We’ve all had bad days. But after really talking to someone with diagnosed major depressive disorder I realized that even on my worst day I probably have never experienced the depth of what depressed folks struggle with. The closest I’ve come to experiencing it has been when coping with loss of loved ones to death. Given the high profile suicides in the media lately, I think we all can agree that all that glitters isn’t gold, and that even if and when we attain certain levels of material success, it is possible to feel empty inside. One thing I do know for sure is that no matter where you are on the spectrum from feeling meh, to literally contemplating ending your life your feelings should never be disregarded or ignored. Depression can come in several forms and differing levels of severity: it can be in response to an external stimulus like a death in the family or job loss, or it can be this overarching mood that doesn’t seem to improve, perhaps without explanation.
What I’ve learned as I deepened my studies of nutrition is that poor diet, lack of supplementation, and nutrient deficiencies can play a HUGE role in depression. In fact, I wish more people knew about the nutrition – depression connection because perhaps more would consider seeing a therapist and a nutritionist to help them cope and heal. In a world where people were woke to this fact, when someone was dealing with depression maybe their doctor would refer them to a nutritionist, or psychiatrists would send clients for micro-nutrient testing before prescribing antidepressants. This article provides a very broad overview of a few imbalances you can look for or speak to your practitioner about if you think you may be depressed or are already diagnosed.
Some of the major nutritional imbalances that can lead to depression can include:
- Imbalance of gut flora – The health of our gut is incredibly essential for overall health and well-being, but most of us have no idea that the health of our gut is also tied to our mental health. The gut-brain axis shows us that there is a link of communication happening between our gut and brain and that it goes both ways. Meaning, if your gut is imbalanced, or there is a lack of good bacteria, intestinal overgrowth, parasites, etc. this gets communicated to the brain and effects your mood. What can you do about this? Well if you have complex gut related issues you need to consult with a health practitioner to address the underlying cause and health the gut. If you have eczema, psoriasis or other skin related issues, you may have an issue with leaky gut, and need to begin a protocol to health the gut, which can in turn improve your mood. For general maintenance, taking a good daily probiotic and including fermented foods with meals at least 2-3 times a week can help. Some good sources of probiotics include: kimchi, sauerkraut, kombucha, Rejuvelac, or homemade yogurt (store-bought can be too processed and have high sugar content).
- Low omega-3 fatty acids – Multiple research studies have found a clear association between low blood levels of EPA and DHA and an increased risk of depression, violence and suicide. Epidemiologic studies have found a clear correlation between a low intake of EPA and DHA and the prevalence of depression. In two studies of population groups in the USA the incidence of depression was found to be 3.7% and 2.9%. Average intake of EPA and DHA in the USA is estimated to be about 0.1 gram per day. In two Japanese studies, on the other hand, the incidence of depression was only 0.9% and 0% and the intake of EPA plus DHA was 1.5 grams per day and 4.2 grams/day respectively. To ensure you are getting adequate omega-3 fatty acids you can include and daily supplement and increase your intake of omega-3 rich plant foods: walnuts, chia, hemp seeds, Flax seeds, avocado. For plant-eaters a good algae based supplement that includes both DHA and EPA is essential. If you are a meat eater: incorporate cold water fatty fish like salmon and consider taking a fish oil. If you are pregnant or planning pregnancy, omega-3 fatty acids are incredibly important to supplement and consume for the babies’ brain health and to prevent postpartum depression after giving birth.
- Low folate – Folate is a water soluble B vitamin that cannot be stored in the body and much be obtained through our diet. Men and women over 18 generally need around 400 micrograms per day of folate, and pregnant women need 600 mcg. In some research studies, individuals with depression have been shown to have low folate levels, which is also known as vitamin B9 [1]. Some good food sources of folate include: edamame, okra, spinach, artichoke, lettuce, turnip greens, asparagus, endive (raw), Brussels sprouts, legumes, beets (cooked).
- Low intake of B vitamins – B12, Niacin, Folate (as mentioned above) etc. – Besides Vitamin B-12 being number one on the must supplement list for plant-eaters, it may also play a role in getting your mind right if you are depressed or experience low moods. This is because B12 and other B vitamins play a role in producing brain chemicals that affect mood and other brain functions and low levels may be linked to depression. For plant-eaters, especially those who are vegan or cut out all animal products, please get a good daily multivitamin with vitamin B12 included, ideally in the methylcobalamin form which is easily absorbed by the body. If your multi or B12 supplement includes cyanocobalamin I recommend switching that out for a new brand. Besides a supplement, using nutritional yeast helps a lot to increase your intake of B vitamins. I tend to sprinkle nutritional yeast on everything: salads, soups, even steam sauteed veg for added nutritional value.
- Low iron – If you are anemic, or have a history or low iron levels in your blood work, this can also contribute to depression. If you are experiencing fatigue, irritability, and brain fog along with depression make sure you have your iron levels tested. Iron supplements can often cause constipation, so it’s important not to supplement if your levels are normal when you get labs, and better to increase intake of iron-rich foods if your levels are low. Some plant food sources of iron include: legumes, tofu (go for non-GMO), spirulina, cacao, nuts and seeds, leafy greens, blackstrap molasses, quinoa.
- Low Zinc – If you missed it, check out my last post on Zinc and why deficiency is so common in adults. Inadequate intake of zinc can play a role in depression because zinc plays a part in modulating the brain and body’s response to stress. Research studies have found that zinc is low in the serum of those suffering from depression. In fact, the more depressed someone is, the lower their zinc level in some cases.
- Other Notable Imbalances: Vitamin D, and Magnesium. Vitamin D is not a vitamin, it’s actually a hormone and is incredibly essential for our immunity and disease prevention overall. Ideally we should all get around 2000 IU per day; so you can find a multivitamin with that amount of vitamin D or close to it, and take it daily. Magnesium may also help with supporting the healing of depression, and is also very essential with helping to relieve anxiety. Read more about magnesium in this past post.
All of these imbalances can contribute in some form, but generally I usually start with examining the gut brain connection and omega-3 fatty acids as they tend to be common. Beyond nutrition, lifestyle interventions are extremely important and can be effective to accelerate treatment as well including daily meditation or mindfulness and exercise.
So if you are depressed what do you do to restore balance? Your best bet is to find a health practitioner than can assess your nutritional status and work with you on a protocol designed to meet your needs. You can also start by assessing your diet. Look at the nutrients mentioned above. Are you getting balanced meals with those foods included? Are you taking a daily multivitamin? Supplementing with omega-3 fatty acids daily (algae based if you are a vegetarian, or fish oil if not) will go a long way. Then you have to look at your gut health. Are there problems with digestion? Do you have a white coating on your tongue, candida, parasites or some other GI imbalance? Do you have skin conditions like eczema or psoriasis which can point to leaky gut? If so, then you begin the journey of healing your gut. If you take the time to work through these questions, and also make the point of getting up everyday rain or shine and exercising in some form and starting a daily mindfulness or meditation practice for 5-10 minutes, you should be able to slowly but surely find your way to recovery.
Hopefully this post gives you a sense that this issue is complex. It’s really important you reach out and work with someone to find solutions based on your personal health history and also seek help from a therapist in tandem especially if your depression is severe and ongoing. Many of my clients have other health issues along with depression and its always incredible to watch how as their nutritional status improves, so does their mood and vitality. -XO
———
Want to work with me one-on-one to assess your nutritional status, reach a health goal, or address a serious condition or disease? Currently running a special on initial Consults via SKYPE until July 15th; instead of $125, it’s $99 for the initial two hour session. Use the code JULY18 at checkout. More more info on my Nutrition Tune-Up sessions visit HERE.
References:
- Bender A, Hagan KE, Kingston N. The association of folate and depression: A
meta-analysis. J Psychiatr Res. 2017 Dec;95:9-18. doi:
10.1016/j.jpsychires.2017.07.019. Epub 2017 Jul 22. Review. PubMed PMID:
28759846. - Bruinsma, Kristen A. and Taren, Douglas L. Dieting, essential fatty acid intake, and depression. Nutrition Reviews, Vol. 58, April 2000, pp. 98-108
- Carabotti, M., Scirocco, A., Maselli, M. A., & Severi, C. (2015). The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems. Annals of Gastroenterology : Quarterly Publication of the Hellenic Society of Gastroenterology, 28(2), 203–209.
- Hall-Flavin, M. D. (2018, June 01). Vitamin B12 and depression: Are they related? Retrieved July 1, 2018, from https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/vitamin-b12-and-depression/faq-20058077
- Szewczyk, B., Kubera, M., & Nowak, G. (2011). The role of zinc in neurodegenerative inflammatory pathways in depression. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 35(3), 693-701. doi:10.1016/j.pnpbp.2010.02.010