56-3 How, by taking care of themselves with a healthy lifestyle, might people find some relief from depression? How does this reflect our being biopsychosocial systems?

The effectiveness of the biomedical therapies reminds us of a fundamental lesson: We find it convenient to talk of separate psychological and biological influences, but everything psychological is also biological (FIGURE 56.4). Every thought and feeling depends on the functioning brain. Every creative idea, every moment of joy or anger, every period of depression emerges from the electrochemical activity of the living brain. The influence is two-way: When psychotherapy relieves obsessive-compulsive behavior, PET scans reveal a calmer brain (Schwartz et al., 1996).

Anxiety disorders, obsessive-compulsive disorder, posttraumatic stress disorder, major depressive disorder, bipolar disorder, and schizophrenia are all biological events. As we have seen over and again, a human being is an integrated biopsychosocial system. For years, we have trusted our bodies to physicians and our minds to psychiatrists and psychologists. That neat separation no longer seems valid. Stress affects body chemistry and health. Thus, our lifestyle—our exercise, nutrition, relationships, recreation, relaxation, religious or spiritual engagement, and such—affects our mental health (Walsh, 2011).

That lesson is being applied by Stephen Ilardi (2009) in training seminars promoting therapeutic lifestyle change. Human brains and bodies were designed for physical activity and social engagement, he notes. Our ancestors hunted, gathered, and built in groups. Indeed, those whose way of life entails strenuous physical activity, strong community ties, sunlight exposure, and plenty of sleep (think of foraging bands in Papua New Guinea, or Amish farming communities in North America) rarely experience depression. For both children and adults, outdoor activity in natural environments—perhaps a walk in the woods—reduces stress and promotes health (MacKerron & Mourato, 2013; NEEF, 2011; Phillips, 2011). “Simply put: humans were never designed for the sedentary, disengaged, socially isolated, poorly nourished, sleep-deprived pace of twenty-first-century American life.”

The Ilardi team was also impressed by research showing that regular aerobic exercise rivals the healing power of antidepressant drugs, and that a complete night’s sleep boosts mood and energy. So they invited small groups of people with depression to undergo a 12-week training program with the following goals:

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In one study of 74 people, 77 percent of those who completed the program experienced relief from depressive symptoms, compared with 19 percent in those assigned to a treatment-as-usual control condition. Future research will seek to replicate this striking result of lifestyle change, and also to identify which of the treatment components (additively or in some combination) produce the therapeutic effect. In the meantime, there seems little reason to doubt the truth of the Latin adage, Mens sana in corpore sano: “A healthy mind in a healthy body.”

TABLE 56.1 summarizes some aspects of the biomedical therapies we’ve discussed.