WITH ELLEN VORA, M.D.
If you’re feeling sad or blue, or suffering from mild to moderate depression, dysthymia, seasonal affective disorder, premenstrual dysphoric disorder, bipolar II, or anxiety, Dr. Ellen Vora has the tips and tools you need to help manage your symptoms and feel vibrantly healthy. Check out her newest mbg class, Managing Depression: A Mind, Body & Spirit Approach, to learn how you can start healing your depression today.
As a holistic psychiatrist, my primary goal is to meet someone who is suffering from a mental health issue like depression before they start medication and offer them an alternative approach to healing. When done right, tailored diet and lifestyle changes and natural remedies can usually help someone avoid the need to ever go on medication at all. In fact, studies have shown that depression medications aren't all that effective for mild-to-moderate depression; meanwhile, other research shows an important link between diet and mental health.
There are four main pillars in my approach to treating depression without medication, and they're a great place to start if you're struggling with your mental health or simply want to optimize your happiness and well-being.
Disclaimer: I recommend that you be in treatment with a good mental health provider who can help you navigate these choices, balancing them with the need for other intervention.
My first suggestion is and will always be: Change the way you feed yourself. The literature tells us there's a strong correlation between diet and mood. If you're depressed, do a radical act of self-love and feed yourself an antidepressant diet. What is that? It's a nutrient-dense, non-inflammatory, real-food diet. Specifically, you eat combinations of real food, such as vegetables; well-sourced meat, fish, and poultry (go to the farmers market or a good butcher and have a conversation about their practices); starchy tubers (translation: sweet potatoes, white potatoes, plantains); nuts and seeds; fermented foods; fruit; and plenty of healthy fats such as ghee, olive oil, avocado, coconut oil, and fatty cuts of meat and fish. What's not there is what most of us crave at 3 p.m. and the foods that make up much of the standard American diet—sugar, refined carbohydrates (i.e., bread, crackers, pasta, cookies, even seemingly healthy vegan baked goods and gluten-free replacement foods), and inflammatory oils, such as canola oil.
Sleep is the cheapest, easiest, most indulgent, and most effective antidepressant on the market. Side effects include a longer life span, better mood, balanced hormones, weight loss, stronger immunity, lower cancer risk, better memory, better creativity, and being a nicer person. So what's stopping all of us from making sleep our No. 1 priority? Personally, I think it's electricity and our epidemic of phone addiction. Get smart about this by dimming the lights in your home after sunset, and get that phone out of your bedroom at night! Go back to an old-fashioned alarm clock and a paper book instead of the phone. Once you make this simple (but admittedly: extremely difficult) change, your sleep and depression will improve. It's time to make sleep just as important (if not more important) than nutrition, mindfulness, and exercise.
To me, the takeaway here is not "Hey, if you’re depressed, go train for a triathlon, join a gym, and hire a personal trainer!" None of that is realistic when you're feeling depressed and struggling with low motivation and low energy levels. A far more useful takeaway is "Hey, if you're depressed, take the pressure off yourself to run a marathon, and just do something—anything—for a few minutes most days." Will this get you washboard abs? Unlikely. (It hasn't for me, yet.) But it will shift your inertia from sedentary to active, and it will give you some of the antidepressant benefits of exercise while still being a realistic endeavor. So commit to this today: Move your body in some way that's free, convenient, and easy for five minutes. I personally like to do some quick Pilates in my living room for about five minutes after work. I'm still waiting on that six-pack, but it definitely boosts my mood.
WITH ELLEN VORA, M.D.
It's almost stressful how much we talk about and focus on stress. I've been treating chronic stress—my patients' and my own—for years. While I agree that a daily meditation practice—whether it be Kundalini, mindfulness meditation, Vedic, Transcendental, or something else—can be transformative, these days I'm pushing people to go further than meditation. If you're living with chronic, toxic stress, it's time to take a major step back and reevaluate the structure of your life. Everything is up for grabs, from job, to career, to geography, to relationships, to how much clutter you've accumulated in your home. Take stock and make decisions about what needs to go and what needs to change. Many people are stuck in a loop of staying in a job they hate so they can afford a certain standard of living. But when that standard of living necessitates chronic stress, I question whether that's really a good quality of life. Don't be afraid to make some rebellious opt-out choices when it comes to the default settings with career and lifestyle. Take some leaps in order to create the right life for you.
5. Extra credit
If you've rehabilitated your diet, sleep, stress, and exercise habits and you're still suffering from depression, a final dimension to healing depression is ensuring that your life is full of connection with nature and positive community. Be in nature weekly, daily, constantly—whatever it takes for your soul to wash away the residue of the air-conditioned fluorescent cubicle. And this last piece is so hard to craft and such a blessing if and when you have it, but never give up on finding your tribe of positive people who see you deeply and can hold space for you to be vulnerable while still letting you know that you belong and you're worthy.
I hope this has given you a sense of the basic outline of my holistic approach to managing depression. Of course, no two people and no two depressions are exactly alike, but sleep, food, exercise, stress, community, and nature are great places to start.
Is there such a thing as too much self-care? This doctor thinks so.
Photo: Art: Megan Lazaros | Photo: Miachel Breton
WITH KATHRYN BUDIG