Dear Mark: Depression Diet?
I occasionally get emails from readers who are interested in lifestyle changes that can either complement or replace their conventional treatments for depression. Since our post a few weeks ago on antidepressants, I’ve gotten a slew of emails asking me about the role of nutrition in mental health. In response I thought I’d devote a Dear Mark to the general question of diet and depression. Thanks to all who wrote in or commented on the boards or forum! It comes as no surprise that nutrition directly impacts brain performance just as it does the functioning of every other organ. Although the roots of clinical depression involve a complex (and theoretically contentious) mix of physiological, genetic and socio-emotional factors, the physical picture hones in on neurotransmitters, chemical messengers that travel between nerves in the brain. Of all the neurotransmitters, the key players in mood disorders are dopamine, norepinephrine and serotonin. When we talk about a diet that supports mental health, we’re essentially looking at nutrition that sustains both optimal neurological functioning and hormone balance. Although it’s not commonly discussed as such, depression is an inflammatory condition. Current research emphasizes the underlying role of inflammation as a cause for both depression itself and the neurodegenerative symptoms seen in those with depression. Researchers have found that people with clinical depression show elevated levels of inflammation biomarkers. Furthermore, risk factors for depression include conditions linked to inflammatory response such as low omega-3 levels, leaky gut, and late pregnancy/postpartum rise in cytokines. Conventional anti-depressant medications, not surprisingly, have anti-inflammatory effects. Of course, I support an anti-infl Continue reading >>
Carbohydrate Intake And Depression – Q&a
Question: I’m a 45 year old female. I currently weigh 221lbs. I’ve lost 30lbs in the last three months. My protein intake is roughly 120 to 130 grams per day. I’m limiting my carb intake to 180 to 200 grams a day. I suffer from life long depression and I find that when I limit by carb intake I slowly slide into a depressed state after two or three months (it’s happening to me now). My sleep is disturbed, I develop anxiety I’m bitchy as hell and I’m dragging ass. Is there a correlation between carb intake and production of neurotransmitters? If so, how can I eliminate the effect lower levels of carbs is having on me? Any information is greatly appreciated. Answer: Dieting in general tends to lower serotonin in the brain and this can cause depression in susceptible people. Interestingly, this effect seems to be more likely to occur in women than men (women being more susceptible to depression in general). In my experience, low carbohydrate/higher proteins diets tend to be even worse in this regards for reasons I’ll explain now. First and foremost, nutrient intake per se affects the production of neurotransmitters with the effects being both direct and indirect. In a very direct way, specific amino acids are the precursors for specific neurotransmitters in the brain. Tryptophan is a precursor for serotonin in the brain and the amino acid tyrosine (as well as phenylalanine which converts into tyrosine in the body) is the precursor for dopamine (and subsequently adrenaline/noradrenaline). As an extreme example of this, researchers will sometimes use something called acute tryptophan depletion (accomplished by providing an amino acid solution containing all of the amino acids except tryptophan) to drastically lower brain levels of serotonin. This is used to test Continue reading >>
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Serotonin And The Connection
According to doctors Olfson and Marcus of Columbia University's College of Physicians and Surgeons (Department of Psychiatry), "Antidepressants have recently become the most commonly prescribed class of medication in the United States" (August 2009 issue of Archives of General Psychiatry). By far, the most popular of this class of drugs are the SSRI's (Selective Serotonin Reuptake Inhibitors). To see how these drugs work, go HERE. Not too long ago, I wrote a post about the relationship between OBESITY, DEPRESSION, AND LOSS OF LIBIDO. As typical, I suggested a LOW CARB OR PALEO DIET as part of the solution to this problem. Not surprisingly, I had a few people email me links to the research by Dr. Richard Wurtman of MIT who has produced forty years worth of studies on sleep, mood, nutrition, and their relationship to neurotransmitters. He has studies showing that Serotonin (the 'feel-good' neurotransmitter whose lack is thought to be a huge factor in developing Depression), is released due to the ingestion of dietary carbohydrates. His wife is Dr. Judith Wurtman (also of MIT) who has published a book on the topic called The Serotonin Power Diet. As you might imagine, she advocates a higher carb / low fat, lower protein approach to eating in order to boost mood. There are many similar books on the market. We have Potatoes Not Prozac and Natural Prozac by Dr. Joel C. Robertson (he advocates a higher carb approach). But there are also books advocating a low carb approach such as Dr. Michael J. Norden's (Psychiatrist) Beyond Prozac. What is the truth? Our goal today is to sift the evidence and see what we find. One of the big reasons that I am such an advocate of Paleo-type eating is that it is a highly non-reactive diet (HERE). This is critical for those dealing with things Continue reading >>
Do High-fat Diets Cause Depression?
Fat-Phobia Strikes Again Earlier this month, the following headline showed up in my inbox: HIGH-FAT DIET LINKED TO ANXIETY, DEPRESSION It was distributed by Medscape (a widely-read e-news source geared towards medical professionals), as well as a variety of other media outlets, including Science Daily. The study itself 1) was published in the British Journal of Pharmacology and is entitled High fat diet-induced metabolic disorders impairs serotonergic function and anxiety-like behaviours in mice. We have been (wrongly) told for decades by public health officials that dietary fat is unhealthy, so we tend to take articles that support this belief at face value, without question. But before you clear your cupboards of all fatty foods, hoping for eternal happiness and tranquility, let me tell you why the results of this MOUSE study need not cause you any additional depression and anxiety. Of Mice and Mental Health Researchers fed one group of mice a low-fat chow and another group a high-fat chow. After twelve weeks, the mice eating high-fat chow had gained more weight. They had also developed high blood sugars, high insulin levels, and glucose intolerance. Sixteen weeks into the study, these mice also showed more signs of emotional distress. Poor meeces. Furthermore, when the high-fat mouse group was treated with the antidepressant Escitalopram (brand name Lexapro), the antidepressant failed to work. The study’s authors concluded that high-fat diets may lead to type 2 diabetes, and that type 2 diabetes may then lead to depression and anxiety symptoms which respond poorly to antidepressants. Hmmm. As a psychiatrist with a special interest in nutrition, I understand how important dietary fat is to the health of the brain, and I know that fat doesn’t cause type 2 diabetes. Continue reading >>
Low-carb Diet = Depression??? Not So Fast!
I’ve noticed a few blogs on the internet recently and posts within our Community from people asking about the effects of Atkins on their sleep or whether doing Atkins would increase their risk of depression. I’ve addressed this topic before, but I thought it would be a great time to revisit it. One study that was well publicized in the past followed a group of adults who were separated into two weight-loss groups: a very low-carb plan and a restricted-calorie, moderately high-carb plan. Both groups lost about the same amount of weight over a year—30 pounds. But, according to the researchers, the low-carb group reported higher levels of anger, depression and confusion vs. the higher-carb group. The researchers suggested a link to better serotonin (a neurotransmitter involved in mood) synthesis with the higher-carb group while the low-carb group had lower levels of serotonin. Concluding that higher carbohydrate intake can increase serotonin concentrations in the brain, while fat and protein reduce concentrations. But it’s just not that simple. Even the researchers suggest that more studies need to be done to support this theory. Let’s start with this indisputable fact: The body needs tryptophan to make serotonin. No one denies this—tryptophan is an essential amino acid, and we need it for all sorts of things, including making serotonin. Tryptophan is a good guy. But no one knows just how much is needed; nor does anyone know exactly how much serotonin we need to make in order to “not be depressed”. What we do know: Depression is a function of an Internet-like maze of interrelationships between serotonin, dopamine, beta-endorphins and other neurotransmitters like norepinephrine and epinephrine. The making of any of these chemical messengers can be influenced Continue reading >>
Can What You Eat Affect Your Mental Health? New Research Links Diet And The Mind.
Jodi Corbitt had been battling depression for decades and by 2010 had resigned herself to taking antidepressant medication for the rest of her life. Then she decided to start a dietary experiment. To lose weight, the 47-year-old Catonsville, Md., mother stopped eating gluten, a protein found in wheat and related grains. Within a month she had shed several pounds — and her lifelong depression. “It was like a veil lifted and I could see life more clearly,” she recalled. “It changed everything.” Corbitt had stumbled into an area that scientists have recently begun to investigate: whether food can have as powerful an impact on the mind as it does on the body. Research exploring the link between diet and mental health “is a very new field; the first papers only came out a few years ago,” said Michael Berk, a professor of psychiatry at the Deakin University School of Medicine in Australia. “But the results are unusually consistent, and they show a link between diet quality and mental health.” “Diet quality” refers to the kinds of foods that people eat, how often they eat them and how much of them they eat. In several studies, including a 2011 analysis of more than 5,000 Norwegians, Berk and his collaborators have found lower rates of depression, anxiety and bipolar disorder among those who consumed a traditional diet of meat and vegetables than among people who followed a modern Western diet heavy with processed and fast foods or even a health-food diet of tofu and salads. “Traditional diets — the kinds of foods your grandmother would have recognized — have been associated with a lower risk of mental health issues,” Berk said. Interestingly, that traditional diet may vary widely across cultures, including wheat for some people but not for others; Continue reading >>
Ketosis For Depression
Depression is so common these days that it seems hard to meet anyone who hasn’t experienced it in some degree. While this has perhaps become the new normal, it doesn’t need to be. Our eating choices not only affect our physical health but our mental health as well—so if you’ve been wondering whether the ketogenic diet can positively impact your emotional state, read on for the use of ketosis for depression. Diet and Depression It’s no secret that most people are overworked, under-rested, and living on a poor diet. It’s also no coincidence that the modern advice to eat a diet high in carbohydrates, low in fat, and with constant snacking or small meals throughout the day has coincided with a rise in diabetes, obesity, and mental issues like anxiety and depression. Let’s take a look at why this difference in diet could be causing these problems—and how ketosis and a ketogenic diet can help. Ketogenic Nutrition and Depression Most of us can agree that a high intake of sugar has a negative impact on mood. Just think of the sugar highs and crashes that result from eating high-carb foods. What follows is feelings of crankiness, low-energy, and maybe even depression. Now, think about how a steady intake of fats from a ketogenic diet could have a positive impact on mood and endorphin levels. Many people who start eating keto have come from a background of eating the Standard American Diet and not exercising enough. Starting a ketogenic diet, removing high-carb refined foods, losing weight, and eating whole foods is bound to help with mood and make you happier. This alone could have benefits for those with depression. In addition, there are some interesting links between ketones and many conditions of the brain similar to depression, including epilepsy and Alzheim Continue reading >>
Is Your Diet Making You Depressed? Expert Warns Ditching Carbs Can Trigger A 'drop In Mood' And Make You 'less Likely To Exercise'
Swapping out your bread, pasta and carbs for a low card diet sounds like a surefire way to drop those extra kilos. But experts are warning to watch for signs of anxiety and mood changes if you do so. Australian dietitian and nutritionist Lyndi Cohen claims when we choose not to include carbohydrates in our diets, our moods can change drastically. Speaking to Body and Soul, Ms Cohen said carbs trigger positive mood chemicals in our brain. 'When your brain doesn't get enough (or produce enough) of these chemicals, it can cause depression, which is just one of the reasons it's essential to keep a balanced diet that includes all food groups,' she told the publication. There is a connection between what we eat and how we feel, and Ms Cohen said as it's the brain that chooses what we eat and when, it's important to account for our mental health for a healthy life as well. 'If you've cut our carbs and experience anxiety or depressive feelings as a result, you're actually less likely to exercise, eat well and take care of yourself,' she said. Ms Cohen was diagnosed with clinical anxiety in 2010, and with the help of her doctor she stopped dieting and calorie counting. 'My friends said I was turning into a recluse,' she previously told Daily Mail Australia. 'The diagnosis (of clinical anxiety) was intimidating and shocking. 'I felt isolated and didn't know where to go for help or what to do. I felt stuck.' Ms Cohen said that instead of obsessing over foods you shouldn't eat, you should focus on the foods you can eat. 'Lots of vegetables and legumes to give slow burning carbohydrates which help to keep your mood and hormones more stable,' she said. Before her diagnosis, Ms Cohen was an emotional eater but has since swapped calorie counting for a healthy, wholesome diet. She told Continue reading >>
7 Things Everyone Should Know About Low-carb Diets
Last week, my staff nutritionist Laura Schoenfeld wrote a guest post for my blog called “Is a Low-Carb Diet Ruining Your Health”. Perhaps not surprisingly, it has caused quite a stir. For reasons I don’t fully understand, some people identify so strongly with how many carbohydrates they eat that they take offense when a suggestion is made that low-carb diets may not be appropriate for everyone, in all circumstances. In these circles low-carb diets have become dogma (i.e. a principle or set of principles laid down by an authority as incontrovertibly true). Followers of this strange religious sect insist that everyone should be on low-carb or even ketogenic diets; that all carbohydrates, regardless of their source, are “toxic”; that most traditional hunter-gatherer (e.g. Paleolithic) societies followed a low-carb diet; and, similarly, that nutritional ketosis—which is only achievable with a very high-fat, low-carb, and low-protein diet—is our default and optimal physiological state. Cut through the confusion and hype and learn what research can tell us about low-carb diets. On the other hand, I’ve also observed somewhat of a backlash against low-carb diets occurring in the blogosphere of late. While I agree with many of the potential issues that have been raised about low-carb diets, and think it’s important to discuss them, I also feel it’s important not to lose sight of the fact that low-carb diets can be very effective therapeutic tools for certain conditions and in certain situations. With this in mind, here are 7 things I think everyone should know about low-carb diets. #1: Paleo does not equal low-carb, and very low-carb/ketogenic diets are not our “default” nutritional state, as some have claimed. Some low-carb advocates have claimed that mo Continue reading >>
Does Anyone Else Get Depressed/anxious On Low Carb?
When I was first starting out with Paleo, I tried to it low-carb. Everything seemed to be well, but after about a month and a half, I started getting*very anxious and stressed out*. What ends up happening is your body must break down protein for glucose needs, and it releases a lot of cortisol to make this happen, leaving you feeling anxious, and stressed, which inevitably leads to depression. Do some carb refeeds. Around 250 grams twice or three times a week. Make your first one today. You'll still be "fat-adapted" with infrequent carb refeeds, but you won't suffer from low glycogen stores. I go through phases, during a low-carb streak... At first: I'm tired, a little depressed, a little cloudy, just sort of feeling overall like I'm missing something. I do get a little anxious after the tiredness passes, I feel that I have more energy than I know what to do with; I usually don't sleep more than five hours a night during this phase. This lasts the first couple days. After that: I break through a wall (low-carb flu) and start feeling really, REALLY good. I'm elated, I'm giddy, I'm clearer than I've been in a long time, I feel like I've figured it all out. A fatty meal makes me feel like I'm flying on several illegal substances. Still sleeping five - six hours a night, but could care less because I have energy. I mean I have ENERGY! This lasts another three or four days. At this point I'm seven - ten days in, and I start noticing that I'm snapping at people here and there. Irritability sets in; I'm not seeking trouble per se, but if anyone shows any sign of weakness or stupidity at all around me, I have ZERO patience and I pounce like a starving lion aiming to rip the throat out. If I continue in this phase, I feel like I might lose my job; it requires both patience and t Continue reading >>
Quieting The Bipolar Mind: Can A Ketogenic Diet Stabilize Mood?
Disclaimer: Please note that I am in no way endorsing nutritional ketosis as a supplement to, or a replacement for medication. There is very little data actually supporting the use of a ketogenic diet as a treatment for bipolar, and a well-documented case where a bipolar patient on valporic acid developed full-blown mania with psychosis after starting a ketogenic diet (thanks to @neurocritic for pointing me to this report; read about it below). This post talks about the theory behind using keto for bipolar disorder and a few recorded clinical cases. Bipolar disorder is often described as a dizzying, sinister and emotionally draining roller-coaster ride. It is marked by dark periods of severe depression interspersed with mania or hypomania – insane energy levels, difficulty concentrating, distorted thinking, euphoria and thoughts that tumble around and around in the brain. To date there is no cure for bipolar disorder, but mood swings can be managed effectively with lithium or anti-seizure medication, such as valporic acid. While effective in many cases, these drugs unfortunately come with a price: in some women lithium may lower thyroid levels causing rapid cycling of depressive-maniac cycles; valporic acid may increase the level of testosterone in young women leading to disruption of menstrual cycles and excess body hair. Many drugs also suffer from the “rebound effect”, where suddenly stopping the medication may worsen bipolar symptoms. In many cases, using a lower drug dose may minimize side effects, but sometimes at the cost of decreased efficacy. What if there’s an alternative way –say, a diet – to stabilize mood in conjunction with drugs? Lucky for mood clinicians, there is in fact a successful pre-existing case: the use of the ketogenic diet to treat Continue reading >>
Although the causes of depression can vary, depression treatment programs which involve changing the diet and healing a leaky gut can be very effective. More specifically, by removing grains and high carb foods from your diet, and making sure you get the right vitamins and minerals, you can heal your gut, heal your body, resolve behavioral issues, and lift your mood. The list of supplement recommendations at right is a good place to start. I want to reiterate that depression is linked to many different triggers, and a change in diet is by no means a comprehensive solution, but it is true that depression can be rooted in biochemical issues such as micro-nutrient deficiencies and fatty acid imbalances. Environmental factors and of course, tragic events over which a person has no control (death of a family member, for instance) are also major causes of depression, and in these cases, dietary changes may have a lesser effect. Gut Health and Depression Current research is linking depression to inflammation linked to a leaking gut. Leaky gut syndrome, a condition in which the lining of the intestines has been compromised by a food substance such as gluten. The damaged lining of the intestinal tract then leaks undigested food particles into the rest of the body, causing inflammatory responses from the immune system. This inflammation then leads to neurological changes which result in mood alterations. A paper by Kiecolt-Glaser et al. discusses how this inflammation in the body drives the symptoms of disease and depression. The authors state "Depression and inflammation fuel one another...Depression, childhood adversity, stressors, and diet can all influence the gut microbiome and promote intestinal permeability, another pathway to enhanced inflammatory responses." Does Followi Continue reading >>
Can A Ketogenic Diet Really Fight Depression? Low-carb, High Fat Foods Shown To Drastically Improve Mental Health
They say you are what eat, and we all know the difference a better diet makes to our complexion and our waistlines. But what about our heads? An increasing number of scientists are pointing to the Ketogenic diet - similar in nature to the low-carb, high-protein Atkins and Caveman meal plans, which have shown promising results in the treatment of depression and bipolar disorder. 'It's a very new field; the first papers only came out a few years ago,' Michael Berk, a professor of psychiatry at the Deakin University School of Medicine in Australia tells The Washington Post. 'But the results are unusually consistent, and they show a link between diet quality and mental health.' A Ketogenic diet typically restricts the intake of carbs to no more than 50g a day. A good rule of thumb is to follow the 60/35/5 rule in which 60 per cent of calories come from fat, 35 per cent from protein, and five per cent from carbs. Grass-fed meat, fish, dairy, nuts and avocado are top of the list in terms of foods that comply. Jodi Corbit, a 47-year-old mother from Catonsville, Maryland, had been battling depression for decades before adopting the Ketogenic diet in a bid to lose weight. To her surprise, she not only shifted several pounds, but also her lifelong depression. 'It was like a veil lifted and I could see life more clearly,' she explains. 'It changed everything.' Chow down: Although research on the mental benefits is still its early days, the Ketogenic diet has already been shown to drastically improve the symptoms of epilepsy, Alzheimer's and even cancer Dr El-Mallakh, a professor of psychiatry at the University of Louisville, believes there is a 'strong link' between Ketogenic eating and mental health. He authored a book on the subject, Bipolar Depression, and last year published t Continue reading >>
Is The Ketogenic Diet The Cure For Depression And Anxiety?
>>Shop Amazon!<< I discuss the effects of a Ketogenic Diet with Alternate Day Fasting on Mental Health. My experiences with anxiety and depression during periods of Ketogenic Fat Adaptation. Intermittent Fasting and Keto are very powerful weapons in the arsenal against mental health issues. I believe it may be a cure for mental illness at least in my situation. I also go over Tryptophan as a building block for Serotonin. So a bad diet may cause depression as well. Stress reduction and dopamine regulation are also key factors. Support this channel and more content… New Music by Wes Derrickson Like me on Facebook >>Shop Amazon!<< Continue reading >>
Gestational Ketogenic Diet Programs Brain Structure And Susceptibility To Depression & Anxiety In The Adult Mouse Offspring
Abstract The ketogenic diet (KD) has seen an increase in popularity for clinical and non-clinical purposes, leading to rise in concern about the diet's impact on following generations. The KD is known to have a neurological effect, suggesting that exposure to it during prenatal brain development may alter neuro-anatomy. Studies have also indicated that the KD has an anti-depressant effect on the consumer. However, it is unclear whether any neuro-anatomical and/or behavioral changes would occur in the offspring and persist into adulthood. To fill this knowledge gap we assessed the brain morphology and behavior of 8-week-old young-adult CD-1 mice, who were exposed to the KD in utero, and were fed only a standard-diet (SD) in postnatal life. Standardized neuro-behavior tests included the Open-Field, Forced-Swim, and Exercise Wheel tests, and were followed by post-mortem Magnetic Resonance Imaging (MRI) to assess brain anatomy. The adult KD offspring exhibit reduced susceptibility to anxiety and depression, and elevated physical activity level when compared with controls exposed to the SD both in utero and postnatally. Many neuro-anatomical differences exist between the KD offspring and controls, including, for example, a cerebellar volumetric enlargement by 4.8%, a hypothalamic reduction by 1.39%, and a corpus callosum reduction by 4.77%, as computed relative to total brain volume. These results suggest that prenatal exposure to the KD programs the offspring neuro-anatomy and influences their behavior in adulthood. Introduction The ketogenic diet (KD), a known treatment for intractable epilepsy, has been recently found efficacious in treating and/or managing a variety of other conditions; from type-II diabetes, to Alzheimer's disease and cancer (Veech et al. 2001; Van der Continue reading >>