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TEDx Talks
Published: 2013-05-24
Source: https://www.youtube.com/watch?v=drv3BP0Fdi8
I believe depression is one of the most tragically misunderstood words in the entire English language and here's the problem depression has two radically different meanings depending on the context so in everyday conversation when people say they're depressed they use the word depression as a synonym her sadness it's the normal human reaction to the slings and arrows of outrageous fortune in that sense all of us know
the pain of depression and yet in a clinical context depression is shorthand for a devastating illness but again there's a for a devastating illness we refer to it technically as major depressive disorder this is an illness which robs people of their restorative sleep robs them of their energy robs them of their focus their concentration their memory their sex drive their ability to experience the pleasures of
life for most individuals it robs them of their ability to love and work and play it may even rob them of their will to live and I'll tell you why because we now know depression lights up pain circuitry of the brain to such an extent that most clinically depressed individuals if you talk to them and they let their guard down they will tell you is they've
told me hundreds of times torment its agony it's torture and many begin to look to death as a welcome means escape depression is the main driver behind suicide which now claims over one million lives every year worldwide now I know what you're probably thinking at this point man this talk is going to be really you know the president so they give you a friendly little spoiler
alert it's not truly not depression yes it is a treacherous follow but what I found in my twenty years of clinical research and clinical work is this is a photo that can be defeated that's the good news and that's the news I'm gonna focus on for most of the talk tonight first a little more bad news depression is now a global epidemic in fact if we
look in the U. S. we now find that nearly one in four Americans will experience that agonizing debilitating pain of depressive illness by the time they reach age seventy five it gets worse the rate of depression seems to be increasing generation after generation so every successive birth cohort is having higher rates of depression than the one that preceded it now I want you to look at
these lines we got four different generations on this crap that the Green Line on the right that's the oldest Americans and by the time they made it out into their sixties and seventies they have a lifetime rate of depression ten percent that's horrible but it's much lower then every succeeding generation now take a look at that the line that really upsets me the most is the
one on the far left that's our youngest American adults you see what happened by the time they're in their mid twenties they already have a rate of depression of twenty five percent remember we're talking about a potentially lethal debilitating illness left unchecked it's an illness that can cause brain damage and if we extrapolate that line but the time they reach middle age their lifetime rate of
depression will already be over fifty for so what in the world is going on what's driving the epidemic what can we do about it what causes depression well on one level we ask this question we're gonna face the answer the it's really complicated there've been literally thousands upon thousands of published studies that have identified a dizzying array of factors that are implicated in the onset of
depression biological psychological cultural social behavioral but if we Wade through this complexity what we begin to find is there is a common underlying pathway a primary driver a primary trigger I call it the brains run away stress now we all know the stress response we think of it probably is the fight or flight response in its most extreme form what you think about that response especially
how it was involved in adapted a service the fight or flight response was designed primarily to aid our ancestors when they faced predators other physical dangers that required what intense physical activity that would go on for a few seconds for a few minutes maybe in extreme cases for a few hours is a very costly response but fine if it shut off what was posted here's the
problem for many Americans Europeans and people throughout the western world stress response goes on for weeks and months and even years at a time and when it does that it's incredibly toxic to the body into the brain it's disruptive to know all circuits in the brain that use your chemicals you've heard of like dopamine and serotonin a seal Colin glutamate and this destruction can lead directly
to the process of illness it also can actually damage the brain when left unchecked over time especially in regions like the hippocampus which is involved in memory consolidation in the frontal cortex and it also triggers an inflammatory reaction throughout the body and brain and here's what we've learned about depression the inflamed brain is a depressed brain and this is really intriguing because epidemiol epidemiologists have now
identified a number a big consolation of illnesses there are rampant and epidemic throughout the entire developed world see the list atherosclerosis diabetes obesity allergies asthma many forms of cancer these are all inflammatory illnesses they're all illnesses that our epidemic in the industrialized modernized world and largely nonexistent among modern day aboriginal I believe we need to add depression clinical depression to this list it shows all the
hallmarks of being a disease of civilization and you know what that means it's a disease of lifestyle so consider the experience of the kalui people of the highlands of Papua New Guinea they've been studied extensively by the anthropologist Edward sheeple and I spent over a decade among the colorfully one of his research questions was how often do the kalui experience the same kind of mental illness
that we do any certainly found some forms of it he interviewed over two thousand members of the kalui and extensively query them for their experience of clinical depression and you know what he found one marginal case out of two thousand that gives them a rate of clinical depression that probably about a hundred times lower than ours I'll tell you why I find it really remarkable because
among other things the kalui lead really really hard lives really they have high rates of infant mortality they have high rates a parasitic infection they have high rates of violent death but they don't become clinically depressed they grieve absolutely they don't get shut down what's protecting them lifestyle Pacific League the co Luli live a lifestyle very similar to that of our ancestors over the entire Pleistocene
epoch that lasted for one point eight million years did you know that ninety nine point nine percent of the human pre human experience was lived and hunter gatherer context so what does that mean most of the selection pressures that a sculpted and shaped our genomes a place to sing we're still really well adapted for that sort of environment and that sort of lifestyle I'm not saying
there hasn't been any change since then because of course ten of twelve thousand years ago we had the invention of agriculture and there has been some genetic selection over that period of time it's been more minor but what happened two hundred years ago with the industrial revolution it's been termed radical environmental mutation I like that term it's as if modern American and western life is radically
discontinuous from everything that came before our environment has radically mutated but how much is the human genome changed over the last two hundred years it houses it hasn't that's eight generations it's not enough time what does that mean there's a profound mismatch between the genes that we carry the bodies in the brains of their building and the world we find ourselves in I'm gonna put for
you as carefully as I can we were never designed we were never designed for this we were never designed for the sedentary indoor socially isolated sleep deprived fast food laden frenzied pace of modern life the result epidemic depressive illness now I'm a depression researcher I was trained in a traditional form of psychotherapy I was trained in a context where I learned all about anti depressant medications
and I I want to tell you right at the outset I am not any medication I believe in fighting depression with every possible tool that we have but you know what if we only throw medication at this epidemic we are not going at least we haven't so far how much do you think antidepressant use has gone up over the past twenty years I'm good I'm good
what would you care to death I like I guess seventeen hundred percent it's gone up over over three hundred percent so your ear gook or close %HESITATION over three hundred percent and what's happened the rate of depression in inner can you to incur one in nine Americans over the age of twelve is currently taking an inter process when I currently one in five according to some
estimates have tried it at some point have we solve the epidemic no we haven't made a dent the answer I believe is a change of lifestyle now you'll see behind you a list of six lifestyle elements when my research team and I seven years ago how disappear Finney we got together we started scouring through the depressive literature asking the question what are the kalui doing is
protecting them specifically based on everything we know about oppression what did our ancestors do the protected them and we quickly found six factors they changed neurochemistry X. factors that are known to be anti depressant six doctors that we can reklame and we've been to the fabric of our day to day life in the present to protect ourselves from this devastating illness and so we designed a
new treatment program was really ambitious I admit that then I think it would work I really wasn't sure you know what I was not trained as a psychotherapy as an interventionist researcher I was doing basic neuroscience psychopathology but I have a passion to see this academic brought to its knees I had a passion to treat individuals who I knew who had tried everything and we're still
depressed and so with great trepidation we set out to design this program the results have exceeded my wildest there are X. major elements of I'm gonna run through them as quickly as I can in our remaining time the first is exercise now exercise is good for us how many because he shook hands how did you came in here today knowing the exercises is really really good
for us right every hand goes up now to change your behavior for some yes everybody knows that exercise is good for us here's the problem many people have trouble making it happen and you know what a lot of people don't realize just how good exercise I'm gonna say something that may be a little bit controversial and say it and I'm not speaking metaphorically exercise is medicine
exercise literally is medicine it changes the brain and the body in beneficial ways that are more powerful than any pill you can take yeah I said more powerful than any pill you can in fact I'm gonna say something even more controversial if you could take the no logical and physiological effects of exercise and capture them in a pill all the beneficial effects on rural signaling the
brain the anti aging affects all the way down to the level of chromosomes in every cell of your body that mental clarity enhancing effects I believe tell me if you if you think I'm crazy I believe that pill would become the best selling drug of all time and I think I think people would pay any price to have it there's a problem no we don't exercise
we don't CDC again tells us that sixty percent of all American adults get no regular physical activity and yet if we look at hunter gatherer groups they get four or more hours a vigorous activity every day in fact they look like elite athletes even when they're in middle age and beyond here's the thing I love them if you ask them they will tell you they do
not exercise they don't believe in not work hoped working out would be crazy to them what they do they live they live here is yeah I know I know I like it too here's the dirty little secret and I really want you if you remember nothing else let's talk exercise is not now we are designed to be physically active in the service of adopted goals we
are not designed to exercise when you put a lab rat on a treadmill and crank that thing up to the point where it's moving faster than it wants to move you know it'll do if if if if you let it heal squat down on its haunches and the trouble starts to wear the fur on the skin right off its back so it kind of feels our
pain right when you stare at a piece of exercise equipment there's a piece of your brain is screaming out don't do it you're not going anywhere on that day so how do we solve this conundrum in our treatment program we've got two things we've made actual size natural and we've made it social what's the most natural activity in the world walking it's what brisk walking you
know the kind like you're late for the bus like you might miss your plane that kind of walking will get your pulse up in the aerobic range and that's where it needs to be based on your age depending on your age it needs to be but your pulse things between about one twenty one fifty that's enough to enhance signaling your dopamine circuit your serotonin circuits it's
been tested head to head against Zoloft twice in the long term it one at what dose thirty minutes three times a week that's a low dose it can change your life now I wish I had time to cover everything else that we need to cover but I tell you about one more thing omega three fats did you know that your brain is mostly made out of
fat did you know the brain is sixty percent that my driveway so if somebody calls you a fat head they might be paying you a compliment alright here's the thing our bodies can make all the facts that we need two exceptions are called essential fats there you've heard of them omega six omega threes but they play complementary roles in the body and brain omega six is
our inflammatory omega threes are anti inflammatory we need them in balance were designed to have them in balance omega threes come from grasses and plants and algae in the animals that eat them or make a sixes from grains and not some seeds in animals that eat them which is by the way most of our meat supply our hunter got got their ancestors that'll make a six
is an omega threes in the optimal balance which is roughly one to one we can define it two to one we can probably do okay a three to one but guess what the modern American diet which is recalled with fast food and processed food and grain fed me you see the ratio they're seventeen to one seventeen to one things away out of balance it's very heavily
inflammatory it's very happily present and that suggests to us of course that if we could supplement with omega threes that might just be anti depressant guess what over a dozen controlled research trials have now shown this to be the case what the anti depressant does and I leave you with this hopefully an important step the best research suggests that there's a specific omega three molecule it's
called E. P. A. and at a dose is a pretty high dose of one thousand to two thousand milligrams per day shown to be anti depressant many of our patients have benefited remarkably not just with respect to their depression but other inflammatory conditions as well my my own story when I began supplementing with omega threes several years ago the tendonitis in my knees went away and