by Stephen S. Ilardi
Da Capo, 2009
Review by James K. Luiselli, Ed.D., ABPP, BCBA on Aug 18th 2009
Psychologist, Stephen S. Ilardi, has a theory about depression: "Human beings were never designed for the poorly nourished, sedentary, indoor, sleep-deprived, socially isolated, frenzied pace of twenty-first century life." It is our contemporary lifestyle, he argues, that increases the risk for depression, caused by the brain's "runaway stress response." Changing brain chemistry through a 6-step non-medication program Ilardi calls Therapeutic Lifestyle Change (TLC) is his depression cure.
The TLC program Ilardi designed and recommends requires a person to take omega-3 fats (fish oil), participate in engaging activities, exercise regularly, increase sunlight exposure, find supportive social connections, and develop healthy sleep habits. He devotes separate chapters in the book to each of these components, citing the research evidence for his conclusions and offering practical suggestions. For example, in the chapter on omega-3 fats, he details the desired dosage amount, the type of nutritional products to purchase, and proper storage techniques. Similarly, there are specific instructions in how to improve sleep and reap the benefits of sunlight exposure. Ilardi's program leans heavily on established depression-treatment methods, including cognitive-behavior therapy and behavioral activation. Throughout the book he advises the reader to write down changes in behavior, mood, and thoughts as the best way to evaluate progress when implementing TLC.
The Depression Cure is a very good self-help book. Ilardi writes clearly, avoiding jargon, and speaking eloquently about many topics. His depiction of negative lifestyle influences on people's emotions and actions are on target--there is nothing to argue about here. Whether his 6-step program adequately addresses these problems is a question that demands research attention. Ilardi references "preliminary clinical trials" that he and his research team conducted at the University of Kansas, yielding "exceptional results--far superior to those typically observed with medication." However, he does not report publication of these findings in a peer-reviewed professional journal. Also, his claim that "we've yet to see someone put the entire TLC protocol into practice without experiencing significant improvement" is not supported by scientific research. I don't doubt that he has seen many clients improve by applying the TLC program but he needs to publish data to support his clinical impressions.
Really, though, this is a splendid book because the recommendations made should lead to a healthier lifestyle for most people. Ilardi is not a physician so, as he acknowledges, setting up a regimen of omega-3 supplementation, changing diet, and adding exercise demands should be medically approved. And although he gives a good account of the side effects and sometimes non-therapeutic impact from antidepressant medication, he does not dispel the role of psychopharmacology in treating chronic and severe clinical depression. My hope and expectation is that the TLC program will be subjected to controlled research evaluation that can be shared with the professional community. Overcoming depression is not a simple challenge but one, I suspect, has a chance of success by reading this book.
© 2009 James K. Luiselli
James K. Luiselli, Ed.D., ABPP, BCBA is a psychologist affiliated with May Institute and a private-practice clinician. Among his publications are 6 books and over 200 journal articles. He reviews books for The New England Psychologist.