Fighting Depression With Nutrition
by Gillian Buckley
What is Depression?
Depression is an illness of the mind and body. It transcends feelings of low mood and manifests as a feeling of persistent sadness, hopelessness and helplessness. So common is depression in all cultures, that it has become a universal experience of painful, unhappy withdrawal. Latest statistical figures supplied by the Depression Alliance, a leading UK charity for people affected by depression, indicate that there are more than 2.9 million people in the UK suffering with depression at any one time. There are currently 7,000 lives lost each year in the UK and Ireland through depression, and 7 out of 10 of those deaths will be attributed to suicide.
Facts About Depression
- At least one out of every five adults will suffer with depression in the course of their lifetime.
- Every year, doctors diagnose two million cases of depression in the UK.
- Every General Practitioner (GP) in the UK sees one person per day with depression, on average.
- Depression affects all age groups.
- Twice as many women are diagnosed with depression than men.
Rates of depression have increased over the past forty years, which may be a direct result of the increasingly stressful and demanding lives people now live and increasing population density. But there is hope, because no matter what the cause, depression can be treated effectively.
Symptoms of Depression
There are many recorded psychological and physical symptoms of depression. Psychological symptoms include low mood, anxiety, depressive thoughts, loss of interest in life, love and sex and other previously enjoyable activities, emotional numbness, memory problems, concentration problems, suicidal impulses, hallucinations and delusions.
Physical symptoms include tiredness, sleep problems (difficulty with ability to get to sleep, waking up often or too early, or getting too much sleep), increase/loss of appetite, increase/loss in weight, slowing down (both physically and mentally), irregular periods in women, constipation. Depression can produce almost any physical symptoms and this includes pain. Pain can appear anywhere but is commonly found in the chest, head, back and stomach. The pain is real, but the cause is depression.
What Causes These Symptoms?
Symptoms can be caused by low levels of certain chemicals in the brain, known as neurotransmitters. These are the method of communication used by the billions of nerve cells in the brain in order for even the smallest task to be undertaken. There are three important neurotransmitters, which are in short supply in depressed people. These are serotonin, dopamine and noradrenaline. Low levels lead to faulty brain communication and may be the cause of depressive symptoms.
How Can Depression Be Treated?
There are many different forms of depression, ranging from mild to severe, requiring different forms of treatment. Doctors like to treat more severe cases with drugs which, being non-holistic, can make matters worse. They are less likely to use drugs for mild cases. Depression can be constant, or it may come and go. Traditional medical treatment involves an initial diagnosis by a doctor to ensure there are no physical problems causing the depression. The three types of treatment, most popular with doctors, are psychological treatment, drug treatment and physical treatment.
Psychological Treatment: This type of treatment is popular, as it does not involve taking tablets. They take time, commitment and a lot of energy. Possible therapies include cognitive therapy, cognitive behavioural therapy, cognitive analysis therapy and interpersonal therapy. These focus on challenging negative thought patterns, behaviour, looking to the past to give ideas of where the source of negativity has sprung from and personal relationships, interactions and communication.
Drug Treatment: Antidepressant tablets can be very effective in treating depression. As stated earlier, levels of neurotransmitters are low in states of depression. Antidepressant medication works by increasing the quantity of neurotransmitters, helping nerve cells to function as required. There are three ways to increase neurotransmitters through drug therapy: 1) increase the amount of neurotransmitter made (tryptophan), 2) help prevent neurotransmitters being broken down (monoamine oxidase inhibitors or MAOI’s), 3) stop neurotransmitters in the synapse being taken back up by the cells (selective serotonin reuptake inhibitors or SSRI’s, tricyclics or tricyclic-like compounds).
Physical Treatment: These treatments are usually offered to those with very severe depression. Electro convulsive therapy (ECT) is an old and controversial treatment, but very effective in some cases and works quickly but can have very severe side effects. It is offered to those who have not responded to antidepressant medication, those who due to contraindicating medical conditions cannot take antidepressants, or those who are so depressed their actions are life threatening. A three-prong attack combining medication, therapy and self-help, may be used to treat depression.
What is ‘Self-Help’?
Self-help is the part that the individual plays in returning to good health. Self-help measures may form part of a prevention plan as well as to promote recovery. It is important to identify which tasks will offer the most benefit. Trying to do all of these might, in itself, create some stress but it may be worth trying some of them before rushing to the doctor for pills.
Self-help measures may include:
- Taking a break. It might only be a day away or a longer break. This aids the ability to think through problems clearly. It is a rest, and distance puts problems into perspective.
- Talking about it. Talking problems over with friends, family or a partner can improve how we feel. Cry if it is needed. Open acknowledgement of hurt and problems is a good starting point for finding solutions.
- Changing lifestyle. Find ‘me’ time; identify contributory factors to the onset of depression; find a support group, share the experience. Changing lifestyle may need to go a long way, move house or even country, change employment, change partner (if there are no children involved).
- Trying some exercise. No matter how little, exercise boosts feelings of well-being. It means getting out of the house and getting fitter to fight! Country walking and swimming are good activities.
- Trying a new activity or hobby to help break the circle of loneliness created by depression. Listen to music or go to the cinema. The smallest things make the biggest difference.
- Managing stress through relaxation. Try alternative therapies such as aromatherapy, reflexology, hypnosis, acupuncture, herbal medicine or massage.
- Getting more sun.
- Changing your diet
Is It Possible To Eat Yourself Happy?
There is growing recognition that depression can have dietary causes linked to vitamin deficiencies and food sensitivity. Many people suffering with depression have an increased appetite for carbohydrates and chocolate. Many experts believe that this may be an attempt by the body to self-medicate. Diet is a very important element in the fight against depression and it is of paramount importance to eat properly during depressive episodes. This means eating a regular, balanced diet supplying all the essential vitamins and minerals that will keep the body well, including maintaining well-being once the bout of depression has abated. Failing to eat properly leaves the body with little physical strength to get better and so begins a vicious circle of ever-worsening depression.
It is widely accepted that B-complex vitamins are essential to the maintenance of mental and emotional well being. B vitamins are destroyed by the consumption of alcohol, refined sugars and caffeine, and nicotine contained in tobacco, all substances that the person in a depressed and despondent state is likely to turn, increasing intake in a bid to resolve their misery.
Recent findings have suggested that vitamin B1 (thiamine) deficiency can have a serious effect on mental health. The brain uses B1 to convert glucose, or blood sugars, into fuel and without it the brain rapidly runs out of energy. This depletion can lead to symptoms of fatigue, irritability, anxiety, suicidal thoughts and depression. Deficiency can also cause memory problems, appetite loss, insomnia and gastrointestinal disorders. To help address this imbalance, an intake of B1 rich foods is essential. The top sources based on mg/100g of food are: yeast extract (4.25mg/100g), peas (0.89mg/100g), oranges (0.70mg/100g), boiled potatoes (0.59mg/100g), pork chop (0.48mg/100g) whole-wheat pasta (0.43mg/100g), wholemeal bread (0.37mg/100g), egg yolk (0.30mg/100g). The recommended daily intake of B1 for adults is 1.4mg.
Vitamin B3 (niacin) deficiency can cause pellagra, a disease with symptoms known as the 3D’s – dermatitis, diarrhoea and dementia. The amino acid tryptophan can be converted to niacin, but a lack of dietary tryptophan can also trigger other symptoms such as headaches, sleep disturbance, thought disorders, anxiety and depression. Many commercial food products contain niacin therefore pellagra has virtually disappeared in the Western world. But there is still evidence of subclinical deficiency of niacin, causing agitation, anxiety, mental and physical slowness. In order to prevent deficiency, an adequate intake of niacin rich foods are required in the diet; top sources based on mg/100g food are: chicken (12.8mg/100g), pork (11mg/100g), beef (10.2mg/100g), wheatgerm (9.8mg/100g), turkey (8.5mg/100g), wholemeal bread (5.9mg/100g), cod (5.7mg/100g), lamb (4.8mg/100g), eggs (3.8mg/100g). The recommended daily intake of B3 for adults is 18mg.
Vitamin B5 (pantothenic acid) is needed for anti-stress hormone formation and the uptake of amino acids and brain chemical acetylcholine, which combine to prevent certain types of depression. Deficiency symptoms include fatigue, chronic stress and depression. Stress, too much alcohol and caffeine can impact on absorption and are best avoided. To combat possible deficiency, the diet should include these top sources based on mg/100g food: calves liver (8.4mg/100g), plain peanuts (2.66mg/100g), tahini paste (2.17mg/100g), sesame seeds (2.14mg/100g), pecan nuts (1.71mg/100g), walnuts (1.6mg/100g), avocado (1.1mg/100g), apples (0.7mg/100g), dried apricots (0.7mg/100g), dried figs (0.51mg/100g). The recommended daily intake of B5 for adults is 6mg.
Vitamin B6 (pyridoxine) is needed to process amino acids and to build all proteins and some hormones. It is required in the manufacturing of serotonin, melatonin and dopamine. Deficiency is rare but can cause impaired immunity, skin lesions and mental confusion. Marginal deficiency can occur in alcoholics, people with kidney failure and women using oral contraception. The use of monoamine oxidase inhibitors (used to treat some forms of depression) can lead to deficiency. Other symptoms include stress, general irritability, low moods, nervousness and lack of energy. In order to prevent deficiency, the diet should include these top sources based on mg/100g food: wheatgerm (3.3mg/100g), wheatbran (1.38mg/100g), ox liver (0.83mg/100g), cod (0.38mg/100g), turkey (0.32mg/100g), beef (0.3mg/100g), banana (0.29mg/100g), brussels sprouts (0.19mg/100g), cabbage (0.17mg/100g), mango (0.13mg/100g). The recommended daily intake of B6 for adults is 2mg.
Vitamin B12 deficiency leads to an oxygen transport problem known as pernicious anaemia. This disorder can cause mood swings, paranoia, irritability, confusion, dementia, hallucinations or mania, followed by appetite loss, dizziness, weakness, shortage of breath, heart palpitations, diarrhoea and tingling sensations in hands and feet. Deficiency develops over a long period of time as three to five years supply of B12 is stored in the liver. Shortages are often due to a lack of ‘intrinsic factor’, an enzyme that allows B12 to be absorbed in the intestinal tract. To prevent deficiency, the diet should include these top sources based on mcg/100g of food: lambs liver (8.1 mcg/100g), liver pate (7.2mcg/100g), pork (2mcg/100g), duck (3mcg/100g), pheasant (2.5mcg/100g), eggs (2.5mcg/100g), cod (2mcg/100g), beef (2mcg/100g), fortified cereals (1.7mcg/100g), yeast extract (0.5mcg/100g). The recommended daily intake of B12 for adults is 1mcg. Vegetarians and vegans will need to take a supplement, of which cyanocobalamin is the best form.
Folic acid (folate) is a form of a water-soluble B vitamin which is needed for DNA synthesis. It is required for the production of SAMe (S-adenosyl-methionine), which is needed for serotonin and dopamine manufacture. Poor diet, illness, alcoholism and the use of contraceptive pills, barbiturates and anticonvulsants can all lead to deficiency. To combat these effects, the diet will benefit from including these top sources based on mcg/100g food: ox liver (290mcg/100g), fortified cereal (250mcg/100g), black eye beans (210mcg/100g), brussels sprouts (110mcg/100g), peanuts (110mcg/100g), spinach (90mcg/100g), broccoli (64mcg/100g), lettuce (55mcg/100g), chick peas (54mcg/100g), avocado (11mcg/100g). The recommended daily allowance of folic acid for adults is 200mcg.
Vitamin C deficiency can cause depression. Drugs such as aspirin, tetracycline and contraceptive pills can deplete the body’s Vitamin C supply. The following top sources have been found to be the most beneficial additions to the diet based on vitamin C content in mg/100g food: papaya (60mg/100g), guava (230mg/100g), blackcurrants (200mg/100g), green pepper (120mg/100g), broccoli (87mg/100g), strawberries (77mg/100g), kiwi fruit (59mg/100g), oranges (54mg/100g), cabbage (49mg/100g), cauliflower (49mg/100g). The recommended daily allowance of vitamin C for adults is 60mg.
As well as the benefits of vitamins in treating depression, many minerals have been identified as key elements in treatment plans. For instance, most diets do not provide enough magnesium and stress depletes the body’s stores. Deficiency symptoms include depression along with confusion, agitation, anxiety, hallucinations and a variety of physical problems. The recommended daily allowance for adults is 300mg and the top sources are: cocoa powder, sunflower seeds, pumpkin seeds, bran, mixed nuts, peanut butter, wheat cereal, rye crisp-bread, plain popcorn and wholemeal flour.
Similarly, calcium depletion affects the central nervous system and low levels cause nervousness, apprehension, irritability and numbness. The recommended daily allowance for adults is 800mg and can be obtained from dairy products, sesame seeds, sardines, dried figs, muesli and green beans.
Zinc deficiency has been linked to apathy, a lack of appetite and lethargy. When zinc levels become low, copper levels in the body increase to toxic levels, which triggers paranoia and fearfulness. The recommended daily allowance for adults is 15mg and can be obtained from lean red meat, sardines, seafood, wheatgerm and pumpkin seeds.
Iron deficiency can often be associated with depression; feelings of general weakness, listlessness, exhaustion and lack of appetite. The recommended daily allowance for adults is 14mg. This can be obtained from consuming bran cereals, sesame seeds, lean red meat, dried fruit and fish.
Manganese is vitally important, as it is needed to aid the proper use of B vitamins and vitamin C in the body. It plays a role in amino acid formation and deficiency may contribute to depression, stemming from low levels of serotonin and norepinephrine. Manganese helps to stabilise blood sugar levels and so prevent hypoglycaemic mood swings. No recommended daily allowance has been established to date, but sources include nuts, soya beans, brown rice, chickpeas and tea.
From all this information, it is apparent that in order to ensure optimal mental health, an adequate intake of vitamins and minerals is required. A healthy, nutritious wholefood diet can provide the mainframe for treatment and prevention of depressive symptoms. The diet should be built on wholegrains, such as wholemeal bread, wholemeal pasta, brown rice and other grains such as couscous, quinoa, buckwheat, bulgar wheat, millet, amaranth, etc. A minimum of five portions of fresh fruit and vegetables should be consumed daily, plus pulses and beans such as lentils, kidney beans, butter beans and chick peas. Small quantities of protein in the form of chicken, turkey, lean red meat or fish should be included, or vegetable protein for vegetarians in the form of tofu or other soy products.
It is apparent from the wealth of knowledge available that the addition of a vitamin B complex supplement plus minerals to the diet is advantageous. It will help prevent deficiency symptoms associated with depressive states and also improve those already in existence.
Depression is an often misunderstood and confusing illness, leaving sufferers feeling they have little command over their life and the all-encompassing sadness that prevails. To regain some control through diet and lifestyle changes is empowering for the sufferer. It is the beginning of the nurturing process and meeting the body’s needs in order to regain full health. We understand how certain foodstuffs can deprive us of feelings of real health and happiness and indeed how we may continue to contribute to the creation of disease throughout our lives, sometimes through ignorance. It is therefore of great comfort to know that we are also able to create a healthy body and mind, and to protect our delicate sanity on a daily basis, simply by acknowledging what we have always known – we are what we eat.
Seeing Red and Feeling Blue: The New Understanding of Mood and Emotion – Dr. Susan Aldridge
Dr. Ali’s Nutrition Bible – Dr. Mosaraf Ali
Optimum Nutrition for the Mind – Patrick Holford
Understanding Depression – Dr. Kwame McKenzie and Dr. Philip Wilson
Depression: The way out of your Prison – Dorothy Rowe
Breaking the Bonds: Understanding Depression, Finding Freedom – Dorothy Rowe
Vitamins and Minerals Handbook – Amanda Ursell
Getting Your Life Back: The Complete Guide to Recovery from Depression – Jesse H. Wright and Monica Ramirez Basco