As a physician with training in two specialties and one subspecialty, I have the utmost respect for the power of science. But lately, I have been pondering the limitations of our heavy reliance on science and technology to enhance our lives. Trust me, I am not anti-technology; I, for one, rely on numerous gadgets to get through my day, and can hardly remember what we did 20 years ago when we didn't have instant access to information.
But, as I go to work each day, I do often wonder how my love of science and desire to understand and help people led me to where I am today. I guess the simplest way I can put my dilemma is this: I have access to the most effective and powerful medications ever devised, but even as I prescribe these medications and watch my patients improve, I recognize that I often don't have time to consider the basics of good health and mental health.
So, I called a friend, Dr. Steve Ilardi, who has been pondering similar questions in a far more sophisticated and scientific way. Dr. Ilardi, associate professor of clinical psychology at the University of Kansas, and author of The Depression Cure, designed and studied an alternative treatment for depression called TLC (Therapeutic Lifestyle Change), and found that 76 percent of the patients assigned to TLC responded favorably to treatment, versus only 22 percent of those assigned to the Treatment As Usual group. TLC was developed as Dr. Ilardi considered how to identify and reclaim the protective features from an ancient way of life " factors that we know from solid scientific evidence are antidepressant.
In order to identify those factors, Dr. Ilardi examined the lifestyle of contemporary hunter-gatherer societies, where depression is virtually nonexistent.
TLC addresses six domains identified by Ilardi: 1) Increased physical activity " at least 30 minutes of aerobic exercise three times weekly; 2) Adding Omega fatty acids with a 2:1 ratio of Omega 6 to Omega 3; 3) Increased sunlight exposure, which both enhances serotonin production and improves sleep architecture; 4) At least eight hours of sleep nightly; 5) Increased social support. TLC participants attend a two hour support group weekly and are asked to schedule at least one meaningful social activity daily, and to value relationships above all else; 6) Decreased rumination, which is the torturous (and psychologically toxic) process in which we get stuck in our heads going over the same set of thoughts over and over again. TLC participants learn techniques to change their focus or to get involved in engaging activities, which could be as simple as reading, when they are ruminating.
TLC is both simple and profound, not to mention, backed by science. As far as I am concerned, we can all use a little TLC. I, for one, am incorporating TLC into my daily life. And, I will be adding TLC to my work life, too, by making the time to suggest some simple changes to my patients and by reinforcing these changes at every visit.
- Deborah L. Steinberg is a psychiatrist practicing in Carson City.