Nedley Hit Hypothesis Statement

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In November 2014, Nature magazine, considered one of the most prestigious peer reviewed, scientific journals came out with an entire issue dedicated to the worldwide problem of major depression. In this issue it stated that Major Depression (Major Depressive Disorder, MDD) is a worldwide problem and by far and away, the leading cause of disability worldwide. Upwards to 400 million people have the condition currently in the world, about 6 percent of the current global population according to Dan Chisolm from the world health organization. In addition there are 76 million years of work lost every year due to depression. This is worse than any other condition, including back/neck conditions, lung disease, and vascular disease. Depression is the 9th leading cause of death worldwide with more deaths occurring as a result depression than lung cancer.

0+ worldwide suffering from depression

The issue states “ Three-quarters of people with depression in the United Kingdom go undiagnosed or untreated — and even if the disorder is diagnosed, today’s medications will work well for only about half of those who seek help. “It’s unbelievable,” says Tom Foley, a psychiatrist at Newcastle University, UK. “If that was the case in cancer care, it would be an absolute scandal.”

In addition, Nature magazine states that cancer research is making far more strides forward than depression research. The unfortunate truth today is that a person with cancer is more likely to be cured than a person with depression—where the illness has a much greater chance of being lifelong with perpertual debilitation with the traditional medical approaches to this disease. Don’t mistake what this is revealing, it’s not that we are doing great with cancer treatments, it’s that we are doing even worse with depression.

Here is a direct quote from Nature regarding the most common treatment for depression today.

“Five decades of work on antidepressant drugs have not made them more likely to lift people out of depression. Medications and psychotherapies help some people with the disease, but fail many others. In a study conducted in real clinical settings, a common antidepressant produced a response in just under half of the participants, and achieved full remission in only 28%. Failures to improve efficacy reflect continued ignorance of the molecular mechanisms of depression.”

In addition Nature states, “clinical trials reveal that only 22–40% of patients emerge from depression with drugs alone.” This means that most people who do recover from depression used additional means, such as light therapy, cognitive behavioral therapy, and other therapies, such as the Nedley Depression Recovery Program, to get there.

Interestingly, the same week that the Nature magazine issue on Depression came out, The American Journal of Lifestyle Medicine came out with an article entitled, “The Nedley Hit Hypothesis: Identifying Depression and It’s Causes. Dr. Nedley, presents data from over 4,200 subjects from multiple countries and ethnic backgrounds and shows that depression stems from usually 4 or more of 10 categories of causes, most of which can be reversed (except for two categories). Once the causes are reversed, depression will no longer exist. The solution to this major worldwide problem has been found. The solution involves educating the person regarding how the brain works, and coaching them through multiple simple lifestyle and thinking changes that can reverse their “hits” or blows to the brain. Fortunately, this eight week educational program is being taught in a few cities throughout the world, but with the worldwide prevalence of depression, it obviously needs to expand to virtually every city and village. The American Journal of Lifestyle Medicine entire article is downloadable for free on the internet.

Within the last few weeks, other studies have been published regarding Nedley’s large data set of community based people. For instance, looking at the pre-program and post-program questionnaires of the subjects who were educated by the 8 week Nedley Depression Recovery program (once a week for a 2 hour session for eight weeks), Nedley found that many subjects were able to discontinue their usage of benzodiazepines during that time. That data was presented by Dr. Ramirez (a colleague of Dr. Nedley’s) at the American Academy of Addiction Psychiatry. Since it is so difficult to get people off of this class of drugs (which includes Lorazapam (Ativan), Xanax, Klonipin, Valium, Temazapam, etc.) the national news organization picked up the story through Medscape entitled, “Novel program reduces depression, benzo use”.

Another study from the data just got accepted for presentation at DDW 2015, the largest gastrointestinal conference in the world. It showed that the vast majority of individuals with Hepatitis C and Depression who go through the program, improve significantly. Such subjects could not be previously treated for Hep C since the treatment would cause worsening of depression and increase the risk of suicide. Now these Hep C subjects with depression can go through the program and emerge as an appropriate candidate for Hep C treatment. The study will be published later this year in the prestigious peer review journal, Gastroenterology.

Dr. Nedley also conducts a residential therapeutic program that incorporates these educational principles plus individualized physician, psychologist and chaplain visits/care. Many of the people who choose this program are quite severe in their depression/anxiety and/or are treatment resistant (not responsive to medications, typical counseling, etc). A phase is being coined, “Diapression” since many people with Diabetes also have Depression. Dr. Ramirez and Dr. Nedley looked at those with Diabetes and found that they improved in like manner to those who were not diabetic. In addition their diet pre-program, was found to be related to their Hemoglobin A1C levels, particularly their meat intake. During the 10 day program their Beck Depression Inventory scores plummeted from an average of 24 (Moderate to Severe Major Depression) down to an average of 6 (no Depression).

More studies will be published soon on what the program can do for those with anxiety and Post Traumatic Head Injury. In addition the test that determines the hits present in a person will soon be available to practioners to help them expand their “toolbox” of treatments.

Nedley Research

Depression is often diagnosed using the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) criteria. We propose how certain lifestyle choices and non-modifiable factors can predict the development of depression. We identified 10 cause categories (hits or “blows” to the brain) and theorize that four or more active hits could trigger a depression episode. Methods. A sample of 4271 participants from our community-based program (70% female; ages 17-94 years) was assessed at baseline and at the eighth week of the program using a custom test. Ten cause categories were examined as predictors of depression are (1) Genetic, (2)Developmental, (3)Lifestyle, (4)Circadian Rhythm, (5)Addiction, (6)Nutrition, (7)Toxic, (8)Social/Complicated Grief, (9)Medical Condition, and (10)Frontal Lobe. Results. The relationship between the DSM-5 score and a person having four hits categories in the first program week showed a sensitivity of 89.98 % (95% CI: 89.20 % - 90.73%), specificity 48.84% (CI 45.94-51.75) and Matthew Correlation Coefficient (MCC) .41 . For the eight-week test, the results showed a sensitivity 83.6% (CI 81.9-85.5), specificity 53.7% (CI 51.7-55.6) and MCC .38. Overall, the hits that improved the most from baseline after the eighth week were: Nutrition (47%), Frontal lobe (36%), Addiction (24%), Circadian rhythm (24%), Lifestyle (20%), Social (12%) and Medical (10%). Conclusions. The Nedley four-hit hypothesis seems to predict a depressive episode and correlates well with the DSM-5 criteria with good sensitivity and MCC but less specificity. Identifying these factors and applying lifestyle therapies could play an important role in the treatment of depressed individuals.


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