I recently put out a call for article topics on my social media. I got a lot of suggestions in the comments of my post, many of which I’ve added to my list. One request came through my DMs though, and it read something like this:
I have complex PTSD and depression, and sometimes dealing with those things takes all of my energy. I just try to survive and keep myself safe from harm, so eating for health at those times isn’t part of the equation. What do I do when my symptoms are more chronic than acute? How do I manage my nutrition?
While a lot of people are counting carbs and drinking $14 celery juice, there are some people who can barely live their lives…never mind nourish themselves properly. I know this firsthand, having worked with this population as a dietitian, and having experienced it firsthand with friends and loved ones.
After the happenings of the past few years, mental health diagnoses are at a critical high. According to the WHO, the prevalence of anxiety and depression has increased by 25% worldwide, and exacerbated the struggles of people with pre-existing mental health diagnoses.
This translates into a world where a lot of people out there might be struggling with their mental health. Maybe one of those people is you.
Nutrition and mental health are inextricably linked.
It can be a vicious cycle: poor mental health can often negatively impact nutrition. Poor nutrition may also negatively impact mental health.
There’s a real stigma around mental health conditions. Maybe it’s because we can’t see a mental health condition like we can see physical ailments?
Many people are still reluctant to admit that they’re on medication, or that they have a mental health diagnosis altogether. Some people don’t want to go on medication, because they believe it’s harmful or that their condition is a sign of weakness. That they just need to ‘snap out of it’ or ‘suck it up.’
The fact is that this stigma hurts people, and can even be deadly. There is no shame in having a mental health condition, or in taking medication.
I’ve been on anxiety medication for a decade now, and it has, without a doubt, added years to my life. I tell everyone about it, because if I can lessen the stigma around mental health for even one person, it’s worth it for me.
You’d take a Tylenol for a headache. You’d take insulin for diabetes. And if you have a mental health or mood disorder, medication for that is just as important. Not everyone will need medications, but if you do, please get them and take them.
There’s a lot out there about how food affects mood. Much of the research around food and mood is observational, but there does seem to be a connection in terms of how we eat, and how we feel.
All in all, it seems that a diet high in whole and minimally processed foods, good fats, and sources of vitamin B12, magnesium, folate, and iron (iron-deficiency anemia, as well as B6, B12, and zinc deficiency, can cause symptoms of depression) is your best bet to help your mood.
Vitamin D may help mood, but the research is mixed.
Omega-3 fatty acids have long been thought to have a positive impact on mood, but a 2021 study in JAMA Network on omega supplements for the prevention of depression found the opposite: some participants in the treatment group actually reported becoming depressed with the supplements (the number was small, however) and overall, the participants had no significant change in their mood.
A 2018 review of studies published in Frontiers in Physiology found that while results of omega supplementation for depression and anxiety were mixed, there does seem to be a connection between omega-3 levels in the body and mood. My issue with this review is that many of the studies were done on rodents, not people.
The SMILES Trial, published in BMC Medicine in 2017, was a 12-week randomized controlled study that looked at the effects of diet on depression.
67 subjects were randomized to either a control group, or an intervention group that ate a mediterranean-style diet (I feel it’s necessary that in this diet, there were 5-8 servings of grains a day…so not low-carb) and 7 sessions with an RD.
The groups self-reported their moods and wellbeing at the end of the study. There was a small but significant improvement in depressive symptoms in the intervention group (which also retained a lot more people through the study period than the control group did.), but no difference in feelings of wellbeing in either group.
The small sample size, coupled by the poor starting diet of participants, and the individualized RD counselling given to the intervention group may all be confounders.
AMMEND, A 2022 study published in the American Journal of Clinical Nutrition on the Mediterranean Diet and depression suggested that the Mediterranean Diet may help improve symptoms of depression. Unfortunately, this study was relatively small – 72 participants – and was only done in males between the ages of 18-24. This isn’t representative of the larger population.
The Mediterranean Diet is one that’s based on fish, vegetables, nuts, whole grains, legumes, and yogurt. A bit of wine. Not so much meat. Very few ultra-processed foods.
There is a field of study called Nutritional Psychiatry, which focuses on food and mood disordered. Drew Ramsey, M.D. is a nutritional psychiatrist and professor at Columbia University in New York. I asked him about the relationship between food and mood, and he told me this:
Dietary pattern is correlated to depression risk, and can be used to successfully augment depression treatment. Optimal mental health depends on nutrition. There is data indicating shifting to a more traditional dietary pattern like the Mediterranean Diet can prevent depression.
His statement about using diet for the prevention of depression is likely based on research, which in some groups has shown a link between depression risk and diet. A diet high in ultra-processed food, for example, is associated with a greater risk for depression; eating more flavonoid-rich foods aka fruits and vegetables, may help prevent depression.
These are observational studies, merely establishing links between diet and risk.
Still, it’s never a bad idea to lower your intake of ultra-processed foods and increase you fruit and vegetable intake. These are things I recommend to everyone, but it’s not always easy.
Notice that Dr. Ramsey used the word ‘augment,’ which indicates that he doesn’t recommend using diet alone to treat depression. Neither do I.
Dr. Ramsey also stated that he does prescribe psychiatric medications to his patients.
It’s easy to find content on social media that seems to link ingredients like sugar and gluten, to mood disorders.
I found the following graphics on Instagram, posted by a local nutritionist:
These sound legit, right? I mean, ‘neuroinflammation’ sounds science-y, and the graphics claim that there’s research behind all of this. Surely, sugar can’t be good for the brain, right?
Except, DON’T BELIEVE EVERYTHING YOU SEE ON SOCIAL MEDIA.
When I asked this person for their research to support this claim, they sent me two studies. Both studies didn’t prove correlation at. all. When I addressed this with them – saying that we don’t know if depressed people eat more sugar, or if sugar caused the depression, they became irate.
They then started to back peddle about their claim (and then blocked me).
Seems like correlation isn’t causation is a real stumbling block for some ‘experts.’
Even doctors like Mark Hyman often posts about the ‘harm’ that certain ingredients can do to our mental health. Here’s a recent post he did:
While we believe that food and mood are connected, his statistic of 50-100% is completely unfounded. Where did he get it? Nobody knows, because he doesn’t give us the citation, and won’t answer comments.
He does this often – he drops a sh*tbomb of bad information and fear tactics, then leaves the area. This practice creates fear and anxiety around food. Not okay.
My issue is not with the fact that food and mood are linked. It’s with people using fear and absolute claims to further their agenda. This can harm people.
So many companies promise that their supplements will make you happier and more relaxed.
Products like Elevacity’s SMART Coffee (read my review of it here) and Amare (read my review of Amare weight loss products here) claim to boost mood with their special proprietary formulas. So do TikTok famous Velovita Snaps (read my review of them here) and Slimroast Optimum (read my review of it here).
I’m sure pretty much every nutrition MLM has a mood-boosting claim somewhere in its supplement listings. Unfortunately, no supplement cures depression or anxiety. Many of them have little to no evidence to show that they even help.
Herbals like St. John’s Wort and other supplements like SAMe haven’t proven to be effective for depression and anxiety. There’s a lack of evidence to support using them for those purposes, but if you choose to try them, please choose a reputable brand and discuss with your pharmacist or doctor first, especially if you’re on other medications.
Adaptogens like ashwangandha may help with anxiety, and are generally safe to try.
If you are struggling to eat a varied diet, then supplementing with vitamins and minerals, in the form of a multivitamin or individual nutrients, is likely warranted. Magnesium, iron, B vitamins, calcium, and zinc are some that I’d pay special attention to.
Food and the gut.
Gut health is important, but it’s also trendy and the subject of plenty of empty claims. Case in point: optimizing the microbiome with promises of improved mood.
I’m sad to say that I’ve even see RDs jumping on this bandwagon, and it’s really disappointing. That’s because there’s no human evidence that shows a connection or mechanism between the microbiome and mood.
People who eat the Standard American Diet (read: full of ultra-processed foods) tend to have a less optimal mix of bugs in their guts. We already know that.
But here’s where it gets murky:
Do more depressed people eat ultra-processed food, causing their microbiomes to have more of certain bugs and less of others? Or is this situation actually causing their depression?
If I have to choose, I’d say the first option. Remember what I said above about the vicious cycle of eating and depression?
Sure, it can go the other way, and nobody knows for sure. So making claims like, ‘heal your microbiome to cure your depression!’ is irresponsible.
Nobody is saying that whole and minimally processed foods won’t make a difference to your gut and/or your health – it’s claims being made as fact that I take issue with.
For people with severe depression and other major mental health diagnoses, it ca be hard to even get out of bed, never mind switch their diet over to a way of eating that requires frequent grocery shops and food preparation.
If this is you, keep reading for strategies on how to manage this.
Here’s the thing: there’s such a focus in our society on eating healthy, eating ‘clean,’ (can’t stand that word), and not consuming processed foods. But to someone who is in a depressive state, who can’t barely get out of bed, let alone make themselves a meal, this can be an overwhelming way to think.
If you’re struggling, your main focus should be eating. something. that. is. all.
If the food that you can manage is physically nourishing, that’s great. But the middle of a crisis is not the time to pressure yourself into making changes to your diet.
When we don’t eat well, we can feel less than well, physically. When we feel like that, it’s sometimes tough to make better food choices. There’s a vicious circle that happens.
Some strategies for nourishing yourself when your energy is low, and you don’t feel like eating are:
Understanding and accepting that your circumstances are such that you may not meal prep, or make your lunch for work every day, and that’s okay. One of my sources told me this:
Last year when things were bad, I was buying my lunch every day from the onsite cafe. They sell four different hot meals a day and a range of sandwiches (pre-made or made to order). With the hot meals, 95% of the time, I would choose a side of veggies, rather than hot chips. I would judge myself negatively for buying my lunch every day when I should be bringing it from home. Particularly when my work friends bring their lunch from home most of the time. The guilt and self-judgement went away as I accepted that I would just buy my lunch until the end of the year. I told the friends I have lunch with that’s what I was doing (not that they cared, but I felt “less than” because they had their sh*t together to bring their lunch in and I didn’t). It was one less thing to stress about when I accepted that I would just buy my lunch.
Do your best, and drop the judgement.
Self-judgement, like my source said above, can be part of a negative cycle. Feeling bad about yourself doesn’t serve you, and may reinforce symptoms of depression. Understand that while eating well may be important, you may have other priorities right now, and that’s okay. Your best is good enough!
Use your good days to your advantage.
Some days will be better than others. When you have the energy, use it to prepare and freeze meals.
Take help where you can get it.
Do you live with people who can cook for you? Do you have friends or family that would be willing to cook for you, drop meals off, or shop for you?
If you take nothing else from this article, remember this:
Diet culture doesn’t give a sh*t about your mental health. If you’ve been prescribed medications for mental illness, and you aren’t taking them because you’re afraid you’ll gain weight, your wellbeing is far more important than a couple of pounds.
Please take your medications as prescribed.
If you’re delaying getting help for your mental health because you’re afraid that you’ll be prescribed medication that will make you gain weight, please do not wait.
I know there are a lot of food and supplement ‘natural cures’ being sold out there, but medication can be life-saving. While food is a piece of the mental health puzzle, it’s not nearly enough in most cases to alleviate the symptoms of mood disorders.
In short, there seems to be a food and mood connection, but we aren’t 100% sure how it works. A diet high in whole and minimally processed foods, good fats, and whole grains aka the Mediterranean Diet seems to be most effective in helping mood, but as always, do the best you can.