09 - Why depression needs a holistic approach that includes nutrition
Every now and again I will be deep diving into a useful research article to discuss the relevant strategies we can all apply in everyday life.
Depression or other disorders of mood, comes up for almost everyone I talk to about their chronic health conditions. Frustratingly, it is misunderstood in common society. Our conversation around depression has been overly simplified to one just of serotonin neurotransmitter deficit, but depression is a mullti layered, complex condition that can include inflammation, neurotransmitters, hormonal changes and nutritional deficits. It can also be a response to trauma, diagnosis of a health condition or as a cofactor with other illnesses.
In this episode I discuss Nutritional therapy can reduce the burden of depression management in low income countries: a review, MB Ekong & CF Iniodu, (2021), IBRO Neuroscience Reports.
Let’s see what nutrition has to offer us in improving our moods.
How depression affects our brain
Depression can alter both the structure and the function of the brain.
Changes in neurotransmitters include not only the well discussed reduction in serotonin, but also reduced dopamine, noradrenaline, GABA and increased glutamate and monoamine oxidase which breaks down the other neurotransmitters.
Alteration in the regulation of the relationship between the hypothalamus, pituitary gland and adrenal glands (known as the “HPA axis”) can affect hormones such as an increase in cortisol (on of our “stress” hormones) and dysregulated feedback mechanism to the brain of cortisol and inappropriate regulation of thyroid hormones and female sex hormones which then cascade to dysregulation of blood sugar levels either directly or through “stress eating” and insulin. Depression is often coexisting with insulin resistance and diabetes and other metabolic conditions.
Inflammation markers also may increase in those with depression also, and the gut microbiome in people with depression shows different dominant microbial species compared with non-depressed individuals. Excess fat can also increase our production of inflammatory cytokines which contributes to systemic inflammation.
A multifactorial approach
When you consider how much of the brain and body’s chemistry, structure and function has changed in someone with depression, doesn’t it make sense to address the condition with a multifactorial approach?
It may be beneficial to address serotonin receptors with pharmaceuticals, and this option should definitely be explored with a medical professional on an individual basis.
AND.. shouldn’t all of the above depression-related changes be addressed for the individual to reach their optimal health? For ANY person experiencing a mood disorder such as depression, not only are cognitive or somatic therapies helpful but nutrition can also be of benefit. For all the underpinning issues above, the food we eat can affect the chemistry of our body and each underlying issue has different nutritional implications.
Nutrition and herbs beneficial in nutrition
Every individual is different and each natural supplement must be considered for suitability and cross checked for the possibility of interactions with other medications. For this reason it is recommended that you discuss natural approaches with a health care professional rather than self prescribe.
Omega 3 fatty acids/ fish oil
Omega 3 fats are vital to reduce inflammation throughout the body and brain. They are essential parts of brain cell membranes. Omega 3 fatty acids are best sourced from fish such as sardines, salmon, mackerel; but also found in walnuts and ground flaxseeds for the vegetarians.
Amino acids
Good quality amino acids (the building blocks of protein) are cofactors in the production of neurotransmitters. Protein is also essential for the production of hydrochloric acid (stomach acid) to ensure optimum absorption of nutrients form food. Specific amino acids affecting mood include tryptophan (for synthesising serotonin), tyrosine (for synthesising dopamine and noradrenaline), and glutamine helps create GABA. Having a variety of protein sources in the diet can help ensure sufficient amino acids for neurotransmitter synthesis, with sources including meats, fish, legumes, tofu, tempeh, quinoa, teff. Specific prescribing of amino acids as supplements should be done cautiously with the advice of a health professional, and caution in those who are pregnant or have kidney conditions.
Avoid sugar and processed foods
Sugar and processed foods increase inflammation in the body and stimulate the excitatory pathways of the brain such as glutamate, in opposition of calming neurotransmitters such as GABA. The more we can reduce these foods, the better the impact on our brains neurotransmitter and mental health.
Vitamins and minerals
Many vitamins and minerals also play a role in management of depression.
Vitamin C is involved in the formation of monoamine, dopamine and noradrenaline neurotransmitters and stored in the adrenal glands so has a key role in managing stress. Ever noticed how after a period of high stress it’s easy to get sick? That’s because vitamin C is pivotal to the immune system also. Good sources include: citrus fruits, berries, capsicum, broccoli, tomatoes and kiwi fruit.
B vitamins are a group of vitamins involved in monoamine synthesis, serotonin, GABA and nerve and brain function. Food sources include salmon, meat, eggs, leafy greens, legumes and yogurt.
Vitamin D helps us to regulate brain function and immune function. The best source is daily exposure to sunlight, obviously at lower UV times of the day to avoid sun damage.
Magnesium is a cofactor in many reaction in the body, neurological regulation and nerve transmission. Our requirement for magnesium increases during times of stress. Food sources include whole grains, leafy green vegetables, legumes and nuts.
Zinc is a neurotransmitter cofactor and pivotal to immune f=unction. Good food sources include oysters, meat, whole grains and pepitas.
What now?
You may find it easy to see where your diet is lacking in some of the nutrients discussed here - or perhaps there’s an excess of sugar or processed foods that stands out to you. If this is the case, make changes that are sustainable for the long term. If you’d like support in this area, book a discovery call here and let’s discuss how I can help you address your chronic health concerns.
Reference
Ekong, M.B. & Iniodu, C.F. (2021), Nutritional therapy can reduce the burden of depression management in low income countries: A review IBRO Neuroscience Reports https://doi.org/10.1016/j.ibneur.2021.06.002