illness and other serious disorders, and has authored over 40 scholarly articles and papers on mental illness.

Over the past six years, Dr. Ilardi and his clinical research team have developed and refined a new, highly effective program for clinical depression: Therapeutic Lifestyle Change (TLC). This innovative treatment is grounded in the insight that human beings were never designed for the sedentary, indoor, socially isolated, sleep-deprived, fast-food-laden, frenzied pace of 21st-century American life. Understanding the modern depression epidemic as the result of our increasingly toxic lifestyle, Dr. Ilardi has helped numerous depressed individuals overcome the debilitating illness by reclaiming six powerful healing habits from our ancestral past. Inspired by the program's success - even in cases of chronic, severe depression that failed to respond to antidepressant medication - Dr. Ilardi has written "The Depression Cure," a step-by-step guide to the Therapeutic Lifestyle Change program.

Reviews

[Mikey · Rating 2 out of 5]

This book is really one big ad for buying fish oil.

It’s 6 common sense rules to getting over depression are:

1. Get 10-30 minutes of sunlight
2. Exercise
3. Social Support...aka make friends (easier said than done)
4. 7-8 hours of sleep
5. Positive thoughts
6. Omega 3 fish oil supplements

That’s pretty much it. I just saved you from reading this book.

You’re welcome.

[Thomas · Rating 4 out of 5]

The Depression Cure offers six practical steps to fighting depression through Stephen S. Ilardi's program Therapeutic Lifestyle Change (TLC). The six components of TLC are:
- dietary omega-3 fatty acids
- engaging activity
- physical exercise
- sunlight exposure
- social support
- sleep

Most of the things above one can garner from common sense, which is why I relished reading The Depression Cure. As someone who suffers from mild depression every now and then I can say that exercise, getting enough sleep, and having a social support system are all invaluable to maintaining a happy mindset. I'm already implementing some of Ilardi's suggestions and considering utilizing more of them.

However, though the writing in this book is simple and Ilardi's attitude pragmatic, I feel like people suffering from severe depression will be overwhelmed by TLC. Even I hesitate to obtain the omega-3 supplements or purchase the artificial light recommended by Ilardi.

This book will benefit people who are willing to take the steps to ensure their recovery, but I don't recommend it to those ensconced completely by the disease or those who view depression with skepticism.

More information on depression here.

*cross-posted from my blog, the quiet voice.

[The Angry Lawn Gnome]

That question, "What did you think?," that shows up at the top of each review. I had never given it much in the way of consideration until I read through this work. For the simple reason that I am unsure what to think about the work in its totality. But this sense only comes from averaging my feelings: I found certain passages sensible, certain parts worthy of further consideration, and certain sections grit-my-teeth stupid, patronizing, annoying, and written in a tone that only a True Believer can bring forth.

Thus, I record my thoughts of the book, but leave the "rating" area blank. Averaging the entire work to a 3 simply would not be a fair reflection of my thoughts.

A great deal of what is contained in Ilardi's program is simple common sense: eat a reasonable diet, get enough sleep each night and get exercise of some sort on a regular basis. Who can argue with that? Moreover, wasn't it Benjamin Franklin who commented that there is nothing less common than common sense? Meaning, you can "know" something to be true, and still not do it. And in Ilardi's program he at least attempts not only a reminder, but build a mental structure to facilitate all of the above.

I'm no expert-- to put it mildly -- to form any sort of opinion on the question of the dietary supplements he recommends, from fish oil to vitamins. Can't see where the fish oil would hurt (other than going down, Ick), but he also seems to be pushing some very high dosages of things like Vitamin D, some other things, to the point where I'd personally not rely just upon his word as final.

Ditto the business of the "light machines" to reduce the affects of Seasonal Affective Disorder. I know I've read something somewhere that says pretty much the opposite of what he does: these things don't work, they're junk. Most likely harmless junk, but again I'd want verification from another source before I even considered buying one.

And now where I think he falls off a cliff: his "anti-rumination" claims, and his requirement for socialization. Ilardi seems to glibly assume that human beings are as fungible as lima beans when it comes to the desire for contact with others, and that somehow this lack of contact contributes to depression. No evidence is offered, either as proof of the first claim or that his conclusion arises from the assumed premise. The anti-rumination business I can sort of see, but I just don't buy that it is as important as he makes it out to be. Heck, he pushes a flavor of Behavioral Therapy himself, which I can only take to mean you work through your depression via action, not thoughts.

As best I can tell both claims are unproven, and both seem pushed with an almost religious fervor. Perhaps Ilardi is saying something via his method of presentation on these two topics? Certainly the comparison between modern society and hunter-gatherer groups was silly, even though I've been told that recently the idea that most members of such groups being dead around age 30 has come under fire, it is as much a matter of debate than anything else.

Finally, why a silly acronym like "TLC?" Ouch.

[Jessica · Rating 5 out of 5]

This book is a miracle, and I cannot enthusiastically recommend it enough. As someone who has suffered from depression for my entire life, with varying degrees of severity, I have tried endless methods of treatment. Medication has worked and been a blessing to many who suffer from this debilitating disease, but it has never worked for me. I have tried many different medications on many different doses, and most have never brought even the slightest degree of relief. Years of trial-and-error experimenting with medication- all with inevitable failure- is more demoralizing and soul-crushing than I can possibly describe- talk about feeding a sense of absolute despair and hopelessness of ever finding recovery or relief.

So at my therapist’s suggestion, I began reading The Depression Cure. Backed by an immense amount of study and clinical research, Dr. Stephen Ilardi created a six-step program that provides, in his words, the most promising treatment for depression he’s witnessed in his entire career of clinical research and practice. Each of the six key elements he suggests- sufficient omega-3 fatty acids, sunlight exposure, sleep, physical exercise, social connections, and engaging activity (to avoid rumination) have been clinically shown *on their own* to be as effective at treating depression as medication. All together, they form a program that (as my therapist says) kicks depression in the ass.

All of the suggestions Ilardi makes seem like common sense on the surface, but the book illuminates the incredible science behind each method and explains HOW they are to be effectively implemented in our lives (some of which are not as straight forward as they would appear, especially regarding the necessity of high-quality, molecular distilled omega-3s in the correct dosage (drug-store varieties are often far too low in dosage, not molecularly distilled, and filled with toxins)).

They’re major lifestyle changes I’ve been trying to incorporate into my daily routine for the last several weeks. My depression is not gone (not even close), but for the first time in a VERY long time, I am beginning to feel improvement, something which I hope continues to grow as I progress and keep up with the treatment.

Ilardi’s research has provided so many insights and such much more understanding to a disease I’ve suffered with for years. Basically, the structure of modern society is a cluster**** for the human mind and body. Human bodies are still evolutionarily adapted for the environment of ancient hunting and gathering. For those of us biologically and environmentally more susceptible to depression, this means that we have to put far more effort and concentration into our diet and daily activities than most other people do. It’s work. It’s hard. It’s unfair, even. But the science behind this shows that it works, and anecdotally speaking, I’m beginning to see that as well.

5/5 stars

[Dan Martinez · Rating 4 out of 5]

Despite its somewhat brazen title, this book’s body is thoughtful and reasonable, backed by detailed notes and a substantive bibliography.

It’s also not merely of interest to those grappling with depression: it has a number of eye-opening things to say about general self-care, particularly nutrition. (Executive summary: agricultural industrialization has had a number of interesting side effects: some obvious, some less so; some beneficial, some less so.) Ilardi isn’t the first to point these things out, and indeed he notes that Michael Pollan documented a notable case study, but he does do an excellent job of focusing on the neurological, and attendant psychological, implications.

[Russ Smith · Rating 4 out of 5]

Initial thoughts: Don't really like the table of contents, chapters aren't clearly indicated, it shows 'Parts" 1, 2, 3, etc. Then CHapters, but then also shows sections within those chapters, just too much info going on. I like a clean TOC.

Chapter 1. The epidemic and the cure. Good read. Introduces the idea that our ancient ancestors (hunter-gatherer types) didn't have as much depression because their lives had more of the basic needs of humans (fatty omega 3, sun light, exercise, etc. Chapter 1, basically introduces the '6 needs' of the life style change, that will cure depression. (sun light, exercies, human interaction, etc)

Chapter 2. Making sense of depression. Basically talks about it's origin, where it comes from, who's most likely to get it. 40% of likely based on genes. Other contributing factors: our life style (social, abused, etc.). He breaks up life style, by looking at social, abuse, exercise, thoughts. Also partly based on our gender. 3 things. 2 we can't control: Genes, Gender, and 1 we can: lifestyle. Either way, we have to play with the cards we are delt, and tools to overcome depression are what the rest of the book is about.

Chapter 3. Treating Depression. List of possible treatments, their clinical testing, their validity, success rate, etc. Interesting to note how much attention goes to drug therapy. Because there is money to be made by drug manufactures, there's a lot of attention, research and development going towards medication, but research shows least effective. Goes through various methods: medication, 'Couch' - sitting with counselor rehashing deep dark, childhood, cognative therapy - seeking to not ruminate, but keep active, and therefore mind focused on other, more productive things, etc. Finally brings up his method, which is life style, which is implementing the 6 'cures' into your lifestyle.

Chapter 4. Fish Oil. Good chapter on the antidepressant: Omega-3 Fat. Which is found in fish oil. He recommends fish oil capsule a day. Lots of good information, sometimes too much info on the molecular blah blah, and how it effects the brain. Sometimes it seems like marketing mumbo jumbo, but i do believe our bodies are mostly the same as they were for the hunter/gatherer generations. Since we are mostly sedentary now, we need to supplement and help our bodies maintain what they used to be in the hunter/gatherer era, when many were active, and ate food rich in Omega-3 (fish, grass feed beef, etc.)

Chapter 5. Rumination. I found this to be one of the most helpful chapters so far. The idea of rumination, and overcoming the habit of thinking too much, is something i've struggled with a long, long time. This for me, could be one of the most valuable chapters in the book. Should probably read this chapter again.

Chapter 6. Exercise. Nothing earth shattering here, or even overly helpful, since I already excersize regularly. A couple good points: STarting is the most difficult - if you have someone hold you accountable, just have them ask you if you started. That's the most difficult part, and 90% most important part. Most everyone, once they get started, and pretty easily keep going for a little while, but that first step, those first moments when you need to decide to start, and then physically start doing something are the most difficult, and most important. Also some good stats on how long to work out, target heart rate, etc. Another interesting note is that exercise has shown in studies to be more effect (especially when looked at long term) than medication.

Chapter 7. Sun Exposure. Actually found some interesting information here. First being that i never really thought about the fact that our Ancient hunter/gatherer ancestors were outside 24/7, all the time, so our bodies, and eyes are used to lots of light, and need it. Helps mental health. Most of the chapter I didn't find enormously helpful, as living in socal, i'm pretty sure i get enough sun light. But it does help explain why I enjoy so much sitting outside at restaurants, or going hiking, or doing things out side. It's as if, my ancestor self really enjoys that stuff. Also good to remember to work at getting out at least a little each day. Current lifestyle is so indoors, how many people spend almost, if not completely all of their day in doors (home, car, work, car, home). But, the research show, that typically, a fair skinned person like me, would get enough Vitamin D, being outside for 2 minutes on a sunny day in Miami. Which is not too far off from my current life style, so I think i'm doing pretty ok with it, but really interesting stuff in the early chapter talking about how our ancient ancestors spent time outside, and how we might instinctively enjoy being out doors (hiking, eating outside), instant mood booster.

Chapter 8. Relationships . Pretty good chapter. I wish it woudl address more specifically introverted people like myself who have an especially hard time connecting with people. Some good information about where to find community, he recommends a church with less than 200 people, or a heavy emphasis on small groups - neither of which i've found at cottonwood, and something that's bothered me, almost from the beginning. I may have to seek out another church, that is either smaller, or with a large emphasis on small groups, the sense of community is really lacking in our lives, and i feel it. Somewhere in the back of my mind is a desire to walk to the store, and see people I know, to refer by name to the people i see on a daily basis, to 'know' and engage with more people, and to feel a stronger sense of community.

There's some good info on vocal rumination, and not letting talking with friends become airing of greivenses. Ultimately it's this, upbeat people = talk or activity. Depressed people = activity (do something like workout, walk, basketball game, etc.)

Good point that the western world is more focused on things, than people, and this has lead to more engagement with things and work, than with people and community.

Chapter 9, Sleeping. Interesting chapter, some good advice on how to get better sleep. (list of good habits). Kind of felt more like a blog post though than a book chapter. But I didn't expect much more from a chapter based on getting good sleep. He does mention almost all his depressed patients had issues with sleeping, which i thought was interesting. Interesting to see the strong correlation between depression and sleep. But most info i had expected, or heard before.

Chapter 10. Summary. This chapter basically puts all the steps together in an 8 week program, implementing little by little, starting with the easiest (supplements). Pretty decent chapter, although, I don't know how practical it is for me personally. It seems that 90% of my stress/depression comes from work, and my lack of it, or lack of motivation for it. I put things off, which causes stress and depression, which causes a spiral down more stress and more depression. Some good suggestions on overcoming rumination, (or at least fighting it). There are several references to getting your stress meter (see Appendix A) down below 10. Also some good information on stress management. Ironically mentions how moving, can sometimes seem easy, but cause a lot of unforeseen stress when all the friends and loved ones are suddenly not there.

Chapter 11. Navigating road blocks, and final word Some good suggestions on finding people to help you. What to do if the life style changed don't work exactly. Some recommendations on clinical psychologists, and resources on finding them. I like his advice on how to find out who you 'click' with, and that you'll know that with in 1 or 2 meetings, so it's best if you don't click pretty soon, to just move on to the next one. It's natural to click with some, and not with others, and obviously you'll want to find someone you click with. Some good info on taking TLC to the next level, more exercise, more Omega-3, less sugar. Good bit on the sugar epidemic in America. Staggeringly grim. eat more meat, work to reduce stress (either remove, or learn ways to cope). Good final word, which is something i'll take from the book definitely, "we were never designed for the sedentary, socially isolated, sleep-deprived, poorly nourished, indoor, frenetic pace of modern American life." Basically, our bodies and minds are more or less the same as they were 5,000 years ago, yet lifestyle has changed rapidly, and in large part negatively.

[Flarne · Rating 4 out of 5]

Lots of researches went into this but they’re deliver in a simple and effective way... the same way this program is purposefully trimmed down to be realistically achievable to the audience intended and I think this is a really good thing!


I’d doubt anyone would have any lingering questions about anything here cause the author is just so thorough in all of our issues, their origins and ways to battle them ..

+there’s lots of real life examples here by his patients _ -even if you’re not that depressed- ou’d relate to a lot of those.

Also, it’d help u become an overall more energetic and productive person I believe. So I highly recommend to everyone.

[Evan · Rating 3 out of 5]

Important disclaimer: both the author, Dr. Ilardi, and I both believe that depression isn't something that can ever be entirely cured. The title is more clickbait than anything, which I'm not a huge fan of, but it serves its purpose of capturing the readers attention. As Dr. Ilardi explains, while depression can't be cured, it can be sent into remission, meaning the severity of the symptoms can be greatly reduced.

That being said, I think Dr. Ilardi has a very solid book here. I really appreciated his scientific approach to everything, and it was evident that he clearly put a lot of research into his work. All of his points were very clearly stated and supported, and I understood the reasoning behind each of his recommendations. I'm glad he actually did research on his recommendations too, safely carrying out trials on patients, nearly all of whom saw improvement (though, it must be kept in mind, this is only one doctor and more testing is likely needed). I feel that many similar books that have been recommended to have have been more along the lines of "just stop thinking negatively, snap out of it, be grateful, etc," this book actually gives practical advice which I really appreciate. Will definitely be trying to put some of Dr. Ilardi's recommendations into practice.

[Marla · Rating 4 out of 5]

Is there ground-breaking, new information here? No. However, Ilardi takes a look at things through the lens how how we used to live - hunger/gatherers. To me, this was a helpful approach as it shone a light on why some of these things make as big a difference as they do. And why depression has been climbing at alarming rates in the 20th and 21st centuries. Because our way of life is exponentially different, but there are things we can do to help combat the affects of those changes.

Do I buy into, whole-heartedly, everything in this book. Again, no. But, I appreciate the way Ilardi offers options, the changes he's seen in his patients who tried it, and never falls back on absolutes. He remains even and fair throughout, acknowledging that we will all deal with the pitfalls of depression differently and that we all have different reasons (even medically induced) for falling into depression.

I plan to keep this one on my shelf and continually go back to it as I struggle and even when I'm not. There are good options here and it can be truly hard to remember to do some of the things folks call "common sense" when you're in the throws of a depressive episode.

[Carol · Rating 3 out of 5]

Over the last 10 years my daughter has suffered from depression. She has been to multiple doctors, outpatient programs including the infamous IOL (Institute of Living) and is no better than when it all began. So why not try the 6 steps this doctor offers in this book?
The 6 steps:
1. dietary omega-3 fatty acids
2. engaging activity
3. physical activity
4. sunlight exposure
5. social support
6. sleep

[Brianna Petersheim · Rating 2 out of 5]

I liked the concepts, but didn’t necessarily appreciate the way it was written. It felt a bit oversimplified and lacking compassion.

[Chrisanne · Rating 4 out of 5]

I called up my insurance to get a preauth for my yearly therapy appointment and the lady who answered the phone tried to convince me to switch to a different clinic.

"They're the number one in the state at diagnosing depression!" she said.

I almost died. It was the first time I had laughed in weeks.

That is a huge red flag. What you really want and should always be asking from your physicians is the odds of complete healing, whenever a procedure or treatment plan is recommended. At the risk of sounding like a broken record: Search for side-effects, take that to your doctor, ask if they've seen any of those effects, how often. Ask them what the worst thing was that ever happened to a patient of theirs during the treatment or surgery. Assume it will happen to you and ask what would be done in that situation. Do it in person so you can see their expressions. And I know that from personal experience.

So I went to my psychologist and we talked about my problems and, after giving me a bit of homework, he reminded me that medication was an option. Per usual, I said I'd rather go as long as possible without it. So he suggested this book.

Other readers have suggested it's similar to Lost Connections. It is. In some ways it's superior to Hari's book because it's got the benefit of Ilardi's PhD and more specific studies, as well as clinical observations. Don't settle for bandaids. I also liked his point about ruminating. Too many professionals make that easier instead of harder. I know someone who's been paying a "professional" to listen to them ruminate for a long time. Unsurprisingly, it hasn't made much of a difference.

But, as I've stated in other reviews, this book struggles like the typical therapists' book touting their new breakthrough(though it's much better because it's based on legitimate studies). The patients are all educated and can afford the regular visits. Hari's book, on the other hand, really illustrates the way that it hits the vulnerable groups the hardest. So I think they both add value.

[Dat Huynh · Rating 4 out of 5]

Lots of practical things that one can do to help beat depression or live an anti-depression lifestyle. Good for all people even without depression. May be hard to implement if you have depression and no one in your life to encourage you to do these things or if you're too depressed to want to improve your life. Good luck to anyone who reads this and needs help. You've made this day special by just your being you. There's no person in the whole world like you. And I like you just the way you are.

[Justin · Rating 5 out of 5]

Fantastic book for those who either suffer directly from depression or love someone who does - which probably covers most of us. Ilardi pulls together the latest research from several fields to create a very practical, common sense strategy for beating the often devastating effects of depression.

[Mèo lười · Rating 3 out of 5]

Có nhiều thông tin hữu ích nhưng hầu hết khá quen thuộc, tác giả chỉ đưa thêm vài dẫn chứng và một liệu trình hợp lý.
Dĩ nhiên, có thể tóm gọn mọi thứ trong 1 trang A4, nhưng dài dòng như này cũng không tới nỗi nào. Giọng văn còn hơi khô (chắc do nội dung sách thế, đố ai dám đùa).

[Lindee Lee Keller]

When I was dusting off this book for the hundredth time to see what time of day I should use my happy lamp to help correct for my body suddenly wanting to stay up all night, it occurred to me that I owe it a review-- because this is a book with substantive and helpful core content distorted by commercial marketing decisions.

You can learn the basics of the TLC protocol here. Take caution with light therapy, it does have side effects and can be harmful for people with epilepsy or bipolar disorder. If you find that's not enough to get it working for you and your life, or want more background, well, that's where the book comes in.

This book, at its core, is a detailed look at six different evidence-based lifestyle interventions effective in treating depression based on the author's clinical research with the University of Kansas, and a plan for implementing them. Unfortunately, wrapped around the core is a lot of pop psychology bullshit like using the word 'toxic' left and right and going on and on about the lifestyle of Stone Age humans. Hey, you know what evolutionary psychology isn't? 1) A prescription for how humans should live. 2) Falsifiable.

And what it's framed as is a 'cure', a 'six-step program' (that you can do by yourself at home!) and a solution rendering medication unnecessary. In the actual text of the book, all these statements come with so many caveats as to render them virtually untrue, most of which don't appear until the book's final section, on troubleshooting.

This book may 'cure' your depression if it is mild or prevent new episodes of depression if you do it in remission, provided you have no other physical or mental health complications. I do not have mild depression with no comorbid conditions. I have severe recurrent depression with a big ol' alphabet soup of other mental health diagnoses. On disability, been to the psych ward, did day treatment, the whole shebang. So for me, and quite possibly for you reading, this book is not a cure.

For me, it's a detailed manual for what have become truly valuable tools in my mental-health toolbox. Like a crowbar and a rubber mallet and some Allen wrenches. (The crowbar is exercise, in case you were wondering.) They haven't enabled me to be completely off of medication, but they have enabled me to be on only one medication as opposed to six. They aren't going to cure my depression, but they do make my remissions last longer and can alleviate my symptoms enough for me to be able to take other steps.

It's not just a simple list of recommendations. It specifies exactly what implementing the change looks like-- like that your light box needs to be 10,000 lux to be effective and where it should be positioned, or how much DHA and EPA needs to be in your Omega-3 supplements and how to avoid fish oil burps-- and how specifically those changes can help, and how researchers know. Many of these are things I personally made mistakes about back in 2009ish when my mental health was rapidly deteriorating and I had no access to care. (This may be less likely now given we have much better access to information.) I read this book for the first time in 2010ish and ten years later I still use it for reference. That's real shit.

I appreciate that, in spite of the title, the suggestions here are modular enough that they can work for someone regardless of how they personally relate to pharmaceuticals or psychiatry, because there's a real need to fill in the gap between 'pharmaceuticals are evil, be in nature more' and 'depression is just like diabetes, shut up and take your insulin'.

I will say I feel like the section on avoiding rumination is not nearly specific enough, and in my (experiential) opinion, if you are experiencing even moderate depression, you probably need a few weeks of the more concrete interventions under your belt easing your symptoms before you're able to tackle it. I would also strongly recommend, rather than the tedious and unsustainable practice of keeping an hourly log, using a golf counter (the kind that goes click, click and bouncers use to monitor crowd capacity at the bar) or some other physical marker when you catch yourself ruminating instead. The book falls a little short of where it could be for addressing the problems that executive dysfunction can present in carrying out the protocol. It also does not include the great big disclaimer anything promoting lifestyle interventions for chronic disease should: don't go around offering this as unsolicited advice, it just sounds like shaming. So I am. Don't do it!

In short, I don't always love the package it's wrapped in, but the information in this book has been of enormous help to me and to people I care about who asked me for guidance on treating their mental health issues without being absorbed into the mental health system.

[Christine Grabowski · Rating 5 out of 5]

I listened to this book on audible. A great book about lifestyle choices a person can make to combat depression. Has tons of ideas of how a person can implement the 6 steps into their lives. Also includes lots of statistics to show lifestyle choices work better, especially in the long-term, than medicine and cognitive therapy. Of course these lifestyle changes can supplement other options as well. These activities can also keep depression at bay.

[Nate Crawford · Rating 3 out of 5]

He is a little too "neat" at times. Mental illness is a lot messier than he allows it at times. But, for a lot of people struggling with minor forms of depression (the clinical minor - no depression is minor), I'm sure this is a very good program.

[Emily Kestrel · Rating 3 out of 5]

Well, this is good advice, but I already do these things, and guess what...I'm still reading this book, so that should tell you. It did motivate me to be more consistent about taking omega three supplements. Overall, I thought Andrew Weil's Spontaneous Happiness was more informative.

[Tomi Kaukinen · Rating 3 out of 5]

I’d give it a 3,5/5. It is a good book and maybe reading Hari’s brilliant Lost Connection just a couple of days before affected my take on this book. Some of the examples Ilardi uses seem to me like he is stating the obvious.

However, for anyone struggling with depression this is a good book indeed.

[Brandon Soat · Rating 4 out of 5]

This book provides simple day to day changes that can equip you to fight depression long term. It also provides a simple 12 week guideline for implementing the TLC program towards the end of the book.

[Brenda · Rating 4 out of 5]

The Depression Cure posits that depression can be most successfully treated not with psychiatric medication or even psychotherapy, but by following Ilardi’s six-step program of lifestyle changes to mimic the lifestyles of our human ancestors. According to Ilardi, the rise in rates of depression in modern day America are because we have lifestyles we did not evolve to live.

Ilardi brings up rising rates of obesity in modern first world countries as a very similar sister example. For ancient humans, food was scarce, and unnecessary physical activity was a waste of valuable calories, so we evolved to take a lot of pleasure in eating energy-rich sugary foods and a lot of displeasure in exercising. But now, our environment has changed — most people in first world countries have easy access to food and don’t have to be constantly running away from predators or chasing after prey. Now that there is this mismatch between our evolutionarily engrained likes and dislikes and the physical demands placed on us by our environment, we face a problem that we did not necessarily evolve to deal with: obesity.

Ilardi believes the primary causes of depression are also rooted in a mismatch between ancient and modern environments. As Ilardi notes, “In developing (third-world) countries, the lifetime rate of depression is often a fraction of that observed in the West. However, the prevalence of depression has begun to go up in those countries where people are shifting from more traditional to more Americanized lifestyles.” (5) This is an observed fact, and many have hypothesized why this might be so. For Ilardi, the reasons people living Americanized lifestyles are more depressed include: being omega-3 fatty acid deficient, thinking too much, not getting enough exercise, not getting enough sunlight, not getting enough social interactions, and not getting enough sleep.

Therefore, to cure depression, Ilardi recommends a six step program:
1. Take omega-3 fatty acid supplements. He recommends molecularly distilled fish oil, and at least 1000 mg of EPA a day and 500 mg of DHA a day.
2. Stop ruminating.
3. Exercise three times a week or more.
4. Spend 20 minutes a day or more under bright light: either sunlight, or light from a light box specifically made for light therapy. “Bright light stimulates the brain’s production of serotonin, that crucial chemical emissary.” (137)
5. Spend more time engaging in social activities.
6. Get enough sleep.

By suggesting lifestyle changes as a front line treatment for depression rather than pills, Ilardi’s recommendations might seem unusual or unscientific, but in fact there exist plenty of scientific studies to back up each of his suggested steps. Ilardi is not anti-psychiatry but he is medication-cautious, acknowledging that most people who taking antidepressants to treat depression tend to eventually relapse despite continuing on medication (and perhaps because of starting it in the first place). (44) “Among those who took the drugs as prescribed, only 23% were depression-free after six months of treatment.” For those who do see improvement on medication… it’s likely most of this improvement (from studies, around 80%) is from the placebo effect. (46) In fact, drug companies do not have to publish all of the studies they do with their drugs, and Ilardi mentions that another researcher found, after obtaining unpublished studies from drug companies for six antidepressants via the Freedom of Information Act, that in 56% of the studies, the antidepressant in question failed to outperform placebo.

He also has some choice words to say about electroconvulsive therapy as a treatment for depression; that it is barbaric, it kills brain cells, it shrinks the brain and it causes (potentially permanent) memory impairment and drop in IQ (60). “I have a strong feeling that future generations will look back on our modern practice of ECT with horror — the psychiatric equivalent of slapping the side of a TV set in a desperate and improbable attempt to render the picture forever clear again. (60) Given the state of psychiatry these days (I’m still confused that ketamine is now a legal treatment for depression but then again we’ve been giving amphetamines to preschoolers who can’t sit still for a long time now) it’s refreshing to see this stance.

I wonder if Ilardi has somehow missed the mark however on the underlying cause of the increase in depression in modern day America. There is rather convincing evidence that overprescription of psychiatric drugs has caused the explosive increase in depression we see in modern first world countries. Psychiatric drugs may help with symptoms in the short term, but they injure the brain and prime it for dysfunction in the longer term. In fact when comparing differences between us and our ancient ancestors, a critical difference that Ilardi disregards is our increase in access to and usage of psychiatric drugs. The journalist Robert Whittaker dives deep into this in his excellent book Anatomy of an Epidemic.

That’s not to say however that following Ilardi’s six step program won’t effectively treat depression. I found this book after I had already recovered from a long period of having a low mood, but a lot of the suggestions Ilardi gives are common suggestions for depressed people, so I had actually tried all of these suggestions while struggling, before I had even heard of this book. Here is my rating of the helpfulness of each of the 6 steps:

1. Taking omega-3 supplements: I took omega-3 supplements during the time I was most depressed. I don’t know if they had any effect on the depression. When I stopped taking them (due to no longer being depressed, being lazy and because I hate spending money) I didn’t notice any difference. I would say this is still a tip that probably doesn’t hurt though, given most people are nutritionally deficient in omega-3s anyway. Usefulness ranking: 2/5
2. Stop ruminating: LOL! Yes, if only it were that easy to just “stop ruminating.” Look, to be fair he has some good tips for actually putting this into practice, like, if you feel the urge to think negative thoughts, try writing them down so that you don’t have to feel like you’re ignoring a potentially important signal. This is the most unhelpful tip though. To me this reads like, “Did you try _not_ being depressed?” Usefulness ranking: 1/5
3. Exercise. So much evidence and so many studies point to exercise being super effective for curing depression, but from my subjective personal experience: it did not really help me much at all. I have theories about why this is. However, I agree exercise is good for the brain (as many studies have also shown). I think it helps me feel more positive and mentally sharper in my day to day life as a non-depressed person, but I don’t know if it can help with all forms of depression. Usefulness ranking: 2/5
4. Increase bright light exposure. I bought a light therapy box to see if it would help me while I was depressed. I used it once and it made me feel even more depressed. Even though light boxes have supposedly “natural” light, it feels like such a poor and offensive imitation of the sun. While using it, it made me feel like the Earth had been destroyed and I was in a space ship with the last remaining humans, huddled around an electronic box emitting sterile, mechanical light and yearning for my lost home. 1/5 for light boxes, 5/5 for the real sun.
5. Social connections. Definitely important. 4/5
6. Get enough sleep. Like step 2, I’m a bit annoyed by this one also. Sleep is easily the hardest thing on this list to control, as I don’t know of anyone who is able to consciously will themselves to sleep. To be fair though, I have never tried to implement Ilardi’s specific methods for improving sleep. 2/5

Misc thoughts:
- Depression as emotional pain. (29)
- “We can observe … the same built-in programming to avoid needless activity in laboratory rats. Exercise researchers have a devil of a time trying to get the little guys to run on a treadmill. The rats will go to incredible lengths to avoid running, even to the point of just squatting down on their haunches until the machine starts to wear the fur and skill off their backsides” (115) I thought rats spontaneously run on wheels that are placed in their cages though?
- “Many researchers now believe this sugar craving represents an attempt to ‘self-medicate’, since surging blood glucose can trigger more serotonin activity in the brain, temporarily lifting mood. But there’s a big downside: eating sugar (and other simple carbs) promotes inflammation — and as we saw in Chapter 2, chronic inflammation is a major culprit in promoting depression.” (140-141)
- This book was published in 2009, and… you can tell. Things mentioned in this book that are very 2009: the Nintendo Wii, a service that mails DVDs to your house, using Skype to connect with friends, listening to music on an iPod.
- Ilardi mentions that it could be hard for depressed people to implement all the steps in this plan because “[Depression] shuts down circuits in the left frontal cortex, the part of the brain that allows us to put our intentions into action.” (232) Technically I agree but I’m not sure it’s helpful to think about things in this way.
- Sugar is bad for the brain but, “Please note that natural sugars found in fruit and vegetables pose no such hazards to the brain.” (247) This is definitely not true…

[YOKO · Rating 2 out of 5]

The author talks about 6 key elements to treat depression without antidepressants.
Dietary omega-3 fatty acids, Engaging activity, Physical exercise, Sunlight exposure, Social support, and Sleep.

Omega 3
I’m not sure if it’s true that the Japanese people’s rate of depression is extremely low because of their raw fish consumption.
Japanese people eat raw fish every day sounded not accurate like other stereotypical assumptions.
If depression is a lifestyle illness, their lifestyle should be mentioned.
It’s disappointing to me that the author’s approach is not vegan-friendly.

Rumination (a nagging negative thinking habit)
The author recommends being engaged in certain activities to distract and escape from your habitual negative thinking, and says being alone tends to make people more depressed.
I think his advice is not totally unhelpful but being alone doesn’t always accompany depression.
As an introvert, I can savor and enjoy solitude without depressive mind activities.
I found Eckhart Tolle’s books more fundamentally helpful no matter what activities we are doing.

I usually read a book until its end but around 45%of the book, the Chapter of exercise, I stopped reading.
There is nothing bad but there is nothing engaging.
The author talks about finding an engaging exercise activity.
When I’m really mentally tired, only thinking about exercise would make me feel even more tired. I just wouldn't have enough energy to allocate for willpower to start new things.
I think there is appropriate timing to start new things or new habits when depression is still heavy.
I prefer focusing on natural movement I can enjoy or I have enjoyed in the past but only one step at a time only little by little.

15 years ago, I suffered from severe depression and also serious side effects of medication.
I was determined to try everything I could except medication.
What worked for me were cognitive therapy and lifestyle shift.
- whole food plant-based diet, yoga, meditation, good sleep, adequate sunlight exposure, activities that I really love doing, a meaningful and fulfilling way of spending time and working, seeing things as they are without adding any stories or dramas, using my mental energy in a positive way.
All of them are still working now.

It's good to know about certain elements you could check when you feel down but I think it's important to figure out what helps YOU feel better, what works for your particular case best.
..if you are vegan or allergic to fish, it's just not your option to take fish oil every day!..
The author’s suggestions, cookie-cutter solutions, might not work best in every situation.

[Ruby · Rating 4 out of 5]

This book sounds promising... How effective is it? Time will tell.

I have a fair bit of faith in this book and the writer's claims. I have battled with my own black dog and become quite disillusioned with conventional therapy, but I also am not someone who has a lot of faith in airy-fairy new age therapy, either. I want to see things tested properly. I want to see proof that they work. There are a lot of snake oil merchants out there, particularly in mental health.

I was impressed with the rigorous scientific study behind this book, and that the program had been successful for so many clients. It has given me a real sense of hope. Other reviewers have said the program might be difficult for people with depression to implement and I agree, however, with social support, I believe many people could adopt the program... It's just the teething stage that might trip people up, in my opinion. I believe many people struggling with a mental health issue hit rock bottom. It sucks, but shortly after that, a time will come where they will resolve to fight it with all they have. It becomes necessary... Catch people in that stage, and they will follow the program (with setbacks perhaps). Also, those in recovery can use these steps to maintain their mental health and prevent relapse.

For me, I am fortunate to have good support around me, and I am convinced enough by this book to attempt to implement the changes it suggests. I have started the program this week, and I have noticed small changes already. I will check in from time to time and offer a report of how I am going with the program, if anyone is interested. Hopefully some other reviewers will do the same, as I am genuinely curious to see how it goes for others.

[Skyline · Rating 5 out of 5]

I've been suffering from mild mood swings for the last 4 years and I didn't do anything about them. It wasn't until 4 months ago when I was feeling so blue and was forced to see a psychiatrist. He diagnosed it with major depression episode and started me with anti-depressants ( prozac ), and I've been on them for a couple of month with no improvement so I started looking for other treatment options.

This book is written in a clear and reasonable way. Dr. Ilardi starts with a brief introduction of depression with several stories about his patients from their therapeutic sessions that I related with most of them. He then discusses and compares the success rates of common treatment plans such as drugs, Electro-Convulsive Therapy, and Cognitive Behavior Therapy.

After that he goes on to explain a method he developed with his colleagues called (Therapeutic Lifestyle Changes), which focusses on eliminating six of depression risk factors, which are
1. decrease on Omega-3
2. decrease Vitamin D
3. sleep deprivation
4. social withdrawal
5. sedentary lifestyle
6. Rumination

In the last part he present a weekly step-by-step program to incorporate all the techniques he talk about. He also presents a scale for depression to measure it severity.

I plan on starting the TLC program tomorrow hoping to beat my depression onece and for all. I'll share my results in 12 weeks.

[Alona Perlin · Rating 5 out of 5]

This book was fantastic. It really speaks about depression in a clear-cut way, so the reader has a true sense of the full meaning of depression. It breaks depression down to its core and talks about depression in a way that people can understand it, relate to it (for those persons that are depressed)and also conquer it. It sheds a new light and understanding on this insidious disease and also eliminates the stigma associated with it.

The only two complaints I have about this book is the efficacy of the treatment techniques without the aid of psychotropic medication. I think that the techniques that are postulated in this book may work, but may not be effective enough to combat the problem of depression sans medication.

Secondly, the author makes countless recommendations to consult with one's physician regarding the various treatment options in this book. How many doctors in our time have sufficient time to discuss all of our treatment options during the medical visits? The business of medicine has become a conveyor belt, in which people are shipped in and out as quickly as possible and are prescribed "band-aids" as coping mechanisms for their problems, rather than gathering at the root of the illness and using a holistic approach to it.

Overall, I really enjoyed the book. The topic of depression was discussed in unique and innovative ways and approached the elements of depression in a true and realistic manner.

[Joe Mama · Rating 5 out of 5]

The book's major insight is that there is an epidemic of clinical depression because humans are poorly designed for modern life. In that sense, depression is an illness of lifestyle like obesity or diabetes. The writer doesn't blame people for getting depressed, but the book does empower them to combat the illness through simple changes in lifestyle. According to the author, many of these changes (things as simple as swallowing fish oil or going for brisk walks) can improve brain chemistry, often more effectively than medication in the long-term. Although the book's six major lifestyle strategies are laid out in easy step-by-step fashion, the author acknowledges that severely depressed readers will probably need the added help of a therapist to coach them through the process (especially to learn how to stop brooding over negative thoughts). Many readers may also benefit from a personal trainer to help with the exercise part of the program. Overall, I thought the book was quite helpful and insightful, and surprisingly easy to read.

[Megan · Rating 2 out of 5]

My problems with this book are not with the content. The content is great, if largely rooted in common sense. Every depressed person has been told that they can fix their depression with sunlight/kale/yoga/etc. My complaint with this book is actually largely with the formatting. Presumably to lead to a more seamless reading experience, the author doesn't do citations by number, but rather has them in the back of the book with the lead-in words to show what was cited. This sounds like a really picky and trivial reason to complain, but the reason I wanted to read the book was to see exactly where the common-sense and practical iterations in the book are rooted in science--not that one can't do that here, but it's not made easy.

[Claire Caterer · Rating 5 out of 5]

While the title may seem like hype, this book offers a real, doable step-by-step program based on solid research to help those suffering from depression. Some things sound like common sense--get more exercise, increase your social interaction--but this program offers specific therapeutic recommendations as well as a way to chart your progress. Easy to read, great information. Highly recommended.

[Dudegreen · Rating 5 out of 5]

If you struggle with depression, this book offers legitimate, tangible, and practical things you can do to fight off the blues. It focuses on how modern life contradicts how we evolved as humans, and what you can do to counteract these effects. The recommendations are easy things to do, and they are not just cognitive-behavioral things but rather distinct and practical changes you can make.