The food you eat can be the most powerful form of medicine, or the slowest form of poison. ~ Ann Wigmore
The CDC reports that 11% of all Americans over 12 years old are currently prescribed antidepressants. This is a staggering 400% increase since 1988. Among women aged 40 to 59, one in four women are on these medications.
At the same time, concerns about the efficacy and safety of psychotropic drugs are the on the rise. Clinical trials show mixed benefit, with a study famously showing superior results from placebo. Because of this, more patients and providers are looking to natural medicine for solutions.
Supporting patients with mood disorders using diet usually involves one or more of the following strategies:
1.Blood Sugar Regulation
2.Providing Nutritional Building Blocks and Precursors
4.Healing the Gut
Blood Sugar and Mood
For the majority of people suffering from anxiety and fatigue, skipping meals is an aggravating factor.
To assess whether blood sugar is an issue, I ask my patient if she feels lightheaded or jittery between meals, tired after meals, or feels much better after a meal. I also ask if she craves sweets. Her answers let me know if I need to work on stabilizing her energy input via food, or whether I need to investigate insulin resistance.
Insulin resistance can also show up as difficulty losing weight, a belly that is wider than the hips, or a tendency to gain weight under stress.
Why is insulin resistance, or pre-diabetes, important in mood issues?
Glucose is the primary fuel source of the brain. Without a steady supply of fuel, synapses don’t work efficiently, neurons
degenerate, and this manifests in suboptimal mood and thought coherence. Insulin resistance is a phenomenon that develops over time, due to a combination of genetics and constant, excessive influx of sugar from the diet.
The natural function of insulin is to trigger glucose absorption into cells. The more glucose is in the bloodstream, the more
insulin is pumped out by the pancreas. Over time, insulin receptors on cells become resistant to the insulin signal. It’s a little bit like starting to tune someone out, if all they do is yell at you all day. Cells naturally become less sensitive to insulin (e.g insulin resistant) when they get too much, too often.
Unfortunately, insulin resistance takes place in the brain as well. Which means brain cells resist the signal from insulin, and don’t absorb their vital fuel, glucose. It’s no wonder that people with diabetes are more likely to suffer from depression – their brains are starving for glucose! But the solution is not to give them more sugar – that’s what got them in trouble in the first place. The solution is to re-set their insulin receptors so that they start to respond to insulin again.
Reversing Insulin Resistance
Have you ever heard the term “so quiet, you could hear a pin drop”? When there is no sound, our ears seem to be extra sensitive even to small noises. It’s the same for receptors. If you lower the volume of insulin, over time, the receptors start to pay attention and follow the signals to absorb glucose again. Note – this only applies to people who are not insulin-dependent!
How do you lower the volume of insulin? By lowering the volume of glucose in the blood. This is done via low-glycemic diet – low sugar, low refined carbohydrates, mostly whole foods. When done right, a low glycemic diet also provides all the nutrients needed for healthy mood and brain function.
Delivering the Raw Ingredients
The physiology of mood is dependent on several players – neurotransmitters, hormones and enzyme co-factors, to name a few. When treating mood disorders with diet, I need to ensure that patients are getting all the raw materials they need. Most neurotransmitters are made up of amino acids. The body gets about 70% of amino acid needs met through the food we eat – specifically, from protein.
The first order of business is usually to eat a palm-size worth of protein three times a day – especially breakfast. Most people skip this meal or power up with coffee and a pastry, setting off a mood and energy rollercoaster. Protein in the morning stabilizes blood sugar, and usually reduces cravings.
It is also important to ensure that they are getting enough fat. Every cell in the body is wrapped in fat, and many vitamins need fat for absorption. Good fats like olive oil, avocados, nuts seeds and fatty fish provide satiety, reduce overeating and provide for proper cell signaling and hormone production.
The fish-sourced EPA and DHA are crucial for mood. DHA in particular makes up a significant portion of the fat in the brain. It is EPA, however, that appears to be more important in treating depression. This may have a lot to do with the fact the EPA is a potent anti-inflammatory.
What is the relationship of inflammation and mood?
Inflammation is a major focus of almost every field of medicine. It a process that appears to underlie all of chronic disease – heart disease, cancer, autoimmunity to name a few. Inflammation is closely related to oxidative free-radical damage, a process implicated in degenerative diseases.
The central nervous system is in constant communication with the periphery –inflammation on one side of the blood-brain-barrier will affect the other. Depressed people are more likely to have inflammatory markers evident in blood tests, compared to non-depressed cohorts. EPA and DHA, powerful anti-inflammatory fats, have been shown to help in the treatment of depression.
The Power of Plants
Plant foods, particularly vegetables and fruit, are undisputed nutritional powerhouses. They are high in anti-inflammatory and anti-oxidant compounds. They contain the vitamin and mineral co-factors needed for the conversion of neurotransmitters. A British study showed that eating seven servings of fruit and vegetables was associated with greater mental well-being.
In addition to their incredible nutrient content, whole plant foods are high in soluble and insoluble fiber, making them essential for gut health. Which, you guessed it, plays a major role in the regulation of mood.
The Gut-Brain Connection
The gastrointestinal tract is also known as the “second brain”; it contains more neurons than the spinal cord or the peripheral nervous system. It contains 95% of our serotonin, as well as a large part of our immune system. The immune system, in turn, regulates inflammation.
The gut has the complicated task of absorbing nutrients, while keeping out microbes and other undesirable elements. This crucial process is disrupted in the medical phenomenon known as “leaky gut” – nutrients are poorly absorbed, and inflammatory particles enter the blood stream, causing immune reactions that can affect the brain. Leaky gut has been associated with depression and alcohol addiction.
Dietary fiber from plant foods helps correct leaky gut by nourishing GI cells with short-chain fatty acids. This is done with the help of beneficial bacteria, also known as probiotics. Research into the relationship between gut microflora and neurological issues is growing, as are findings that link the status of the “microbiome” with inflammation.
For the patient with a combination of mood problems as well as digestive problems, normalizing the GI is essential in the
restoration of balance and can have profound benefits. By stabilizing blood sugar, supplying the raw materials for
neurotransmission, controlling inflammation and healing the gut, it is possible for many individuals to avoid or minimize their need for medication.
The process does require education, commitment and patience. It also has the potential not just to treat mood disorders, but also prevent other disease, making it an incredibly efficient use of time and effort on the part of the clinician and the patient.
Dr. Teray Garchitorena has been practicing naturopathic medicine in Berkeley for five years, and is co-founder of the Berkeley Naturopathic Medical Group. Her programs provide integrative solutions for depression, anxiety, autoimmunity and fatigue.
2615 Ashby Avenue, Berkeley CA