My last post literally scratched the surface of some of the countless factors that can possibly contribute to depression. Genetic susceptibility, chronic stress, financial and housing problems, family and relationship issues, bullying or exclusion at school, college or in the workplace, bereavements and other difficult life events, physical illnesses in which there is inescapable pain or discomfort, unemployment and the daily pressures we face can all have an impact.
HOW FOOD CAN AFFECT YOUR MOOD
Diet is also certainly something that can affect our mental well-being as it has a vast impact on our biochemistry and this is often not considered or addressed at all. It is a highly complex subject so I'll just give a brief, simplified summary of the main factors. For anyone interested, Patrick Holford's books explain the subject of nutrition and mental well-being very well.
Biochemically speaking, depression is thought to be caused by a lack of or faulty signalling of 2 main neurotransmitters: serotonin (associated with feelings of calm and serenity) and dopamine (associated with motivation and drive). The dietary choices we make over extended periods of time can dramatically alter our body chemistry, including that of the brain.
Neurotransmitters (hormones of the nervous system if you like) are made from amino acids which come from protein, meaning consuming adequate protein (on average around 0.8g per kg body weight) is crucial. B-vitamins, particularly vitamin B6 (sources include nuts and seeds, wholegrains and bananas) are needed to convert amino acids into neurotransmitters. In order for these neurotransmitters to signal correctly, the correct quantity and type of fat is essential. Omega 3 (usually associated with oily fish but are also found in flax and chia seeds and their oils and algae supplements) and omega 6 fatty acids (nuts and seeds, vegetable oils) are both required by the brain but our current diet tends to be far too high in the omega 6 kind in comparison to omega 3. In addition to this, many of us also consume unhealthy fats found in deep-fried food, take-aways, poor quality baked goods and processed foods, which further impairs this signalling process. Think of your brain as a train network whose tracks need oiling with the correct kind of oil on a regular basis in order for the serotonin and dopamine trains to travel from one brain destination to another doing their job of making you happy, calm and motivated (if it helps!).
In addition to this, antioxidant rich foods (deeply coloured fresh fruits and vegetables, herbs and spices, nuts and seeds, dark chocolate) are essential to protect these fats from damage and keep our cells healthy.
What is becoming more widely researched in recently is an amino acid in the blood called homocysteine of which high levels are associated with depression (amongst many other illnesses including cancer, diabetes and Alzheimers). Folic acid and vitamin B12 are essential for keeping homocysteine at safe levels. Vitamin D3 deficiency (very common due to the lack of sunlight in the UK!) is now also thought to play a part in the aetiology of depression and is being researched. No causal relationship has been established yet but it's definitely something worth investigating.
As you can imagine, long periods of eating the wrong kinds of food or failing to identify and correct nutritional deficiencies can seriously hinder your brain's ability to keep us mentally well. Nowadays many of us are so busy and stressed that we feel we don't have the energy to devote attention to our diets and can rely on unhealthy foods and alcohol to relieve stress.
The likelihood is, most of us, whether we're omnivore, pescatarian, vegetarian or vegan are deficient or have less than ideal levels of one nutrient or other. My view is that vegans should not be singled out as at risk of suffering from depression due to dietary factors. Antioxidants, folic acid and vitamin B6 are plentiful in vegan foods, providing you eat a wide variety and in my post http://samanthathesanevegan.blogspot.co.uk/2014/07/you-can-have-your-cake-and-eat-it-under.html, I've mentioned about some of the vegan sources of protein and omega 3 fats. That being said, there are some nutrients that need attention.
It's crucial for vegans (and everyone else!) to get enough vitamin B12 in order to keep homocysteine levels sufficiently low to avoid the risk of depression and other illnesses. Some foods and brands of dairy alternatives to milk are fortified with vitamin B12 and there are some kinds of algae that claim to be sources. I personally eat predominantly organic food (which cannot be fortified with B12) and it is not safe to rely on algae as a vitamin B12 source so I take a supplement.
I've encountered many vegans who have the attitude of 'well I've not taken vitamin B12 in years and I feel fine!' The trouble with this is, high homocysteine or inadequate vitamin B12 status might be symptomless and so it's not something you can assume is ok without a test. I've not had my homocysteine tested yet as it's not widely available on the NHS at the moment (I'm currently a nutritional therapist who can't afford nutritional therapy, haha!) but I take a B12 supplement daily and I've had my level tested recently by my GP. There are some vitamins and minerals that are harmful in excess but vitamin B12 is not one of them. It's far safer to take it than to not take it. B12 supplements are also widely available and affordable.
Vitamin D is also not widely found in plant foods and deficiency can affect anyone. It's advisable to get one's levels tested in order to ascertain whether supplementation is necessary.
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| user friendly guide to nutrition and mood |
Biochemically speaking, depression is thought to be caused by a lack of or faulty signalling of 2 main neurotransmitters: serotonin (associated with feelings of calm and serenity) and dopamine (associated with motivation and drive). The dietary choices we make over extended periods of time can dramatically alter our body chemistry, including that of the brain.
Neurotransmitters (hormones of the nervous system if you like) are made from amino acids which come from protein, meaning consuming adequate protein (on average around 0.8g per kg body weight) is crucial. B-vitamins, particularly vitamin B6 (sources include nuts and seeds, wholegrains and bananas) are needed to convert amino acids into neurotransmitters. In order for these neurotransmitters to signal correctly, the correct quantity and type of fat is essential. Omega 3 (usually associated with oily fish but are also found in flax and chia seeds and their oils and algae supplements) and omega 6 fatty acids (nuts and seeds, vegetable oils) are both required by the brain but our current diet tends to be far too high in the omega 6 kind in comparison to omega 3. In addition to this, many of us also consume unhealthy fats found in deep-fried food, take-aways, poor quality baked goods and processed foods, which further impairs this signalling process. Think of your brain as a train network whose tracks need oiling with the correct kind of oil on a regular basis in order for the serotonin and dopamine trains to travel from one brain destination to another doing their job of making you happy, calm and motivated (if it helps!).
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| antioxidants galore! |
What is becoming more widely researched in recently is an amino acid in the blood called homocysteine of which high levels are associated with depression (amongst many other illnesses including cancer, diabetes and Alzheimers). Folic acid and vitamin B12 are essential for keeping homocysteine at safe levels. Vitamin D3 deficiency (very common due to the lack of sunlight in the UK!) is now also thought to play a part in the aetiology of depression and is being researched. No causal relationship has been established yet but it's definitely something worth investigating.
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| unhealthy foods give us a temporary 'high' but in the long run they make us feel like this! |
The likelihood is, most of us, whether we're omnivore, pescatarian, vegetarian or vegan are deficient or have less than ideal levels of one nutrient or other. My view is that vegans should not be singled out as at risk of suffering from depression due to dietary factors. Antioxidants, folic acid and vitamin B6 are plentiful in vegan foods, providing you eat a wide variety and in my post http://samanthathesanevegan.blogspot.co.uk/2014/07/you-can-have-your-cake-and-eat-it-under.html, I've mentioned about some of the vegan sources of protein and omega 3 fats. That being said, there are some nutrients that need attention.
It's crucial for vegans (and everyone else!) to get enough vitamin B12 in order to keep homocysteine levels sufficiently low to avoid the risk of depression and other illnesses. Some foods and brands of dairy alternatives to milk are fortified with vitamin B12 and there are some kinds of algae that claim to be sources. I personally eat predominantly organic food (which cannot be fortified with B12) and it is not safe to rely on algae as a vitamin B12 source so I take a supplement.
I've encountered many vegans who have the attitude of 'well I've not taken vitamin B12 in years and I feel fine!' The trouble with this is, high homocysteine or inadequate vitamin B12 status might be symptomless and so it's not something you can assume is ok without a test. I've not had my homocysteine tested yet as it's not widely available on the NHS at the moment (I'm currently a nutritional therapist who can't afford nutritional therapy, haha!) but I take a B12 supplement daily and I've had my level tested recently by my GP. There are some vitamins and minerals that are harmful in excess but vitamin B12 is not one of them. It's far safer to take it than to not take it. B12 supplements are also widely available and affordable.
Vitamin D is also not widely found in plant foods and deficiency can affect anyone. It's advisable to get one's levels tested in order to ascertain whether supplementation is necessary.
Specialist nutritional therapy and tests for potential nutritional causes of depression can be provided at the Brain Bio centre in Putney, London http://www.foodforthebrain.org/brain-bio-centre.aspx.
These nutritional factors are certainly something people should be conscious of, but as I've mentioned our nutritional status is one of many factors in depression and therefore nutritional therapy should never be used as a sole therapy without addressing the other issues.
ME, FOOD AND MOOD
ME, FOOD AND MOOD
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| If I'd had this ingrained in my brain all my life that would have saved me from a great deal of misery! |
Some people might wonder why as a nutritional therapist I didn't cover this in my first blog on depression. Everyone's experience is different and as I'd made it partly about mine I wrote a little about some of the factors that affect me most and how I've dealt with them.
My personal most significant contributory factors are: genetic susceptibility (depression and other mental health issues run in my family) having had a difficult upbringing (poverty-wise), feeling excluded and different throughout my life (which contributed to low self-esteem) work and studying-related stress, comparing myself with others and putting unnecessary pressure on myself.
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| don't compare yourself with others Samantha! certain recipe for depression! |
The other reason I've not used nutritional therapy to treat my depression is the lack of motivation that commonly accompanies depression. Making positive dietary changes can be challenging for anyone whether they have depression or not. Some sufferers might be willing to improve their diet and make positive changes whilst suffering from depression which is wonderful, but in my history I've always waited too long to address it and ended up at the stage where I have very little motivation to do anything. In my last episode I took an antidepressant of the SSRI class (escitalopram) for 6 weeks and had a kind of therapy called Guided Self Help which worked for me (in fact too well, I have hypomania now!). I was extremely lucky!
I've yet to research whether vegans are more susceptible to depression than others but even if this is the case, I doubt that diet is the sole cause. I believe there may be another reason:
THE 'EMPATH' OR 'HIGHLY SENSITIVE PERSON'
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| I score 21 out of 23 on the 'Highly Sensitive Person' scale! |
Where there are psychopaths, on the opposite end of the scale, there is such a thing as an 'empath' or 'highly sensitive person' (HSP). This personality type is characterised by a higher than average level of empathy, tendency to feel overwhelmed, low self-esteem and introversion (not in all cases, I don't consider myself an introvert). It doesn't appear to be very widely researched but reading Aron's book made me feel much more understood.
I was considered shy as a child, I find it difficult to watch horror films, anything with cruelty or extreme violence, I'm a bit of an ignoramus when it comes to politics and current affairs because I can't cope with reading newspapers or watching the news, I support several charities and non-profit organisations, always try to do the right thing and wish I could solve all the problems in the world. I always felt like I was strange because I didn't really know other people like me. I'm very happy to know there's nothing wrong with me, it's just a personality type (that has its merits as well as disadvantages!).
It has been said that it's not necessarily the case that HSPs are more prone to depression but it would make sense. As I said in my last blog what I feel most when I have an episode of depression is an overwhelming sense of being unable to cope whether it's with stress, measuring up to my self-imposed standards, sad or depressing life events or situations that happen in the world beyond my control. In my opinion having this personality type has almost certainly contributed to my depression.
It's not all bad though. It also means I sometimes have the ability to feel overwhelmed by positive emotions and excitement which I'm very grateful for!
I also believe that there might be some association between the HSP personality type and the decision to adopt a vegan diet.
I'm sure it's not necessarily the case that all vegans are HSPs, you certainly don't have to be to be appalled by factory farming once you've read or seen videos about it. I'm also not suggesting that all non-vegans are psychopathic and insensitive. Given that an estimated 15-20% of the population have this personality and only about 1% of people are vegan, of course there are non-vegans who are extremely sensitive, caring people who feel more strongly about different causes. But it would make sense that those who decide to adopt a dietary choice and lifestyle aimed at reducing suffering in the world would likely to have this personality. Where nutritional deficiencies have been ruled out in anyone, this personality type should be considered as one of the contributing factors to depression.
Being a HSP is not a mental disorder or something or something that needs 'treating'. It can, however make life slightly more challenging in some ways. Elaine Aron's book 'The Highly Sensitive Person' has useful advice on how to manage life as a HSP and view one's personality trait as a gift, not a flaw.
So, the moral of this very long story is: food can definitely be one of many factors contributing to depression and eating the correct foods and correcting nutritional deficiencies can certainly be of help. But as it's such a complex illness, there is never one simple cause and as follows, there's no one simple treatment. Anyone encountering a health practitioner who insinuates one's depression (or any health issue) is solely the result of not eating oily fish (I have encountered MANY with this attitude!) remember this blog!
It has been said that it's not necessarily the case that HSPs are more prone to depression but it would make sense. As I said in my last blog what I feel most when I have an episode of depression is an overwhelming sense of being unable to cope whether it's with stress, measuring up to my self-imposed standards, sad or depressing life events or situations that happen in the world beyond my control. In my opinion having this personality type has almost certainly contributed to my depression.
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| anyone remember this episode of Friends? me at the moment! hypomania is fun! |
I also believe that there might be some association between the HSP personality type and the decision to adopt a vegan diet.
I'm sure it's not necessarily the case that all vegans are HSPs, you certainly don't have to be to be appalled by factory farming once you've read or seen videos about it. I'm also not suggesting that all non-vegans are psychopathic and insensitive. Given that an estimated 15-20% of the population have this personality and only about 1% of people are vegan, of course there are non-vegans who are extremely sensitive, caring people who feel more strongly about different causes. But it would make sense that those who decide to adopt a dietary choice and lifestyle aimed at reducing suffering in the world would likely to have this personality. Where nutritional deficiencies have been ruled out in anyone, this personality type should be considered as one of the contributing factors to depression.
So, the moral of this very long story is: food can definitely be one of many factors contributing to depression and eating the correct foods and correcting nutritional deficiencies can certainly be of help. But as it's such a complex illness, there is never one simple cause and as follows, there's no one simple treatment. Anyone encountering a health practitioner who insinuates one's depression (or any health issue) is solely the result of not eating oily fish (I have encountered MANY with this attitude!) remember this blog!
