In this episode, I speak with Dr. Achina Stein and Silvia Covelli about their soon-to-be-launched venture, The Healing Depression Project.
If you’re a long-time depression sufferer, this episode is for you. And if depression isn’t an issue you deal with, please consider passing this episode on to someone you love who lives with this disease. There are so many helpful steps we discuss…it might be what they need to finally feel a difference in their life and spark hope.
Table of Contents
In this podcast, Dr. Stein, Silvia, and I discuss:
- How Silvia had to be her own advocate and find alternatives to her pharmaceutically-treated depression because drugs simply weren’t working
- How The Healing Depression Project offers a new approach to treating depression (that takes into account the entire person, not just the brain)
- The fact that 60% of people who take depression medications get little to no benefit…where should people turn when nothing else has worked?
- What depression actually is and how it’s viewed and diagnosed in the conventional medical model
- Why is the serotonin theory still the dominant explanation for depression, even after being debunked for years?
- The strong role of the placebo effect in depression treatment
- The 2 primary focuses of The Healing Depression Project and why retreat-based treatment is the best way to heal this chronic illness
- The biggest needle-movers for depression Dr. Stein has seen in her practice
Listen or download on iTunes
Listen outside iTunes
Transcript
Ari Whitten: Hey, this is Ari. Welcome back to The Energy Blueprint Podcast. In this episode, I’m going to be talking with Dr. Achina Stein and Silvia Covelli about the Healing Depression Project. A little background about them. Dr. Stein is the Clinical Director at the Healing Depression Project. She’s a leading expert in functional medicine psychiatry and a best-selling author with 30 years of experience helping people recover from depression. She’s a board-certified psychiatrist, a distinguished fellow of the American Psychiatric Association, a certified practitioner of the Institute for Functional Medicine, and a former clinical assistant professor of psychiatry and human behavior at the Warren Alpert Medical School of Brown University.
Dr. Stein’s international best-selling book, What If It’s NOT Depression?: Your Guide to Finding Answers, offers groundbreaking functional medicine perspectives, instilling hope and providing healing pathways for those facing chronic depression. In the 45-day depression recovery program offered by the Healing Depression Project, Dr. Stein works on identifying and addressing all the root causes of your depression-like symptoms. This program brings hope to those who have long struggled with depression and have not found relief with other treatments, including antidepressant medications.
Silvia Covelli is the founder of the Healing Depression Project. She’s an honors graduate from Boston College and a former social science researcher at Harvard University. She pursued graduate studies in finance and business law and dedicated her career to entrepreneurship, becoming a skilled businesswoman. In parallel with her thriving career, Silvia faced relentless and chronic depression, exploring over 60 different treatments without finding sustained relief.
Her personal struggle, combined with her extensive background in human transformation and mind-body connection, led her to develop a program that remarkably eradicated 25 years of depression symptoms, leaving her depression-free ever since. This breakthrough later inspired the creation of the Healing Depression Project, what we’re going to be talking about in this podcast, and inspired her to dedicate her life to helping others break free from depression. Now, please enjoy this podcast with Dr. Achina Stein and Silvia Covelli about the Healing Depression Project. Welcome to the show, Dr. Stein and Silvia.
Achina Stein: Thank you for having us.
Silvia Covelli: Hi, Ari, thank you for having us.
Healing Depression Project
Ari: It’s my pleasure. First of all, to get us started, I would love for both of you to describe sort of the backstory of how you came together and why you started the Healing Depression Project.
Silvia: Okay, so the project comes out of my own experience. I struggled with depression for more than 25 years and nothing that I did was really able to help me. I looked for help in the psychiatry and in so many other, also medical treatment models, and nothing was really able to make my symptoms go away or to stay well for a long time.
Eventually, I put my own program together out of more than 60 different programs and approaches that I had tried in the past. At that point, that program, I only used it for myself. It really took away all my symptoms that I had been feeling for 25 years. Long into my recovery, I had this feeling and a connection of, “This can help others.”
At that point, I just wrote down what I did and I reached out to Dr. Kat Tubbs. She’s our research director for the program. I didn’t know her. I didn’t know none. Actually, I didn’t know a doctor in functional medicine. I wrote to her. I told her about my story and what I thought a great program would be. We set up a meeting, and in that meeting– well, I had been trying to contact Dr. Stein before for quite some time, writing her some messages, and she did not reply. Then Kat for the meeting, she said, she asked me, “Is it okay if I invite a friend?” I’m like, “Sure. Who are you inviting?” Then she said, “Achina Stein.” I’m like, “No way.”
Achina: To my defense, it was LinkedIn. I don’t go to LinkedIn very much that she sent messages to.
Silvia: This was in the functional medicine annual conference. We had a meeting. I explained my vision and the process that I had been through. That’s how the program began at that day. We just put a lot of other minds together and added all the sciences to the things that I had done just to really empower, to get this program to the next level. Now, we’re ready to launch. We’re having our first program in March next year.
Ari: What’s the mission statement here? What’s the big vision of this project?
Silvia: We want to change the narrative in psychiatry. The current narrative of psychiatry is that depression is a lifelong condition, that chances for recovery are very small. Also, they mostly rely on medication. What we’re bringing to the table and what we want to start talking about and the conversation to go to is that to add tools different from medications and to show that there’s other approaches, such as functional medicine, psychiatry, and metabolic psychiatry, and lifestyle medicine that can actually bring effective treatment to people that are trapped in years and years of depression. That’s what we want to do. We want to show that these treatments are very effective just as so much research is already doing. We want to join that and offer treatment that can really end the cycle of depression.
Ari: Dr. Stein, do you want to follow with anything on this first question?
Achina: Yes. I’m sure you’re familiar with functional medicine, and psychiatry is really an extension of that, and finding root causes of the problems, of the symptoms, rather than suppressing symptoms with medications and bring the body back into balance by addressing them, using food, going after chronic infections, going after toxins, stress. Really, it’s looking at all of the things, not just one thing, and then saying, “Oh, well, that failed.” Then going to the next thing and, “Oh, that failed.”
It’s not a silver bullet approach. It’s an approach where you’re looking for all of the pieces of the puzzle, which is different for every individual on some level, and addressing each and every one of those and making changes in the lifestyle. 80% of chronic disease, and I consider “treatment-resistant depression” as a chronic mental disease, and that it’s lifestyle, it’s related to lifestyle. A lot of people don’t really know that.
They’re not aware that there are lots of things that can cause depression. It’s not necessarily something that they’ve inherited. Maybe they have some family history, but we all know about genetics and epigenetics. That there are things that we can do to reverse certain things. It’s not perfect. Some people will get better, but it’s on a spectrum, just like there’s a spectrum of people who do have improvements in their symptoms with medications.
I think 60% of people who take medications get little to no benefit, or they get some benefit, but then their symptoms return. Then they start having side effects. Then they go through what I call this medication merry-go-round and polypharmacy. Then it just gets worse and worse and worse. Nobody talks about inflammation. Nobody talks about how certain diets can resolve depression on some level.
There’s so many experts out there who talk about these individual things that improve depression, that what we want to do is show how we can stack all of these treatments, one on top of the other, and really work towards teaching people lifestyle changes in a retreat style setting of daily follow-up. That’s a four-week period of doing all the things, which is really a lot of education, teaching people how to change their lifestyle.
We’ll sit down with each individual and plan for all the obstacles that they imagine coming up, when they return home and address them, have a plan of attack, essentially, but what are the obstacles that are going to come up for you? Let’s get ahead of that and address those things so that you’re going to be successful once you return home.
There are people who go to psychiatric hospitals, and they’re there for weeks and weeks and weeks, and they’re discharged, and they’re discharged with an appointment with their therapist or their psychiatrist, which might be weeks to months later. Everything that they’ve accomplished, even in that psychiatric treatment program tends to fall apart. We want to make sure that people are successful in continuing these habits that they’ve learned and implemented, and to continue those habits, because ultimately, it is lifestyle. That’s a big part of these mental health symptoms.
What is depression?
Ari: I want to sort of step back for a second into the realm of what might seem obvious or may actually be obvious to some people, but I want to spell it out, which is depression. What is depression? This is obviously a word that everyone’s heard many thousands of times in their life, but what you’re referring to is depression as the psychological or psychiatric disorder. That is characterized, that is diagnosed by the presence of certain criteria and symptoms. Can you explain exactly what those are? What is depression in the way you’re speaking about it?
Achina: Sure. Depression, just the word depression, it’s a symptom, and that can mean a lot of things for people. Sometimes people use the word depression and they really just mean irritated or anxious or disappointed or unhappy. It’s thrown around quite a bit. There’s so many other words that might be a better description of what they’re actually experiencing. I don’t like that word just because it’s used so often for so many different things.
Depression is a symptom, and in the DSM, the Diagnostic Statistical Manual that we psychiatrists and psychotherapists use to diagnose mood disorders, has a specific diagnosis called major depressive disorder. Then there’s other mood disorders. There’s dysthymia, there’s premenstrual dysphoric disorder. There’s a whole bunch of mood disorders. There’s bipolar disorder. Treatment-resistant depression is a type of depression of major depression where you fail several trials of medications.
Going back to what major depression is, it’s basically having five of nine symptoms for every day, most of the day, for at least two weeks. Many of those symptoms, believe it or not, are actually physical symptoms or what I consider neurological symptoms. For example, having a sleep problem, having problems with concentration, problems with energy. Boy, I’m blanking on all the symptoms, but sleep, energy, concentration, restlessness. There’s suicidal ideations, feeling guilty. We’re talking about every day, most of the day, that you might have these symptoms. Then it could be to the extreme of suicidal ideations, intent, or a plan. It also includes the possibility of psychosis.
There’s a number of symptoms, and you have to have five of nine of those symptoms every day, most of the day, for two weeks in order to be given that diagnosis. Then there’s mild, moderate, and severe. One of the criteria is also that it has to cause severe dysfunction within relationships or occupational functioning, including school. That’s the actual criteria for a diagnosis. I missed a couple of symptoms, but many of those symptoms are physical symptoms, and nothing in the diagnostic criteria talks about what causes these symptoms. This is how you diagnose it. You want to make sure that you rule out an acute medical cause or a substance use disorder.
Once these acute issues are ruled out, it’s generally thought that it’s in your head, that it’s not something that’s caused in the body, that it’s caused by some biopsychosocial problem. There might be a chronic problem like hypothyroidism or B12 or folate deficiency that’s commonly looked for and maybe ruled out. There’s so many other causes that we don’t even search for as psychiatrists. Many psychiatrists aren’t really trained to be able to do that. There’s more and more happening.
The modern medicine approach to depression
Ari: Okay, I do want to get to that. Before we get to that, so we have this understanding of what depression is now. Before you explain sort of the paradigm that you’re advocating, can you explain the standard paradigm in medicine, in psychiatry, of how they see what depression is and what is causing it physiologically?
Achina: Sure. We look at a number of things. There is this whole decision tree that we go down. You want to look at if there’s a genetic predisposition, if there’s any triggers from stress.
Ari: Wait, are you talking about your paradigm, or are you talking about the standard allopathic paradigm?
Achina: The standard allopathic paradigm. Yes, we’ll get a family history. If you have a strong family history for depression, it’s like, oh, there’s a genetic component for you. That’s not surprising then that you’re now depressed.
Ari: Can you sort of crystallize how conventional medicine sees depression? For decades, the public has been indoctrinated. At this point, the American public has an understanding of what “the cause” of depression is that has been directly passed down from the paradigm of medicine and psychiatry of depression, which is the chemical imbalance, serotonin-based theory.
Achina: I wasn’t sure what you’re asking me.
Ari: Rather than sort of in practice, how a physician would deal with a patient with depression and the steps they’d go through, can you explain the paradigm level of how they conceptualize what depression is?
Achina: Sure. We do a psychiatric evaluation and we look at the whole history, including family history, medical history, any triggers that might have, and it’s usually more psychiatric or psychosocial triggers, above the neck, things that have happened in your mind that generally causes this thing. Ultimately, the belief is, and very strongly believed by psychopharmacologists, is that it’s an imbalance, it’s a chemical imbalance, or an imbalance in neurotransmitters in the brain. That has been debunked decades ago. In the early 1990s, that was debunked, but a lot of people still–
Ari: More recently, there was a big review paper that came out, reviewing all the body of evidence around the serotonin depression link that came out, what, six months ago, a year ago, something like that.
Achina: Absolutely. It comes out pretty regularly, but it doesn’t hit the media, and people continue to talk about it as a chemical imbalance.
Ari: Explain that in depth because 90% plus of people are still operating in the chemical imbalance serotonin deficiency model of depression. Explain the basic idea of what that is, sort of being charitable, and then explain why it’s been debunked.
Achina: The serotonin theory or neurotransmitter theory or chemical imbalance theory is that there is a deficiency in serotonin, a deficiency in norepinephrine or dopamine, and there’s a combination of those deficiencies that can occur in a person. Generally, it’s some type of imbalance at the neurotransmitter or neuron level in the brain. There’s some kind of imbalance. Nobody really talks about why. We don’t know why that there is an imbalance. We also don’t know why, or at least they don’t think that there’s a reason why, and we don’t know why antidepressants work.
Antidepressants like SSRIs or SNRIs are basically medications that increase serotonin in the synapse of the neurons, and it prevents the reuptake of that serotonin in the synapse or the reuptake of norepinephrine in the synapse. That’s what these medications do, but they don’t do it in a specific part of the brain, it’s in the entire brain. That’s why people have side effects. It’s not just deep in the brain, it’s the whole body really. It’s not very specific. Some people still have side effects because serotonin is made in the gut. Major side effect of these medications is having gut side effects. That’s basically, in a nutshell, what people believe to be the case, yes.
Ari: What’s the evidence that’s come out debunking the serotonin or chemical imbalance model of depression?
Achina: They don’t have any ability to prove that. I don’t have in my mind, I’m sorry, and the specific evidence that you’re referring to.
Ari: Just in general, what are the types of evidence that have suggested that that serotonin deficiency model is not accurate? I don’t mean for you to rattle off the names of specific papers necessarily, but to just say, what is the evidence that has debunked this paradigm?
Achina: We don’t know how these medications work. It causes a number of side effects. I’m not sure what specific thing you’re referring to. It might be very simple that you’re talking about.
Ari: Yes, from–
Silvia: I think maybe it’s that they haven’t been able to find– that they found that there’s no relationship between depression and serotonin, that people having very deep states of depression, they have high levels of serotonin, and the opposite also is true. I guess this is one of the things that has contributed to see, “Wow, this cannot be the root cause look at these people.” Maybe that’s one of the things that you’re looking for.
Ari: Yes, that’s what I was getting at, is the paper that came out six months or a year ago cited a large body of evidence that’s basically failed to show any sort of efficiency or low levels of serotonin or imbalance of serotonin in the brain of people who are depressed.
Achina: Okay, I wasn’t sure what you were looking for. I tend to go high-level detail as opposed to the simple answer.
Ari: Sure. Yes, but this is a fascinating– we can do a whole podcast, probably multiple hours of discussion just on the fact that for decades, hundreds or billions of people have been indoctrinated into this view of depression that has been portrayed as “the science”. This is the cutting-edge evidence. This is what we know, what all these fancy technologies and this large body of evidence has proven beyond a shadow of a doubt.
Depression is caused by this chemical problem in the brain. Then, all of a sudden, decades later, there are papers being published saying– after, by the way, billions of people have been put on antidepressant drugs based on this premise, all of a sudden, now there’s papers saying, “Oh, actually there’s no real good evidence to show that serotonin levels are even linked with depression.”
Achina: Right, and that started in 1992. 1992, these papers began. That’s 20, 30 years ago.
Ari: Meanwhile, antidepressant drugs are one of the best, the top-selling drugs that– I don’t know the exact statistics, but it’s something like– I think other than maybe blood pressure drugs and a few other medications, they’re pretty much the medications that the largest number of people are prescribed.
Silvia: The medication, it’s very interesting because it has been going on for a long time because regarding how ineffective medication is, in 1998, a study by Jude Lewis and 11 other people showed the results of a longitudinal 12-year study that they follow 431 people for 12 years. They measure all of them taking medication. They follow on a weekly basis, just asking and doing an interview about the symptoms. The results are unbelievable because 90% of people show symptoms. Only 10% of the people got better, got well.
There’s a lot of evidence showing that medication is not being effective, but it’s still, it is being prescribed and prescribed. Today, I was talking to someone that wants to register for the program. She has been on medication for 10 years. Now on the six different medication, is taking a combination of four. She was telling me, I keep telling the doctor, this is not working, but the doctor keeps saying “You need to stay on. You need to believe, you need to continue.” Let’s change it. It’s a matter of doses.
Then they believe in this so blindliness that they don’t even want to look at the evidence that is out there. Not even when it’s the patient, we ourselves telling the doctor, because I was there in so many situations telling this is not working. Then the doctor was like, “Yes, it is.” I’m like, “No, it’s not.” Even to get off of medications is really difficult.
In my case, I insisted. I have to say, “I want to get off this medication because, for me, the result is very clear that, in my case, it’s not helping me.” I didn’t get the help to do that. Eventually, I had to do it on my own. I informed myself and did the process by myself. That’s how embedded this belief in medication is in conventional psychiatry.
Ari: Yes. There’s another dimension to this, which is that as a result of decades of indoctrinating billions of people around the world to believe in this paradigm of depression, the belief itself, the widespread cultural belief itself is now something that creates a very strong placebo effect. It leads to the perpetuation of this paradigm by virtue of the fact that many people do get on these drugs and do have the experience of getting better, which is the same experience for many of them, for a large percentage of them.
There’s been some researchers that have specifically done a large amount of work around the placebo effect as it applies to antidepressants. Literally, the same benefits that they would have gotten with a sugar pill had they believed that what’s inside of that pill is a fancy chemical that’s altering the chemicals in their brain that are the cause of their depression. Now, this whole belief that the public has been indoctrinated in is now a force, its own force that is sort of perpetuating this paradigm, this debunked paradigm of psychiatry.
Silvia: The placebo effect is so strong because you as a patient, you go to a doctor that since childhood is being told that he’s a figure of authority, a wise person, and then as a patient, you’re struggling with a lot of things. Then here comes the doctor bringing a pill that only the name has a placebo effect because it’s antidepressant. It’s supposed to help you to get out of depression just by the name itself. Then here’s the doctor telling you that it works. That effect is incredible.
The opposite, too. Negative placebo effect is so strong because also what doctors, one of the main messages in conventional psychiatry is that medication is forever. They never prescribed medication, just saying, “Okay, this is only for three months and this is our plan. This is the strategy. We’re going to do this while you get to this point. After that, this is the treatment.” They don’t do that. They say, “Take this for how long. Keep taking it.”
Now, we have kids that began even when they were 11 and now they’re like adults in their 30s, and their nervous system and the neurons and everything is completely affected in their bodies because there is this belief in conventional psychiatry that you cannot get cured from depression. I always say, even if you ask Google, can depression be cured? The answer is no, there’s no cure for depression. There’s only treatment for the symptoms.
That’s also talking about the placebo effect. That really affects the mind of the patient, because if you know that you have a condition that will never get cured. Antidepressants are going to make it better according to the doctor, but the same doctor is telling you that this is not going to cure you, or this is just going to make things a little better. That also makes you experience the condition for a really long time and lose hope in really finding a solution that it makes you long-term, brings you long-term wellbeing.
The Healing Depression Project approach
Ari: Yes. I would love for you guys to tell me about your paradigm of depression and why you think it’s a better one.
Achina: We consider depression as being caused by multifactorial reasons, and a root cause being inflammation, but there’s lots of things that can cause inflammation, on a cellular level, in particular organs that ultimately affect the brain and the mind.
It’s looking for those factors that cause inflammation in the body that affects the brain and reversing those factors, but that’s it in a nutshell. There’s different areas of foods, chronic infections, toxins, stress, all of which can affect hormones. Particularly your stress hormones, cortisol, and the sex hormones. When there’s aberrations in these areas, they can ultimately cumulatively come together and manifest as depression.
Ari: What about like the psycho-spiritual dimension of this and social dimension of it? Just to make a sort of caricature of an example here, let’s imagine that someone who lives off of Burger King, French fries, and potato chips, and eats at Pizza Hut, and eats ice cream and donuts at Dunkin’ Donuts for breakfast, and doesn’t exercise, and spends most of their day on social media, is addicted to porn, works a job that they hate, is lonely or has a dysfunctional relationship, on and on and on.
They go to their doctor and their doctor says, “Well, the cause of your depression is clearly that you have a serotonin deficiency in your brain. Here’s this really advanced science. Through the power of science, we’ve developed this chemical that will alter the cause of your depression, which is the serotonin levels in your brain. That’s the solution.” There is this constant sort of overlooking of the deeper dimensions of a person’s life, of the way they actually live and operate in the world, and a constant sort of conflation of physiological correlates.
Even if the serotonin model of depression were true, even if low serotonin levels were genuinely linked to depression, the scenario I just talked about would still be totally wildly wrong in the way that they’re thinking about it, because you’re still overlooking all of the dimensions of how this person is living that are the actual causes of why their serotonin is low. You’re then saying you are a victim of this chemical in your brain. Therefore, here’s another chemical that will alter the chemical in your brain.
Achina: They’re talking about it as this serotonin deficiency, for example, if that were true, as something that’s a problem downstream. If you just fix it downstream by giving you this medication, then everything will be all right. You’re absolutely right. I think, at some point, you have to take a look at all of the things.
I talked about the functional root causes, but you have to look at not just the biology and the functional root causes, but the psychology and the spiritual aspects and how this person lives in the environment or their perspective of the world or worldview and what they grew up with, how they were treated, all of that makes a difference. Psychotherapy would certainly be a part of this work and working through the trauma of the things that they’ve gone through.
One thing that is not talked about enough is how the body keeps the score, and how releasing this trauma from the body, not necessarily just talking about it over and over again with the therapist, but actually releasing these traumatic things that have happened to them that is embedded in the tissues of the body. There are ways to do that and somatic techniques that we talk about as well.
Silvia: Precisely, because of everything that Dr. Stein is saying, our healing model is called 360 whole person approach, and we do body, mind, emotions, and spirit. The first piece in that order, first, we address through functional medicine, extensive lab testing, and assessment, and treatment plan. We look at those root causes in the body that, what’s happening in the body, what are the dysfunction, the imbalances that are contributing or causing these symptoms.
Then we also go to the mind, which is we use a lot of– because in the example that you were saying about this person having that type of life, so there’s so many things that are taking place there. Then is the physical piece. Then there’s also the mindset. For the mindset, we’re going to be doing meditations that are– it’s a special type of meditation that lower your brain cells from beta to alpha so that the subconscious can be accessed because, as you know, 95% of the brain is the subconscious mind and only 5% is the conscious mind. That’s why like making a change, just out of wheel, it’s really difficult and to stop reactivity from things that you are used to do or things that happened in the past, it’s also very hard just out of wheel.
In this type of meditation, then we’re able to reset your brain with new thoughts, new emotions, and new possibilities so that that person can break free or leave that state where the person is at that moment. Then the also piece that we do when we do the emotions is, as Dr. Stein was saying, is the trauma work. We’re going to be doing more than the talk therapy. Talk therapy only takes you so far. It helps you understand, discover things, but then what you really need to in order to live your life and get out of so many patterns and things that you’re doing is to really work through that trauma.
We’re going to be doing experiential therapy, specifically psychodrama, which has been shown in research to be very effective for depression. The piece also combining the emotion, and together with the somatic therapy that, like Dr. Stein was saying, just to help that trauma, lift the body to move through you and eventually get out of your body.
Then there’s always the spiritual piece, which is because what is– how connected do you feel to life? Do you have a life purpose? What do you do on your day-to-day life? What do you wake up for in the mornings? In the example that you were giving us, Ari, this person has no reason what to wake up for. He hates job. He has all this accumulation of all things that he does.
We also treat that and work with the overactive mind that keeps you normally very in the past, feeling sorrow, maybe for something that happened, or in the future, feeling really anxious about something that you don’t even know it’s going to happen and takes away the only thing that is real and that you could actually enjoy, which is the present moment. That model is very– it’s empowered by lifestyle medicine. We do grounded on lifestyle medicine and on the science of habits formation.
We train people on two things. One, how to break free from habits that are not helping the person physically and mentally and emotionally, and breaking from those habits is very difficult. We help them to do that, and we help them to cultivate, form new habits, and that’s why it’s also the length of the program, 30 days. Through practice, through repetition, what we are looking for is for this person to completely change their habits and get into this beautiful morning routine that will set them up for success, to really maintain the gains that they’re going to be having at the program. Once you do all this functional medicine approach on really bringing your body back to balance, and then you also have this super powerful nutrition grounded on metabolic psychiatry, that is going to reset the metabolism of your brain cells and give you basically a new chance to start over so many new things in your life.
Once you have that, and you have made all these gains in the program, when you go back home, you need to implement, continue these lifestyle habits in order for that to really create a transformational change in your life. Otherwise, it’s like anything, just having the information or knowing that something’s good, we all know that’s not good enough. I went through that. I had so much information. I knew the best things, the best practices, but then I had to talk. I had to really have a talk to myself in all honesty, how many of those do you do on your daily life? about this, the way you should be eating, are you doing this on your daily life? It’s this real, transparent look to your life and just being able to say, “No, I don’t,” for whatever reasons. One of the reasons is depression itself, because if you think about what do you need in order to make a change in your life, are the things that in a way depression is taking from you. Because you need motivation, you need hope, you need vitality, you need physical levels of energy.
Just changing your diet requires a lot. You need to change so many things and buy the ingredients or cook or find how that’s going to work. Then there’s, so that’s also that we know that we take care of that. The reason why we put the lifestyle pieces, especially for that, so that you can maintain and really for this to be the foundation of a new life, a new beginning.
How to start overcoming depression
Ari: You brought up so many good points there. One thing that you touched on is what I would describe as relating very strongly to willpower, which is we have this issue with apathy, with lack of motivation, with lack of energy. It’s also been shown in research that the seat of willpower in the brain, it’s a part of the brain called the anterior mid-cingulate cortex, is smaller and less active in people with depression. There’s less will to be able to drive yourself to do difficult things, which itself presents an obstacle for people in that situation to get better, to do the things that are necessary to get better. How do you guys overcome that? How do you navigate getting people to actually start taking action on doing the things to get on the path to getting well?
Achina: I think part of the way that people get motivated is when they’re in a group, it’s the group dynamic that I think makes a big difference. When people see other people stepping forward and going all in, they might not be an early adopter, but when they see other people doing things, it might motivate them to also do things. It’s almost like, “Hey, I’m going.” They reach out a hand and, “You want to come along?” They’re more likely to be motivated when you do it in a group format. We’re going to have 15 people doing this all together and supporting each other.
They’re not treating each other, just supporting each other and helping each other come along. The group dynamic is extremely powerful in that, but it’s also setting them up early on with asking them, “How do you foresee yourself in the future?” Dismantling this idea of who they are and giving them a sense of hope of where they could be and having goals of where they would like to see themselves and putting that into the future. Giving them hope that, yes, you can do this. Having short-term goals and some little bit longer goals about where they could be potentially in the long term as well. It’s the group dynamic that’s going to be very powerful in making that happen. What were you going to say, Silvia?
Silvia: Exactly that. Very well said. That it’s like having your best friend knocking on your door and saying, “Come on, we’re going for a walk now.” You know that person isn’t at the door you’re going to come out. That, so that’s, it’s a handholding system that is going to, it’s seven stages. It’s very gradual transformation. You’re expected that, day two, you’re outside running. It’s understanding how depression works and how you’re feeling and meeting you where you are at. It’s starting a step-by-step, it’s a gradual, a slow process. The other thing that we do is, as both of you were mentioning, we work a lot on motivation.
There’s the one workshop that I love that is finding your big why, because like if your why is not big enough, then there’s nothing that you’re going to do. If this is just like, “Well, it’s just that eating makes me feel better,” but if you find a why of how this is really affecting your life, what are the things that you’re losing? Most importantly, what would happen to your life if you don’t change, if you continue to be like this for, I don’t know, 10, 20 more years? In that, through a process, we make the person find the why of like, “Oh my God, I really need to do that,” and in that process to change from, “I should,” to, “I must.”
It’s not like, “I should eat better. No, it’s like, “I must eat better because my life depends on it. I must go outside for a walk because my physical, my mental health depends on this. This is my time. This is my moment to change.” Then we’re also going to give a lot of examples, beginning with my example of how even after 25 years, you can do it. That this is possible. We’re going to work a lot on that and hope and motivation. Then the group is what brings the magic, when you see others who are like, “I’m going to do this too.” Then we’re going to give all the tools for you to continue that at home. Nothing that we’re going to be teaching is something that you cannot do on your own. Everything is, you need to be able to replicate it at home.
That’s one of the things that we, one of our standards. If we teach it, you can do it.
Achina: The other thing is, when we work with individuals, it’s part of health coaching, you start with the lowest hanging fruit. When you have a group, everybody has a different low hanging fruit. You might have an early adopter with one situation and, “Come along, come along with me.” Then another person might be an early adopter for another situation. There’ll be a lot of taking turns in different things that they’ll be learning about saying, “Hey, come along, let’s do this together.” I know I prefer exercising with other people and not by myself. That’s why I play sports. I like to play as opposed to just do exercise by myself.
There are a lot of people who are like that, I think you have to be super disciplined to be able to do things on your own. I think it’s true for most people, even people who are not depressed.
Ari: Dr. Stein, in your experience of working with so many people with depression, what have you seen are the biggest needle movers as far as the biggest factors in people’s lives that when they make those changes, they get better, their depression resolves or radically improves?
Achina: A big one is diet for sure. The first two months when I work with people, we focus on digestion and diet. Just from that, it, it’s a huge improvement. I don’t think people really recognize how much that can impact people. The other thing is chronic infections. There are people who have dysbiosis, they have H. pylori, they have all sorts of gut infections that can cause increased gut permeability. Gluten can cause increased gut permeability, stress can cause increased gut permeability. It’s different for everybody, but I think the biggest change that can occur is with diet, and the diet is variable.
It’s finding the right diet for your body type. Some people are starving themselves and don’t realize it. They might not necessarily be anorexic, they’re trying to lose weight but they end up starving themselves and they’re not getting enough nutrition. Then there’s other people who think that a ketogenic diet is the right thing to do, but they’re not doing it properly. They think they’re doing it properly, but they’re not even measuring their ketones. They’re not doing it correctly, and they’re finding that they’re gaining weight because they’re eating too much fat and protein. Everyone is different in terms of trying to find the right diet. You have to basically do an assessment and see where they are metabolically and figure it out.
Ari: Sylvia, in your experience struggling with depression for over two decades, what were the biggest needle movers for you, the biggest personal breakthroughs that really led to you overcoming depression?
Silvia: As activities, as a day-to-day thing, one of the main ones for me was also diet. The change I saw was incredible with diet. The other one that is so important and overlooked is sleep. Actually, the symptoms when you are sleep-deprived are very similar. If you read the symptoms of that and the symptoms of depression, they are so alike. One of the things that really transformed me was to reestablish that sleep cycle, start going to bed early, forcing myself to finish in my routine at 9PM and have that hour and having a nighttime routine, sleep routine, so that I could really be in bed at 10.
Sometimes, you stay late. They’re just like, watching TV or media, whatever it is that you’re doing. The way I started seeing and understanding it is that every time I was choosing that, I was choosing depression. That really kicked in my brain and said like, “Wait, no, I’m not choosing depression.” That was another huge factor in my life. The other, if I was going to say three, would be movement. I understood that this, I love this sentence, that emotion comes from motion. I felt like the way I was feeling, it was nothing really. I felt like, “Either way, I don’t care.” I started to make the connection between like movement and then motion and emotion. That really had a transformational change for me.
Every morning I started exercising, even if it was a walk or a soft bicycle ride, depending on how I was feeling. Then, eventually, now I run. That was a whole process to get me there. I think that was, that’s still a big piece of, transformation, just getting out of the house. Even if it’s for a walk, but moving your body.
Achina: Ultimately, I think what people need to understand is that it’s a number of things that come together. It’s stacking all of them and doing it consistently. I think I mentioned that earlier. I think that’s the piece that makes the biggest difference. That really is the key. It’s habit stacking and doing it every single day. It’s not just trying one thing and saying, “That didn’t work so I stopped doing it.” Then trying another thing. “That didn’t work.”
Ari: That’s an extremely common mistake that people make, not just in depression, but across all dimensions of trying to improve various symptoms and health problems, is looking for the one thing. That’s what our culture indoctrinates us with from the time we’re little kids. The idea that there’s one cause, quote unquote, of this problem. That therefore there’s one treatment that’s going to resolve it. You get these people who are treatment-hopping from one to the next. In isolation, all of these things fail. Where the real magic is, as you’re describing it, by stacking them together and doing them consistently over time, you get a totally different result.
Achina: Absolutely. It is also understanding that it takes time and having patience with yourself around it. Having a lot of love and compassion for yourself and believing in yourself, which is really hard when you’re depressed, in the beginning. It is creating this atmosphere of believing in them for them in the beginning and creating and cultivating that outlook that will then hopefully propel them in the direction of sticking to it. The stick-to-itiveness. It does happen. It does change. It may be slow. There might be some quick shifts depending on what it is for that person. There’s also some slow shifts as well. We’re going to be here cheerleading for them and guiding them. They have to do the work.
That’s the thing when it comes to this treatment program is that you do have to have some amount of energy to be moving forward, even getting to the program, right? It’s not going to be for everyone. That’s why we offer a discovery call to really talk about and see if it’s right for them.
There is hope
Ari: The last thing I want to ask you is, the nature of these conversations, particularly when we have three instead of just two people on the call, is, we all have things we want to talk about. I’m asking questions that are directing us down certain pathways. Is there anything that you feel is really important that we haven’t yet spoken about or touched on? Any last words that you want to leave people with of something that’s important for them to know that we haven’t gotten into?
Silvia: For me, we touched on it, but I want to just say it again because to the audience, your audience that is listening to this, is it’s about hope. With chronic depression or treatment resistant depression, and just if you have been struggling with that for years and you have tried one thing after the other after the other, it’s so easy to lose hope. It breaks my heart because that’s how I was feeling. What I want to tell people is that there’s hope. There’s new research in psychiatry. There’s new research in medicine showing that there’s different alternatives to just medication and talk therapy. If what you’re doing is not working, keep looking, keep searching.
If you don’t resonate with what your doctor is saying, it’s okay. Change your doctor. If you feel that you need a different type of therapy, then look for that. It’s just that know that a lot of people like me and hundreds of others just managed to get out of it. It’s not something that you have to live for the rest of your life. That is a misbelief. That is not true. You can find the appropriate help. With the right treatment, there’s a whole new life waiting for you.
Ari: Beautiful. Beautifully said. Let people know where they can get in touch with you or how they can work with you, how they can follow the Healing Depression Project or wherever you want to direct people.
Silvia: They can go to our website, is healingdepressionproject.com. There is a place where you can book a discovery call. There’s no cost for that call. The call is going to be directly with me or Dr. Stein, one of the two of us. We’ll just talk about your situation, your story. You tell us about you. We tell you about the program and see if we’re a good match for each other. At that point, there’s an application process that the person has to go through to see if they qualify. The other thing that I want to talk about is that we managed to get, really good funding that we are passing completely to the participants. On the form of scholarships, the way the scholarships cover up to 80 percent of the cost of the program.
This is an amazing time to do it. This applies for 2025. We have a program in March, another one in August. That will be my invitation. Go to our website. We also have a really good e-guide that is called Why Am I Still Depressed? The Top Four Mistakes I’m Making. It’s based on my story on all the research and learning and putting this program together, of all the main things that is stopping you to recover. You can get that for free just on the website. Again, healingdepressionproject.com/gift. Then you go there, you download it, and it’s a really good resource to have if you want to start. Yes, just reach out, contact us, and see if maybe this is what you’ve been waiting for.
Ari: Beautiful. Thank you both for coming on the show and doing this, and thank you for the work that you’re doing in the world.
Achina: Thank you Ari.
Silvia: Thank you so much for this.
Show Notes
00:00 – Intro
00:42 – Guest Intro
03:09 – Healing Depression Project
11:35 – What is depression?
16:16 – The modern medicine approach to depression
29:58 – The Healing Depression Project approach
41:50 – How to start overcoming depression
55:31 -There is hope
Links
Recommended Podcasts
