When I was 34 and very pregnant with my first child, hormonal changes caused me to start having panic attacks and severe claustrophobia. They came completely out of the blue and I thought I was losing my mind. A year later, I suffered an enormous personal loss and I have been on anti-depressants ever since.
Do I like having to take these meds? No. But I don’t like debilitating bouts of sadness or random attacks of irrational terror either, so- I take them. A big part of me feels like a failure for not conquering this “weakness”. And there is a discomfort with putting something into my system that has “control” over me. Anyone who has failed to get to the pharmacy before closing on a long weekend knows the withdrawal that comes from missing a few doses of these medications.
They are serious business!
Is there a better way? Now I am not suggesting that anyone stops taking their prescribed medications for anxiety or depression. Please hear me, I am not. I haven’t stopped taking mine! But… I aspire to!
Feeling like I couldn’t write this piece perfectly has kept me from writing it for 1 1/2 years. Just like knowing I probably won’t make it to lunchtime fitness classes every day during the week often keeps me from going at all. All or nothing – it creeps into all our patterns!
But here I am today, so if you have or are suffering from depression, know that you are not alone.
According to the Canadian Mental Health Association – Middlesex, 5% of Canadians are depressed. About 25% of Canadian women and 10% of Canadian men will suffer from depression at some point in their lives. Most people experience their first depressive episode between 15-25 years of age. 10% of women will experience depression after childbirth. According to CMHA, most people will live with symptoms of depression for at least 9 months without seeking help. Approximately 25% of those with depression go on to make attempts or die by suicide.
That just got scary REAL.
As a dietitian who has experienced depression, I am fascinated by the research being done in the area of nutrition and mental health. As a person of faith, I believe that God has given us everything that we need. Before there was medicine, there were plants. And the intuition of people to know what those plants could be used for. I believe that God has also gifted us with the intelligence to develop technology, and understand science. But first, there was food. And water. And oxygen. And moving the body daily. And rest.
With that in mind, there are 2 ways to look at nutrition as it relates to mood and depression.
To look at the role specific nutrients play
To look at the role that dietary patterns as a whole play
Let’s get started!
Specific Nutrients & Depression
A very interesting study in the World Journal of Psychiatry looked at all the research conducted on depression and any of the 34 essential nutrients for human health, and the studies were then examined for the quality of their design and the strength of their findings. The results were compiled to identify the most important single nutrients that were demonstrated by human studies to play a role in the prevention or treatment of depressive disorders. And the twelve winners were… long-chain Omega – 3 fats (EPA and DHA), Vitamins B12, B6, thiamine, zinc, magnesium and vitamins D, C, A, folate, iron, selenium and potassium. They then further categorized the best food sources of these nutrients and compiled an Antidepressant Food Score which can guide you to choosing specific foods and categories of plant and animal foods which have been shown to positively affect depression. It’s not very dietitian-ish of me to mention this, but the top scorers on this list are not particularly appetizing to me.
Dietary Patterns & Depression
Because nutrients interact in amazing and largely still unknown ways, focus on taking a few, specific nutrients is like putting all your eggs in one basket. So, another way to approach this topic is to look at whole-diet patterns. This allows for groups of nutrients that are common in different foods to be identified, but also allows for the idea that maybe they are more valuable working together than alone in a super-food or pill. The traditional Mediterranean style of eating is the most studied, and has impressive stats when it comes to improving health and mood disorders.
The “SMILES” trial (Supporting the Modification of lifestyle in Lowered Emotional States) is a 12-week randomized, controlled trial(the best kind) which treated moderate-to-severely depressed people with either diet intervention (Mediterranean eating style) or a social intervention (befriending) to see if the components of that style of eating would have a beneficial affect on depression. The befriending treatment would provide similar caring, attentive social contact as the diet group received, and so the only difference would be the change in nutrition. The Mediterranean “diet” is rich in vegetables, fruits, whole grains, oily fish, legumes, raw, unsalted nuts and seeds, extra virgin olive oil, and lower amounts of dairy and red meat or processed meats. The study participants could eat as much as they wanted according to appetite, without any weight loss focus. (yay for non-dieting!!) They also received one-on-one dietitian counselling, support with goal-setting, and identification of barriers and motivators to change, education, food budget tips, recipes and food hampers filled with the main components of the diet. A healthy relationship with all foods was encouraged, as well as mindful eating and no foods were prohibited. The really cool thing about this study was that after the 12 weeks, the “befriending” treatment group was offered the whole Mediterranean diet treatment too!
The results of this study were that by the end of the 12 weeks, the diet quality of the diet group significantly improved, as did their scores on a variety of depression rating scales, but the befriending groups did not. My take on this is that yes, the increased intake of some key nutrients that are rich in these foods supported the body and brain in amazing ways which improved depression, which I will unpack in more detail in further articles. But more than just providing a list of foods to eat and foods to avoid, the study design also provided the means for the participants to take the steps toward healthful habits. The education, and the supportive goal-setting and trouble-shooting EMPOWERED the people to follow through to see those great results! They provided the means for self-efficacy.
One More Thing…
An article in The Lancet Psychiatry recognized the growing evidence of nutrition as a crucial factor in mental health just as it is in physical health of the heart or other organs, and the authors recommended that “Nutritional Psychiatry become a routine part of mental health clinical practice”! Mind you that was in 2015, but hey, I think we are getting there!
So, in a nutshell… we do know that the Mediterranean style of eating – diets rich in brightly coloured fruits, vegetables, whole grains, nuts, seeds, water, infrequent use of processed meats, junk food and packaged foods, and doing life (rest, celebrating life, family, friends, less stress, and red wine) reduces the risk for heart disease, stroke, diabetes, Alzheimer’s… and now depression! (Note: this is NOT a “diet for depressed people”, because honestly the last thing we all need is another list of “shoulds”). And in my opinion so does the belief that you have what it takes (self-efficacy) to make small, positive changes for your own well-being! That doesn’t always come easy when you are feeling depressed. So, let’s be that cheering section for someone in our life who needs an ounce of “I believe you can do it and I’m here to help!” Invite someone who you know is going through a tough time to come over and share a meal. Or how about a fun Saturday afternoon of companionship and batch-cooking?
Nourishment for the body and the soul!
LET’S KEEP THE CONVERSATION GOING!
Feel free to send me your questions and comments about how diet may have an effect on mood and I will do my best to find the answers you are looking for in a future post!