By Dr. Mercola

Every year, some 230 million prescriptions for antidepressants are filled, making them one of the most-prescribed drugs in the United States.

Despite this, the incidence of all forms of depression is now at 10 percent, according to 2012 statistics¹, and the number of Americans diagnosed with depression increases by about 20 percent per year².

Such statistics are a strong indication that what we're doing is simply not working, and that instead, these drugs are contributing to other serious health problems. Fortunately, there are other, safer, more effective ways to address depression—including something as simple as spending more time outdoors.

Gardeners Are Happier than Most Others

According to a recent survey for Gardeners World magazine³, 80 percent of gardeners reported being “happy” and satisfied with their lives, compared to 67 percent of non-gardeners.

And the more time spent in the garden, the higher their satisfaction scores—87 percent of those who tend to their gardens for more than six hours a week report feeling happy, compared to those spending less time in their gardens.

Monty Don⁴, a TV presenter and garden writer, attributes the well-being of gardeners to the “recharging” you get from sticking your hands in the soil and spending time outdoors in nature.

I can personally confirm this as over the past year I have started a major interest in high performance agriculture and biodynamic gardening, and have been busy applying it to my edible and ornamental landscape. I hope to soon teach all that I have learned.

Interestingly, fitness researchers have also found that when you exercise outdoors, you exercise harder but perceive it as being easier than when exercising indoors, which can have significant health benefits.

This feeling of well-being can have more far-reaching implications for your physical health too. According to recent research from Johns Hopkins⁵, having a cheerful temperament can significantly reduce your odds of suffering a heart attack or sudden cardiac death. According to lead author Lisa R. Yanek, M.P.H., an assistant professor in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine⁶:

"If you are by nature a cheerful person and look on the bright side of things, you are more likely to be protected from cardiac events. A happier temperament has an actual effect on disease and you may be healthier as a result."

What the Research Says About Exercise and 'Ecotherapy' for Depression

Three years ago, I interviewed medical journalist and Pulitzer Prize nominee Robert Whitaker about his extensive research and knowledge of psychiatric drugs and alternative treatments for depression. He mentioned an interesting study conducted by Duke University in the late 1990’s, which divided depressed patients into three treatment groups:

1. Exercise only
2. Exercise plus antidepressant
3. Antidepressant drug only

After six weeks, the drug-only group was doing slightly better than the other two groups. However, after 10 months of follow-up, it was the exercise-only group that had the highest remission and stay-well rate. According to Whitaker, some countries are taking these types of research findings very seriously, and are starting to base their treatments on the evidence at hand.

The UK, for example, does not routinely recommend antidepressants as the first line of therapy for mild to moderate depression anymore, and doctors there can write out a prescription to see an exercise counselor instead under the “exercise on prescription programme⁷.”

Part of the exercise can be tending to an outdoor garden, taking nature walks, or repairing trails or clearing park areas—as discussed in the BBC video above. According to Dr. Alan Cohen, a British general practitioner with a special interest in mental health⁸:

“[W]hen people get depressed or anxious, they often feel they're not in control of their lives. Exercise gives them back control of their bodies and this is often the first step to feeling in control of other events.”

Within the first few years of the introduction of this so-called “Green Gym” or “Ecotherapy⁹” program in 2007, the rate of British doctors prescribing exercise for depression increased from about four percent to about 25 percent.

Studies on exercise as a treatment for depression also show there’s a strong correlation between improved mood and aerobic capacity. So there’s a growing acceptance that the mind-body connection is very real, and that maintaining good physical health can significantly lower your risk of developing depression in the first place. According to a 2009 report on Ecotherapy by the British Depressionalliance.org¹⁰:

“94 percent of people taking part in a MIND survey commented that green exercise activities had benefited their mental health; and 100 percent of volunteers interviewed during an outdoor conservation project agreed that participation benefited their mental health, boosted self-esteem and improved confidence. Furthermore, the National Institute for Clinical Excellence asserts that for ‘patients with depression... structured and supervised exercise can be an effective intervention that has a clinically significant impact on depressive symptoms.’”

Ready, Set, Garden!

Aside from increasing your sense of well-being, keeping a garden can also improve your health by providing you with fresher, uncontaminated food, and cutting your grocery bill. And you don’t need vast amounts of space either. You don’t even have to have a backyard. Apartment dwellers can even create a well-stocked edible garden.

There are tons of creative solutions that will allow you to make the most of even the tiniest space, and engaging your own creativity to solve space limitations can be part of your therapy. You can also start growing sprouts which is rapidly rewarding as, unlike gardens, in about one week you will have food that you can harvest and eat.

In her book The Edible Balcony, Alex Mitchell details how to grow fresh produce in small spaces. Filled with beautiful color photographs throughout, the book helps you determine what might work best for you, depending on your space and location, and guides you through the design basics of a bountiful small-space garden. For example, those who live in a high-rise apartment will undoubtedly have to contend with more wind than those who live on the bottom floor. There are solutions for virtually every problem, and in this case, wind-tolerant plants can be used, or you could construct some sort of protective screening.

You can use virtually every square foot of your space, including your lateral space. Hanging baskets are ideal for a wide variety of foods, such as strawberries, leafy greens, runner beans, pea shoots, tomatoes, and a variety of herbs. And instead of flowers, window boxes can hold herbs, greens, radishes, scallions, bush beans, strawberries, chard, and chiles, for example. Just start small, and as you get the hang of it, add another container of something else. Before you know it, large portions of your meals could come straight from your own edible garden.

To learn more, please see my previous article on creating edible gardens in small spaces. I garden both outdoors and indoors. As I mentioned previously, sprouts are one of my favorite tight-space crops, as they provide so much nutrition, which is another critical factor for beating the blues and they give you far more immediate feedback than growing a garden.

Six Additional Strategies That Can Help You Address Depression

The following five strategies are important to consider if you are facing depression. These strategies have nothing but positive effects and are generally very inexpensive to implement:

1. Optimize Your Gut Flora. Mounting research indicates that the bacterial colonies residing in your gut may play key roles in the development of brain, behavioral and emotional problems—from depression to ADHD, autism and more serious mental illness like schizophrenia. A recent proof-of-concept study found that probiotics (beneficial bacteria) actually altered participants’ brain function¹¹. Compared to the controls, the women who consumed probiotic yogurt had decreased activity in two brain regions that control central processing of emotion and sensation. The implications are particularly significant in our current era of rampant depression and emotional “malaise.”

   In a very real sense you have two brains, one inside your skull and one in your gut, and each needs its own vital nourishment. It’s important to realize that you have neurons both in your brain and your gut -- including neurons that produce neurotransmitters like serotonin. In fact, the greatest concentration of serotonin, which is involved in mood control, depression and aggression, is found in your intestines, not your brain! Perhaps this is one reason why antidepressants, which raise serotonin levels in your brain, are often ineffective in treating depression, whereas proper dietary changes often help.

   Fermented foods are the best route to optimal digestive health, as long as you eat the traditionally made, unpasteurized versions. Some of the beneficial bacteria found in fermented foods are also excellent chelators of heavy metals and pesticides, which will also have a beneficial health effect by reducing your toxic load. Healthy choices include fermented vegetables, lassi (an Indian yoghurt drink, traditionally enjoyed before dinner), fermented milk, such as kefir, and natto (fermented soy). If you do not eat fermented foods on a regular basis, taking a high-quality probiotic supplement is definitely recommended.

2. Do a Bit of Emotional Housekeeping. It is helpful to view depression as a sign that your body and life are out of balance, rather than as a disease. What you need to do is regain your balance. One of the key ways to do this involves addressing negative emotions that may be trapped beneath your level of awareness. My favorite method of emotional cleansing is Emotional Freedom Technique (EFT), a form of psychological acupressure.

   If you have severe depression, it would be best to consult with a mental health professional who is also an EFT practitioner. But for most of you with depression symptoms, this is a technique you can learn to do effectively on your own. In fact, it's so easy that children are learning it.

   There are other effective stress-management methods you could try as well, such as meditation, journaling, breathing exercises, yoga, or simply sharing your feelings with a close friend. Experiment with a number of approaches, and then pick the methods you find most helpful, but please remember that although it is very easy to learn EFT and far less expensive to use it yourself, it is nearly always better to seek a professional to perform EFT with you as it truly is an art that takes many years of refined practice to maximize its effectiveness.

   In the videos below, EFT practitioner Julie Schiffman shows how you can use EFT to relieve your physical pain and depression.

3. Get Regular Exercise. Regular exercise is one of the "secret weapons" to overcoming depression. It works by helping to normalize your insulin levels while boosting the "feel good" hormones in your brain. For more information, please review my article about the many ways exercise can benefit your brain. As Dr. James S. Gordon, MD, a world-renowned expert in using mind-body medicine to heal depression, said:

   "What we're finding in the research on physical exercise is that exercise is at least as good as antidepressants for helping people who are depressed… physical exercise changes the level of serotonin in your brain. And it increases your endorphin levels, your 'feel good hormones.'

   And also—and these are amazing studies—exercise can increase the number of cells in your brain, in the region of the brain called the hippocampus. These studies were first done on animals, and they're very important because sometimes in depression, there are fewer of those cells in the hippocampus. But you can actually change your brain with exercise. So it's got to be part of everybody's treatment, everybody's plan."

4. Improve Your General Nutrition. Another factor that cannot be overlooked is your diet. Foods have an immense impact on your body and your brain, and eating whole foods as described in my nutrition plan will best support your mental and physical health.

   Avoiding sugar (particularly fructose) and grains will help normalize your insulin and leptin levels, which is another important aspect of depression. Sugar causes chronic inflammation, which disrupts your body's normal immune function and can wreak havoc on your brain. Sugar also suppresses a key growth hormone called BDNF (brain derived neurotrophic factor), which promotes healthy brain neurons and plays a vital role in memory. BDNF levels are critically low in people with depression, which animal models suggest may actually be causative.

5. Supplement Your Diet with Omega-3 Fatty Acids. I strongly recommend taking a high-quality, animal-based omega-3 fat, like krill oil. This may be the single most important nutrient for optimal brain function, thereby preventing depression. DHA is one of the Omega-3 fatty acids in fish and krill oil, and your brain is highly dependent on it. Low DHA levels have been linked to depression, memory loss, schizophrenia, and Alzheimer's disease.
6. Let the Sun Shine Down on You. Have you ever noticed how great it can feel to spend time outdoors on a sunny day? Well, it turns out that getting safe sun exposure, which allows your body to produce vitamin D, is great for your mood. One study even found that people with the lowest levels of vitamin D were 11 times more prone to depression than those who received adequate vitamin D. You can optimize your vitamin D either by sunlight exposure or by using a safe tanning bed, or by taking a high-quality vitamin D3 supplement.

Your Lifestyle Can Significantly Impact Your Emotional Well-Being

I strongly believe that energy psychology is one of the most powerful tools for resolving emotional issues, but the importance of connecting with nature through a gardening project or other outdoor activity simply cannot be ignored. The evidence clearly points to the fact that activities like gardening can have a significantly beneficial impact on depression, and exercise in any form is one of the best-kept secrets to preventing depression in the first place.

Strengthening your spiritual faith can be another important aspect of mental and emotional health, as discussed in a recent article.

In terms of diet, dramatically decreasing your consumption of sugar (particularly fructose), grains, and processed foods is very important, as is getting adequate vitamin B12. In fact, vitamin B12 deficiency can contribute to depression and affects one in four people. Vitamin D and omega-3 fats are also very important for your mood and brain health. You may also want to evaluating your salt intake. Sodium deficiency actually creates symptoms that are very much like those of depression. Make sure you do NOT use processed salt (regular table salt), however. You’ll want to use an all natural, unprocessed salt like Himalayan salt, which contains more than 80 different micronutrients.

All in all, your lifestyle may be one of the most fundamental contributors to depression, so you’d be well advised to address the factors discussed in this article before resorting to drug treatment—which science has shown is no more effective than placebo, while being fraught with potentially dangerous side effects.