Thursday, November 1, 2012

Food and Mood

Pardon the lack of posting for the past week, I have suffered the death of a laptop and a return of my good friend Seasonal Affective Disorder (SAD)., compounded by a lovely head cold.  New laptop has arrived, happy light on, medications adjusted, and back to posting.  Which reminds me of another question/set of questions that I get frequently regarding whether or not there is a particular "diet for depression."

First of all, let's first try to get a definition of what depression is: Depression is a medical illness that causes a persistent feeling of sadness and loss of interest.  It's not just a bout of the blues, it's not a sign of weakness, it's not something you can just "snap out of."  It is a chronic illness requiring long term treatment, just like diabetes or high blood pressure.  The Mayo clinic website has a pretty good summary here

Second of all, when people usually ask this question what they are really asking is "is there one magic food that I can include in my diet that will lift my mood/keep me off medication, etc?"  The straight answer is no, there is no evidence that any one particular food or that one particular way of eating will cure your depression, cure cancer, cause you to live longer, etc.  Keep in mind that our moods are controlled by a complex interaction of neurotransmitters like serotonin, dopamine, beta-endorphins, norepinephrine, and epinephrine.  Be aware of diet plans that tell you that there are "magic foods" that somehow make all of these work together.

Now, all that said, if you are eating in such a way that your body is actually deficient in a particular nutrient, or you are eating in such a way that you are aggravating another chronic condition that you have, or possibly getting too much of a particular nutrient, then your diet might be aggravating your depression as well.  So there really is no "depression diet" but you do have to make sure you are meeting your particular needs.  So if you are trying to improve your mood by making sure that you are eating adequately, here are some tips.

1) If you do have another chronic condition, make sure that you are eating in such a way as to improve that condition.  For example, if you have type 2 diabetes (or another insulin-mediated condition like high blood pressure or heart disease), and you eat excessive amounts of carbohydrate, the subsequent elevations/fluctuations in blood glucose and blood pressure are going to make you feel pretty crummy.  If you have celiac disease and you eat gluten, your intestines won't even be able to absorb nutrients and the pain isn't going to make you feel so hot either.  Whatever you might have, if you can seek out the services of your friendly neighborhood evidence-based dietitian, please do.  Otherwise try to use evidence-based sources you find on the web.

2) Try to get your nutrition through food as oppossed to supplements.  Some of the nutrients of interest in treating depression are zinc, selenium, folic acid, dietary antioxidants, and omega-3 fats (Link).  Remember, "of interest" is the appropriate phrase here, and that correlation does not equal causation.  There are plenty of other good reasons to get these nutrients in our diets, but when it comes to minerals like zinc and selenium, the popping of pills can lead to some nasty side effects and might interact unfavorably with one another (1, 2).  If you are eating a variety of protein sources that include wild-caught fish, fats from pasture-raised animals, and leafy green vegetables, you are going to get what you need.  If you choose to supplement, make sure you find out what upper limits are safe.  One noteable exception in the supplement area is vitamin D.  If your levels are already low and you live in a place where it's hard to get year-round sunlight, you might want to consider a supplement.

3) Try to avoid concentrated sources of carbohydrate.  First of all, if you are loading up on processed carbs like pasta and bread you might not be allowing room for foods with higher nutrition density, and you are probably taking in more calories than you need anyway  Carbohydrate foods can also help us make serotonin, which at first sounds like a good thing, but if we have a lot of sertonin hanging around, it might interfere with dopamine production (Link). 

4) Get regular exercise.  This seems to boost endorphins in a way that doesn't lead to excess and is not addictive in a bad way.

5) Consider limiting caffeine.  Excessive amounts are likely going to interfere with the complex neurotransmitter interaction as stated above. (Link ) The problem here is that there haven't been a lot of studies to determine how much is too much, so at the very least cut out your sources that might also be providing you with excess calories (regular soda, energy drinks, etc).

6) If your depression is so severe that you can't even get out of bed, let alone get up to prepare healthy food, you do need to pick up your phone and make an appointment with your trusted physician.  It is very likely that you need some type of medication to help improve your depression, or if you're already on medication it might need to be adjusted.  Yes, you heard me, sometimes diet can't solve everything, despite what many natural health pseudoscience websites might say. As I've said before, if a person is having a heart attack, I'm not going to stand over them and tell them to stop eating the donuts (particularly since I don't even know what caused their heart attack), I'm going to help that person get the best that medical science has to offer in the form of pills and procedures, get them stable, then we will talk diet and exercise.    Sometimes you need help in the pill form to have the desire and ability to actually prepare healthy food and exercise.  Maybe after you've straightened out your eating and exercise you might be able to reduce the dose of medication or go off of it; maybe you will need to stay on something much longer.  Do what you need to do to take care of yourself.  And of course if you are suicidal you definitely need to call someone who can help.

Take home message--While there is no specific diet for depression, making sure that you follow an overall healthy plan that includes adequate protein, vegetables, good fats, and the appropriate carbohydrate level for you can give you an edge in treating your depression.

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