underlying problem for many people, rather than the cause
of depression itself. This kind of insight is sorely needed,
especially considering that one in ten Americans now takes
an antidepressant medication; among women in their forties
and fifties, the figure is one in four.^21 And are they
effective? A recent JAMA meta-analysis concluded:
The magnitude of benefit of antidepressant medication
compared with placebo increases with severity of
depression symptoms and may be minimal or
nonexistent, on average, in patients with mild or
moderate symptoms. For patients with very severe
depression, the benefit of medications over placebo is
substantial.^22In other words, for a lot of people, antidepressants are no
better than a placebo, with the exception being the most
severe cases of depression (and even then,
nonpharmacologic treatments have shown impressive
successes, like the recently published SMILES trial—see
sidebar for more—as well as experiments involving anti-
inflammatory compounds such as curcumin, a component
of the spice turmeric).^23
CAN DIET REALLY TREAT DEPRESSION? THE
SMILES TRIAL
The link between depression and poor diet is well