Brianne Baker's
boyfriend barricades the apartment door. He won't let her leave, but more so he
won't let her run from reality.
"If you keep doing
this to yourself you're going to kill yourself," he says.
At first glance
Brianne might look anorexic; she's lost three pants sizes in the past few
months. She's a only 20-year-old sophomore at KU, but she has bags under her eyes and her normally vivid red hair is dull and
sickly looking. Brianne doesn't eat or sleep anymore. She doesn't socialize
with her friends and her grades are slipping more and more each day. She's even
contemplated suicide.
Finally her
boyfriend's words hit. Brianne sinks to the floor sobbing.
"I need help."
Brianne was
experiencing a severe episode of major depressive disorder, the number one cause of disability in the United States. After realizing she needed to get help, Brianne went to her doctor who
prescribed her an anti-depressant.
"I didn't like how
the meds made me feel," said Brianne. "I was emotionally dead. I stopped caring
about people."
Dr. Steve Ilardi, an associate professor of psychology at KU, has developed his own treatment for depression called Therapeutic Lifestyle Change (TLC). The medication-free program is based on an evolutionary perspective and focuses on reclaiming protective lifestyle features that have become neglected in modern industrialized society.
"Our bodies were never designed for a twenty-first century way of life," said Ilardi. "Depression, much like diabetes, heart disease, or even tooth decay, is almost non-existent in groups unaffected by modern ways of living, such as the Amish or aboriginal groups. In essence, depression is a disease of modernity." 
TLC focuses on changing brain chemistry by implementing a specific set of lifestyle changes, including aerobic exercise, sunlight, omega-3, social connection, sleep and engaging behavior.
Brianne is one of
many for whom anti-depressants generate negative side effects. A federally funded study conducted a year and a half ago called Star*D, which had a sample of more than 4,000 participants
at 41 different testing sites in the U.S., found that after being treating with medication
less than 7 percent of participants were "well" after one year. On average, most studies show that anti-depressants help approximately only 30 percent patients.
Ilardi began
recruitment for the TLC program more than four years ago, targeting patients
who were previously resistant to other forms of treatment.
"Someone
who hasn't responded well to treatment in the past doesn't have a good
prognosis for wellness," Ilardi said.
More than 100 patients
were randomly assigned to either participate in the TLC protocol or placed on a
waitlist for 14 weeks. Those on the waitlist were asked to maintain "treatment
as usual," or to treat their depression as they normally would. The waitlist
served as a control group for the study. Brianne initiated the steps of the program on her own with guidance from Professor Ilardi.
"After I started the program I was a different person. Everyone noticed the change and asked me what I was doing. It was the first time in a year that I didn't cry myself to sleep every night," Brianne said.
Those
who participated in the TLC protocol had an approximate success rate of 74
percent, while the control group had less than a 20 percent wellness rate.
"We
base wellness on whether or not the patient meets criteria for clinical
depression," said Ilardi. "Patients who are considered successfully treated may
still show some symptoms, but they are functional."
After
a six-month follow-up, the patients had maintained the same level of wellness
and at 12 months the rate had only a negligible decrease. Ilardi suspects this
slight decline was due to lack of adherence to the exercise component of the
program, which requires 30 minutes of aerobic exercise each day.
"Exercise
is probably the most important part of the treatment," said Christina Williams,
a clinical psychology graduate student who works on the TLC program. "This is a
huge lifestyle change for these patients though and finding the motivation to
go work out can be hard for them."
IIardi
and his team of graduate students are currently revamping the TLC protocol for
future studies. They are focusing on improving adherence to the aerobic
exercise regimen, as well as trying to maintain the wellness rate over the
long-term. They are also trying to make the program more user-friendly and
accessible.
IIardi
is close to finishing writing the data analysis, which he hopes to have
completed in the next two weeks. He will likely seek publication in
"Professional Psychology Research and Practice," a scientific journal geared
toward practicing clinicians.
TLC
is not without its skeptics, however. David Holmes, professor of psychology at
KU, said he doesn't believe there is one cure-all for depression. Holmes said
heralding the study as a success was "premature" and he was still waiting to
see the published evidence.
"I'm
open to being proven wrong, but at this point, I'm just not convinced its as
effective as Steve says its going to be," Holmes said.
Brianne
had to undergo major surgery a year ago and stopped using Ilardi's
treatment method. Exercising wasn't feasible after her surgery and she simply
got out of the habit.
"There
was an obvious difference after I stopped doing TLC. Without it I feel like I'm
fighting a day-to-day battle, Brianne said.
It
should be mentioned that Brianne is still taking an anti-depressant. Her once
regular panic attacks have recently started again and she's experiencing other
symptoms of relapse. She plans on restarting the TLC techniques.
"It's
so much more effective than popping a pill. I stopped caring about the ones I
loved because of a pill. There aren't side effects to this," Brianne said.