Treating depression through diet and supplements
Depression can be a complex and debilitating condition. It is often treated with anti-depressants, but not everyone wants to take these and, in any case, they are not always effective and may cause unpleasant side effects.
Other forms of treatments such as cognitive behavioural therapy and counselling do have an important part to play, but they may not be available to, or work for, everyone.
Improving their nutrition is an important way for people to do something to help themselves to feel better and it can be done alongside any other treatment they may undergo.
Whilst depression may be caused/triggered by stress or a specific event (for example death of a loved one), sometimes it can be hard to pin down why it came about. It is known, however, that various nutritional deficiencies can be factors in depression, so eating a good diet and, where appropriate, taking nutritional supplements, may be of benefit.
Depression Diet
It is, of course, important to eat a nutritious and well balanced diet for all aspects of our health. There are however some things that you should be particularly aware of if you suffer from depression:
Processed Carbohydrates & Sugars
Craving carbs and sweet foods when one is feeling low is very common. Now partly this may be due to comfort eating – having a treat to cheer yourself up – but there is a physiological reason why we tend to turn to processed carbs and sugary foods when we are depressed.
Processed sugars and carbohydrates cause a rise in the insulin level of the blood and also raise the endorphins levels. Endorphins are neurotransmitters which have a pain-killing effect and also produce a feeling of wellbeing. In essence, these sugars causes the body to have a mental chemical high, which results in a lift in mood.
Regular large doses of sugar and/or carbohydrates, can cause the brain’s endorphins sites to slow production to regulate the amount of endorphins in the brain. When the body cuts back on endorphin production less endorphins are available in the body and the reduced level of endorphin in the brain causes depression.
In order to maintain a normal level of endorphins in the brain you must then eat more sugar and/or carbohydrates to get out of depression. The result is that the body receives a massive dose of sugar that goes straight into the blood system. The body then injects a massive dose of insulin in order to keep its blood sugar levels balanced. The insulin works to neutralise the sugar and lowers the mood. While the sugar’s effect on the body is short lived and wears off within an hour, the effect of the insulin continues long after the sugar wears off, resulting in depression and lethargy.1
So what do we then do? Why, we go and have some more sugary, high carb foods, of course!
So you can see that, while there are good reasons why me might crave highly processed, high-carb, high sugar products, they are really causing us problems and should be avoided.
The best way to get out of, or avoid, this addictive sugar/carb cycle is to start eating a low GI/GL diet.
GL stands for glycemic load which is related to the GI (glygemic index) of foods. The glycemic index depends on the speed with which the carbohydrates within food are converted into glucose. The faster a food is converted into glucose, the quicker your blood sugar levels rise – not a good thing, especially for someone who is trying to stabilise their blood sugar levels. Pure glucose has a GI of 100, so the lower the number, the more slowly the carbs in the food are converted.
A diet which looks at the GL of each food is a refinement of GI diets, since GL not only considers how quickly the carbohydrate in a food is converted into sugar, it also relates that to how much carbohydrate there is in the food, so a high carb but low GI food may raise your overall blood sugar level by more than a lower carb food with a higher GI level.
I will be writing more about a low GI/GL diet elsewhere.
Protein
It is important to ensure that you are getting enough protein in your diet if you are depressed. The chances are that your protein and carbohydrate balance are severely out of whack, as most of us crave carbs not protein! And of course carbs are so convenient to snack on…
You need to eat adequate levels of protein to ensure that your body is getting enough of the amino acids which are necessary for the production of neurotransmitters such as serotonin – that all important “happy” chemical!
One amino acid that is important for this is tryptophan and not getting enough of it is likely to make you depressed. A trial showed that people fed food deficient in tryptophan became rapidly depressed within hours.
Turkey, salmon and milk are all meant to be good sources of tryptophan, low levels of which reduce the brain’s production of mood regulating serotonin.
Essential Fats
While most of us probably eat too much fat, especially if we eat a lot of processed foods, most of us probably don’t have an adequate intake of the essential fatty acids, omega 3 and 6. They are called essential fats, since they are essential to the body but it cannot manufacture them from other foods.
These essential fats can be incorporated into the diet by eating seeds and fish (preferably oily fish, 2 to 3 times a week).
Depression is a symptom of a deficiency of fatty acids.
Vitamins Minerals & Supplements
Ideally we would get adequate amounts of all the essential nutrients from our diets, without the need for any supplementation. Realistically though, it may be that we need to consider using supplements to help make up any nutritional short fall.
It is important to be aware however, that taking vitamins and supplements may not offer the same benefits as we would get by eating these in their natural food forms.
Also it is very, very important to understand that supplements need to be used sensibly. It is possible to overdose on some supplements and they can interact with other supplements, foods or medicines and people with certain health/medical conditions should not take some supplements as they can be dangerous to them.
Before starting to take any supplements it is best to check with your doctor.
If you suffer from depression, it may be helpful if you check that you are getting an adequate amount of the following nutrients in your diet.
• Vitamin B complex
• Vitamin C
• Vitamin D
• Vitamin E
• Essential fats: Omega-3 & omega-6
• 5-HTP
• Chromium Picolinate
Vitamin B complex
This includes, B1 (Thiamin), B2 (Riboflavin) B3 (Niacin), B5 (Pantothenic Acid), B6 (Pyridoxine), B12 (Cobalamin), Folic acid
Vitamin B1 – Thiamine- is essential for converting the carbs in food into energy. Researchers believe that deficiency may be linked to depression and that a high dose supplement may be helpful. A study of young women who were not deficient in Thiamin, found that a Thiamin supplement helped boost their mood even though they already had an adequate dietary intake of the vitamin.
All you tea and coffee drinkers should also be aware that tea and coffee (even decaf) may deplete the body’s store of Thiamin.
Good dietary sources include lean pork, whole grains, beans, nuts and seeds.
Vitamin B2 – Riboflavin – is important for production of the thyroid hormone, which helps to ensure a steady supply of energy and is involved in transforming protein, fats and carbohydrates into fuel for the body. Another important function is to convert Niacin and B6 (see below) into the active forms needed to function and may work along with other B Vitamins to help with depression.
Milk, cheese, yogurt, liver, beef, fish, wholegrain breads and cereals, eggs, avocados and mushrooms are all good dietary sources of B2.
Vitamin B3 – Niacin (Nicotinamide)- is needed to release energy from carbs and is involved in controlling blood sugar. There is evidence that it can ease depression, anxiety and insomnia.
Good sources of niacin include high protein foods such as chicken, beef, fish and nuts. Some bread and cereal products are enriched with Niacin. Since the body converts Niacin from chemicals in tryptophan, foods that are rich in tryptophan (even if they are low in niacin), such as eggs, milk and other dairy products, are beneficial.
Vitamin B5 – Pantothenic Acid- fatigue, chronic stress, and depression are all symptoms of deficiency. It is needed for hormone formation and the uptake of amino acids and the brain chemical acetylcholine, which combine to prevent certain types of depression.
Food sources of B5 include calf’s liver, raw sunflower seeds, corn, broccoli, squash (the vegetables not the drinks!), cauliflower, eggs and strawberries.
Vitamin B6 – Pyridoxine (P-5-P) - manufactures brain chemicals (neurotransmitters) such as serotonin, low levels of which are associated with depression. Up to 25% of people with depression may be deficient in vitamin B6.
Vitamin B6 also helps to process homocysteine. Homocysteine is an amino acid, raised levels of which may be associated with depression, particularly in the elderly. (A study focused on elderly men.) Raised levels of homocysteine in the blood are also associated with cardio-vascular disease. At the moment there does not appear to be any evidence to show that lowering homocysteine levels will improve depression or cardio-vascular disease, but trying to keep homocysteine levels low makes sense.
Vitamin B9 – Folic Acid – is a very important vitamin for general health as it is used in numerous bodily functions. Most people know that pregnant women need plenty for the health of the baby, otherwise developmental defects may occur.
As many as 90% of adults don’t eat enough folic acid!
Folic acid regulates the production and use of homocysteine (see above for more info about this amino acid). It also is essential for health in many, many other ways.
Depressed people are commonly found to be deficient in folic acid. Folic acid supplementation affects noradrenaline and serotonin receptors in the brain, which could be why supplementation with folic acid when on anti-depressants may offer benefits, as some studies have shown.
Folic acid may also have a role to play in the prevention of obesity and type 2 diabetes, both of which can be associated with depression.
Vitamin B12 – Cobalamin – deficiency is unusual but even mild deficiency may increase depression along with a number of other conditions. As excess B12 is excreted in urine there are no known side effects from a high intake.
Vegetarians (especially vegans) need to particularly careful that they are getting enough B12 in their diet, as animal based foods are the main source of this vitamin. Sardines, other fish, eggs, meat, cheese, brewer’s yeast and fortified breakfast cereals are all good sources.
Vitamin C
Even low level deficiency of vitamin C can cause depression. Stress increases the body’s need for this vitamin.
Good dietary sources of vitamin C include citrus fruits, broccoli, dark green leafy veg, red peppers, strawberries and kiwi fruit.
Vitamin D
This is the vitamin associated with sunshine, as exposure to sunlight enables our body to manufacture the vitamin. It is perhaps not surprising that low levels of vitamin D have been associated with Seasonal Affective Disorder (SAD) also referred to as the winter blues. Vitamin D supplementation has been shown to be more effective than light therapy in a small study of patients with SAD.
However it may not just be seasonal depression that is affected by the availability of Vitamin D. A study done in Norway showed a relation between blood levels of vitamin D and symptoms of depression. They also found that giving high doses of vitamin D seemed to help the symptoms of depression. This seems to suggest that vitamin D deficiency may cause depression. Vitamin D increases the levels of serotonin in the brain.
Vitamin D is not found in a particularly wide range of foods but sources include: oily fish, eggs and fortified foods such as breakfast cereals, margarines and powdered milk. We get most of our vitamin D from exposure to sun as the vitamin forms under our skin in reaction to sunlight, so getting out and about every day (taking care to avoid damaging levels of sun exposure) is probably the most important way we can ensure we have an adequate supply of vitamin D.
Taking too much vitamin D as a supplement over a period of months may cause constipation or diarrhea, headache, loss of appetite, nausea, vomiting, irregular heartbeat and extreme tiredness. Continued high doses may cause even more severe problems as they may disrupt the balance of calcium and phosphate, weaken bones and allow calcium to accumulate in muscles and other soft tissues. A dose of no more than 15mcg a day is normally recommended.
Vitamin E
Low levels of one of the components of this vitamin, alpha tocopherol, appear to be associated with depression. It was found that depressed individuals eating the same amount of vitamin E in their diet as non-depressed individuals had lower levels of alpha tocepherol in their blood.
Also alpha-tocopherol levels were inversely related to depression score. In other words the less of the alpha-tocopherol found in the blood, the more depressed the individual was likely to be. While there may not yet be evidence that increasing vitamin E levels will help to reduce depression, vitamin E has an important role to play in the body, so it would seem to make sense, if you’re depressed, to increase your intake as your body seems to use more of it than non-depressed people.
Vitamin E is one of those nutrients that can be found in a wide variety of foods. Plant oils such as soya, corn and olive oil are particularly good sources, as are wheat germ, nuts, seeds, whole grains and green leafy vegetables.
While you may not experience any side effects from taking large doses of vitamin E, you could affect your body’s absorption of vitamin A.
Omega-3
See the information provided in the section, Essential Fats, above
Minerals
Deficiencies in a number of different minerals are also associated with depression.
Magnesium:
Deficiency can result in depressive symptoms, along with confusion, agitation, anxiety, and hallucinations, as well as a variety of physical problems. Most diets do not include enough magnesium, and stress also contributes to magnesium depletion.
Calcium
Depletion affects the central nervous system. Low levels of calcium cause nervousness, apprehension, irritability, and numbness.
Zinc
Inadequacies result in apathy, lack of appetite, and lethargy. When zinc is low, copper in the body can increase to toxic levels, resulting in paranoia and fearfulness.
Iron
Depression is often a symptom of chronic iron deficiency. Other symptoms include general weakness, listlessness, exhaustion, lack of appetite, and headaches.
Manganese
This metal is needed for proper use of the B-complex vitamins and vitamin C.
Since it also plays a role in amino-acid formation, a deficiency may contribute to depression stemming from low levels of the neurotransmitters serotonin and norepinephrine.
Manganese also helps stabilize blood sugar and prevent hypoglycemic mood swings.
Potassium
Depletion is frequently associated with depression, tearfulness, weakness, and fatigue.
Chromium Picolinate
It is believed that chromium picolinate’s effect on depression may be related to insulin, the hormone that controls blood sugar. Studies have shown that chromium picolinate increases insulin sensitivity and helps body cells take up glucose from the blood stream. The brain requires a constant supply of glucose to maintain proper function.
Diabetics have a rate of depression that is at least twice that of the general population, with an even higher rate found in diabetic women and depression makes the body less sensitive to insulin.
Insulin is also related to the production of neurotransmitters, such as serotonin.
Chromium picolinate occurs in whole grains, liver, mushrooms and other foods.
There are however some concerns about using this mineral as a supplement, since it may cause kidney problems.
Other Nutritional Supplements
5-HTP
5-Hydroxytryptophan (5-HTP), also known as oxitriptan, is an amino acid and a building block of the “happy” hormone, serotonin. 5-HTP increases the production of serotonin.
Although 5-HTP is not available in large quantities in foods, the body makes it from made from another amino acid called tryptophan, dietary sources of which include: turkey, milk, potatoes, pumpkin, and various greens.
Conclusion
Although there is no absolute guarantee that you can beat depression by using supplements and improving the nutritional value of your diet, it has definitely helped some people and the chances are that by eating more healthily you will at least start to feel phyically better and your mood could improve too!
- Whitney, Cataldo, & Rolfes, 1991 [↩]