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-inflammatory diet and lifestyle through the Primal Blueprint model for optimum physical and mental health. Not surprisingly, there’s a strong link between depression and insulin resistance. Although researchers are still probing the chicken versus the egg concept  on this, they know that many depressed individuals are carb-addicted. Carbs, of course, raise the level of serotonin, one of the mood-related neurotransitters. The glucose spike offers a quick feel-good fix, but it also contributes to the overall problem when the effect wears off. The carb ascent and inevitable descent become a chronic crash and burn roller coaster ride  – for mental energy and hormone levels. In addition, the constant carb intake further fuels inflammation, which only exacerbates the physiological problem.
A diet that supports mental health should do four key things:
- Limit inflammation inducers
- Include anti-inflammatory substances
- Prioritize antioxidants to counter oxidative stress
- Contain the essential building blocks for neurotransmitter synthesis
Cutting out grains and limiting carbohydrates to beneficial sources (fruit  and veggies ) will help maintain hormonal homeostasis and will keep further inflammation at bay . It’s also important to eat a clean diet, which will minimize environmental toxins  that can stimulate the body’s inflammatory response. Of course, I would especially suggest a healthy dose of omega-3s  each day to fight existing inflammation. Keep your diet as close to the 1:1 ratio of omega-3 to omega-6 as possible, and include an omega-3 supplement as added insurance. (Experts have known for years now that fish oil is an effective therapy for depression.) Eat copious amounts and a wide variety of vegetables and low-glycemic fruits for maximum antioxidant and mineral power. Research publicized last week highlighted the Mediterranean diet as a means to decrease risk of depression . The researchers believed that the combined prevalence of omega-3 fatty acids and high antioxidant power of olive oil, fruits and vegetables served as integrative protective factors. Other studies have highlighted the positive impact of minerals (like selenium , chromium , and magnesium ) on mental functioning and mood. Furthermore, make sure you include plenty of quality protein  in your diet. Amino acids are vital precursors to neurotransmitters.
In addition to a solid, PB-style diet , I’d suggest a good overall supplement  to fill in dietary gaps, counteract the effects of modern toxins  and stress , and boost intake levels of several key nutrients especially tied to mental energy and neurotransmitter balance. Neurological functioning is supported by a whole web of nutrients, including the amino acids and minerals mentioned above as well as the B-vitamins, vitamin C, and vitamin D just to name a few. A quality supplement will enhance your overall nutritional profile and make sure you’re covered consistently day to day.
There are other aspects to the Primal Blueprint lifestyle that will have “anti-depressive” effects. In the past we’ve discussed how Chronic Cardio increases systemic inflammation , and the importance of low level aerobic exercise  (walking), play , quality sleep  and regular exposure to sunlight for mental health . This is what makes the Primal Blueprint  so unique in the health and fitness world: all behaviors work synergistically to promote the kind of gene expression we desire.
Finally, a good diet that supports mental health, let me say, offers powerful protective and therapeutic factors. Nonetheless, it’s not a panacea. People with depressive symptoms should discuss comprehensive treatment options with their doctors and other care providers.
Let me know what you think. In the meantime, thanks for the great questions, and keep ‘em coming!