Depression is not something you think your way out of. It is a biological state that disrupts motivation, planning, sleep, energy, and the ability to imagine a future that feels worth moving toward.
In Part Two of this depression series, Dr. Ravi Kumar shifts from understanding to action. This episode lays out a clear, evidence-based, step-by-step roadmap for healing from depression.
IMPORTANT: If you are unable to perform basic self-care, experiencing psychosis, or having thoughts of self-harm (especially with intent or a plan), seek immediate professional help.
Free Depression Roadmap PDF
Download the comprehensive Depression Roadmap — a visual guide that outlines all the interventions and treatment approaches discussed in this episode. Perfect for reference as you follow along.
Download Free PDFEpisode Highlights
- Why depression requires a structured roadmap, not a single fix
- Step 0: PHQ-9 tracking, basic labs, and choosing one support person
- Step 1: Lifestyle foundations (sleep, morning light, movement, diet, microbiome, connection)
- Foundational supplements: vitamin D, magnesium glycinate, EPA-dominant omega-3s, plus zinc and L-methylfolate when indicated
- Step 2: CBT or behavioral activation, plus optional biohacks to build momentum
- Step 3: Evidence-based supplements (tiered approach, one at a time, tracked)
- Step 4: When medications make sense, and why persistence and iteration matter
- Step 5: Advanced options including TMS, ketamine, psychedelic-assisted therapy where legal, and ECT for severe cases
Show Notes
Measure Your Depression (PHQ-9)
Start by completing the PHQ-9, a validated clinical questionnaire used by physicians to assess depression severity and track recovery. Repeat it every 4 weeks to measure progress objectively.
Take it here: PHQ-9 Depression Questionnaire
Step 0: Assessment + Support
- Take the PHQ-9 and establish a baseline
- Choose 1 support person (not your doctor). Isolation ends on day zero
- Consider labs with your doctor: thyroid function, vitamin D, CBC, B12, folate
Step 1 (Weeks 1–4): Lifestyle Foundations
- Fixed wake time + 10 to 30 minutes of outdoor morning light
- Sleep routine + cool, dark bedroom
- Daily movement (10 to 20 minutes)
- Whole-food diet (Mediterranean-style works well)
- Fermented foods or evidence-based probiotics (L. helveticus, B. longum)
- Daily social connection (minimum 1 touchpoint per day)
Foundational supplements (discuss with your doctor):
- Vitamin D (optimize if low)
- Magnesium glycinate at night (200 to 300 mg)
- EPA-dominant omega-3s (target 1 g EPA per day)
- Zinc or L-methylfolate when deficiency or impaired metabolism is present
Reassess PHQ-9 at 4 weeks. If improving, continue. If stuck, move to Step 2.
Step 2 (Weeks 5–8): CBT or Behavioral Activation + Biohacks
- CBT (therapist or app-based options)
- Behavioral activation: schedule small activities first, log mood before and after
Optional biohacks to support momentum:
- Cold exposure
- Sauna
- Breathwork
- Mindfulness or body scan meditation
Reassess PHQ-9 again at 4 weeks.
Step 3: Evidence-Based Supplements
Add one at a time and track for 4 to 6 weeks.
Tier 1: St. John’s wort (drug interactions matter), saffron, SAMe, bioavailable curcumin, creatine
Tier 2: L-theanine, rhodiola
Step 4: Medications (With Your Doctor)
SSRIs and SNRIs can help, but require time and iteration. Switching and augmentation are often part of successful treatment.
Step 5: Advanced Treatments
- TMS
- Ketamine (where legally available and medically supervised)
- Psychedelic-assisted therapy (where legal)
- ECT for severe or life-threatening depression
Resources
Free Depression Roadmap PDF — Download a comprehensive, evidence-based guide to depression interventions and treatment approaches. This roadmap complements the podcast episodes and provides a visual reference for the step-by-step recovery plan.
PHQ-9 Questionnaire: https://drkumardiscovery.com/calculators/phq9/
Breathwork YouTube Channel (Breathe With Sandy): https://www.youtube.com/@BreatheWithSandy
CBT App (Clarity): https://www.thinkwithclarity.com/
Behavioral Activation Guide: https://www.therapistaid.com/therapy-worksheet/behavioral-activation
Important Disclaimer
This podcast is for educational purposes only. Dr. Kumar is a physician, but he is not your physician. Work with your healthcare provider for diagnosis and treatment.