KU study exploring treatment for depression without drugs

'Caveman' plan touts mood boost

Behave more like a caveman.

That’s the advice of a Kansas University professor who thinks he’s found a medication-free way to beat depression, a major illness that has afflicted about 20 percent of Americans.

And Steve Ilardi’s cure includes mimicking the habits of our hunting and gathering ancestors of 2 million years ago.

“The results have been very encouraging,” the KU psychology professor said about his regimen.

Ilardi, 41, argues that depression has become epidemic – “One in five Americans have experienced an episode of major depressive illness,” he said – because our brains and bodies aren’t designed for our 21st century lifestyles.

“The human brain has been sculpted by 2 million years of life within a hunter-gatherer context. Agriculture has only been around for 10,000 years, and it’s only been since World War I that we’ve become truly toxic,” Ilardi said. “We were never designed to be so sedentary, so socially isolated.”

Depression, he said, is the evolutionary consequence of a person’s brain being out of synch with their social environment.

“There’s a mismatch,” Ilardi said.

Ilardi has come up with a six-part regimen designed to reconnect depression sufferers with their hunter-gatherer roots – more exercise, more sunlight, more sleep, more fish oil, less isolation and fewer negative thoughts.

He calls his system Therapeutic Lifestyle Change or TLC.

Kansas University psychology graduate students, from left, Jennifer Prohaska, Leslie Karwoski, Andy Lehman, Chris Heath and professor Stephen Ilardi are working on an alternative to drug therapy for treating depression. The program uses aerobic exercise, light therapy and other treatments to combat depression in people who aren't responding to prescription drugs. The group is pictured at the KU Student Recreation Center in this 2005 file photo.

“It’s a very active treatment plan,” said Leslie Karwoski, a doctoral student who’s helping Ilardi. “If you’re looking for an easy way out, this isn’t it.”

The regimen does not include anti-depressants.

“I’m not anti-medication,” Ilardi said. “It’s just that for a lot of people they don’t work – and if they do work, it’s short-term. Relapse is a huge issue. So, if you can achieve the superior results long-term without medication, the advantage seems pretty clear.”

Promising results

Last semester, Ilardi and Karwoski assembled a group of five adults, all of whom had been diagnosed with severe depression. Some had suffered for at least a year, but all study participants had been depressed at least six months.

The group met about once a week for 15 weeks. Each session lasted between 90 minutes and two hours, during which participants learned about each component of Ilardi’s behavior system and figured out how to incorporate them into their lifestyles.

Of the five participants, four “experienced a highly favorable treatment response,” Ilardi said, noting that the results beat the 50- to 60-percent response rate for anti-depressants.

Volunteers sought for program

For more information or to apply for participation in Steve Ilardi’s depression study group, contact project coordinator Leslie Karwoski, 218-6336 or karwoski@ku.edu.

Applicants must be:

¢ Between ages 18 and 65.

¢ Live within an hour drive of Lawrence.

¢ Committed to attending 12 early evening sessions over a 15-week period.

¢ Meet diagnosis criteria for clinical depression.

Must not be:

¢ Addicted to alcohol or drugs.

¢ Bipolar or manic depressive.

Deadline for applications: June 10

“Exercise was the hardest part for some people,” said Jane, a 27-year-old KU student who took part in the first group. “But for some it was the easiest. It depends.”

A new beginning

Jane, who asked not to be identified, said the group gave her hope.

“I’d been depressed off and on for like eight or nine years,” she said. “It’s horrible. I used to sleep all the time – when I wasn’t sleeping, I’d wish I was. I was tired all the time. I couldn’t stay interested in anything. I wasn’t really anti-social, I just didn’t want to be bothered. Nothing was fun.”

Now, she said, “I’m happy. I just graduated from KU and I’m really looking forward to moving, finding a job and starting my life.”

A second group is now in its seventh week.

“It’s doing remarkably well,” Ilardi said.

Volunteers sought

Ilardi and Karwoski are looking for adults to take part in two more groups, starting later this month.

It’s proving to be a popular undertaking. Ilardi said he and Karwoski received 40 inquiries after the project was recently featured in a Kansas Alumni magazine cover story.

Jane said she, too, has been bombarded with questions from family members and friends.

“It makes so much sense,” she said. “Everybody wants to know how they can do it.”

A second opinion

Still, there are skeptics who say Ilardi may be underselling the benefits of anti-depressant drugs.

“I’m not being critical – everything he’s doing is logical and beneficial,” said Dr. Stuart Munro, chairman of the psychiatry department at University of Missouri -Kansas City Medical School.

“Exercise is always recommended,” he said. “For some, sunlight is beneficial. And more and more, the literature shows that fish oil can be effective for some.”

But medication coupled with “talk therapy” has proven effective and should not be dismissed, Munro said.

“It’s an arrow I wouldn’t leave in the quiver,” he said.

Ilardi said he’s aware of the concern expressed by Munro.

“I wouldn’t disagree,” he said. “The approach we’re taking could work in tandem with medication, but, again, medications are not as effective as the public assumes they are, the side effects are often intolerable, and for many, relapse occurs as soon as they stop taking them.”


Therapeutic Lifestyle Change or TLC is a treatment for depression based on the idea that the human brain is still wired for life in the Stone Age and altering one’s lifestyle is better than relying on medications.

The six TLC essentials:

¢ EXERCISE: Aerobic exercise is a potent antidepressant. Elevate your pulse between 120 to 160 beats per minute for 35 minutes three times weekly.

¢ SLEEP: Chronic sleep deprivation puts one at risk for depression; get 7 or 8 hours nightly.

¢ SUNLIGHT: The brain needs 2,500 lux for 30 to 60 minutes per day. Spend a half hour outdoors on a sunny day or in front of a 10,000 lux light when it is overcast.

¢ EAT FISH: 1,000 milligrams daily of Omega-3 type EPA fatty acids has been shown to relieve depression. It is found in highly concentrated fish oil, also in tuna, mackerel, sardines, lake trout and salmon.

¢ SOCIALIZE: Social support helps prevent depression during major losses. Separation from friends and family is a common trigger for depression.

¢ THINK POSITIVE: Don’t dwell on repetitive, negative thoughts. Learn to redirect attention to more engaging activities.