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Before I was Bulletproof, I suffered from serious mood swings. My bursts of anger and bouts of depression and anxiety impacted my work, my health, and most importantly, my relationships. When your mood can affect so many parts of your life, it’s no wonder 1 in 6 adults have filled at least one prescription for a psychiatric drug.

Antidepressants are the most popular psychiatric medication out there, with anti-anxiety drugs, sedatives, and hypnotics coming in second. So, what? Is this a problem? Can you upgrade your brain and kick depression naturally? Read on to find out.

What is depression?

Please note: Depression is a serious medical condition and can require medical attention. If you suffer from depression, please call your doctor for diagnosis and a treatment plan that works for you.

The first problem with depression is its definition. A feeling or mental state isn’t easily measured or defined. Sure, there’s a clinical definition, but diagnostic criteria can be awfully subjective. Because of this, and because of the pressure for doctors to prescribe expensive drugs, antidepressants are doled out to people who don’t qualify for the diagnosis of major depression. This includes giving pills to people with insomnia, muscle spasms, or really any report of being bummed out.[ref url=”https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/  “]

The DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders) lays out the diagnostic criteria for Major Depressive Disorder (MDD) like this (more or less):

Five (or more) of the following symptoms have to be present for a consecutive 2-week period. At least one of these has to be “depressed mood” or “loss of interest or pleasure”:

• Depressed mood (i.e., sad, empty, hopeless)
• Diminished of pleasure in all (or almost all) activities
• Change in weight more than 5% in one month when not dieting
• Insomnia or hypersomnia nearly every day
• Psychomotor changes (slowed down or sped up) – must be observed by others
• Fatigue or loss of energy nearly every day
• Feelings of worthlessness or excessive or inappropriate guilt nearly every day
• Diminished ability to think or concentrate, or indecisiveness, nearly every day
• Recurrent thoughts of death, suicidal thoughts, or suicidal attempts

Again, while it’s likely that doctors are overprescribing antidepressants, it’s important that if you’re suffering from any of the above criteria, you call your doctor to get some help!

Doctors are doing the best they can with the information they have, but few of the above symptoms are really measurable, and many of them are self-reported, which doesn’t result in an objective diagnosis. So what is depression, really? Let’s explore some theories. But first …

Is it normal to feel sad?

Yes!. Movies, TV shows, social media, and advertisements may make it seem like most people are happy all the time, but life naturally comes with ups and downs. Many of my friends who are psychiatrists and brain specialists would argue it’s even healthy to feel sad now and again.

In more dramatic cases when you’re experiencing big life changes or the death of someone close to you, it’s a big problem if you don’t feel sad. You must feel an emotion in order to let it go.

But, sometimes sadness and depression persist. When this happens, it’s ok to seek professional help.

The serotonin model of depression

For decades, the answer for why people get chronically depressed was simple: an imbalance in brain chemistry. Doctors and researcher thought if they could just balance your neurotransmitters (specifically the happy-making neurochemical, serotonin), then you’d be cured. But there are a couple of problems with this theory. First of all, it’s impossible to accurately measure serotonin levels in a live human brain. Second, the drugs that pharmaceutical companies are making to alter serotonin levels in depressed people aren’t working.

In one analysis of published and unpublished data on antidepressant drugs, it turns out that most, if not all, the benefits of these drugs are thanks to the placebo effect.[ref url=”https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/”]

Does your doctor still think these things work? Bad science is to blame. In a famous New England Journal of Medicine analysis, researchers found that a whopping 88% of clinical trials showing that antidepressants don’t work weren’t published. That means your doc is seeing a huge bias in favor of antidepressants in the published literature.[ref url=”http://www.nejm.org/doi/full/10.1056/NEJMsa065779″]

So if serotonin levels aren’t to blame for depression, what is?

The inflammatory model of depression

A growing number of doctors are looking at a new theory of depression – that high levels of inflammation from infection or other stressors are to blame.

Depressed people have higher levels of inflammatory markers called pro-inflammatory cytokines in their blood[ref url=”http://www.sciencedirect.com/science/article/pii/S1471490605002887 “][ref url=”https://link.springer.com/chapter/10.1007/7854_2012_211″] and some research shows that inflammation slows down the growth of new brain cells.[ref url=”http://www.pnas.org/content/100/23/13632.short”]

Depressed people also show signs of extreme oxidative stress and lower overall antioxidants levels.[ref url=”http://www.sciencedirect.com/science/article/pii/S0278584610001776″] When you have less antioxidant activity, you end up with more oxidative stress, and your brain is especially vulnerable to it. Ongoing oxidative stress leads to chronic inflammation, which is bad for your brain.

Nutrient deficiencies and depression

There’s other evidence that nutrient deficiencies can lead to chronic depression. Lower levels of omega-3 fatty acids, B vitamins, zinc, magnesium, and vitamin D are all linked to lower levels of brain function and can contribute to depression.

You can test your nutrient levels with a functional medicine or naturopathic doctor. If you want to avoid prescription drugs, you’ll have to get to the root cause of the issue.

Side effects of antidepressants

The jury is still out on whether or not prescription antidepressants even work. It’s not my job whether or not to tell you to take them or not. Prescription drugs, in general, are overprescribed and the number of prescriptions written rise year after year with no sign of stopping.In 2016, doctors doled out 4.4 billion prescription drugs in the U.S., up 1.9% from 2015.[ref url=”https://www.medscape.com/viewarticle/886404″]

For all the claims of happiness, antidepressants sure come with a lot of risks. Here are just a few of the most common side effects of antidepressants:

• Stomach upset
• Anxiety
• Agitation
• Insomnia
• Sexual dysfunction
• Weight gain
• Sleep disturbances

I think we can do better.

Getting to the root cause of depression

Since hacking my brain and body, I’ve learned to tune in to the root cause of my depression and anxiety. It takes time, but with the following hacks, I’ve been able to build a brain and body that’s more resilient to the stressors that come with being a dad, husband, and CEO.

5 science-backed hacks for a stronger brain

Whether you’ve been diagnosed with chronic depression or simply have the blues now and then, building a better brain through lifestyle hacks and better nutrition can help you rebound mentally and physically. Here are my top hacks to build a more resilient brain:

1. Meditation and mindfulness

This might sound annoyingly simple. But new clinical applications of mindfulness-based cognitive therapies (MBCT) for depressed patients are showing really promising results.

Studies out of the University of Exeter are finding that daily 30-minute mindfulness meditation sessions are better than drugs or counseling alone for depression. Three-quarters of patients in one study felt good enough to stop taking antidepressants after four months with no other intervention besides MBCT.

The science is young, but mindfulness and meditation studies are showing promising results alleviating symptoms like pain, stress, anxiety, depression, and disordered eating.[ref url=”https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3500142/”] I know it has for me!

2. Get outside more

Humans evolved over millions of years living outside. Only in the last several thousand years have we migrated into the sheetrock caves we now call offices. Getting out into nature, specifically under some big trees (aka forest bathing) rapidly lowers stress hormone levels, blood pressure, pulse rate and heart rate variability compared with exposure to a city environment.[ref url=”http://www.ncbi.nlm.nih.gov/pubmed/19568835″]

Sunlight also helps you relax and destress through the release of endorphins.[ref url=”https://www.ncbi.nlm.nih.gov/pubmed/6250104 “] These hormones can also help reduce pain, support hormone regulation, and even inhibit cancer growth.[ref url=”https://www.ncbi.nlm.nih.gov/pubmed/10816643?dopt=Abstract “][ref url=”http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2290997/”][ref url=”https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104618/”][ref url=”https://www.ncbi.nlm.nih.gov/pubmed/6091217″][ref url=”http://www.sciencedirect.com/science/article/pii/B9780124166738000113″]

Sunlight also increases dopamine release and dopamine receptors in your body. This is good news if you suffer from depression or seasonal affective disorder, which suggest low levels of dopamine, and even Parkinson’s disease, where dopamine neurons are damaged.[ref url=”https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3819153/”]

3. Exercise

Short bursts of vigorous exercise naturally increase BDNF, a compound that increases the production of new neurons and neuronal connectivity. This is likely just one of the ways exercise reduces stress and improves depressive symptoms.[ref url=”https://www.ncbi.nlm.nih.gov/pubmed/11148895 “] And if high-intensity intervals aren’t for you, there’s plenty of evidence that running and lifting can help alleviate anxiety and depressive symptoms.[ref url=”https://www.ncbi.nlm.nih.gov/pmc/articles/PMC474733/ “][ref url=”https://www.ncbi.nlm.nih.gov/pubmed/21659891 “] Some forward-thinking doctors are even prescribing exercise instead of antidepressants, taking into account the poor risk-to-benefit in patients with mild depression. In other words, exercise is more effective and safer, at least for people with mild depression.

4. Nutrition

Possibly the most effective way to keep depression at bay is to decrease inflammation and support your nutrient levels with a nutrient-dense diet. The Bulletproof Diet eliminates most food allergens responsible for inflammation. It’s also rich in nutrient-dense veggies, herbs, spices, and healthy fats and protein.

The Bulletproof Diet is also high in omega-3 fats, clean saturated fats, and moderate amounts of animal protein to give your body what it needs for a stable mood, but not too much to cause inflammation.

Get the details on the Bulletproof Diet.

5. Decrease oxidative stress

When you don’t have enough antioxidants present to counteract the free radicals in your body, you begin to suffer from oxidative stress. Oxidative stress is a sign of mitochondrial problems, and scientists believe it is a cause of many diseases including cancer, ADHD (attention deficit/hyperactivity disorder), autism, Parkinson’s, Alzheimer’s, chronic fatigue syndrome, and depression.

Glutathione is a protective antioxidant that serves as mitochondria’s main line of defense against damage from oxidative stress, but sometimes your body doesn’t make enough of it. There are, however, ways to get your mitochondria to increase their production of antioxidants like glutathione:

• Eliminate crappy fats like canola oil, peanut oil, safflower, oil, and other bad fats as outlined in the Bulletproof Roadmap.
• Increase your polyphenols with an abundance of fresh herbs, darkly colored fruits and veggies, and a ton of colorful, anti-inflammatory spices like turmeric.
• Increase your natural production of glutathione, your body’s master antioxidant. (I also supplement).

Lifestyle interventions alone may not be for everyone suffering from depression – especially those diagnosed with major depressive disorder. But all of the hacks in this article are safe to try alongside drugs if you’re already on them. And they all work together to mitigate stress and help you build a stronger, more resilient brain.

Using a combination of high doses of fun, bright lights or nature exposure, the right kind of exercise, and the Bulletproof Diet, you can help fight mild depression and optimize your mental performance.

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