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A KU professor is rethinking how we treat depression: ‘A disease of civilization’

University of Kansas psychology professor Steve Ilardi was on the forefront of the basketball data analytics revolution. He says his six-step approach to treating depression can be similarly impactful on the mental health crisis
Submitted by Steve Ilardi
University of Kansas psychology professor Steve Ilardi was on the forefront of the basketball data analytics revolution. He says his six-step approach to treating depression can have a similar impact on the mental health crisis.

A neuroscientist and University of Kansas professor, Steve Ilardi has identified six steps toward better mental health. Developing a meaningful hobby can make a difference. His is basketball data analysis.

It’s Game Three of the NBA Finals between the Boston Celtics and Dallas Mavericks and Steve Ilardi is reclining on his basement couch with his family’s puppy, Ringo, curled in his lap.

His eyes are locked on the action, even when he chimes in with a remark about what’s just taken place. He’s particularly interested in Celtics guard Jrue Holiday, who he considers to be the most impactful player in the series to this point — even though basic statistics in the box score might not reflect that opinion.

Ilardi is not your average fan, and his assertion of Holiday’s impact isn’t a random opinion. Ilardi is a basketball data analyst who was among the first to start unraveling the sport's statistical mysteries.

“Knowledge is power,” Ilardi says. “How can we leverage knowledge, how can we leverage the tools of mathematics, the tools of statistics, the tools of research design, to really answer questions that matter — to somebody.”

Ilardi is the co-founder of Real Plus-Minus, one of ESPN’s statistics to help measure a player's relative value and overall impact on the game. He’s worked as a consultant for both the Phoenix Suns and Houston Rockets, aiding the front office in identifying potential draft picks that could find future success.

Right now, even as the playoffs wind to a close, he’s consulting with Unique Sports Management about their client Tobias Harris, set to become a free agent later this summer.

Ilardi isn’t sure what attracted him to basketball, but he remembers being enamored with legendary New York Knicks Point Guard Earl “The Pearl” Monroe when he was just six years old. He says the time he spent getting his PhD at Duke University, or now teaching at the University of Kansas, both among the best basketball programs in the country, probably reinforced his interests.

Or maybe it was the unsolved puzzle of basketball analytics.

“Now, does the NBA really matter? Not in a cosmic sense,” he says. “But to millions of us who love the game, who are fans of the game and all of that, it represents just like, yeah, these things kind of matter.”

What matters most to Ilardi is mental health. As disconnected from mental health as it might sound, analyzing basketball data can help stave off rumination on negative thoughts. And preventing negative rumination is one of the six elements Ilardi has established for battling depression.

He calls the approach Therapeutic Lifestyle Change, or TLC.

The six steps

In addition to avoiding rumination — which can be done by building a meaningful hobby, having a conversation with a friend or listening to music — TLC includes five other steps:

  • Getting regular exercise, even a brisk 30-minute walk three times a week will do.
  • Daily exposure to sunlight, particularly in the morning. A SAD lamp can be used in the winter.
  • Good quality sleep, ideally eight hours a night.
  • Staying socially connected. Becoming a pet owner counts.
  • Increasing the amount of omega-3 fatty acids in your diet. Fish oil supplements are recommended.

Seems pretty obvious, right? We’ve known for years that most of these things have positive effects on mental health. Ilardi acknowledges in his book The Depression Cure that the idea might seem too good to be true on the surface.

But as a neuroscientist, he understands that it can be difficult and sometimes near impossible to do these things on your own when you’re already suffering from depression.

“I was very conflicted about writing that book because, and I say right in the intro, if you're severely depressed, there's a really good chance you're going to need a professional to help you,” Ilardi says.

Notably absent from the process are antidepressants. Ilardi says he’s not anti-medication, but he doesn’t believe antidepressants are as good as people believe they are or need them to be.

If medication enough were alone, Ilardi wonders why the country’s depression and mental health crisis continues to get worse. In a 2023 Gallup poll, 29% of U.S. adults reported having been diagnosed with depression in their lifetime. That’s up nearly 10% from 2015.

Meanwhile, according to a 2024 study, between January 2016 and December 2022, the monthly antidepressant dispensing rate increased 66.3% among adolescents and young adults.

“Our treatments are OK. They're not great,” Ilardi says. “And if we treat them with meds only, the average patient is going to have a very unsatisfactory outcome in the long term.”

Instead, Ilardi says, a good baseline plan of attack is rooted in our hunter-gatherer origins.

You can keep your Latte

It was the work of Edward Schieffelin, who spent more than five years among a remote Aboriginal group in the highlands of Papua New Guinea, that kickstarted Ilardi’s process.

Schieffelin, who began the study in 1966, was fascinated by how the psychological sufferings and mental illnesses of the modern world would differ from these groups. Using the Diagnostic and Statistical Manual of Mental Disorders, or DSM, to assess the Kaluli people, he found the burden of depression was near zero.

Ilardi says he did a double take when he first read this. The Kaluli still had plenty of other diseases, such as low life expectancy, high infant mortality and considerable intergroup violence. They still felt sadness and grief. But their baseline mental health remained steady. He wondered what habits had the modern world gained or lost that would cause such a dramatic difference.

“Depression is a disease of civilization, which makes it a disease of lifestyle,” Ilardi says.

Biologically, Ilardi says, we still have Stone Age bodies, even if our technology and standard of life has far exceeded that of our Paleolithic predecessors. Unfortunately, those advances also don’t always mix well with our bodies' baseline.

In a 2013 TEDx talk, Ilardi said humans simply were not made to be poorly nourished, sedentary, indoors and socially isolated the way we are now.

“We don't have to be Luddites. We don't have to let go of our local lattes and our laptops and our iPhones,” he says. “Our goal is how can we reclaim healing habits of the past and weave them into the fabric of day-to-day life in the 21st century.”

That’s not to say medication won’t improve in the coming years — and, of course, Ilardi recognizes it does work well for some. He simply sees medication as failing to solve the problem and says we need an updated standard of care.

His ideas are obviously resonating. His lectures and TED talks now have more than 5 million views on YouTube.

Balance life, balance brain

Now, in his full-time job at the University of Kansas, part of Ilardi's work is to further refine and expand the ways TLC can be applied.

This summer, he is working with a graduate student and area VA hospitals to see how they can expand his protocol in treatment for veterans with severe PTSD.

“We have been running the TLC protocol for about four years now on an outpatient basis,” says Michael Black, staff psychologist at the Topeka VA. “What we’re trying to do is adapt a 12-session protocol that would occur once a week into a four-week inpatient program.”

Ilardi says even a church reached out asking to use his approach to help members of its congregation. It’s a rewarding feeling for Ilardi, who had three close family members burdened by depression.

Now, after nearly 27 years at KU, he finds it’s actually something he didn’t receive training for that provides satisfaction: teaching undergraduate students. At any given time, Ilardi might have 600 to 700 college students on his class rolls. And he hopes he can be there in some way for them — especially at a time when mental illness is so prevalent.

“I love being able to be a resource for them,” Ilardi says. “There's something so magical about being present with young people at a time in their lives when they’re often incredibly open, intellectually curious and intellectually hungry.”

What he hopes to impart on those students, peers and anybody willing to listen is this: You can balance your brain chemistry by balancing your life. Even a small life change can have a huge impact.

As KCUR's health reporter, I cover the Kansas City metro in a way that reflects our expanding understanding of what health means and the ways it touches different communities and different areas in distinct ways. I will provide a platform to amplify ideas and issues often underrepresented in the media and marginalized people and communities in an authentic and honest way that goes beyond the surface of the issues. I will endeavor to find and include in my work local experts and organizations that have their ears to the ground and a beat on the health needs of the community. Reach me at noahtaborda@kcur.org.
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