Appendix A

Th e ­A n t i-​­I n f l a m m at or y D i e t

It is becoming increasingly clear that chronic inflammation is the

root cause of many serious ­illnesses — ​including heart disease, many
cancers, and Alzheimer’s disease. We all know inflammation on the
surface of the body as local redness, heat, swelling, and pain. It is the
cornerstone of the body’s healing response, bringing more nourishment
and immune activity to a site of injury or infection. But when inflam‑
mation persists or serves no purpose, it damages the body and causes
illness. Stress, lack of exercise, genetic predisposition, and exposure to
toxins (like secondhand tobacco smoke) can all contribute to chronic
inflammation, and dietary choices play a big role as well. Learning how
specific foods influence the inflammatory process is the best strategy for
containing it and reducing ­long-​­term disease risks.
The ­A nti-​­Inflammatory Diet is not a diet in the popular ­sense — ​it
is not intended as a ­weight-​­loss program (although people can and do
lose weight on it), nor is it an eating plan to stay on for a limited period
of time. Rather, it is a way of selecting and preparing foods based on
scientific knowledge of how they can help your body maintain opti‑

SpontaneousHap_HCtextF1.indd 225 8/12/11 2:15:13 AM

 Appendix A

mum health. Along with influencing inflammation, this diet will pro‑
vide steady energy and ample vitamins, minerals, essential fatty acids,
dietary fiber, and protective phytonutrients.
You can also adapt your existing recipes according to these ­anti-​
­inflammatory diet principles:

General Diet Tips

• Aim for variety.
• Include as much fresh food as possible.
• Minimize your consumption of processed foods and fast food.
• Eat an abundance of fruits and vegetables.
• Limit sweets of all kinds.

Caloric Intake
• Most adults need to consume between 2,000 and 3,000 calories a
day.
• Women and smaller and less active people need fewer calories.
• Men and bigger and more active people need more calories.
• If you are eating the appropriate number of calories for your level
of activity, your weight should not fluctuate greatly.
• The distribution of calories you take in should be as follows: 40 to
50 percent from carbohydrates, 30 percent from fat, and 20 to 30
percent from protein.
• Try to include carbohydrates, fat, and protein at each meal.

Carbohydrates
• On a 2,­000-​­calorie‑a‑day diet, women should consume between
160 and 200 grams of carbohydrates a day.
• Men should consume between 240 and 300 grams of carbohy‑
drates a day.
• The majority of carbohydrates consumed should be in the form of
­less-​­refined, ­less-​­processed foods with a low glycemic load.

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 Appendix A

• Reduce your consumption of foods made with flour and sugar,

especially breads and most packaged snack foods (including chips
and pretzels).
• Eat more whole grains, such as brown rice and bulgur wheat, in
which the grain is intact or in a few large pieces. These are prefera‑
ble to ­whole-​­wheat-​­flour products, which have roughly the same
glycemic index as ­white-​­flour products.
• Eat more beans, winter squashes, and sweet potatoes.
• Cook pasta al dente and eat it in moderation.
• Avoid products made with ­high-​­fructose corn syrup.

Fat
• On a 2,­000-​­calorie‑a‑day diet, 600 calories can come from ­fat — ​
that is, about 67 grams. This should be in a ratio of 1:2:1 of satu‑
rated to monounsaturated to polyunsaturated fat.
• Reduce your intake of saturated fat by eating less butter, cream,
­high-​­fat cheese, unskinned chicken and fatty meats, and products
made with palm kernel oil.
• Use ­extra-​­virgin olive oil as your main cooking oil. If you want a
­neutral-​­tasting oil, use ­expeller-​­pressed, organic canola oil.
Organic, ­high-​­oleic, ­expeller-​­pressed versions of sunflower and saf‑
flower oils are also acceptable.
• Avoid regular safflower and sunflower oils, corn oil, cottonseed oil,
and mixed vegetable oils.
• Strictly avoid margarine, vegetable shortening, and all products
listing them as ingredients. Strictly avoid all products made with
partially hydrogenated oils of any kind.
• Include in your diet avocados and nuts, especially walnuts,
cashews, almonds, and nut butters made from these nuts.
• For omega‑3 fatty acids, eat salmon (preferably fresh or frozen wild
or canned sockeye), sardines packed in water or olive oil, herring,
and black cod (sablefish, butterfish); omega‑3 fortified eggs; and
hemp seeds and flaxseeds (preferably freshly ground).

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 Appendix A

Protein
• On a 2,­000-​­calorie‑a‑day diet, your daily intake of protein should
be between 80 and 120 grams. Eat less protein if you have liver or
kidney problems, allergies, or autoimmune disease.
• Decrease your consumption of animal protein except for fish and
­high-​­quality natural cheese and yogurt.
• Eat more vegetable protein, especially from beans in general and
soybeans in particular. Become familiar with the range of whole
soy foods available and find ones you like.

Fiber
• Try to eat 40 grams of fiber a day. You can achieve this by increas‑
ing your consumption of fruits (especially berries), vegetables
(especially beans), and whole grains.
• ­Ready-​­made cereals can be good fiber sources, but read labels to
make sure they give you at least 4 and preferably 5 grams of fiber
per ­one-​­ounce serving.

Phytonutrients
• To get maximum natural protection against ­age-​­related diseases
(including cardiovascular disease, cancer, and neurodegenerative
disease) as well as against environmental toxicity, eat a variety of
fruits, vegetables, and mushrooms.
• Choose fruits and vegetables from all parts of the color spectrum,
especially berries, tomatoes, orange and yellow fruits, and dark
leafy greens.
• Choose organic produce whenever possible. Learn which conven‑
tionally grown crops are most likely to carry pesticide residues and
avoid them. (Go to http://www.ewg.org, the website of the Envi‑
ronmental Working Group, for their lists of the Dirty Dozen and
Clean ­Fifteen — ​the most and least contaminated crops.)
• Eat cruciferous (­cabbage-​­family) vegetables regularly.
• Include whole soy foods in your diet.

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 Appendix A

• Drink tea instead of coffee, especially ­good-​­quality white, green,

or oolong tea.
• If you drink alcohol, use red wine preferentially.
• Enjoy plain dark chocolate in moderation (look for a minimum
cocoa content of 70 percent).

Vitamins and Minerals

The best way to obtain all of your daily vitamins, minerals, and micro‑
nutrients is by eating a diet high in fresh foods with an abundance of
fruits and vegetables.
In addition, supplement your diet with the following antioxidant
cocktail:

• Vitamin C, 200 milligrams a day.

• Vitamin E, 400 IU of natural mixed tocopherols (d‑­alpha-​
­tocopherol with other tocopherols or, better, a minimum of 80
milligrams of natural mixed tocopherols and tocotrienols).
• Selenium, 200 micrograms of an organic (­yeast-​­bound)
form.
• Mixed carotenoids, 10,­000–​­15,000 IU daily.
• Antioxidants can be most conveniently taken as part of a daily
multivitamin/multimineral supplement that also provides at least
400 micrograms of folic acid and 2,000 IU of vitamin D. It
should contain no iron (unless you are female and having regular
menstrual periods) and no preformed vitamin A (retinol). Take
these supplements with your largest meal.

Other Dietary Supplements

• If you are not eating oily fish at least twice a week, take supple‑
mental fish oil in capsule or liquid form (­2–​­3 grams a day of a
product containing both EPA and DHA). Look for molecularly
distilled products certified to be free of heavy metals and other
contaminants.

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 Appendix A

• Talk to your doctor about going on ­low-​­dose aspirin therapy,

two baby aspirins a day (162 milligrams).
• If you are not regularly eating ginger and turmeric, consider tak‑
ing these in supplemental form.
• Add CoQ10 to your daily regimen: ­60–​­100 milligrams of a softgel
form taken with your largest meal.
• If you are prone to metabolic syndrome, take ­alpha-​­lipoic acid,
­200–​­400 milligrams a day.

Water
• Drink pure water or drinks that are mostly water (tea, very diluted
fruit juice, sparkling water with lemon) throughout the day.
• Use bottled water or get a home water purifier if your tap water
tastes of chlorine or other contaminants, or if you live in an area
where the water is known or suspected to be contaminated.

230

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 Appendix B

Sug g e s t e d R e a di ng, R e s ou r c e s ,
a n d Su pp l i e s

Books
Baumel, Syd. Dealing with Depression Naturally: Complementary and
Alternative Therapies for Restoring Emotional Health. New York:
McGraw Hill, 2000.
Challem, Jack. The ­Food-​­Mood Solution: ­All-​­Natural Ways to Banish
Anxiety, Depression, Anger, Stress, Overeating, and Alcohol and Drug
­Problems — ​and Feel Good Again. Hoboken, N.J.: John Wiley &
Sons, 2007.
Easwaran, Eknath. The Mantram Handbook: A Practical Guide to
Choosing Your Mantram and Calming Your Mind. Tomales, Calif.:
Nilgiri Press, 2008.
Haidt, Jonathan. The Happiness Hypothesis: Finding Modern Truth in
Ancient Wisdom. New York: Basic Books, 2006.
Horwitz, Allan V., and Jerome C. Wakefield. The Loss of Sadness: How
Psychiatry Transformed Normal Sorrow into Depressive Disorder. Oxford:
Oxford University Press, 2007.

SpontaneousHap_HCtextF1.indd 231 8/12/11 2:15:13 AM

 Appendix B

Ilardi, Stephen S., PhD. The Depression Cure: The 6‑Step Program to
Beat Depression Without Drugs. Cambridge: Da Capo Press, 2009.
Larson, Joan Mathews, PhD. ­Depression-​­Free, Naturally: 7 Weeks to
Eliminating Anxiety, Despair, Fatigue, and Anger from Your Life. New
York: Ballantine Books, 1999.
Nhat Hanh, Thich. Happiness: Essential Mindfulness Practices. Berkeley,
Calif.: Parallax Press, 2009.
Prochnik, George. In Pursuit of Silence: Listening for Meaning in a
World of Noise. New York: Doubleday, 2010.
Schachter, Michael B., MD, and Deborah Mitchell. What Your Doctor
May Not Tell You About Depression: The Breakthrough Integrative
Approach for Effective Treatment. New York: Wellness Central, 2006.
Seligman, Martin E. P. Learned Optimism. New York: Alfred A. Knopf,
1991.
Solomon, Andrew. The Noonday Demon: An Atlas of Depression. New
York: Scribner, 2001.
Sood, Amit, MD, MSc. Train Your Brain, Engage Your Heart, Trans-
form Your Life: A Two Step Program to Enhance Attention; Decrease
Stress; Cultivate Peace, Joy, and Resilience; and Practice Presence with
Love. Rochester, Minn.: Morning Dew Publications, LLC, 2010.
Watters, Ethan. Crazy Like Us: The Globalization of the American
Psyche. New York: Free Press, 2010.
Weil, Andrew. 8 Weeks to Optimum Health: A Proven Program for Tak-
ing Full Advantage of Your Body’s Natural Healing Power, rev. ed.
New York: Ballantine Books, 2006.
Weil, Andrew. Natural Health, Natural Medicine: The Complete Guide
to Wellness and ­Self-​­Care for Optimum Health, rev. ed. Boston:
Houghton Mifflin, 2004.
Weil, Andrew. Spontaneous Healing: How to Discover and Enhance Your
Body’s Natural Ability to Maintain and Heal Itself. New York: Bal‑
lantine Books, 2000.
Weil, Andrew, and Rosie Daley. The Healthy Kitchen: Recipes for a Bet-
ter Body, Life, and Spirit. New York: Knopf, 2002.

232

SpontaneousHap_HCtextF1.indd 232 8/12/11 2:15:13 AM

 Appendix B

Websites
My website, www.drweil.com, has a great deal of content on depres‑
sion, as well as content related to therapies recommended in this book,
including dietary supplements, exercise, meditation, breathing tech‑
niques, and more. Use the search function to find specific articles and
videos. Click “Free Health Emails from Dr. Weil” on the homepage to
subscribe to Dr. Weil’s Body, Mind and Spirit Newsletter, which offers
weekly email tips and inspiration.
I also have a dedicated Spontaneous Happiness website that provides
a comprehensive step‑by‑step program to improve emotional health.
Visit www.SpontaneousHappiness.com for more information.
The website of the Arizona Center for Integrative Medicine, www
.AzCIM.org, has information about integrative medicine and a physi‑
cian locator on the homepage.
Other websites with depression content that meets my criteria for
quality include:

Medicinenet
www.medicinenet.com

National Institute of Mental Health

www.nimh.nih.gov

Netdoctor.co.uk
www.netdoctor.co.uk

WebMD.com
www.webmd.com

Recommended websites with content related to specific therapies

recommended in this book include:

233

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 Appendix B

­Cognitive-​­Behavioral Therapy:

National Association of ­Cognitive-​­Behavioral Therapists

www.nacbt.org

Compassion Training:

Providers and Classes

www.­training-​­classes.com/learn/_k/c/o/m/compassion/

Empathy Training:

The Empathy Training Console

http://empathytrainingconsole.com/

Forgiveness:

Stanford Forgiveness Project

http://learningtoforgive.com

Gratitude:

Spirituality and Practice

www.spiritualityandpractice.com/practices/practices.php?id=11

Laughter Clubs:

Laughter Yoga International

www.laughteryoga.org

234

SpontaneousHap_HCtextF1.indd 234 8/12/11 2:15:13 AM

 Appendix B

Meditation:

Insight Meditation Center (Vipassana)

www.insightmeditationcenter.org

Project Meditation
www.­project-​­meditation.org

Susan Piver (meditation resources)

www.susanpiver.com

Mindfulness Training and MBSR:

Mindful Living Programs

www.mindfullivingprograms.com

Physical Activity:

Mayo Clinic (fitness section)

www.mayoclinic.com/health/fitness/MY00396

Positive Psychology:

Positive Psychology Center

www.ppc.sas.upenn.edu

Visualization:

Academy for Guided Imagery

www.acadgi.com

Visualization Exercises
www.­key-​­hypnosis.com

235

SpontaneousHap_HCtextF1.indd 235 8/12/11 2:15:13 AM

 Appendix B

Audio Programs
Jon ­Kabat-​­Zinn, “Mindfulness for Beginners,” Sounds True audio edi‑
tion, 2007.
Andrew Weil, “Breathing: The Master Key to Self Healing,” Sounds
True audio edition, 1999.
Andrew Weil and Jon ­K abat-​­Zinn, “Meditation for Optimum
Health: How to Use Mindfulness and Breathing to Heal Your
Body and Refresh Your Mind,” Sounds True audio edition, 2001.
Andrew Weil and Rubin Naiman, “Healthy Sleep: Wake Up Refreshed
and Energized with Proven Practices for Optimum Sleep,” Sounds
True audio edition, 2007.

The first Integrative Mental Health Conference was held in Phoenix, Ari‑
zona, on March ­22–​­24, 2010, and featured presentations by the leaders
in the field. CDs and DVDs are available from www.conferencerecording
.com. Type “integrative mental health” into the search box.
I also recommend CDs and audio downloads from psychotherapist
Belleruth Naparstek, especially those titled “Depression,” “Relieve
Stress,” and “Healthful Sleep.” These and other resources are available
at her website, www.healthjourneys.com.

Dietary Supplements
I recommend and use Weil Nutritional Supplements brand vitamins,
minerals, and supplements, which are available from DrWeil.com. I
have developed these ­science-​­based formulations and oversee their pro‑
duction. Go to www.drweil.com and click on the “Marketplace” tab or
the “Vitamin Advisor” link. These products are also available at many
specialty health stores.
Products that align with recommendations in this book include:

Antioxidant & Multivitamin

Mood Support
Omega‑3 Support

236

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 Appendix B

(All of my ­after-​­tax profits from royalties from sales of these prod‑

ucts go to the Weil Foundation, www.WeilFoundation.org, a nonprofit
organization that supports the advance of integrative medicine through
education, research, and public policy reform.)

Other products that also meet my specifications for quality:

Standardized extracts of ashwagandha, Rhodiola rosea, St. John’s wort,

and valerian:
Nature’s Way Products, Inc.
3051 West Maple Loop Dr., Suite 125
Lehi, UT 84043
www.naturesway.com

Fish oil capsules and liquids:

Nordic Naturals, Inc.
94 Hangar Way
Watsonville, CA 95076
www.nordicnaturals.com

Extracts of holy basil, rhodiola, and turmeric:

New Chapter, Inc.
22 High St.
Brattleboro, VT 05301
www.newchapter.com

Melatonin sublingual tablets:

Source Naturals
23 Janis Way
Scotts Valley, CA 95066
www.sourcenaturals.com

237

SpontaneousHap_HCtextF1.indd 237 8/12/11 2:15:13 AM

 Appendix B

SAMe:
Nature Made
P.O. Box 9606
Mission Hills, CA 91346
www.naturemade.com/products/segments/SAMe

Other Products
Light box (free of wavelengths that may cause retinal damage):
Lo‑LIGHT Desk Lamp, model D 120
Sunnex Biotechnologies
Suite ­657-​­167 Lombard Ave.
Winnipeg, MB Canada ­R 3B-​­0V3
1‑­877-​­778-​­6639
www.sunnexbiotech.com

­ oise-​­cancellation headphones:
N
Bose QuietComfort 15 Acoustic Noise Cancelling Headphones
Bose Corporation
The Mountain
Framingham, MA 01701
1‑­800-​­999-​­2673
www.bose.com

­ hite-​­noise generator:
W
Marpac SleepMate 980A ­Electro-​­Mechanical Sound Conditioner
Marpac Corporation
P.O. Box 560
Rocky Point, NC 28457
1‑­800-​­999-​­6962
www.marpac.com

238

SpontaneousHap_HCtextF1.indd 238 8/12/11 2:15:13 AM

 Notes

Introduction
4: The Harvard psychologist Daniel Gilbert has made a lifelong
study of just how abysmal human beings are at predicting
which future events will make them happy: “The Science of
Happiness: A Talk with Daniel Gilbert,” introduction by John
Brockman, www.edge.org/3rd_culture/gilbert06/gilbert06_index
.html.
7: Cardiologists now know that loss of ­heart-​­rate variability is
an early sign of disease: E. Kristal et al., “Heart Rate Variability
in Health and Disease,” Scand J Environ Health 2 (April 21,
1995): ­85–​­95. See also editorial by J. M. Karemaker and K. I.
Lie, “Heart Rate Variability: A Telltale of Health or Disease,”
European Heart J 21 (March 2000): ­435–​­37, www.heartmath
.org.
8: Ramakrishna Paramahansa (­1836–​­1886), a famous Indian
saint: Walther G. Neevel Jr., “The Transformation of Sri Rama­
krishna,” in Hinduism: New Essays in the History of Religions,
edited by Bardwell L. Smith (The Netherlands: E. J. Brill, 1976),
­53–​­97. See also Peter Holleran, “Ramakrishna ­Paramahansa —­ ​­­­

SpontaneousHap_HCtextF1.indd 239 8/12/11 2:15:13 AM

 Notes

God-​­Intoxicated Saint,” www.mountainrunnerdoc.com/articles

/article/2291157/31005.htm.

CHAPTER 1. W hat Is Emotional ­Well-​­Being?

22: Yet enforced, almost bullying cheerfulness dominates our
culture: Barbara Ehrenreich, ­Bright-​­Sided: How the Relentless
Promotion of Positive Thinking Has Undermined America (New
York: Metropolitan Books, 2009).
22: “The president almost demanded optimism,” noted Bush’s
secretary of state Condoleezza Rice: Ehrenreich, Bright-Sided,
10. See also Richard Pine, “Bush’s Toxic Optimism,” Huffington
Post, September 16, 2007, www.huffingtonpost.com
/richard-​­pine/­bushs-​­toxic-​­optimism_b_64616.html.
22: One [study], from 2004, notes: Yukiko Uchida et al., “Cultural
Constructions of Happiness: Theory and Empirical Evidence,” J
Happiness Studies 5 (2004): ­223–​­39.
22: Other scholarly articles report significant differences from
country to country in rates of reported happiness: Roya
Rohani Rad, “Happiness: A Literature Review of Cross Cultural
Implications,” November 2010, www.selfknowledgebase.com/files
/happinessliteraturereview.pdf.

CHAPTER 2. An Epidemic of Depression

25: The World Health Organization predicts that by 2030 more
people worldwide will be affected by depression than by any
other health condition: “Depression Looms as Global Crisis,”
BBC News, September 2, 2009, http://news.bbc.co.uk/2/hi
/health/8230549.stm.
25: The number of Americans taking antidepressant drugs dou-
bled in the decade from 1996 to 2005: Amanda Gardner,
“Antidepressant Use in U.S. Has Almost Doubled,” Healthday,
August 3, 2009, http://health.usnews.com/­health-​­news/­family

240

SpontaneousHap_HCtextF1.indd 240 8/12/11 2:15:13 AM

 Notes

-​­health/­brain-​­a nd-​­behavior/articles/2009/08/03/­a ntidepressant

-​­use‑in‑us‑­has-​­almost-​­doubled.
25: Today an astonishing one in ten people in the United States,
including millions of children, is on one or more of these medi-
cations: Katharine Kam, “Can Antidepressants Work for Me?”
WebMD, February 20, 2011, www.webmd.com/depression
/features/­are-​­antidepressants-​­effective.
26: the Diagnostic and Statistical Manual of Mental Disor-
ders (DSM): Diagnostic and Statistical Manual of Mental Disor-
ders, Fourth Edition, Text Revision (DSM‑IV‑TR), published by the
American Psychiatric Association, 2000. DSM‑V will appear in
2012.
26: The current edition of the DSM gives specific criteria for the
diagnosis of this most severe form of depression: DSM‑IV‑TR.
27: The novelist William Styron, author of Sophie’s Choice, pro-
vides: William Styron, Darkness Visible: A Memoir of Madness
(New York: Vintage, 1992), 50.
28: The English writer Aldous Huxley wrote of it: Aldous Huxley,
Beyond the Mexique Bay: A Traveler’s Guide (New York: Harper
and Brothers, 1934).
29: According to the DSM’s classification, I would have been
diagnosed with dysthymic disorder, the commonest form of
mild to moderate depression: DSM‑IV‑TR.
30: A prominent health website notes that in one group sur-
veyed: “The Relationship Between Depression and Anxiety,”
HealthyPlace.com, January 13, 2009, www.healthyplace.com
/depression/main/­relationship-​­between-​­depression-​­a nd-​­a nxiety
/menu‑id‑68/.
30: Women are twice as likely as men to experience depression:
Stephanie A. Riolo et al., “Findings from the National Health
and Nutrition Examination Survey III,” Am J Pub Health 65,
no. 6 (June 2005): ­998–​­1000.

241

SpontaneousHap_HCtextF1.indd 241 8/12/11 2:15:13 AM

 Notes

31: We know also that depression commonly coexists with physi-

cal illness: National Institute of Mental Health, 2002, www
.nimh.nih.gov/health/publications/depression/­complete-​­index
.shtml.
31: Nevertheless, experts on aging agree that depression is not a
normal consequence of growing older: National Institute of
Mental Health.
31: The National Institute of Mental Health reports that in any
given year, 4 percent of adolescents in our society suffer severe
depression: National Institute of Mental Health.
31: Depression is also being diagnosed much more frequently in
preteens than ever before: Harvard University study reported in
Harvard Mental Health Newsletter, February 2002, www.health
.harvard.edu/newsweek/Depression_in_Children_Part_I.htm.
See also: www.­about-​­teen-​­depression.com/­teen-​­depression.html;
“Depression Facts and Stats,” www.upliftprogram.com/depres
sion_stats.html#4; “Depression in Children and Adolescents Fact
Sheet,” National Alliance on Mental Illness, July 2010, www
.nami.org/Template.cfm?Section=by_illness&template=
/­ContentManagement/ContentDisplay.cfm&ContentID=17623;
E. R. Cox et al., “Trends in the Prevalence of Chronic Medica‑
tion Use in Children: ­2002–​­2005,” Pediatrics 122, no. 5 (Novem‑
ber 2008): ­e1053–​­61, pediatrics.aappublications.org/cgi/content
/abstract/122/5/e1053.
31: Along with attention deficit hyperactivity disorder (ADHD)
and the autistic disorders, depression accounts for the unprec-
edented, widespread use of prescribed psychiatric drugs by
our young people: Harvard University study reported in Har-
vard Mental Health Newsletter, February 2002, www.health
.harvard.edu/newsweek/Depression_in_Children_Part_I.htm.
See also: www.­about-​­teen-​­depression.com/­teen-​­depression.html;
“Depression Facts and Stats,” www.upliftprogram.com
/­depression_stats.html#4; and Cox et al., “Trends,” ­e1053–​­61.

242

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 Notes

32: In 1996, the pharmaceutical industry spent $32 million on

DTC antidepressant ads; by 2005, that had nearly quadru-
pled, to $122 million: Liz Szabo, “Number of Americans Tak‑
ing Antidepressants Doubles,” USA Today, August 4, 2009, www
.usatoday.com/news/health/2009‑08‑03‑antidepressants_N.htm.
32: More than 164 million antidepressant prescriptions were
written in 2008, totaling $9.6 billion in US sales: “Study:
Antidepressant Lift May Be All in Your Head,” USAToday.com,
January 5, 2010, www.usatoday.com/news/health/2010‑01‑06
‑antidepressants06_ST_N.htm.
33: Crazy Like Us: Ethan Watters, Crazy Like Us: The Globalization
of the American Psyche (New York: Free Press, 2010).
33: A Nigerian man . . . ​something akin to loneliness”: Watters,
Crazy, 195.
33: Over the past decade, however, a massive marketing cam-
paign launched in Japan: Watters, Crazy, 225.
34: The fact that DTC advertising is illegal in Japan was little
impediment: Watters, Crazy, ­187–​­248.
35: A study published in the April 2007 issue of the Archives of
General Psychiatry: Jerome C. Wakefield et al., “Extending the
Bereavement Exclusion for Major Depression to Other Losses:
Evidence from the National Comorbidity Survey,” Arch Gen Psy-
chiat 64, no. 4 (April 2007): ­433–​­40.
35: the rate [of depression] has more than doubled. . . . ​It is also
going up in the rest of the developed world: W. M. Compton
et al., “Changes in the Prevalence of Major Depression and
Comorbid Substance Use Disorders in the United States Between
­1991–​­1992 and ­2001–​­2002,” Am J Psychiat 163, no. 12 (Decem‑
ber 2006): 2­ 141–​­47.
37: the same study reports that the day‑to‑day sense of how happy
one feels (“positive feelings”) is almost entirely unconnected
to income level: Ed Diener et al., “Wealth and Happiness Across
the World: Material Prosperity Predicts Life Evaluation, Whereas

243

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 Notes

Psychosocial Prosperity Predicts Positive Feeling,” J Pers Soc Psy-

chol 99, no. 1 (2010): ­52–​­61.
37: The risk of developing major depression has increased ten-
fold since World War II: Martin E. P. Seligman and In J. Buie,
“ ‘Me’ Decades Generate Depression: Individualism Erodes
Commitment to Others,” APA Monitor 19, no. 18 (October
1988): 18.
37: People who live in poorer countries have a lower risk of
depression than those in industrialized nations: “Unipolar
Depressive Disorders World Map,” http://en.wikipedia.org/wiki/
File:­Unipolar_depressive_disorders_world_map_-_DALY
_-_WHO2004.svg.
37: In modernized countries, depression rates are higher for city
dwellers than for rural residents: JiamLi Wang, “­Rural–​­Urban
Differences in the Prevalence of Major Depression and Associ‑
ated Impairment,” Soc Psychiat and Psychiat Epidemiol 39, no. 1
(2004): ­19–​­25.
37: In general, countries with lifestyles that are farthest removed
from modern standards have the lowest rates of depression:
“Unipolar Depressive Disorders World Map.”
37: Within the United States, the rate of depression among mem-
bers of the Old Order Amish: J. A. Egeland and A. M. Hostet‑
ter, “Amish Study, I: Affective Disorders Among the Amish,
­1976–​­1980,” Am J Psychiat 140, no. 1 (January 1983): ­56–​­61.
37: ­Hunter-​­gatherer societies in the modern world have extremely
low rates of depression: Chantal D. Young, “Therapeutic Lifestyle
Change: A Brief Psychoeducational Intervention for the Preven­­
tion of Depression,” Submitted to the graduate degree program in
Psychology and the Graduate Faculty of the University of Kansas
in partial fulfillment of the requirements for the degree of Doctor
of Philosophy, August 27, 2009, 31, http://kuscholarworks
.ku.edu/dspace/bitstream/1808/5946/1/Young_ku_0099D
_10545_DATA_1.pdf.

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 Notes

38: “neither of these ­pre-​­modern cultures has depression at any-

thing like the prevalence we do”: Martin E. P. Seligman and
R. E. Ingram, eds., “Why Is There So Much Depression Today?
The Waxing of the Individual and the Waning of the Commons,”
Contemporary Psychological Approaches to Depression: Theory,
Research, and Treatment (New York: Plenum Publishing, ­1989–​
­1990), ­1–​­9.
38: “The more ‘modern’ a society’s way of life, the higher its rate
of depression. . . . ​The human body was never designed for the
modern ­post-​­industrial environment”: Stephen Ilardi, The
Depression Cure (Cambridge, Mass.: Da Capo Press, 2009), 6.
39: Agriculture began ten thousand years ago, and as recently as
1801, 95 percent of Americans still lived on farms: www
.l a nd i n s t it ute.or g /v ne w s /d i spl ay.v/A RT/2 0 0 4 /0 4 /0 8
/4076b2169776a.
39: And before the advent of industrial agriculture, farmers lived
far healthier lives than most of us today: Ilardi, Depression
Cure, 122.
39: The term nature deficit disorder has recently entered the
popular vocabulary: Richard Louv, Lost Child in the Woods:
Saving Our Children from ­Nature-​­Deficit Disorder (Chapel Hill,
N.C.: Algonquin Books, 2005).
40: ­Hunter-​­gatherers and other “primitive” peoples do not
develop the deficits of vision: www.physorg.com/news
168157251.html.
42: More than twenty studies support a link between depression
and creativity: www.cnn.com/2008/HEALTH/conditions/10
/07/creativity.depression/index.html.
42: Clinical psychologists see rumination as a “way of respond-
ing to distress that involves repetitively focusing on the
symptoms of distress, and on its possible causes and conse-
quences”: S. ­Nolen-​­Hoeksema et al., “Rethinking Rumination,”
Persp Psychol Sci 3 (2000): ­400–​­424.

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 Notes

43: a 2010 New York Times Magazine article titled “Depression’s

Upside”: Jonah Lehrer, New York Times Magazine, February 28,
2010, 41, www.nytimes.com/2010/02/28/magazine/28depression‑t
.html.
44: “Do you not see how necessary a World of Pains and troubles
is to school an Intelligence and make it a soul?”: John Keats,
Selected Letters, Robert Gittings, ed. (New York: Oxford Univer‑
sity Press USA, 2009), xiii.

CHAPTER 3. The Need for a New Approach to Mental Health

45: In 1977, the journal Science published a provocative article:
George L. Engel, “The Need for a New Medical Model: A Chal‑
lenge for Biomedicine,” Science 196, no. 4286 (April 8, 1977):
­129–​­35.
48: In 1980, the American Psychiatric Association radically
revised the Diagnostic and Statistical ­Manual-​­III (­DSM-​­III)
to be in accord with the biomedical model: www.allacademic
.com/meta/p_mla_apa_research_citation/1/7/5/4/0/p175408
_index.html.
49: In 1921, Otto Loewi (­1873–​­1961), a German pharmacologist,
demonstrated that nerve cells (neurons) communicate by
releasing chemicals: Renato M. E. Sabbatini, “Neurons and
Synapses: The History of Their Discovery,” chapter 5, “Chemical
Transmission,” Brain & Mind 17 (2003), www.cerebromente.org
.br/n17/history/neurons5_i.htm.
51: The first antidepressant drug was discovered serendipitously
in 1952: Joseph A. Lieberman, “History of the Use of Antide‑
pressants in Primary Care,” “Primary Care Companion,” J Clin
Psychiat 5, S.7 (2003): ­6 –​­10.
52: Amazon sells nearly three thousand books with the word
[serotonin] in the title: Keyword search in August 2010 by
author for serotonin in Books section of Amazon.com.

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 Notes

53: In fact, a new pharmaceutical known as ­tianeptine — ​sold in

France and other European countries under the trade name
­Coaxil — ​has been shown to be as effective as Prozac: Sharon
Begley, “The Depressing News About Antidepressants,” News-
week Online (January 29, 2010), www.newsweek.com/2010/01/28
/­the-​­depressing-​­news-​­about-​­antidepressants.html.
53: As psychologist Irving Kirsch of the University of Hull in
England told Newsweek: Begley, “Depressing News.”
53: The first such analysis, published in 1998: Begley, “Depressing
News.”
54: In April 2002, the Journal of the American Medical Associa-
tion (JAMA) published the results of a large randomized con-
trolled study: Wayne Jonas et al., “St. John’s Wort and
Depression,” JAMA 288, no. 4 (April 2002): ­446–​­49. See also:
http://nccam.nih.gov/news/2002/stjohnswort/q‑and‑a.htm.
54: Zoloft also worked no better than the placebo: Begley,
“Depressing News.”
54: Irving Kirsch summarized the growing body of evidence
against SSRIs in his 2010 book: The Emperor’s New Drugs:
Explo­ding the Antidepressant Myth (New York: Basic Books, 2010).
54: the most recent analysis, published in the January 6, 2010,
issue of JAMA: Jay C. Fournier et al., “Antidepressant Drug
Effects and Depression Severity: A ­Patient-​­Level ­Meta-​­analysis,”
JAMA 303, no. 1 (January 5, 2010): ­47–​­53.
54: About 13 percent of people with depression have very severe
symptoms: Begley, “Depressing News.”
54: One of the authors of the JAMA paper, Steven D. Hollon, PhD,
of Vanderbilt University, has said: Begley, “Depressing News.”
55: Loneliness, for example, is a powerful predictor of depres-
sion: R. A. Schoevers et al., “Risk Factors for Depression in Later
Life: Results of a Prospective Community Based Study (AMS‑
TEL),” J Affect Disord 59, no. 2 (August 2000): ­127–​­37.

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 Notes

57: I quoted Albert Einstein on the subject of conceptual models:

The quote is from Einstein and Infeld, Evolution of Physics (Cam‑
bridge, UK: Cambridge University Press, 1938), 152.
59: individuals trained in meditation have different brain activ-
ity from those without such training: Britta K. Hölzel et al.,
“Mindfulness Practice Leads to Increases in Regional Brain Mat‑
ter Density,” Psychiat Res Neuroimaging 191, no. 1 (January 30,
2011): ­36–​­43.

CHAPTER 4. Integrating Eastern and Western Psychology

61: Lewis ­Mehl-​­Madrona: Coyote Medicine (New York: Simon and
Schuster, 1997).
62: “The Lakota language does not have a concept of strictly
mental health”: Lewis ­Mehl-​­Madrona, personal communica‑
tion and lecture content, March 2010.
62: “In these ways of thinking of the mind and mental health,
the community is the basic unit of study, not the individual”:
­Mehl-​­Madrona communication.
64: Mind and Life XV, held in 2007 at Emory University in
Atlanta: “Mind and Life XV,” www.mindandlife.org/dialogues
/­past-​­conferences/ml15/.
64: “­mindfulness-​­based therapies, along with techniques to
enhance compassion, may prove especially useful in the treat-
ment of depression”: “Mind and Life XV,” www.mindandlife
.org/dialogues/­past-​­conferences/ml15/.
65: Davidson’s studies, along with those of others, demonstrate
that neuroplasticity is a fundamental characteristic of our
brains: Richard Davidson and Antoine Lutz, “Buddha’s Brain:
Neuroplasticity and Meditation,” IEEE Signal Processing Maga-
zine 25, no. 1 (January, 2008): ­174–​­76.
66: In a January 2007 interview, Ricard told the British newspa-
per The Independent: www.independent.co.uk/news/uk/­this
-​­britain/­the-​­happiest-​­man‑in‑­the-​­world-​­433063.html.

248

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 Notes

66: The Dalai Lama, who believes that “the purpose of life is
happiness,” also teaches that “happiness can be achieved
through training the mind”: His Holiness the Dalai Lama
and Howard Cutler, MD, The Art of Happiness: A Handbook for
Living (New York: Putnam Books, 1998), ­13–​­14: See also:
www.1000ventures.com/business_guide/crosscuttings/cultures
_buddhism_dalai_lama.html.
67: Studies show it [MSBR] to be effective at improving outcomes
and quality of life in patients with chronic pain and a variety
of diseases: Margaret ­Plews-​­Ogan et al., “A Pilot Study Evaluat‑
ing ­Mindfulness-​­Based Stress Reduction and Massage for the
Management of Chronic Pain,” Gen Intern Med 20, no. 12
(December 2005): ­1136–​­38. See also: E. Bohlmeijer et al., “The
Effects of ­Mindfulness-​­Based Stress Reduction Therapy on Men‑
tal Health of Adults with a Chronic Medical Disease: A ­Meta-​
­A nalysis,” J Psychosom Res 68, no. 6 (June 2010): ­539–​­44; and
www.mindfullivingprograms.com/whatMBSR.php.
67: In a study reported in January 2011 in Psychiatry Research:
Britta K. Hölzel et al., “Mindfulness Practice Leads to Increases
in Regional Brain Gray Matter Density,” Psychiat Res Neuroimag-
ing 191, no. 1 (January 30, 2011): ­36–​­43.
67: Another ­application — ​­mindfulness-​­based cognitive therapy
(MBCT): www.mindfullivingprograms.com/whatMBSR.php.
See also: “­Mindfulness-​­Based Cognitive Therapy,” www.mbct
.com and Zindel V. Segal et al., “Antidepressant Monotherapy vs.
Sequential Pharmacotherapy and ­Mindfulness-​­Based Cognitive
Therapy, or Placebo, for Relapse Prophylaxis in Recurrent Depres‑
sion,” Arch Gen Psychiat 67, no. 12 (December 2010): ­1256–​­64,
http://archpsyc.­ama-​­assn.org/cgi/content/short/67/12/1256.
67: Daniel Siegel, MD, clinical professor of psychiatry at
UCLA . . . ​calls this ability “mindsight”: Daniel J. Siegel, Mind-
sight: The New Science of Personal Transformation (New York:
Bantam Books, 2010), ­xi–​­xiii.

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 Notes

CHAPTER 5. Optimizing Emotional ­Well-​­Being by Caring

for the Body
73: Up to 20 percent of people suffering from depression are defi-
cient in thyroid hormones: I. Hickle et al., “Clinical and Sub‑
clinical Hypothyroidism in Patients with Chronic and
­Treatment-​­Resistant Depression,” Austral NZ J Psychiat 30 (April
1996): ­246–​­52. See also: “Depression Explored, with Dr. Barry
­Durrant-​­Peatfield,” November 19, 2003, http://thyroid.about
.com/b/2003/11/19/­depression-​­explored-​­with‑dr‑­barry-​­durrant
​­-peatfield.htm.
74: Dysfunction of the pituitary and adrenal glands also com-
monly affects emotional health, as do the drugs used to treat it:
W. F. Kelly, “Psychiatric Aspects of Cushing’s Syndrome,” Q JM 89
(1996): ­543–​­51, http://qjmed.oxfordjournals.org/content/89/7/543
.full.pdf+html?sid=­1ce50d74-​­b3f4-​­4d2a-​­b7b0-​­8d367d3133ee.
74: Depression in some older men can be relieved by boosting
low testosterone levels: M. Amore et al., “Partial Androgen
Deficiency, Depression and Testosterone Treatment in Aging
Men,” Aging Clin Exper Res 21, no. 1 (February 2009): ­1–​­8.
74: People with diabetes are more likely to be depressed than
people without it: Pan An et al., “Bidirectional Association
Between Depression and Type 2 Diabetes Mellitus in Women,”
Arch Int Med 170, no. 21 (November 22, 2010): ­1884–​­91. See
also: S. H. Golden et al., “Examining a Bidirectional Association
Between Depressive Symptoms and Diabetes,” JAMA 299, no. 23
(2008): ­2751–​­59.
74: A recent study in animals with type‑1 diabetes demonstrated
a previously unknown effect of insulin: “Insulin’s Brain Impact
Links Drugs and Diabetes,” Vanderbilt University Medical Cen‑
ter, ScienceDaily, October 17, 2007, www.sciencedaily.com­
/releases/2007/10/071017090131.htm.
74 (footnote): Concern about this possibility in one Addison’s suf-
ferer, John F. Kennedy: Thomas H. Maugh, “John F. ­Kennedy’s

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 Notes

Addison’s Disease Was Probably Caused by Rare Autoimmune

Disease,” Los Angeles Times, September 5, 2009, http://articles
.latimes.com/print/2009/sep/05/science/­sci-​­jfk-​­addisons5.
75: One in three heart attack survivors experiences depression,
as does one in four people who have strokes and one in three
patients with HIV: “Co‑Occurrence of Depression with Other
Illnesses,” from National Institute of Mental Health publication
“Men and Depression,” NIMH (2005): www.nimh.nih.gov/health
/publications/­men-​­a nd-​­depression/co‑occurrence‑of‑­depression
-​­with-​­other-​­illnesses.shtml.
75: An even higher ­percentage — ​50 ­percent — ​of people with
Parkinson’s disease suffer from depression: Miranda Hitti,
“Depression Common with Parkinson’s Disease,” WebMD Health
News, September 29, 2004, www.webmd.com/parkinsons-­disease
/news/20040929/­depression-common-with-parkinsons-disease.
75: “The depression is part of the illness, not simply a reaction to
the disease”: Hitti, “Depression Common.”
76: As many as 25 percent of persons with cancer experience
depression: Dana Jennings, “After Cancer, Ambushed by
­Depression,” New York Times, Health Section, September 29,
2009.
76: With some kinds of ­cancer — ​notably ­pancreatic — ​the per-
centage is much higher: Frank J. Brescia, “Palliative Care in
Pancreatic Cancer,” Cancer Control 11, no. 1 (January/February
2004): ­39–​­45.
77: A commonly reported side effect of interferon therapy is severe
depression; some patients have even killed themselves: Molly
McElroy, “Scientists Build on Case Connecting ­Inflammatory
Disease and Depression,” Illinois News Bureau, July 27, 2004,
http://news.illinois.edu/news/04/0727depression.html.
77: In addition to severe physical side effects, it can cause
­paranoia and hallucinations: Timothy DiChiara, “What You
Need to Know About Interleukin‑2 for Metastatic Melanoma”

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 Notes

About.com, March 31, 2009, http://skincancer.about.com/od

/treatmentoptions/a/interleukin.htm.
77: when proinflammatory cytokines are administered to ani-
mals, they elicit “sickness behavior”: K. W. Kelley et al.,
“­Cytokine-​­Induced Sickness Behavior,” Brain Behav Immun 17, 1
(February, 2003): ­112–​­18.
77: in the 1960s, research revealed a ­blood-​­borne factor to be
responsible: J. E. Holmes and N. E. Miller, “Effects of Bacterial
Endotoxin on Water Intake, Food Intake, and Body Temperature in
the Albino Rat,” J Exp Med 118 (1963): ­649–​­58. See also: N. Miller,
“Some Psychophysiological Studies of Motivation and of the Behav‑
ioral Effects of Illness,” Bull Br Psychol Soc 17 (1964): ­1–​­20.
80: These are classified as ­high-​­glycemic-​­load foods because they
raise blood sugar quickly: Jennie ­Brand-​­Miller et al., The Glu-
cose Revolution: The Authoritative Guide to the Glycemic Index
(Emeryville, Calif.: Marlowe & Company, 1999).
81: People who are fit and who exercise regularly have less inflam-
mation than others: E. S. Ford, “Does Exercise Reduce Inflam‑
mation? Physical Activity and C‑reactive Protein Among U.S.
Adults,” Epidemiol 15, no. 5 (September 2002): ­561–​­68: See also:
Rainer Rauramaa et al., “Effects of Aerobic Physical Exercise on
Inflammation and Atherosclerosis in Men: The DNASCO Study:
A ­Six-​­Year Randomized, Controlled Trial,” Ann Int Med 140, no.
12 (June 15, 2004): ­1007–​­14.
81: The quantity and quality of your sleep also influences inflam-
mation, as does stress: “Poor Sleep Quality Increases Inflamma‑
tion, Community Study Finds,” Science Blog, November 14,
2010, http://scienceblog.com/40178/­poor-​­sleep-​­quality-​­increases
-​­inflammation-​­community-​­study-​­finds/. See also: Robert A.
Anderson, “Inflammation and Stress,” Townsend Letter for
­Doctors and Patients, May 2005, http://findarticles.com/p
/articles/mi_m0ISW/is_262/ai_n13675741/; and N. Simpson and

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 Notes

D. F. Dinges, “Sleep and Inflammation,” Nutr Rev 65, no. 12,

part 2, supplement (December 2007): ­244–​­52.
83: Many studies link specific nutrient deficiencies to subopti-
mal brain function and mental/emotional health: David F.
Horrobin, “Food, Micronutrients, and Psychiatry,” Int Psychoge-
riat 14, no. 4 (January, 2005): ­331–​­34.
83: omega‑3 fatty acids. These special fats are critically impor-
tant for both physical and mental health: “Fish Oils and Men‑
tal Health/Depression,” posted on oilofpisces.com database, 2010,
www.oilofpisces.com/depression.html.
83: Dietary supplementation with these fats, usually in the form
of fish oil, has proved to be an effective, natural, and non-
toxic therapy: “Fish Oils and Mental Health/Depression.”
83: Very high doses of fish ­oil — ​20 grams a day or ­more — ​have
been used as treatments without any ill effects: “Fish Oils and
Mental Health/Depression.”
84: A gorilla, eating mostly leaves and other raw vegetable matter
that is very low in fats, has a brain that is about 0.2 percent of
overall body weight: Imonikhe Ahimie, “The Difference
Between Human Primates and Ape Primates,” posted on Helium
.com, September 1, 2009, www.helium.com/items/1572554
-differences-between-human-primates-and-ape-primates.
86: vitamin D, and it is almost impossible to get enough of it
from diet alone: “Vitamin D Important in Brain Development
and Function,” Science News, April 23, 2008, www.sciencedaily
.com/releases/2008/04/080421072159.htm.
87: not just for bone health but for protection against many
kinds of cancer, multiple sclerosis, influenza, and other dis-
eases: “Vitamin D Important.”
87: more doctors now routinely check blood levels of vitamin D
in their patients and are documenting deficiency in many of
them: “Vitamin D Important.”

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 Notes

87: High vitamin D levels may protect against ­age-​­related cogni-

tive decline: D. M. Lee et al., “Association Between 25‑hydroxyvi‑
tamin D Levels and Cognitive Performance in ­Middle-​­Aged and
Older European Men,” J Neurol Neurosurg Psychiat 80, no. 7
(Epub May 21, 2009): ­722–​­29.
87: (The last correlation is posed as a possible explanation for the
surprisingly high incidence of schizophrenia in ­dark-​­skinned
immigrants who move to northern European countries):
M. J. Dealberto, “Why Are Immigrants at Increased Risk for
Psychosis? Vitamin D Insufficiency, Epigenetic Mechanisms, or
Both?” Med Hypotheses 70, no. 1 (2008): 211.
88: Deficiencies of other vitamins and trace minerals have been
reported in people with mood disorders: David F. Horrobin,
“Food, Micronutrients, and Psychiatry,” Int Psychogeriat 14, no. 4
(January 2005): ­331–​­34.
89: A national news story from June 2010 described an “unorth-
odox treatment for anxiety and mood disorders”: Laura
Blue, “Is Exercise the Best Drug for Depression?,” Time Maga-
zine Online, June 19, 2010, www.time.com/time/health
/article/0,8599,1998021,00.html.
89: “In order for man to succeed in life, god provided him with
two means”: Plato, 4th century BCE, quoted in Andreas
Struohle, “Physical Activity, Exercise, Depression and Anxiety
Disorders,” J Neural Transm 116 (2009): ­777–​­84.
90: Many studies show that depressed patients who stick to a
regimen of aerobic exercise improve as much as those
treated with medication and are less likely to relapse:
Struohle, “Physical Activity, Exercise, Depression and Anxiety
Disorders.”
90: The data also suggest that exercise prevents depression and
boosts mood in healthy people: Struohle, “Physical Activity,
Exercise, Depression and Anxiety Disorders.”

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 Notes

90: Most prospective studies have used walking or jogging pro-

grams: Struohle, “Physical Activity, Exercise, Depression and
Anxiety Disorders.”
91: some research finds nonaerobic exercise such as strength and
flexibility training as well as yoga to be effective, too: Struohle,
“Physical Activity, Exercise, Depression and Anxiety Disorders.”
See also: B. G. Bergen and D. R. Owen, “Mood Alteration with
Yoga and Swimming: Aerobic Exercise May Not Be Necessary,”
Percept Mot Skills 75, no. 3, part 2 (December 1992): ­1331–​­43.
91: clinical psychologist and yoga therapist Bo Forbes explains:
Quote following is from Bo Forbes, Yoga for Emotional Balance,
(Boulder, Colo.: Shambhala Publications, 2010), 39.
91: The most important conclusions of research to date are that
regular physical activity: Struohle, “Physical Activity, Exercise,
Depression and Anxiety Disorders.”
95: Most experts agree that sleep and mood are closely related:
Lawrence J. Epstein, MD, “Sleep and Mood,” December 15,
2008, http://healthysleep.med.harvard.edu/­need-​­sleep/whats‑in‑it
‑­for-​­you/mood.
95: Studies report that about 90 percent of patients with major
depression have difficulty initiating and maintaining sleep:
Epstein, “Sleep and Mood.”
95: chronic ­insomnia — ​on and off for the better part of a ­year — ​
is a strong clinical predictor of depression: Epstein, “Sleep and
Mood.”
95: Five to 10 percent of the adult population in Western indus-
trialized countries suffer from chronic insomnia: Epstein,
“Sleep and Mood.”
95: Most of it involves sleep deprivation: human subjects are
observed in laboratories over days or weeks when they are
allowed to sleep less than normal amounts: Ruth M. Benca,
“How Does Sleep Loss Affect Mood?,” Medscape Family Medicine

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 Notes

7, no. 2 (2005), cme.medscape.com/viewarticle/515564. See also:

Monica Haack and Janet M. Mullington, “Sustained Sleep Restric‑
tion Reduces Emotional and Physical ­Well-​­Being,” Pain 119, no.
1 (December 15, 2005): ­56–​­64.
95: One study at the University of Pennsylvania: David Dinges
et al., “Cumulative Sleepiness, Mood Disturbance, and Psycho‑
motor Vigilance Decrements During a Week of Sleep Restricted
to ­4 –​­5 Hours Per Night,” Sleep 20, no. 4 (April 1997): ­267–​­77.
96: Another study, by investigators at Harvard Medical School
and the University of California, Berkeley, used functional
MRI to assess changes in brain function with sleep depriva-
tion: ­Seung-​­Schik Yoo et al., “The Human Emotional Brain
Without ­Sleep — ​A Prefrontal Amygdala Disconnect,” Curr Biol
17, no. 20 (October 23, 2007): ­R877–​­78.
96: because sleep deprivation also increases inflammation in the
body: Deborah Simpson and David F. Dinges, “Sleep and Inflam‑
mation,” Nutr Rev 65 (December 2007): ­S244–​­52.
96: Mood disorders are also strongly linked to . . . ​REM (rapid
eye movement) sleep: Rosalind Cartwright, The ­Twenty-​­four
Hour Mind: The Role of Sleep and Dreaming in Our Emotional
Lives (New York: Oxford University Press, 2010), 7.
96: “REM/dream loss is the most critical overlooked ­socio-​
­cultural force in the etiology of depression”: Rubin Naiman,
“Circadian Rhythm and Blues: The Interface of Depression
with Sleep and Dreams,” Psychology Today Blog by Rubin
Naiman, PhD, February 28, 2011, www.psychologytoday.com
/blog/bloggers/­rubin-​­naiman-​­phd.
96: Of significance is the fact that most medications used to help
people sleep suppress REM sleep and dreaming: Naiman,
“Circadian Rhythm and Blues.”
96: Research suggests that the emotional content of many dreams
is negative: Naiman, “Circadian Rhythm and Blues.”

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 Notes

104: With ­long-​­term use, steroids cause emotional instability,

mania, and, most often, depression: S. B. Patten, “Exogenous
Corticosteroids and Major Depression in the General Popula‑
tion,” J Psychosom Res 49, no. 6 (December 2000): ­447–​­49: See
also: Diagnostic and Statistical Manual of Mental Disorders, Fourth
Edition, Text Revision (DSM‑IV‑TR), published by the American
Psychiatric Association, 2000.
105: (Interestingly, Iceland is an exception, probably because its
inhabitants have unusually high tissue levels of omega‑3 fatty
acids from a diet rich in oily fish, as well as high dietary
intake of vitamin D): Daphne Miller, The Jungle Effect: Healthi-
est Diets from Around the World: Why They Work and How to
Make Them Work for You (New York: Harper, 2009), ­137–​­39.
105: In 1984, Norman E. Rosenthal, MD, and colleagues at the
National Institute of Mental Health described a form of
depression that recurred seasonally: N. E. Rosenthal et al.,
“Seasonal Affective Disorder: A Description of the Syndrome and
Preliminary Findings with Light Therapy,” Arch Gen Psychiat 41,
no. 1 (1984): ­72–​­80.
106: his 1993 book, Winter Blues, is the classic treatise on the
subject: Norman E. Rosenthal, Winter Blues (New York: Guil‑
ford Press, 1993).
106: An estimated 6.1 percent of the US population suffers from
SAD, and more than twice as many people are prone to a
milder form called subsyndromal seasonal affective disorder,
or SSAD: D. H. Avery et al., “Bright Light Therapy of Subsyn‑
dromal Seasonal Affective Disorder in the Workplace: Morning
vs. Afternoon Exposure,” Acta Psychiatrica Scandinavica 103, no.
4 (2001): ­267–​­74: See also: M. Said, “Seasonal Affective Disor‑
ders,” Priory (January 2001), priory.com/psych/SAD.htm.
106: Whatever its cause, treatment with ­f ull-​­spectrum ­light — ​not
the same as ordinary indoor ­light — ​works to relieve SAD as

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 Notes

effectively as antidepressant drugs and faster: Robert N. Golden

et al., “The Effect of Light Therapy in the Treatment of Mood
Disorders: A Review and ­Meta-​­A nalysis of the Evidence,” Am J
Psychiat 162 (April 2005): ­656–​­62.
106: but analysis of data so far suggests that it can be effective for
treating nonseasonal depression, again working as well as
medication: Golden, “Effect of Light Therapy.”
107: Many devices include wavelengths of blue light that are
­hazardous to the eye, increasing the risk of ­age-​­related
­macular degeneration (AMD): “The Dark Side of Light: Rho‑
dopsin and the Silent Death of Vision. The Proctor Lecture,”
Investig ­Ophthalmol Vis Sci 46 (2005): ­2672–​­82: See also: “The
Risk of Eye Damage from Bright Light and Blue Light Ther‑
apy,” www.sunnexbiotech.com, www.sunnexbiotech.com/therapist
/main.htm.
107: (Herbert Kern, the engineer who first tried it, reported in an
article in Science in 2007): Y. Bhattacharjee, “Psychiatric
Research. Is Internal Timing Key to Mental Health?” Science 317,
no. 5844 (September 14, 2007): ­1488–​­90.
111: Recent research suggests that antidepressant medications
may increase the risk: Steven Rosenberg, “Study Hints at Link
Between Antidepressants and Heart Trouble,” report on presen‑
tation by Dr. Amit Shah at the 2011 annual meeting of the
American College of Cardiology, HealthDay News, April 2, 2011;
L. Cosgrove, Ling Shi et al., “Antidepressants and Breast and
Ovarian Cancer Risk: A Review of the Literature and Research‑
ers’ Financial Associations with Industry,” PlosOne, www.plosone
.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0018210.
112: This European plant (Hypericum perforatum) has a long his-
tory of medicinal use, including as an herbal mood booster:
Paul Hammernes et al., “St. John’s Wort: A Systematic Review of
Adverse Effects and Drug Interactions for the Consultation Psy‑
chiatrist,” Psychosomatics 44 (August 2003): ­271–​­82.

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112: most experimental results with mild to moderate depression

have been positive, with St. John’s wort performing better
than a placebo, often doing as well as prescription antide-
pressants, and sometimes proving more effective than the
drugs: Hammernes et al., “St. John’s Wort.”
114: SAMe has been extensively studied as an antidepressant and
treatment for the pain of osteoarthritis: “SAMe for Treatment
of Depression,” The National Center for Complementary and Alter-
native Medicine at the National Institutes of Health, December 22,
2008, www.healthyplace.com/depression/­alternative-​­treatments
/same-​­for-​­treatment‑of‑depression/menu‑id‑68/.
114: In recent research . . . ​investigators from Harvard Medical
School and Massachusetts General Hospital gave SAMe or a
placebo to ­seventy-​­three depressed adults: George I. Papakos‑
tas et al., “S‑Adenosyl Methionine (SAMe) Augmentation of
Serotonin Reuptake Inhibitors for Antidepressant Nonresponders
with Major Depressive Disorder: A ­Double-​­Blind, Randomized
Clinical Trial,” Am J Psychiat 167 (August 2010): ­942–​­48.
116: Rhodiola rosea: Richard P. Brown et al., “Rhodiola rosea: A
Phytomedicinal Overview,” American Botanical Council, Herb-
alGram 56 (2002): ­40–​­52.
116: [Rhodiola rosea] has been extensively studied by scientists in
Russia and Sweden: Brown et al., “Rhodiola rosea.”
116: Rhodiola root contains rosavins, compounds that appear to
enhance activity of neurotransmitters in the brain and may
be responsible for the herb’s beneficial effects on mood and
memory: Brown et al., “Rhodiola rosea.”
116: In a 2007 ­double-​­blind, ­placebo-​­controlled human study
from Sweden: V. Darbinyan et al., “Clinical Trial of Rhodiola
rosea L. Extract SHR‑5 in the Treatment of Mild to Moderate
Depression,” by Nordic J Psychiat 61, no. 5 (2007): ­343–​­48.
117: Valerian comes from the root of a European plant (Valeriana
officinalis) used safely for centuries to promote relaxation

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 Notes

and sleep: American Botanical Council, The ABC Clinical Guide

to Herbs (New York: Thieme Publishers, 2003), ­351–​­64.
117: Kava is another root with a sedative effect: ABC Clinical Guide
to Herbs, ­259–​­71.
117: Kava is an excellent ­a nti-​­anxiety remedy, shown in controlled
human trials to be as effective as benzodiazepine drugs: ABC
Clinical Guide to Herbs, ­259–​­71.
118: Animal research shows ashwagandha to be equivalent to true
Panax ginseng in stress protection, without ginseng’s stimu-
lating effect: “Materia Medica: Withania somnifera,” Europ J
Herbal Med 4, no. 2 (1998): ­17–​­22. See also: S. K. Bhattacharya
and A. V. Muruganandam, “Adaptogenic Activity of Withania
Somnifera: An Experimental Study Using a Rat Model of Chronic
Stress,” Pharmacol Biochem Behav 75, no. 3 (June 2003): ­545–​­55.
118: Human studies in India demonstrate ashwagandha’s ­a nti-​
­anxiety and ­mood-​­elevating properties and confirm its lack
of toxicity: S. K. Kulkarni and A. Dhir, “Withania Somnifera:
An Indian Ginseng,” Prog Neuropsychopharmacol Biol Psychiat
32, no. 5 (July 1, 2008): ­1093–​­1105.
119: Holy basil, or tulsi (Ocimum sanctum), is a sacred plant in
India. . . . ​Modern research in both animals and humans dem-
onstrates a lack of toxicity and a variety of benefits: S. Singh
et al., “Evaluation of ­A nti-​­inflammatory Potential of Fixed Oil of
Ocimum sanctum (Holy Basil) and Its Possible Mechanism of
Action,” J Ethnopharmacol 54 (1996): ­19–​­26. See also: David
Winston and Steven Maimes, Adaptogens: Herbs for Strength, Stam-
ina, and Stress Relief (Rochester, Vt.: Inner ­Traditions — ​Bear &
Co., 2007), and Dr. Narendra Singh and Dr. Yamuna Hoette,
­Tulsi — ​Mother Medicine of Nature, International Institute of
Herbal Medicine (Lucknow, India), 2002, www.­holy-​­basil
.com/6685.html and www.pharmainfo.net/reviews/ocimum
-sanctum-and-its-therapeutic-applications.

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120: My colleague Jim Nicolai, MD, medical director of the Inte-

grative Wellness Program at Miraval Resort and Spa in Tuc-
son, tells me he has great success with holy basil in his
patients: Personal communication, 2010.
121: Turmeric, the yellow spice that colors curry and American
yellow mustard, is a potent natural ­a nti-​­inflammatory agent:
American Botanical Council, HerbalGram 84 (2009): ­1–​­3, http://
cms.herbalgram.org/herbalgram/issue84/article3450.html.
121: Its active constituent, curcumin, has shown promise as an
antidepressant: S. Kulkarni et al., “Antidepressant Activity of
Curcumin: Involvement of Serotonin and Dopamine System,”
Psychopharmacol 201, no. 3 (September 3, 2008): 435–42.
121: Indian researchers suggest doing clinical trials to explore its
efficacy as a novel antidepressant: S. Kulkarni et al., “Potentials
of Curcumin as an Antidepressant,” Scientific World J 9 (Novem‑
ber 2009): ­1233–​­41.
121: absorption is greatly increased by the presence of piperine, a
compound in black pepper: G. Shoba et al., “Influence of
­Piperine on the Pharmacokinetics of Curcumin in Animals
and Human Volunteers,” Planta Med 64, no. 4 (May 1998):
­353–​­56.
121: in a controlled trial from China in 1994, depressed patients
treated six times a week with acupuncture for six weeks
improved as much as those treated with amitriptylene (Elavil):
X. Yang et al., “Clinical Observation on Needling Extrachannel
Points in Treating Mental Depression,” J Tradit Chin Med 14, no.
1 (March 1994): ­14–​­18. See also: Pavel Jalynytchev and Valen‑
tina Jalynytchev, “Role of Acupuncture in the Treatment of
Depression, Benefits and Limitations of Adjunctive Treatment
and Monotherapy,” Psychiat Times 26, no. 6 (May 12, 2009),
w w w.ps ychiatrictimes.com /depression/content /a r ticle
/10168/1413274.

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122: Some studies use electroacupuncture: G. A. Ulett et al., “Elec‑

troacupuncture: Mechanisms and Clinical Application,” Biol
Psychiat 44, no. 2 (July 15, 1998): ­129–​­38.
122: We know that animal and human infants deprived of physi-
cal contact do not develop normally; some actually sicken
and die: Katherine Harmon, “How Important Is Physical Con‑
tact with Your Infant?,” Scientific American Newsletters (May 6,
2010): www.scientificamerican.com/article.cfm?id=­infant-​­touch.
122: Some new, intriguing studies are documenting the biochemi-
cal benefits of touch: Mark Hyman Rapaport et al., “A Prelimi‑
nary Study of the Effects of a Single Session of Swedish Massage
on ­Hypothalamic-​­Pituitary-​­Adrenal and Immune Function in
Normal Individuals,” J Compl Alt Med 16, no. 10 (October 18,
2010): ­1079–​­88.
123: Touch promotes the release of oxytocin, which in turn causes
the release of dopamine in the brain’s reward center: Paul J.
Zak et al., “The Neurobiology of Trust,” Ann New York Acad Sci
1032 (2004): ­224–​­27.
123: Paul J. Zak, PhD, a founder of the contemporary field of neu-
roeconomics: Paul Zak with Susan Kuchinskas, “The Power of a
Handshake: How Touch Sustains Personal and Business Relation‑
ships,” Huffington Post, September 29, 2008, www.huffingtonpost
.com/paul‑j‑zak/­the-​­power‑of‑a‑handshake_b_129441.html.
124: The brains of those who got massage released more oxytocin
than the brains of those who rested. And the massaged sub-
jects returned 243 percent more money to the strangers who
showed them trust: Vera B. Morhenn et al., “Monetary Sacrifice
Among Strangers Is Mediated by Endogenous Oxytocin Release
After Physical Contact,” Evol Human Behav 29, no. 6 (November
2008): ­375–​­83.
124: An article with the provocative title “Is Dirt the New Pro-
zac?”: Josie Glausiusz, Discover, July 2007, http://discovermagazine
.com/2007/jul/­raw-​­data‑is‑­dirt-​­the-​­new-​­prozac.

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CHAPTER 6. Optimizing Emotional ­Well-​­Being by Retrain-

ing and Caring for the Mind
129: Mark Twain advised to “drag your thoughts away from your
troubles . . . ​by the ears, by the heels, or any other way you can
manage it”: Popularly attributed to Mark Twain.
130: the field known as positive psychology is quite recent. Its
chief proponent is Martin Seligman: Martin E. P. Seligman,
Authentic Happiness: Using the New Positive Psychology to Realize
Your Potential for Lasting Fulfillment (New York: Free Press,
2004).
130: “Remember that foul words or blows in themselves are no
outrage, but your judgment that they are so”: Quote attrib‑
uted to Epictetus (­55–​­135 CE), Internet Encyclopedia of Philoso-
phy, 2011, www.iep.utm.edu/epictetu.
132: Seligman has tested many interventions to help people enjoy
greater pleasure, flow, and meaning in their lives and has found
three to be particularly effective: Seligman, Authentic Happiness.
135: American psychiatrist Aaron T. Beck (­1921–​­ ), who devel-
oped a cognitive theory of depression in the 1960s, is regarded
as the father of cognitive therapy: http://en.wikipedia.org/wiki
/Aaron_Temkin_Beck.
135: (In his original treatment manual, Beck wrote, “The philo-
sophical origins of cognitive therapy can be traced back to
the Stoic philosophers”): A. T. Beck et al., Cognitive Therapy of
Depression (New York: Guilford Press, 1979), 8.
136: In a 2011 publication, the British Royal College of Psychia-
trists concluded that CBT: Bullet points following are from
“Cognitive Behavioural Therapy (CBT),” Royal College of
­Physicians, 2011, http://rcpsych.ac.uk/mentalhealthinformation
/therapies/cognitivebehaviouraltherapy.aspx?theme.
136: Depressive symptoms often improve in this initial stage, and
many patients are no longer depressed after only eight to
twelve sessions: A. C. Butler and A. T. Beck, “Cognitive Therapy

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 Notes

for Depression,” The Clinical Psychologist 48, no. 3 (1995):­

3–​­5.
137: In a study reported in the December 2010 issue of the Archives
of General Psychiatry: Zindel V. Segal et al., “Antidepressant
Monotherapy vs. Sequential Pharmacotherapy and ­Mindfulness-​
­Based Cognitive Therapy, or Placebo, for Relapse Prophylaxis in
Recurrent Depression,” Arch Gen Psychiat 67, no. 12 (December
2010): ­1256–​­64.
142: The elephant steps right along with his stick held upright in a
steady trunk: Eknath Easwaran, Meditation: A Simple ­Eight-​
­Point Program for Translating Spiritual Ideals into Daily Life,
(Tomales, Calif.: Nilgiri Press, 1991), 58.
142: Using Easwaran’s The Mantram Handbook, several research-
ers have documented the efficacy of this method: Eknath Eas‑
waran, The Mantram Handbook: A Practical Guide to Choosing
Your Mantram and Calming Your Mind, (Tomales, Calif.: Nilgiri
Press, 2008).
142: One study, published in the Journal of Continuing Education
in Nursing in 2006: Jill E. Bormann et al., “Relationship of
Frequent Mantram Repetition to Emotional and Spiritual ­Well-​
­Being in Healthcare Workers,” J Cont Educ Nursing 37, no. 5
(September/October 2006): ­218–​­24.
143: Other researchers have come to similar conclusions after test-
ing mantram repetition in male veterans and ­HIV-​­positive
individuals: Jill E. Bormann and Adam W. Carrico, “Increases in
Positive Reappraisal Coping During a ­Group-​­Based Mantram
Intervention Mediate Sustained Reductions in Anger in ­HIV-​
­Positive Persons,” Int J Behav Med 16, no. 1 (January 2009): ­74–​
­80. See also: J. E. Bormann et al., “Mantram Repetition for Stress
Management in Veterans and Employees: A Critical Incident
Study,” J Adv Nurs 53, no. 5 (March 2006): ­502–​­12.
144: (C. J. Jung incorporated the use of mandala into his psycho-
analytic work with patients): Gerald Schueler, “Chaos Theory:

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 Notes

Interface with Jungian Psychology,” 1997, www.schuelers.com

/chaos/chaos1.htm.
148: “A Wandering Mind Is an Unhappy Mind” is the title of a
report: Matthew A. Killingsworth and Daniel T. Gilbert, Science
300, no. 6006 (November 12, 2010): 932.
150: If you can recognize, even occasionally, the thoughts that go
through your mind as simply thoughts: Quote from Eckhart
Tolle, Stillness Speaks (Vancouver, B.C.: Namaste Publishing,
2003), ­14–​­15.
150: I wrote about the value of meditation in my first book, The
Natural Mind, back in 1972: Andrew Weil, The Natural Mind
(Boston: Houghton Mifflin Company, 1972).
152: In his compelling recent book, In Pursuit of Silence: Listen-
ing for Meaning in a World of Noise, essayist George Proch-
nik tells a story of going on patrol with a Washington, DC,
police officer named John Spencer: Excerpt that follows is from
George Prochnik, In Pursuit of Silence: Listening for Meaning in a
World of Noise (New York: Doubleday, 2010), ­17–​­18.
156: We get much more information than we desire: Excerpt is
from Francis Heylighen, “Complexity and Information Overload
in Society: Why Increasing Efficiency Leads to Decreasing Con‑
trol,” Free University of Brussels, 2002 (draft for The Informa-
tion Society), http://pespmc1.vub.ac.be//Papers/­Info-​­Overload
.pdf.
162: In 1900, only 5 percent of US households were ­single-​­person
households: “Loneliness and Isolation: Modern Health Risks,”
The Pfizer Journal 4, no. 4 (2000).
163: A 2006 study in the American Sociological Review found that
Americans on average had only two close friends to confide
in, down from an average of three in 1985: Miller McPherson
et al., “Social Isolation in America: Changes in Core Discussion
Networks Over Two Decades,” Am Soc Rev 71, no. 3 (2006):
­353–​­75.

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163: Social isolation and loneliness are strongly correlated with

depression: R. A. Schoevers et al., “Risk Factors for Depression
in Later Life; Results of a Prospective Community Based Study
(AMSTEL),” J Affect Disord 59, no. 2 (August 2000): ­127–​­37.
163: In his classic work, Suicide, Émile Durkheim (­1858–​­1917),
the father of modern sociology, wrote: Émile Durkheim, Sui-
cide (New York: Free Press, 1997), 210.
163: Researchers have documented an association between Inter-
net use and social isolation as well as depression among ado-
lescents: Carole Hughes, “The Relationship of Use of the Internet
and Loneliness Among College Students,” Boston College Dis‑
sertations and Theses, Paper AAI9923427, January 1, 1999, http://
escholarship.bc.edu/dissertations/AAI9923427/. See also: Kim‑
berly S. Young and Robert C. Rodgers, “The Relationship Between
Depression and Internet Addiction,” Cyber Psychol Behav 1, no. 1
(1998): ­25–​­28; Christopher E. Sanders et al., “The Relation‑
ship of Internet Use to Depression and Social Isolation
Among ­Adolescents,” Health Publications, summer 2000, http://
findarticles.com/p/articles/mi_m2248/is_138_35/ai_66171001
/pg_2/.

CHAPTER 7. Secular Spirituality and Emotional ­Well-​­Being

170: Mind/body medicine is coming into its own, and more scien-
tists are taking placebo responses seriously: Harald Walach
and Wayne B. Jonas, “Placebo Research: The Evidence Base for
Harnessing ­Self-​­Healing Capacities,” J Alt Comp Med 10, no. 1
(2004): ­S103–​­12.
173: A great deal of scientific research confirms the benefits to health
in general and emotional health in particular of living with
companion animals: J. Nimer and B. Lundahl, “Animal Assisted
Therapy: A ­Meta-​­Analysis,” Anthrozoo 20, no. 3 (2007): ­225–​­38.
170: Lynette A. Hart, PhD, a professor of veterinary medicine
at the University of California, Davis, writes: Lynette A.

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 Notes

Hart, “Companion Animals Enhancing Human Health and Well­

­being (Proceedings),” CVC Proceedings, August 1, 2008, http://
veterinarycalendar.dvm360.com/avhc/content/printContent
Popup.jsp?id=567242.
170: “Being around pets appears to feed the soul, promoting a
sense of emotional connectedness and overall ­well-​­being”:
Dennis Thompson Jr., “Pet Therapy and Depression,” Everyday
Health, 2011, www.everydayhealth.com/depression/­pet-​­therapy
-​­and-​­depression.aspx.
174: “It is important to develop and uplift human consciousness
through beauty,” he wrote: Quote attributed to Mokichi Okada
(­1882–​­1955), http://ikebanasangetsu.org/.
176: In his 2001 book, The Healing Power of Doing Good: Allan
Luks, The Healing Power of Doing Good (New York: Fawcett Col‑
umbine, 1991).
176: lawyer Allan Luks introduced the term “helper’s high” to
describe the rush of good feelings that people get when they
help others: Luks, “Healing Power of Doing Good,” xiii.
176: Since then, neuroscientists have demonstrated that helping
others activates the same centers in the brain involved in
­dopamine-​­mediated pleasure responses to food and sex:
Shoshana Alexander and James Baraz, “The Helper’s High,” The
Greater Good, February 1, 2010, http://greatergood.berkeley.edu/
article/item/the_helpers_high/.
176: In one study, these pleasure centers lit up when participants
simply thought about giving money to a charity: Alexander
and Baraz, “Helper’s High.”
176: From a study of more than three thousand volunteers, Allan
Luks concluded that regular helpers are ten times more likely
to be in good health than people who don’t volunteer: Luks,
“Healing Power of Doing Good,” xi.
176: “Giving help to others protects overall health twice as
much as aspirin protects against heart disease”: Quote and

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 Notes

excerpt following are from Christine L. Carter, “What We Get

When We Give,” Psychology Today, February 18, 2010, www
.psychologytoday.com.
177: One of the findings of the landmark Social Capital Commu-
nity Benchmark Survey of thirty thousand Americans, pub-
lished in 2000: A. C. Brooks, “Does Giving Make Us Prosperous?”
J Econ Finance 31, no. 3 (fall 2007): ­403–​­11.
177: Is charity “really ­self-​­interest masquerading as altruism”:
Anthony De Mello, Awareness: A De Mello Spirituality Conference
in His Own Words, edited by J. Francis Stroud (New York: Ran‑
dom House, 1992), 19.
177: The Dalai Lama uses the term selfish altruism without any
pejorative sense: Alexander and Baraz, “Helper’s High.”
179: compassion and affection help the brain to function more
smoothly: Quote is from the Dalai Lama, “Compassion Is the
Source of Happiness,” The Berzin Archives, May 2008, www
.­b erzinarchives.com/web/en/archives/sutra/level2_lamrim
/advanced_scope/bodhichitta/compassion_source_happiness.html.
180: In his ­brain-​­imaging studies, Richard Davidson and col-
leagues have documented changes in the brains of both
Tibetan monks and laypersons trained in compassion medi-
tation: Antoine Lutz et al., “Regulation of the Neural Circuitry
of Emotion by Compassion Meditation: Effects of Meditative
Expertise,” PLoS ONE 3, no. 3 (2008).
180: In his excellent book The Compassionate Mind, psychologist
Paul Gilbert: Quotes that follow are from Paul Gilbert, The
Compassionate Mind (London: Constable, 2009).
181: “always forgive your ­enemies — ​nothing annoys them so
much”: Quote popularly attributed to Oscar Wilde.
181: Research shows that those who forgive enjoy better social
interactions in general and become more altruistic over time:
C. V. Witvliet et al., “Forgiveness and Health: Review and Reflec‑
tions on a Matter of Faith, Feelings, and Physiology,” J Psychol

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 Notes

Theol 29 (2001): ­212–​­24. See also: C. V. Witvliet and K. A.

Phipps, “Granting Forgiveness or Harboring Grudges: Implica‑
tions for Emotion, Physiology, and Health,” Psychol Sci 12 (2001):
­117–​­23.
181: a 2009 study documents an inverse correlation between for-
giveness and depression: J. L. Burnette et al., “Insecure Attach‑
ment and Depressive Symptoms: The Mediating Role of
Rumination, Empathy, and Forgiveness,” Personality and Indi-
vidual Differences 46, no. 3 (February 2009): ­276–​­80.
182: such as a ­six-​­hour “­empathy-​­oriented forgiveness seminar”:
Stephen J. Sandage and Everett L. Worthington, “Comparison of
Two Group Interventions to Promote Forgiveness: Empathy as a
Mediator of Change,” J Mental Health Couns 32, no. 1 (January,
2010): ­35–​­57.
182: “For me it was a limitation that we were so bound from con-
necting the material, tangible, and measurable world to spiri-
tual questions and pursuits”: Quote is from Frederic Luskin,
MD, in Teresa Rose, “Director of the Stanford Forgiveness Project
Frederic Luskin Suggests Forgiving to Mediators” (video), Exam-
iner.com, San Francisco, June 4, 2010, www.examiner.com/sf‑in
‑­s an-​­f rancisco/director‑of‑­t he-​­s tanford-​­f orgiveness-​­project-​
­frederic-​­luskin-​­suggests-​­forgiving‑to‑­mediators-​­video.
184: “The free expression by outward signs of an emotion intensi-
fies it. On the other hand, the repression, as far as this is pos-
sible, of all outward signs softens our emotions. . . . ​Even the
simulation of an emotion tends to arouse it in our minds”:
Quote is attributed to Charles Darwin in his Expression of the
Emotions in Man and Animals (London: John Murray, 1872). See
also: Charles Darwin, The Expression of the Emotions in Man and
Animals, Joe Cain and Sharon Messenger, eds. (New York: Pen‑
guin, 2009), xxviii.
184: A 1988 study by researchers at Universität Mannheim, Fed-
eral Republic of Germany, did just that: F. Stack et al., “Inhibiting

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 Notes

and Facilitating Conditions of the Human Smile: A Nonobtru‑

sive Test of the Facial Feedback Hypothesis,” J Pers Soc Psychol
54, no. 5 (May 1988): 768‑77.
185: similar studies demonstrate clearly that emotions stimulate
physical expressions, and physical expressions stimulate
­emotions: Studies include: M. Zuckerman et al., “Facial, Auto‑
nomic, and Subjective Components of Emotion: the Facial Feed‑
back Hypothesis Versus ­Externalizer-​­Internalizer Distinction,” J
Pers Soc Psychol 41 (1981): ­929–​­44; R. Tourangeau and P. C.
­Ellsworth, “The Role of Facial Response in the Experience
of Emotion,” J Pers Soc Psychol 37, no. 9 (September 1979): ­1519–​­31;
Pamela K. Adelmann and R. B. Zajonc, “Facial Efference and the
­Experience of Emotion,” Ann Rev Psychol 40 (1989): ­249–​­80.
185: Begun by Dr. Madan Kataria, a physician from Mumbai,
India, the first laughter club convened in March of 1995
with a handful of people: “What Is Laughter Yoga?” www
.laughteryoga.org/index.php?option=com_content&view=article
&id=180:what‑is‑­l aughter-​­y oga&catid=85:­a bout-​­l aughter​
­-yoga&Itemid=265.
186:  ​regular participation in laughter clubs has been shown to
improve ­long-​­term emotional and physical health in a variety
of ways: “Laughter Lowers Blood Pressure,” July 21, 2008, www
.laughteryoga.org/index.php?option=com_content&view=category
&id=125&layout=blog&Itemid=275&limitstart=160.
187: “Why? Are we afraid of what we will discover when we come
face-to-face with ourselves there?”: Quote from Susan Hill,
“Silence, Please,” StandPoint Magazine, June 2009. www
.standpointmag.co.uk/­silence-​­please-​­features-​­june‑09‑­susan-​­hill.
187: “silence is a rich and fertile soil in which many things grow
and flourish”: Hill, “Silence, Please.”
188: We now have scientific evidence for emotional contagion:
­A lison L. Hill, et al., “Emotions as Infectious Diseases in a Large

270

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 Notes

Social Network: the SISa Model,” Proc Biol Sci 277, no. 1701
(December 22, 2010): ­3827–​­35.
188: if you have a happy friend who lives within a mile of you,
your chance of happiness increases by 25 percent: James H.
Fowler and Nicholas A. Christakis, “Dynamic Spread of Happi‑
ness in a Large Social Network: Longitudinal Analysis over 20
Years in the Framingham Heart Study,” BMJ 337, no. a2338
(December 4, 2008).
188: That is one finding of a study published in the British Medi-
cal Journal in 2008: Fowler and Christakis, “Dynamic Spread
of Happiness.”
189: Other analyses of the same data show that negative emotions
are just as transmissible as positive ones. . . . ​The same is true
of depression: Michael Yapko, Depression Is Contagious: How the
Most Common Mood Disorder Is Spreading Around the World and
How to Stop It (New York: Free Press, 2009).
189: We have strong evidence of the power of gratitude to boost
mood: Discussion that follows is from research by Robert
Emmons. See: Robert A. Emmons, Thanks! How Practicing Grat-
itude Can Make You Happier (New York: Houghton Mifflin
­Harcourt, 2007).
190: regularly practicing grateful thinking can move your emo-
tional set point for happiness by as much as 25 percent in the
right direction: Brad Lemley, “Shiny Happy People: Can You
Reach Nirvana with the Aid of Science?” Discover, August 2006,
http://discovermagazine.com/2006/aug/shinyhappy.
191: First, gratitude is acknowledgment of goodness in one’s own
life: Emmons, Thanks!, 4
192: The method used most frequently in research on the effects of
practicing gratitude is the Gratitude Journal: Alvaro Fernan‑
dez, “Enhance Happiness and Health by Cultivating Gratitude:
Interview with Robert Emmons,” SharpBrains, November 29,

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 Notes

2007, www.sharpbrains.com/blog/2007/11/29/robert-emmons‑on
‑the-positive-psychology‑of‑gratitude/.
193: “The thankful receiver bears a plentiful harvest”: The Com-
plete Poetry & Prose of William Blake, edited by David V. Erdman
et al. (New York: Anchor; rev. ed., 1997), 37.

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 About the Author

Andrew Weil, MD, is a ­world-​­renowned leader and pioneer in the field

of integrative medicine, a ­healing-​­oriented approach to health care that
encompasses body, mind, and spirit.
Dr. Weil is the founder and director of the Arizona Center for Inte‑
grative Medicine at the University of Arizona Health Sciences Center,
where he is also a clinical professor of medicine, professor of public
health, and the ­Lovell-​­Jones Professor of Integrative Rheumatology.
Dr. Weil received both his medical degree and his undergraduate
degree in biology (botany) from Harvard University.
Dr. Weil is an internationally recognized expert on maintaining a
healthy lifestyle, healthy aging, and the future of medicine and health
care. Approximately 10 million copies of Dr. Weil’s books have been sold,
including Spontaneous Healing, 8 Weeks to Optimum Health, Eating Well
for Optimum Health, The Healthy Kitchen, and Healthy Aging.
He is the editorial director of www.drweil.com, the leading Web
resource for healthy living based on the philosophy of integrative medi‑
cine. He authors the popular “­Self-​­Healing” special publications and is
the director of Integrative Health and Healing at Miraval Resort in
Tucson, Arizona. As a columnist for Prevention magazine and frequent
guest on numerous national shows, Dr. Weil provides valuable insight
and information on how to incorporate conventional and complemen‑
tary medicine practices into one’s life to optimize the body’s natural
healing power.

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