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Depression

What is depression?

There are many different types of depression including SAD (seasonal affective disorder), bi-polar disorder, uni-polar disorder, post-natal depression and the Blues.

(a) Bi-polar disorder, also known as manic depression, is characterised by periods of extreme confidence, euphoria, enthusiasm and /or delusions of grandeur followed by periods of severe depression and despair.

(b) Uni-polar disorder is characterised by episodes of depression followed by periods of feeling normal for months or even years.

(c) SAD is characterised by feeling depressed or low during the winter when the days are shorter and darker, and probably the most common especially this time of year.

(d) Post-natal depression can occur any time within a couple of years of giving birth.

(e) There is another category which I created that I simply call 'The Blues'. This is like the Blahs or the 'Can't Be Bothered' Feeling, and it can be very common in the Winter when the kidneys are working overtime. You would be amazed how many people experience this feeling of malaise at some point in their lives, just about everyone!

At the end of the day, it really is irrelevant as to the actual name we give such conditions. For a few people, there may be certain cases of serious depression which require the intervention of a medical specialist, sometimes medication. This is few and far between.

But for the vast majority of the rest of us, The Blues can be managed, sorted and resolved with some information and focused attention on you, your lifestyle and your diet.

So there are two extremes here: one that is severe and needs professional medical attention but not commonplace; the second is the ordinary feeling of the drabs or the blues that strikes most of the population at some point. I am not into labelling such conditions. In this case, it is either severe for your doctor to handle or ordinary for you to look at yourself.

Symptoms might include altered sleep patterns, lack of interest in anything, irritability, anger, low self esteem, changes in appetite, withdrawal from socialising and so on.

Causes


There may be a number of possible contributory factors in the development of such feelings:

  • Lack of omega 3 fats
  • Nutrient Deficiencies
  • Food allergies or intolerances
  • Yeast overgrowth
  • Stress
  • Hypothyroidism
  • Hypoglycaemia - blood sugar imbalances
  • Diabetes
  • Childhood trauma or a traumatic life event
  • Heavy metal toxicity
  • Imbalanced brain chemistry
  • Genetic Makeup

 

PLEASE CHECK OUT PAGE 35 ON 'STRESS' IN GILLIAN McKEITH'S ULTIMATE HEALTH PLAN BOOK. The YOU ARE WHAT YOU EAT BOOK (Penguin) has a few areas of interest on Stress as well as on Foods That De-Stress, Teas for Tension and so on. Please check it out.

Click Here for the ADRENAL STRESS TEST in our online Clinic

The 3 main brain chemicals that have been researched in relation to mood are:

  • Serotonin which has many functions in the body, including the influencing of appetite, memory, learning, mood and behaviour. It is generally a feel good chemical. Low levels of serotonin tend to make people feel depressed and generally down, with sleep and appetite commonly affected.
  • Dopamine has numerous functions including involvement in motivation, alertness, sleep regulation, attention, learning, sociability, feelings of pleasure, pain, endorphins and the reward centres of the brain. Low levels can lead to feelings of apathy with poor concentration, inability to focus on tasks and increased sensitivity to pain. Low dopamine is associated with drug addiction as many drugs raise dopamine levels causing a temporary high.
  • Noradrenalin (also called norepiniphrine) helps to keep you feeling energised. Without sufficient levels you may feel tired and lethargic.

 

Research into Depression


Over the years there has been much research into the effects of diet, nutrient status and lifestyle on depressive disorders. Here we shall look at some of the findings. Below this you will find an action plan that takes these findings into consideration.

. Hospitalised elderly clients were given a multi-nutrient supplement in a double blind, placebo controlled study alongside a normal hospital diet for 6 weeks. Significant improvements were found in those taking the multi-nutrient. Blood levels of folate and B12 were found to have increased in the supplemented group. Low folate and B12 levels are both associated with depressive disorders (1).

. In a study of national dietary habits and the prevalence of depression a greater consumption of refined sugar and dairy products were found to increase the prevalence of depression. (2)

. The same study found that a high intake of fish, seafood and starchy roots was associated with a reduced prevalence of depression. (2)

. Research from the University of York has found that low folate levels are associated with an increased prevalence of depression. Previous research from the same team had found that people with chronic depression may have a genetic defect that means they do not metabolise and use folate very efficiently. They would therefore have a higher need for the nutrient. Low dietary folate was shown to increase the risk of being depressed by researchers in Finland. (3)

. Vitamin B6 is used in the control of homocysteine (which has been linked to mental health disorders), for the manufacture of dopamine, melatonin and serotonin (low levels of which can all be associated with depressive disorders), in the regulation of mood and mental processes and for the use of amino acids in the body. It is a co-factor in literally hundreds of enzyme reactions in the body. (4)

. Taking oral contraceptives may be associated with an increased incidence of depressive mood changes. It is thought that the oestrogen in the contraceptive pills causes a functional pyridoxine (B6) deficiency. It is suggested that the depression may be alleviated by supplementing with vitamin B6. (5,6)

. B vitamins, including B1, B2 and B6 have been shown to be deficient in those with mental health problems. (7)

. Low B2, B6 and B12 vitamin status has been associated with depression in both geriatric clients and young adults. (8)

. Some research supports the use of L-tryptophan as an augmentation strategy in treatment-resistant depression, bringing about symptom improvement in 56% of the sample. This compares favourably to the published 50-60% response rate with lithium augmentation.(9) The protective effect of tryptophan hydroxylase on people in Sweden with unipolar and bipolar depression was shown by research in 2006. (10)

. There is much research to show that the omega 3 fats from oily fish can reduce depression in those suffering with it. Levels tend to be low in those with depressive disorders. (11,12,13)

. Overweight women who gradually loose weight are found to experience improved mood.(14)

. Eating breakfast has also been found to improve mood, energy and feelings of calmness.(14)

. The effect of exercise on depression has found that 30 minutes of aerobic activity every day is effective in reducing depression. (15)

. Another study showed that exercise was as effective as medication at triggering improvements in depressed clients. After 10 months the subjects who exercised without taking any medication had less symptom recurrence than those on the medication. (16)

. Research in Australia found that meditation and running both had equally beneficial affects on brain chemistry and mood. (17)

 

Action plan

1. It is vital to keep blood sugar levels stable as swings in blood sugar can affect mood and brain chemistry. Eat small regular meals and snacks and avoid sugar, refined carbohydrates (white flour products, white rice, white pasta etc), alcohol, caffeine, drugs, nicotine and additives.

2. Avoid all potential food sensitivities or allergens. Eating foods to which you are intolerant can alter brain chemistry and create mood swings and addictions. Gluten (from wheat, rye, oats and barley) and dairy products are common culprits. Others may include chocolate, peanuts, eggs, soya and corn.

3. If you suspect a yeast overgrowth then follow an anti-candida diet. This involves avoiding sugar, refined carbohydrates, potatoes, yeast and alcohol.

4. Avoid artificial sweeteners and additives. These can have a negative impact on brain chemistry so avoid all processed foods.

5. Eat a diet of whole natural foods. This is the best way to ensure that you get all necessary nutrients and avoid toxins and dietary challenges. A diet of fruit, vegetables, nuts, seeds, pulses, whole grains, fish and lean meats is the way to go. Eat food that has been cooked or prepared from scratch wherever possible.

6. Include green vegetables, beans and lentils in your diet. These are high in folic acid which has been found to be low in those with depressive disorders.

7. Eat foods rich in vitamin B6. B6 is found to be low in those with depressive disorders. It is found in wheatgerm, brewer's yeast, molasses, egg yolks, bananas, pulses, soya beans, sunflower seeds, avocados, prunes, raisins, sprouting seeds and grains.

8. Eat oily fish 2-3 times a week. These contain omega 3 fatty acids that have been shown to reduce depression in many sufferers.

9. Include ground flax seeds, hulled hemp seeds, pumpkin seeds and their cold pressed oils in your diet daily. These contain essential fats needed for neurotransmitters in the brain as well as the anti-oxidant vitamin E needed to protect the brain. Sprinkle the seeds onto porridge or muesli and use the oils in salad dressings.

10. Avoid toxic metals such as lead, aluminium, cadmium and mercury. These can interfere with brain chemistry and nutrient absorption. Sources include pollution, amalgam fillings, deodorants, cigarette smoke, some paint, lead water pipes, aluminium cooking utensils and some fish such as tuna, swordfish and shark.

11. Reduce toxic overload by taking the green superfood chlorella. This acts like a magnet in removing metals such as mercury from the body. Sea vegetables, pectin and vitamin C are also helpful. Pectin is a fibre found in apples, plums, Concorde grapes, the pith of citrus fruits, red currants and cranberries.

12. Get adequate sleep and rest. This is particularly important during manic phases when energy seems boundless. Establishing a regular daily routine can help keep you on a more even keel. Go to bed and rise at the same time each day and eat meals at regular times.

13. Supplement with fish oils containing EPA. Aim for 1000mg of fish oils daily.

14. Get aerobic exercise daily for 20-30 minutes. Exercise is great for improving blood sugar control, balancing brain chemistry, dissipating stress hormones and improving mood generally. Jogging, brisk walking, swimming, cycling, skipping, dancing and rebounding can all make you feel better and improve overall health.

15. Get outside every day in daylight. Daylight is vital for normalising body rhythms and moods. Aim for at least 30 minutes a day.

16. Deal with stress. Depression is often linked to chronic and acute stress. If stress is a problem for you then consider talking therapies, yoga, tai chi and visualisations. Support groups can also be helpful.

17. Learn to meditate. Meditation has been found to be as effective as exercise against depression. There are many courses, books and tapes that can aid meditation. Put aside some time each day to quieten the mind. This can help to keep things in perspective and to help you deal with the challenges of life.

18. Keep a journal. This can help you keep track of your moods and responses to life and can help to identify when depressive phases are developing and possible triggers.

 

References


1. Gariballa S, Forster S, Effects of dietary supplements on depressive symptoms in older clients: a randomized double-blind placebo-controlled trial", clinical nutrition, published on line ahead of print, July 2007

2. Peet M, International variations in the outcome of schizophrenia and the prevalence of depression in relation to national dietary practices: an ecological analysis, Brit J Psychiatry, 2004; 184:404-408

3. 11. Tolmunen T, Voutilainen S, Hintikka J et al. Dietary folate and depressive symptoms are associated in middle-aged Finnish men, J Nutr. 2003 Oct;133(10):3233-6

4. Williams, Cotter et al. The role of vitamin B 6 as treatment for depression; a systematic review. Fam Pract. 2005; 22:532-537

5. Adams, Wynn et al. Effect of pyridoxine hydrochloride (B6) upon depression associated with oral contraception. Lancet 1973;1:897-904

6. Winston F, Oral Contraceptives, Pyridoxine, and Depression, Am J Psychiatry, Nov 1973 130:1217-1221

7. Carney, M.W., Ravindran, A., Rinsler, M.G. and Williams, D.G. . "Thiamine, riboflavin and pyridoxine deficiency in psychiatric in-patients." British Journal of Psychiatry 1982;141: 271-272.

8. Bell IR, Edman JS, Morrow FD, et al. B complex vitamin patterns in geriatric and young adult inpatients with major depression, J Am Geriatr Soc. 1991 Mar;39(3):252-7

9. Smith S, Atmakur P, L-tryptophan for treatment resistant depression, Psych Bulletin, 2004;28:183

10. Van Den Bogaert A, Sleegers K, De Zutter S et al. Association of brain-specific tryptophan hydroxylase, TPH2, with unipolar and bipolar disorder in a Northern Swedish, isolated population, Arch Gen Psychiatry, 2006 Oct; 63(10):1103-10

11. Peet M, Horrobin DF, A dose-ranging study of the effects of ethyl-eicospentaenoate in clients with ongoing depression despite apparently adequate treatment with standard drugs, Arch Gen Psychiatry, 2002 Oct; 59(10):913-9

12. Song C, Zhao S, Omega-3 fatty acid eicosapentaenoic acid. A new treatment for psychiatric and neurodegenerative diseases: a review of clinical investigations, Expert Opin Investig Drugs, 2007 Oct;16(10):1627-38

13. Edwards R et al. Omega-3 polyunsaturated fatty acid levels in the diet and in the red blood cell membranes of depressed clients, J of Affective Disorders, 1998;48:149-155

14. Lombard CB, What is the role of food in preventing depression and improving mood, performance and cognitive function? Med J Aust. 2000 Nov 6;173 Suppl:S104-5

15. Stein MB, Sweating away the blues: Can exercise treat depression? Am J Preventative Medicine, 2005;28:140-141

16. Babyak M, Blumenthal JA, Herman S et al. Exercise treatment for major depression: Maintenance of therapeutic benefit at 10 months, Psychosomatic Medicine, 2000; 62:633-638

17. Harte JL, Eifert GH, Smith R. The effects of running and meditation on beta-endorphin, corticotropin-releasing hormone and cortisol in plasma, and on mood. Biological Psychology (NETHERLANDS) June 1995; 40 (3):251-65