I have a question about depression. I have for a long time thought it’s very odd how much more depressed people are today and how commonplace it has become over the last decade or so. I feel there is a nutritional reason and want to know if that’s true. Could you please explain what your thoughts are?
Lee from Bradford
Dear Lee from Bradford,
Your question is timely, as this season can trigger sadness and exacerbate depression for many. So thank you for submitting it. I will do my best to answer.
First, I think it’s important to clarify what we mean by depression – because I think the term can be misleading. I have met people who mistakenly think depression just means sadness, and in some contexts it can be translated thus. But as a clinical definition there are a number of symptoms that are embodied by a depressive disorder, in addition to a sad mood. For the exact symptom checklist, you can go here or to the DSM-V, but what I want to highlight is that it often includes fatigue, a lack of drive and motivation, a lack of pleasure from previously pleasurable events or stimuli, brain fog, and an inability to tolerate the normal day to day demands of life.
In holistic, functional medicine / orthomolecular nutrition we look not only at the medical diagnosis to understand a dis-ease state, but the systems it embodies to help trace what the root issues may be. Fatigue can be caused by a number of areas of dysfunction – from mitochondrial dysfunction to food intolerances to malabsorption to parasites to toxicity to liver insufficiency to deficiency states. And the same can be said for most of the symptoms on the depressive symptom list. This particular symptom set can also stem from systemic inflammation, blood sugar dysregulation, and insulin intolerance, as well as poor quality sleep, environmental toxins, and extreme, prolonged stress.
So yes, there is a huge correlation between clinical depression and nutrition considerations. Remember, the science of nutrition isn’t just about what you eat. It’s also about the quality of what you eat, how you digest what you eat and how you absorb and uptake nutrients from that, as well as what inhibits that process and what could be underlying those inhibitory factors. And, thanks to academic and clinical mavericks like Julia Rucklidge and Drew Ramsey, the correlation is becoming clearer. Both of these TED talks are inspirational and worth watching if you can find the time. For a few stories of people who’ve successfully treated their depression and anxiety with food, read here.
Contrary to popular belief, in nutrition science we see that different people need differing amounts of various nutrients. One person can function perfectly with a moderate (suboptimal) level of vitamin B12, for example, while another person can have optimal levels in their diet and either be not absorbing it efficiently or in such an imbalanced state that they need more to function optimally. Symptoms tell us when a person is likely deficient but when that doesn’t line up with intake we have to go looking more closely. This is where the science of nutrition becomes an art.
The astute clinician has to know how to tease this information out of a complex case and understand the implications. If you’re getting enough of a nutrient in your diet but are showing signs of deficiency you may have low stomach acid or malabsorption, an excess of nutrients or drugs that are inhibiting absorption or skewing the levels, or a higher than normal need for said nutrient due to a number of factors. And when one nutrient is out of balance, usually there are a number of nutrients that need to be bolstered. You may even need to change your cookware or the pipes in your home, or supplement to offset damage from that. It’s a clinician’s job to sleuth out these underlying issues and create a protocol to address the imbalance at the root.
When viewed this way, depression can be related to a number of nutritional problems. So let me spell out just a few ways depression is fundamentally impacted by nutrition considerations:
1. Systemic inflammation: inflammation can affect any part of the body. In some people it’s the knees (arthritis) or the colon (colitis) or the sinuses (sinusitis). Where we are impacted has to do with our genetic fault lines. In some people this is the mind. Inflammation in the brain impedes proper function, just as it does with the joints. This can manifest as many brain related illnesses, including depression, Autism spectrum disorders, and alzheimer’s. Systemic inflammation can almost always be traced back at least in good part to malnutrition or toxicity related to dietary imbalances.
2. Gut biome: a less than healthy gut biome has now been shown to lead to chronic inflammatory states and directly correlate to depression. Not only does the microbiota impact how we absorb nutrients from food, but it also plays a regulatory role in inflammatory processes in the body. For an excellent article on this emerging data as it pertains to depression, go here. I think it’s noteworthy that the extreme increase in mental illness in our society correlates with the indiscriminate use of antibiotics. This is not the only factor that correlates, but given the data emerging on the gut biome connection, it’s an interesting one.
3. Food intolerances: food intolerances not only drive inflammation, they can trigger very specific mood and personality changes. Wheat, for example, contributes to brain fog, skin issues, and lethargy in intolerant individuals. Dairy intolerance contributes to mucous formation and wet, oozy skin conditions and congestive health problems, with corresponding sensitive, weepy mood conditions. Sugar intolerance tends to manifest in hyperactivity or obsessive or oscillating mood conditions, as parents have long observed in children. These are only a few common examples, but they bear out surprisingly often in clinical application. Whenever there is a bonafide mood disorder, food intolerances should be investigated by a knowledgeable professional. Watch interviews of parents and children with ADHD related to food intolerances here.
4. Deficiency states: deficiency states leave the body with less than the necessary amount of one (or more often) multiple nutrients. In the absence of nutrients, the functions that most rely on those nutrients are hindered. The B vitamins are necessary in abundance to help the body cope with stress, and are often lacking when we don’t eat enough red meat or have malabsorption. B12 deficiency has been linked to depression, as has folate. High rates of deficiency have been noted in teens and elderly with depressive symptoms. Omega fatty acids, amino acids (broken down proteins), and minerals are all equally important to mental health with data linking deficiency states to depression.
Keep in mind, science is only just starting to investigate and document the role of nutrition in mental health, but integrative practitioners have been using this common sense for decades to help people who are open to explore the benefits they can enjoy with improvements to their diet. If you or anyone you know would like help with this, I invite you to contact me.
Thank you again for your query, Lee. As always, readers are encouraged to ask their nutrition questions via the email below.
Nonie De Long is a registered orthomolecular nutritionist with a clinic in Bradford West Gwillimbury, where she offers holistic, integrative health care for physical and mental health issues. Check out her website here.
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