Episode 102 | Oct 17, 2024

Breaking Free From Chronic Depression, With Dr. Achina Stein and Silvia Covelli

Depression rates are higher than ever, and many are left feeling trapped in what seems like a never-ending cycle of despair. What if the traditional treatment path isn’t the only way out? In this week’s episode of Health Coach Talk, Dr. Sandi welcomes two remarkable guests, Dr. Achina Stein and Silvia Covelli, to explore their groundbreaking approach to healing depression through their 45-day Healing Depression Project.

“I want to really bring hope to everybody that is listening and tell them that I did it. A lot of other people are doing it. They’re breaking free from this condition and to keep searching for the solution, even though maybe if your doctor is not giving you one, go for another doctor… There’s a way out. There’s a solution.”

Silvia Covelli

Dr. Achina Stein, a board-certified psychiatrist and expert in functional medicine, and Silvia Covelli, a former social science researcher who overcame 25 years of chronic depression herself, have teamed up to create a comprehensive recovery program designed specifically for those who have long struggled with depression and haven’t found success in traditional treatments.

The Healing Depression Project takes a fresh approach, combining the power of functional medicine, trauma therapy, and lifestyle changes, along with the critical support of health coaching. Silvia shares her own journey of trying over 60 different treatments without lasting relief and how this project was born out of the need to put all the pieces together that allowed her to finally recover. In the episode, they delve into how their program addresses the root causes of depression through personalized care, creating a truly holistic approach to healing.

For health coaches, this episode provides valuable insights into how lifestyle changes can be the missing link for clients with depression. Dr. Stein emphasizes the importance of personalized care, noting that coaching plays an integral role in helping individuals sustain their recovery once they leave the retreat setting. Health coaches are not just cheerleaders—they help clients navigate setbacks, reinforce the “why” behind daily habits, and provide ongoing encouragement to keep moving forward. 

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Dr. Sandi: We have a real crisis. Depression is off the charts. So many people are characterizing themselves as depressed. And what’s more, so many physicians, particularly psychiatrists, are diagnosing people with treatment-resistant depression. So, what are we going to do about it? Well, that’s the topic for today’s “Health Coach Talk.” I have two really special guests. They are Dr. Achina Stein and Silvia Covelli. Let me tell you about them. They started a project that is The Healing Depression Project. It is a 45-day program that includes a retreat.

I’m going to tell you about Dr. Stein first. She is the clinical director of The Healing Depression Project. She is a leading expert in functional medicine psychiatry and a bestselling author with 30 years of experience helping people recover from depression. She’s a board-certified psychiatrist, a distinguished fellow of the American Psychiatric Association, a certified practitioner of the Institute for Functional Medicine, and she was a former clinical assistant professor of psychiatry and human behavior at the Warren Alpert Medical School of Brown University. She is an international bestselling author of “What If It’s Not Depression? Your Guide to Finding Answers.” In this 45-day depression recovery program that’s offered by The Healing Depression Project, Dr. Stein works on identifying and addressing all of the root causes of depressive-like symptoms. This program brings hope to those who have long struggled with depression and have not found relief with other treatments, including antidepressant medications.

And let me tell you about Silvia Covelli. She is also the founder of The Healing Depression Project. She’s an honors graduate from Boston College and a former social science researcher at Harvard University. She pursued graduate studies in finance and business law and dedicated her career to entrepreneurship. In parallel with her thriving career though, she faced relentless and chronic depression, exploring over 60 different treatments without finding sustained relief. Her personal struggle, combined with her extensive background in human transformation and mind-body connection, led her to develop a program that remarkably eradicated 25 years of depressive symptoms, leaving her depression-free ever since. This breakthrough later inspired the creation of The Healing Depression Project and helping others to break free from depression became her life mission.

I am so excited to bring to you these two amazing individuals who are truly making a difference for people with chronic depression. So, I hope you are going to enjoy this episode as much as I loved having the opportunity to interview these two remarkable individuals. Welcome both of you.

Oh, thank you for having us.

Thank you for having us.

Dr. Sandi: So let’s dive right in. I would love for our audience to hear about The Healing Depression Project. What is it? How does it work? What results are you seeing?

Silvia:This is a program designed specifically for people that have been struggling with depression for many years and have not found an answer, people that have tried different treatments and are still experiencing the symptoms of depression, which is a large number of the people that are looking for treatments, they’re still just having to live with this condition and just managing it or trying to manage it the best possible way. It’s for them and it’s a program that is absolutely comprehensive. It’s a 45-day program, 30-day in a retreat, so in an in-person retreat at a ranch in Texas, and 15 days at home after the program. And it’s a program that puts all the pieces of the puzzle together that, in my case, it took me 25 years going to over 60 different programs and treatments and basically looking backwards like what I was doing is just putting all these pieces together to finally be able to recover.

So, this program does that. It has the functional medicine piece, so functional medicine psychiatry, and it’s in the residential part of the program in the 30 days. So there is all this investigation that the doctors that Dr. Stein will conduct just looking at why is this person experiencing depression, which again for me was something that I was never able to find or I was even able to have this conversation with doctors of, okay, where is this coming from? Why do I have these symptoms? For example, why do I feel so energy-drained? Like, why do I wake up in such level of fatigue? Why everything is so hard to get done, activities that other people, I would see them like just doing them like no problem?

So, I was never given an answer for that. And even in my search for that was never even an option. So, we have the functional medicine piece to do that through labs, and the assessments, and the extended intakes, and all the work that the functional medicine doctors do. But it doesn’t stop there because that is a very important piece but that’s not the only piece for depression, especially again, when we’re talking about chronic depression, something that has been going on for a certain amount of years. Then added to that, we have all the trauma piece addressed as well with somatic therapies and trauma therapies, like in a group setting and a lot of work also in the mindset, and the emotions, and limiting beliefs and really powerful meditations that help people break from those emotional places where you live, where you have been having depression for that long.

And then we also have, of course, together with this, it has an amazing training to do a lifestyle change, which is fundamental piece to change, in my opinion, any chronic condition but for sure depression because that’s what I experienced. So, only until I was able to really change my daily habits and change them in a way that it was a daily practice, only then I really saw all the results of all the other programs and practices putting together. So, it is a training because we’re teaching people how, we’re teaching them why. So, it’s bringing all the awareness of why this is important and what does this do for you. And basically changing all the shoulds to must. So it’s like, oh, yeah, I should exercise more.

So, what this program is intended to do is to really change that to “I must” because my life, my health, and my emotional state of being depends on that. So, it’s all that training, and we do what I love to call a hand-holding system, which just basically is like your best friend or like health coaches do, that they’re basically like your friends with a wealth of knowledge and just knocking on your door and saying like, “Come on, we’re going out for a walk today.” So, we’re doing that for 30 days because I understood the huge challenges of changing your life. When you’re going through a deep depression, the things that you need to make a change are the things that depression steal from you. It’s hope, motivation, and then you need physical energy to do those things. Some of them take a lot of energy like changing your diet. That requires a lot of work to be successful at that. So, we’re going to be doing that for 30 days. And the metabolic psychiatry piece is together with the food, so it’s nutritional interventions to reset the metabolism of the brain cells and give you a complete new star to be able to have everything in your favor to really beat this condition that is well known for being horrid and sometimes at least conventional psychiatry believes it is a lifelong condition.

Dr. Sandi: Wow, this is so, so powerful, and it took me back to the day when I practiced as a clinical psychologist and I used that kind of integrated approach where we were talking about what they were eating. And I would take walks with my clients and also focusing on changing their beliefs. But I’d love to get into Dr. Achina, how did you get into this field? I know you are an Institute for Functional Medicine certified practitioner, but can you describe what exactly is functional psychiatry and why is it so potent?

Dr. Achina: Yeah. Well, functional psychiatry is a subspecialty of functional medicine. It’s basically looking for the root causes of depression, anxiety, and other mental health disorders. And we’re familiar with the biopsychosocial approach. And so sometimes people will say, well, yeah, we do look for root causes. We see it’s rooted due to trauma, family dynamics, and things like that. And, yeah, sure, we might do some blood work to rule out some basic functional causes like B12 deficiency and folate deficiency or hypothyroidism. We might look at the biology, the psychology in terms of, oh, it’s rooted in the way that you’re thinking, right? And it’s your belief system that might be causing you to project certain things onto other people. It tends to be relegated from the neck up as opposed to see how other root causes primarily inflammation in your body is the neck down, right? Things that are happening in the body metabolically, physiologically, and in the gut that can affect the brain, the hardware and the software of the brain.

So, we see things as being all connected. And if we can manipulate the mitochondria and actually nurture them and provide the nutrients that it needs on a cellular level, provide the nutrition through food and movement and fasting. And there’s a whole bunch of things that we can do to change and shift the energy that’s used in the body and move things along. So, it’s not just the mitochondria, it’s not just the microbiome. It’s also how people are nutrient deficient. There are gut pathogens that can affect the problems. There’s digestive issues that are involved. So, there’s multiple layers on a physiological and what we call functional level, and that’s what we look for. We look for all the puzzle pieces that can contribute, that come together and create this perfect storm of symptoms. And it’s not just mental health symptoms. There’s other symptoms as well, metabolic disorder, weight gain, a host of other problems that can show up. So, we look for all the symptoms of toxicity in the body, and look for patterns of inflammation, and address those by creating a plan to reduce inflammation as a whole.

And so there’s a certain method of doing that. It’s changing the diet for sure and addressing… Everybody would get a foundational diet, but then it’s fine-tuned to how it aligns with their personality and their lifestyle and things like that. And that’s where health coaching comes in, trying to figure that out for each individual. But there’ll be a foundational diet involved and moving the body, not just because exercise is important, but it’s also great for the lymph drainage to remove toxins. You want to feed the body certain nutrients to get your liver and your kidneys appropriately eliminating and your gut eliminating all the toxins that, kind of, build up over time that can contribute to inflammation.

So, it’s foods, infections, toxins, and the big thing is stress. A lot of people don’t realize how much stress can affect your hormones, particularly cortisol, especially chronic stress. If it starts as a young child and there aren’t changes in the way that you look at the stress as affecting… Maybe it might not affect your mind because some people are type A personalities and go, but it’s their body that might be saying, “Uncle, we got to rest here. I need to rest here,” and you’re ignoring that. So, ultimately all of these factors can come together and it’s different. Everybody has a different fingerprint of how it shows up for them. It’s finding that fingerprint for that person, and developing a plan, and individualizing that plan for them. They’ll go home with that plan, and it’ll be integrated into their regular lifestyle.

I do want to emphasize that there’s 2 weeks after that 30 days where we help the person integrate their lifestyle into their home environment. And we’ll try to predict all of the barriers and all the issues that might come up before they even leave. It’s like, okay, so what’s going to get in the way of you implementing the plan? What do you need to order? How do you need to prepare for this? And you’ll get two weeks of daily follow-up after those 30 days, so that will be successful, because a lot of times people do programs and they get home and everything just drops because they just go back to their old ways because they have all these priorities that they have to address and everything comes before themselves. And so it’s really addressing…like, you really need to put yourself first, get yourself established as if you’re still away, go back home, but you’re going to get your routine in place first and then see what you’re going to fit in, what you’re going to get rid of, and what you’re going to delegate, right?

Dr. Sandi: This is incredible, and it is night and day from the programs that I knew about when I practiced because at that time, I’m talking about in the ’80s and the early ’90s, and I did some work in inpatient units. I would go in and do a lot of testing, but I also did biofeedback and relaxation work. But it was really most of the time based on, “We’ll get you on the right meds and then you’ll be out of here.” But you are really looking at an integrative functional medicine approach and you use health coaches, which we didn’t have back in the day. So, can you talk about the importance of health coaching? How do you see health coaching being integrated into your model?

Silvia:It is a fundamental piece because the reason why this program is residential is, as I was saying before, just to really get the person started on all these changes and to build that habit. So, we’re going to have a health coach there helping with that as well. But then once they go back home, we have this 15-day integration phase that Dr. Stein was talking just now, which is super important because the scariest day of all of a residential program is the day that you go back home and not knowing what to do with that and being afraid that you’re going to lose your gains. And you do. That’s what happens with those programs.

So, even though we’re going to have this 15-days integration stage, the recommendation and what we’re going to do, we’re going to link the people to a local health coach that can continue the follow-up for them and continue to encourage them and also help them when they derail because you do derail. This is not a perfect process that you start one day and then from that day on, you exercise every day. No, it’s like ups and downs and then you do really well for X amount of weeks, then you forget about it for a few days and then you go back. But it’s always the ability and have someone, which in this case, what we’re going to be doing is with health coaches, is to have that someone that will help you to get back and that will help you remember the why because that’s so important. Why are you doing that? And that that why is really big and to maintain that fresh in your life. So, that’s how we see health coaches here.

Dr. Sandi: I love it. Another thing that I was really excited about is the fact that this is a program that I believe incorporates a lot of community because you are in a retreat. This is group, and loneliness is a killer. And I believe it’s tied in with the rising incidence of depression. We’re isolated. We work remotely. Many people can go weeks. They don’t even see anybody other than online and through social media. So, can you address that, the importance of social health and what you have seen in participants?

Dr. Achina: Absolutely. I mean, just group therapy, the principles of group therapy are definitely going to be falling in. There’s always going to be those early adopters who were, like, gung ho, “I’m going to do this.” And it’s the late adopters who have less confidence or they might be a little more introverted or shy. And when they see the early adopters doing the tasks that are at hand, and they see the success and how easy it was or the benefits from it, it’s almost like we’re holding each other’s hands in terms of moving forward. So, everybody is going to rise in the situation because you’re all doing it together.

It’s so much easier to change habits when you have it in a group format. I do exercise in a sports venue. I play Ultimate Frisbee, but I’m not likely to go to the gym by myself and just lift weights as much as I want to. I’m more likely to go to my friend’s house that’s three miles away, get in the car, go to her house and we do a routine together and come back, than go down my stairs to my little gym and do it by myself. So, some people are like that and they’re more likely to follow through if they do it in a group format. So, I think there’s multiple benefits in that way. And it’s the universe, everyone, when you’re talking about their feelings and their symptoms and what they’re experiencing, it’s like, “Oh, wow, I feel that way too. I’m not alone in this.” There are other people who feel this way too, whether they’re talking about difficult feelings, like feeling vulnerable or feeling shame or feeling embarrassed, guilty, or people think that they’re lazy. There’s an invisibility around depression. So, that’s why people tend to isolate or not reach out to others. And so this is all going to be very supportive and teaching skills about how to reach out, how to connect about what you need. So, all of those kinds of things will be role-modeled for them during the program and hopefully practiced while they’re there.

Dr. Sandi: It’s so important. And I think one of the ways that groups can be so beneficial is that participants can actually be of service to others. And that is so healing. And so that plus, as you mentioned, the social proof. Well, if they can do it, I can do it. And it’s the success of AA, Weight Watchers, and health coaches can lead groups. So, depression is off the charts right now. And we have a shortage of mental health providers and very few people are offering your type of model. And obviously, it’s not feasible right now. I hope we can see the day when everybody can be treated with your 45-day program and particularly your retreat. But if it’s not an option for somebody to go to that residential component, do you have any plans or suggestions for how this can be done remotely? For example, how you can take your program and scale it?

Silvia:Yes. In the future, we’re going to have an online version, which is going to have a lot of limitations compared to what we can do in person. But again, for those that cannot attend an in-person program. But for now, based on my experience and based on putting all this program together and talking with so many doctors and therapists, I put a guide together that is called “Why Am I Still Depressed? The Top Four Mistakes I’m Making” is a guide on how to start that recovery process on your own. So, it takes you to the hidden factors of why the treatments are not working and what you can do and what are the steps. Like, what type of professionals you should reach out to? So that and maybe also suggest an order so that there’s a holistic and comprehensive healing for that. And that guy, we’re offering it for free to anyone. It’s in our website. It’s healingdepressionproject.com/gift. So, that is a great point to start. And if you have a lot of conviction and discipline, then you can do it on your own. I did it on my own. I mean, it took me 25 years. There’s a lot of challenges on doing it on your own, but yes, it can be done.

In the guide, it also talks about resources that you can reach out to in order to create as much of a support around you as possible. But most importantly, it explains why what you’re doing right now, it’s not working. I talk all the time to people that are calling us, people with 10, 15, 20, 30, 40 years of depression. [inaudible 00:23:18.564] you see the same things that they’re doing basically the same things that I was doing wrong and that it took me so long. And then finally I had the breakthroughs of like, “This is why one of the things is what we’re talking about, like missing the body or this connection between mental health and physical health that Dr. Stein was just talking about.” And so it guides you to other things and small steps that you can take as well, because with depression, that’s very important. Something starts small. Because if you see all the leads of all the things you have to do, you won’t even start.

Dr. Sandi: That’s so important. Yeah. Even something like walking and having a coach break that down to micro steps. And then rating. Well, how did you feel before the walk? What was your mood like after the walk? And 9 times out of 10, oh, I felt better. And especially if they’re walking outside. But of course then dealing with some of the obstacles. Well, maybe they’re not living in a neighborhood conducive to walking, for example. Maybe there are other reasons or they think they can’t because they’re in physical pain. And so that’s where having that support comes in as well as being involved in the group process.

Dr. Achina: Yeah, people have to take a look at what the cost is to their life because they are still depressed. You mentioned cost of the program. There’s lots of rehabs that are very expensive. And this program is to me less expensive compared to other programs. And I feel like it’s going to have a lot more success because we’re addressing multiple root causes and we will help them to put it in the right order. Sometimes things are not done in the proper order, and that’s why they’re not getting better, but it’s also habit stacking, doing all the things, prioritizing certain things that are habit stacked in order to get benefit, and there are activities, lifestyle changes that need to be done on a daily basis.

It’s using the coach to figure out and prioritizing the lowest-hanging fruit, and stacking them, and staying consistent, and seeing the gains over time. And Silvia hasn’t mentioned it, but there is a scholarship for this program. People, if they’re interested at all, really should make a discovery call with her and also with me and learn more about it. Because if I were depressed for years and years and given a diagnosis of treatment resistant depression, failed multiple trials of medication and ECT, and you have to function a little bit obviously to be able to do the things that we’re going to be having you do. But if you’ve been living with depression for a long time and some things have worked a little bit but not completely or maybe you had a program that worked really well, but then the depression came back and creeped back in. You’re the type of person that would benefit from this program. And it’s totally worth it because you have to really weigh against it, the cost of not getting this treatment.

Dr. Sandi: Absolutely. And that term “treatment-resistant depression,” if you’re given that, it is really like a death sentence. It’s like a doctor saying you have six months to live that mindset then that is going to be that you have this fixed condition and it’s like it’s attacking you and you can’t get better. And so how would you…

Silvia:It is actually worse than six months to live because, in the six months to live, it’s just six months. But this is worse. I mean, I lived it for so long. It’s like being alive without really being alive. And then knowing and the doctors telling you that this is forever. And then you’re just saying like, “I can do this forever.” “What do you mean forever?” There’s going to be a solution. There’s going to be a way out. But conventional psychiatry reinforces, really reinforces this belief of prescribing lifelong medication and saying that depression, that there’s no cure for depression, only treatments that will help you manage symptoms. And honestly, they don’t even do that because you still have the symptoms. Everybody that I’m talking to that are calling us, everybody, it’s a medication, everybody is on a treatment and they’re still reaching out for help in a desperate way. Like, please help us.

Dr. Sandi: This is just music to my ears. And I think back when I was practicing and I was a health psychologist and a renegade. And so I was not doing the long-term talk therapy. I was focusing on integrative approaches and… What I would say the triad for depression is you look in your past. Everything was awful in the past. My past was horrible. Life sucks right now. It’s not getting any better. The future is bleak. There’s no hope. It’ll always be this way. And you start attacking their belief system and helping them to think through logically. Maybe they can think back to a wonderful experience they had. Maybe they can focus on taking in something through their senses, laughing in the moment. And then the future, well, prove it. Can you prove it? Like my mentor Albert Ellis, who is one of the founders of cognitive therapies, used to say, “Well, somebody could be miserable. They could have no relationship and they could say, ‘I’m never going to meet anybody. I’m always going to be alone and lonely.’ ” And then when they’re 95, they could have a wonderful. So, it’s not true, if you prove that you’ll never ever whatever it is they’re focusing on that is distressing them. So, what would you say are the main takeaways if somebody is listening and they are suffering from depression?

Dr. Achina: Treatment resistance is a myth. When we talk about treatment-resistant depression, it’s really treatment with medication alone. It’s a very narrowed definition and lifestyle… The American Psychiatric Association indicated this year of 2024 as being the theme. They have a theme every year. The new theme this year is lifestyle and connecting lifestyle changes for treatment. And that to me is a breath of fresh air. So, I feel like there is a paradigm shift. There is hope and there are new programs that are different from the traditional programs out there that will help you. And there are other treatments other than medications that are actually doing a better job in getting you well than medication. I’m not suggesting that you stop the medication. I just want to say that don’t stop the medication, get these other treatments in place, and then you’ll realize that you got better, not because of the medication, because that wasn’t changed. Everything else changing will prove to you that it wasn’t the medication. And then you’ll have more confidence to know, okay, I can now taper the medication.

And my hope someday, if I live to see it, is that medication is like a cast. It’s in the same way that if you got hit by a car, you’re going to want to be helicoptered, have the jaws of life, open up the car and take you out and helicopter you to the hospital and have emergency surgery. And we might be put in a body cast, but everybody knows when they’re put in a body cast that they’re going to come out of it, right? Unless you have had some serious structural changes, but there are people with broken legs, like, okay, I’m going to be in a cast. I’m going to be disabled for a period of time, but they know that they’re going to come out and have rehab and they’ll be walking again most likely. And I want to see antidepressants in that same category, that it’s used temporarily until you can find the root causes, figure out what happened. And so you use the medications to improve symptoms temporarily and acutely so that you can get back on your feet. And then find those root causes, get your body, mind and spirit back into balance, and then taper and discontinue the medications. And more and more the research is showing that long-term use of medications is actually causing more harm than good over time.

Dr. Sandi: That’s a great perspective. Where can people find you? You mentioned before, but as we draw to a close, how can people reach you and learn more?

Silvia:The main place is our website is healingdepressionproject.com. And there you can read about the program. There’s also a place to schedule a call. The call will be taken directly by myself or by Dr. Stein. And there’s also the guide I mentioned that is the same guide. And so that’s where they can find the information. And for me, adding to what was being said, the main takeaway I want to give people is hope because when you have been struggling with this condition and you feel so trapped in it and everything is so dark, you really don’t think that one day you’re going to be who you used to be or who you want to be.

So, I want to really bring hope to everybody that is listening and tell them that I did it. A lot of other people are doing it. They’re breaking free from this condition and to keep searching for the solution, even though maybe if your doctor is not giving you one, go for another doctor. That’s okay. Fine. If you need to go to a functional medicine psychiatrist, that’s what you should do. If they’re not giving you answers, keep searching because there’s a way out. There’s a solution. And definitely take a look on your daily habits to really power any gains that you make and to get that transformation that is needed.

Dr. Sandi: Wow. So powerful. And hope is the most powerful way to heal. Once you have hope, because when you’re depressed and you have no hope, that is a hallmark of depression and hope is healing. So, my hope for you is that your model spreads. And you may have some people who have gone through your program and they may choose to now help others. And so we’ll keep passing along the healing and they may train to become health coaches.

Dr. Achina: Mm-hmm, absolutely.

Dr. Sandi: You never know. But it is a powerful model and kudos to the two of you for starting this wonderful healing depression project. It’s been a joy to talk with you both. Thank you.

Silvia:Thank you, Sandi.

Dr. Achina: Thank you. It’s been great talking to you too, Sandra.