Early in the first episode of season 14 of Silent Witness, a hospital doctor completely loses it as he observes patients in an outdoor lounge smoking dope and cigarettes and drinking beer and soda. He knocks smokes and cans out of their hands, shrieking: “What is the point?!” They will not regain health if they continue their unhealthy behavior.

There are all sorts of magical diets and pills available for people looking to live healthier lives. In the mean time, they avoid addressing the obvious: sleep, diet, exercise, focus. Someone I know ate a restaurant salad, had an “allergic reaction,” and concluded she was responding to tiny bits of cheese she ate by mistake. Maybe it was the lettuce? About 20% of E.coli infections come from leafy greens. Most of us cannot be troubled to change our behavior unless we are offered that change as a near-magical cure for what ails us.

Sometimes we are depressed because our lives are depressing. We can’t always do anything about that. Sometimes only time will heal us—everyone is depressed when a loved one dies. Taking a pill might not help at all, though we have faith in pills.

Improved health for most of us is simpler than medication. It might come down to getting enough sleep, eating better, avoiding soft drinks and alcohol, taking regular walks, and stilling our minds.

Until there were anti-depressants and an irrational percentage of Americans making Big Pharma billions, nearly everyone with clinical depression recovered with or without treatment within a few months. Medication today has its role, but most anti-depressants need a couple of weeks or months to become effective. While we wait, we might try taking better care of ourselves. This might not be the only answer, but it is a good place to start. And for most of us, it is exactly what we need.

A minimum of eight hours of sleep a night was considered normal for at least a hundred years. That recommendation has dropped to a range of seven to ten hours, and may continue to drop in response to the amount of time we actually sleep. We want to believe our sleep patterns are “normal” and theories seem to evolve in order to support our desires. Is it natural for anyone to “need” only a few hours of sleep? Perhaps not.

A hundred years ago and more, we slept more because it was dark at night. Today we sleep less because we are on our devices with electric lighting. For a long time the belief about sleep was that it kept human beings out of trouble. Except for our intelligence, the reasoning went, we are a harmless and relatively defenseless species. We do not see well in the dark compared to most predators. Curling up someplace safe and sleeping, biologists assumed, kept us out of trouble. They were wrong.

Some medications, advancing age, and brain damage all impact sleep. But sleep does a great deal more than keep us out of trouble. Research into Daylight Savings Time revealed a connection between that one lost hour of sleep and an uptick in heart attacks. We now know that the various stages of sleep allow us to sort and save information (remember), cope with daytime concerns, repair the synapses in the brain, and heal. Lack of deep sleep contributes to dementia. Lack of REM sleep makes us fractious. Lack of sleep can lead to weight gain by making us hungrier, but also has an impact on depression, anxiety, and suicidality. “Add the above physical and mental health consequences up, and a scientifically validated link becomes easier to accept: the shorter your sleep, the shorter your life.” (The Guardian)

Get your sleep. Stop eating a few hours before bed. Turn off devices. Avoid caffeine and other stimulants. Make the room dark and go to sleep at a decent hour.

What we eat makes a difference too. It is amazing to me sometimes how readily people accept that sugar impacts the behavior of small children, but how resistant these same people often are to the impact of what they eat and drink on their own mental state. Sugar, too much meat, refined grains, alcohol and other drugs—all these impact mood.

“Eat food. Not too much. Mostly vegetables.” advised Michael Pollan in The Omnivore’s Dilemma. He’s right about that. Though Pollan does not have the formal training to be considered an expert in nutrition, he has earned his prestige. Because I am largely vegetarian, people like to call themselves “carnivores” when we eat together. No. No, we clearly are not. Look in the mouth of a cat, research the structure of their digestive system. Cats are carnivores. Humans do not have the mouth, teeth, digestive chemistry, or other physiogomy to survive on a meat-based diet. Peoples in the far north such as the Inuit can because 98% of them have a genetic mutation allowing them to exist on fish and mammal flesh. They are genetically adapted to the cold and a meat-centered diet.  For most human beings, nothing about us is adapted to eating that way, though many of us have one of the several genetic mutations allowing us to consume milk after childhood.

Wheat has been part of the human diet for at least ten thousand years. We have been cooking foods for at least hundred thousand years. (There is no physical proof yet, but many anthropologists and evolutionary biologists believe that cooking foods, especially foods that are easier to digest such as legumes, is the reason humans became the smarter, smaller-toothed species we are today.) The wheat found today is somewhat genetically different from what our very distant ancestors consumed. The animals we consume today are also very different genetically, far removed from what our distant ancestors consumed. They are also fed and raised differently. There is nothing remotely Paleolithic about today’s beef, pork, or chicken.

Of more significance is that most of our food (not to mention our water and air) is contaminated. All foods, domesticated plants and animals, are weighted down with chemicals our ancestors could not have known. Pesticides, herbicides, and broad-spectrum poisons that were invented only in the last century. Our drinking water in major cities has trace amount of antibiotics, anti-depressants, and other chemicals as well. You already know about the lead.

Eat better. Save sugar for a rare special occasion. Avoid alcohol and refined foods, packaged foods, “foods” containing chemicals, most meats and conventionally raised food.

There is overwhelming evidence that regular exercise results in improved physical and mental health, less disease and longer life. Fifteen minutes a day could do it.

Meditation or even just sitting quietly for a few minutes each day lowers blood pressure and relieves all sorts of symptoms. The mental rest disconnects us from day-to-day stresses. Turn off social media and stop stewing over things we cannot control. “Relax!” they tell us.  We hear it all the time, and it is excellent advice.

Social interaction is healthy and so is reading a cheerful book. Maybe turn off the news, social media, the gloomy or horrific Netflix movie. Watch something funny. Read a hopeful novel (honest, it’s a proven-effective therapy), and refuse to discuss politics with your raging-reactionary uncle.

Getting enough sleep, eating a healthy diet, moderate exercise, and giving our emotions a clear break from day-to-day stresses and demands absolutely result in improved mental and physical health. Seriously. No doubt about this at all. Trusting that making such healthy changes also triggers hope and hope is another essential. It is likely the primary benefit of most anti-depressants. Taking that little pill each day triggers hope that we might feel better tomorrow. That impact will wear off if the problem is actually untreated mental or physical exhaustion, or if the underlying problem is grief. Everyone feels depression and reveals the symptoms of clinical depression after a beloved family member dies. Such grief mostly needs time for a cure.

SLEEP. DIET. EXERCISE. REST. TIME.

All this is hard if we are depressed. I get that. Depression means it is hard to care much about anything. It’s hard to get out of bed. But if we can care enough to take ourselves to a doctor, perhaps we can care enough to listen to soothing music or take a walk, eat a little better or have a conversation with a friend.

“Dorian Deshauer, a psychiatrist and historian at the University of Toronto, has written that the chemical-imbalance theory, popularized in the eighties and nineties, ‘created the perception that the long term, even life-long use of psychiatric drugs made sense as a logical step.’ But psychiatric drugs are brought to market in clinical trials that typically last less than twelve weeks. Few studies follow patients who take the medications for more than a year. Allen Frances, an emeritus professor of psychiatry at Duke, who chaired the task force for the fourth edition of the DSM, in 1994, told me that the field has neglected questions about how to take patients off drugs—a practice known as ‘de-prescribing.’ He said that ‘de-prescribing requires a great deal more skill, time, commitment, and knowledge of the patient than prescribing does.’ He emphasizes what he called a ‘cruel paradox: there’s a large population on the severe end of the spectrum who really need the medicine’ and either don’t have access to treatment or avoid it because it is stigmatized in their community. At the same time, many others are ‘being overprescribed and then stay on the medications for years.’ There are almost no studies on how or when to go off psychiatric medications, a situation that has created what he calls a ‘national public-health experiment.’ ”—“Bitter Pill” The New Yorker

We have survived as a species for 200,000 years, and we’ve had anti-depressants for only the past few decades. Today, one American in five is taking medication for something no one had access to until recently. Suicide rates have been going up instead of down ever since the introduction of anti-depressants. Let that sink in.

Toward the end of the episode, Nikki is exhibiting symptoms, which a doctor diagnoses as depression: “My soul has the flu.” As it turns out, her brain is not sick nor is her chemistry out of order. Something in her life causes the problem. She experiences anxiety and sadness, and even depression as part of the normal range of emotions every human experiences in life. She does not need medication. Mostly Nikki needs some sleep, a better diet, regular exercise, some mental rest and decompression, and a little time to recover.

We all do.