Ideal Life 10: How to Beat Depression
Better than pharmaceuticals
This is 3x more powerful than drugs to make you happier: go for a run with a friend or spouse in a forest and then eat a home cooked meal. Read on to find out why.
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Back to depression,
Depression is more common than you might think. One meta-analysis study found the incidence rate of depression across lifetime is 10.8%. If you have depression, or feel sad, don’t feel that something is wrong with you. It’s ok and common.
What is not ok is how we deal with depression.
Drugs for depression fail
1 in 10 people in the United States take antidepressants. Additionally, 1 in 4 women in their 40s and 50s admit to take the drugs.
Antidepressants can produce a noticeable improvement in symptoms for about 40-60% of sufferers. This does not mean they provide a cure, but that about half of people see some improvement.
The price for this improvement is substantial, as antidepressants have significant harmful effects:
A meta-analysis on 16 studies, in total 375,000 participants, found people on antidepressant had a 33% higher risk of dying early. The researchers only included robust studies.
Then antidepressants have:
Common Side Effects
Nausea and vomiting
Weight gain, and its associated long-term harms
Diarrhea or constipation
Sexual dysfunction, such as reduced sexual desire or difficulty reaching orgasm
Drowsiness or fatigue
Dry mouth
Insomnia or sleep disturbances
Headache
Dizziness
Less Common but More Serious Side Effects
Increased risk of suicide. Especially in children, adolescents, and young adults under 25
Serotonin syndrome. This is a rare but life-threatening condition. It is characterized by high fever, agitation, confusion, trembling, and sudden muscle contractions.
Withdrawal symptoms if the medication is stopped abruptly, including dizziness, nausea, and flu-like symptoms.
Bleeding disorders, especially for SSRIs and SNRIs, which can increase the risk of bleeding.
Mania or hypomania, particularly in individuals with bipolar disorder.
Severe hyponatremia (low sodium in the blood), especially in older adults.
Long-term weight gain with prolonged use, which can increase the risk of other health problems.
Bone density loss over long-term use, increasing the risk of fractures.
Rare Side Effects
Blood pressure changes with certain antidepressants, particularly older ones.
Heart rhythm abnormalities with some medications.
On top of all of this abrupt discontinuation can worsen depression or lead to withdrawal symptoms
1. Better than drugs: exercise, especially walking or running
A meta-analysis looked at results from 218 randomized clinical trials. This involved more than 14,100 people on what are the best methods to treat depression.
It compared SSRI (common antidepressants class) with cognitive behavioral therapy and with various types of exercise. What did it find? Is exercise close to antidepressants in efficacy?
No.
Exercise is better than antidepressants in treating depression.
A systematic review and meta-analysis with meta-regression published in the British Journal of Sports Medicine, supports the efficacy of exercise in reducing depressive symptoms for individuals with depression. This study is one of the largest syntheses on depression. It analyzed results from 41 studies involving 2,264 adult participants post-intervention. The findings show moderate to large effects of exercise on depressive symptoms. So high that exercise is as (or more) effective than current first-line treatments for depression. (British Journal of Sports Medicine, 2023) (BJSM).
What is the best form of exercise for depression? Walking or running.
Long story short: if you feel depressing or are sad, go for a walk or a run, not for a prescription.
As you can see, all forms of exercise are useful. So if you like yoga or body-building, do that. You don’t have to switch to running.
Why is walking/ running the most effective? One factor might be that it is the most human of movements. It uses all parts of our body and it is what we evolved to do for long periods of time.
But also walking/ running exposes you to two other zero-cost treatments for depression that are better than pharmaceuticals:
2. Better than drugs: sunlight
Sunlight is a natural healer. It tells your brain to be happy. Try to catch some rays daily. A morning walk is perfect. It's like a daily dose of joy.
A study published in "Heliyon" journal investigated the impact of sunlight exposure therapy on improving depression and quality of life in post-stroke patients. This randomized controlled trial showed that sunlight for at least 30 minutes per day over 4 weeks significantly improved their depression scores and daily functioning. Another study found that participants with more extended exposure to sunlight reported fewer depressive symptoms. (PLOS).
Bright light therapy (BLT) is evolving as an effective depression treatment for Seasonal Affective Disorder (SAD) and in non-seasonal depression and bipolar disorders. It has benefits comparable to antidepressants and possibly more robust in patients with bipolar disorder. The antidepressant action of BLT is fast and safe, though it requires mood stabilizers in bipolar disorder to protect against manic switch. Side effects are generally mild and rare (Maruani & Geoffroy, 2019).
Bright light therapy (BLT) is evolving as an effective depression treatment not just in Seasonal Affective Disorder (SAD) but also in non-seasonal depression and bipolar disorders, showing effects comparable to antidepressants and possibly more robust in patients with bipolar disorder. The antidepressant action of BLT is fast and safe, though it requires mood stabilizers in bipolar disorder to protect against manic switch. Side effects are generally mild and rare (Maruani & Geoffroy, 2019).
A study on operating room nurses in Shandong, China, found that more hours of sunlight exposure per day were associated with better mental health outcomes. (Dove Med Press).
Another study looked at sunlight in the workplace. Findings indicate that exposure to natural elements and sunlight at work is associated with reduced levels of depression and anxiety, increased job satisfaction, and organizational commitment. The research suggests that natural and sunlight exposures in the workplace can mitigate the negative effects of work-related stressors on mental health and work attitudes, proposing an intriguing area for enhancing workplace wellness strategies (PLOS).
3. Better than drugs: nature
Trees, rivers, and the great outdoors aren't just beautiful. They're a haven for our hearts and minds. Studies show that people who spend time in nature are happier. It's as if the air, the greenery, and the peacefulness tell our worries to take a hike. So, go outside, and let nature do its work.
Research shows nature walks have a positive impact on reducing state anxiety, (MDPI).
Further, studies propose a dose-response relationship between nature exposure and mental health. The frequency, duration, and intensity of nature exposure can influence depressive symptoms. One study suggested that visiting green spaces at least once a week and engaging in activities like forest bathing for more than 5 hours a week lowers the incidence of depression. (Frontiers In).
Moreover, a study conducted by Stanford University found that walking in natural areas, as opposed to high-traffic urban settings, decreases activity in brain regions associated with depression (Stanford News).
4. Better than drugs: connect with others
Chatting face-to-face or sharing a laugh with someone does more than pass the time. It lights up our brains in ways that make us feel good. Research tells us that real-life connections can keep sadness at bay better than any online chat. It’s like our hearts are wired to be happy when we’re together. So, make time for friends and family. And prioritize real relationship over online chats, even if they are more difficult.
Substantial research underscores the importance of social bonds in contributing to a fulfilling life. Studies have consistently found that individuals are happiest when in the company of friends, followed by time spent with family members (Pursuit of Happiness).
The Harvard Study of Adult Development, one of the longest-running studies of adult life, has highlighted the central role of relationship satisfaction as the best predictor of a happy and healthy life. Contrary to initial expectations that physical health indicators like cholesterol levels or blood pressure at midlife would be the strongest predictors of later life health and happiness, it found that the quality of one's relationships was far more significant (Harvard News).
Echoing these findings, the Center for Compassion and Altruism Research and Education emphasizes that good social relationships stand as the most consistent predictor of a happy life. The quality of these relationships, characterized by positive communication and mutual support, has been linked with enhanced well-being, lower instances of depression, and even longer life spans (Compassion University).
5. Better than drugs: healthy food
“Eat healthy” is a loaded phrase. It means different things for different people. However, there is clear evidence that food processing is a big factor. The NOVA system classifies foods in 4 categories from ‘Not processed’ to ‘Ultra-processed’. Eating lots of ultraprocessed food makes you depressed and anxious.
To be happier, eat real foods. Not foodstuff in boxes.
The best resource for this is the book Ultraprocessed people. But let’s look at a few specific studies.
One study in a Mediterranean cohort found that individuals with higher consumption of UPFs had significantly greater odds of depressive symptoms. This association persisted even after adjusting for overall diet quality, suggesting that factors beyond nutritional content of UPFs influence mental health (MDPI).
Another comprehensive systematic review and meta-analysis encompassing 17 observational studies (with a total of 385,541 participants) highlighted a clear association between UPF consumption and an increased risk of both depressive and anxiety symptoms. (MDPI).
Another study from the Melbourne Collaborative Cohort Study with over 23,000 Australians found that those consuming the most UPFs had a 23% higher risk of developing depression compared to those who consumed the least. This association held true even after adjusting for various lifestyle and socioeconomic factors, reinforcing the link between UPF consumption and depression risk (Neuroscience News).
If you are feeling depressed or sad or anxious, you don’t have to take powerful pharmacological drugs, with all their associated risks and side-effects. First try one of the (more) powerful behavioral solutions to make yourself happier:
Do physical exercise
Spend time in sunlight
Walk outside in nature
Spend time with people you care about
Eat real foods, not ultraprocessed
If you want to optimize it for maximum effect: go for a run with a friend or spouse in a forest and then eat a home cooked meal.
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Eating healthy food, exercise, taking daily hikes in the woods, companionship didn’t help my depression and I desperately tried it all for years. The only way out for me was psilocybin for instant relief and then prescription medication for ongoing stability.
When I hear people dismiss, discourage or belittle medication like this it makes me sad because I wish I would have tried medication years sooner but I had these kinds of voices in my head saying “no, just try harder doing this or that you don’t need pills and all the side effects”. I think that can work for some people and is a good place to start but for others, medication is the only thing that sustainably works and that is in no way a failure like many people imply (intentionally or not).
To anyone who is struggling and can’t manage to cook healthy food or reach out or even leave the house, there IS hope!!! Even when it seems absolutely hopeless, things can change for you if you don’t give up, I promise. And please don’t let anyone stop you from trying medication if you want ❤️