A 15-year-old Ellie* began feeling down much of the time, she ate less, and went through some big struggles with food and feelings. “I think food affects mood, concentration and relationships tremendously,” she says. “Eating too little drained me. Everything looked black and white. I was never fully in a moment and always felt very disconnected. I think food played a key role in stabilizing my mood and pulling me out of depression. Once I started eating to feed my brain and the rest of my body, I had all these new and creative ideas for art and music that I didn’t have before. It was amazing. I still notice my mood drop dramatically if I forget to eat breakfast or don’t have enough food throughout the day. It is crazy how important nutrition is.”
According to the American Psychiatric Association (APA), depression is a serious condition characterized by sadness, loss of interest in activities previously enjoyed, changes in appetite and sleep, challenges with focus and concentration, and can lead to suicidal thoughts. Depression is one of many different, but sometimes related, mental illnesses that are common and treatable with the right help. No one should feel shamed or embarrassed if he/she is struggling with depression. You would get medical help if you had a broken leg, and mental illness is no different. Nutrition is just one of many tools in the mental care toolbox, and it’s important to find what works for you.
We all know that we get “hangry” when we go for too long without eating. Skipping meals and snacks, however, has been shown to decrease mood, increase anxiety and can contribute to a downward spiral toward depression. When someone feels depressed, it can feel overwhelming to muster the energy to meal plan and shop for food. While working toward treatment, stock up on easy to prepare frozen meals, healthy packaged foods, high protein/high fiber bean-flour noodles that only take five to eight minutes to heat, and pre-cut/pre-washed fruits and vegetables. There are many food delivery services out there like Instacart, Amazon Prime Pantry and the budget friendly Thrive Market.
Twenty-six-year-old Addie* used to try to restrict food intake during the day, and then by the evening she was starving. “Food can definitely affect my mood,” she shares. “If it has been several hours since I have eaten, I am irritable, sluggish, and I tend to have a more negative outlook on life. Fruits and vegetables are what make me feel most alive. And by that, I mean they make me feel full of energy, vibrant and not weighed down. Fresh, ripe fruit always elevates my mood.” Addie went down a difficult road of restricting and then binging in the evenings. This set her up for feeling guilty and depressed every evening, which led to a vicious cycle. Break the cycle by recognizing that the body needs nourishment. Eating frequently has clearly been shown to manage mood, cravings and stress.
Ellie and Addie worked to eat smaller, more frequent meals throughout the day. This wasn’t easy at first, but overtime it got better, and they were able to use food to help them feel better about life.
Depression and Nutrient Deficiencies
Low levels of vitamin B-12 have been associated with depression and impaired neurological function5,6. Low levels of folate, B-6, and the omega-3 fatty acids DHA and EPA are also linked with impaired mood, concentration, attention and increased rates of depression. Some people have a genetic anomaly that makes it difficult for the body to convert B-12, folate and B-6 to their active forms that the body can use. This is actually somewhat common, so taking the active or “methyl” form makes the vitamin more bioavailable to the body for these people. Healthy fats make for healthy brains. Flax, hemp, pumpkin, chia, sunflower seeds, avocados, nuts, olive oil, sunflower seed oil and fish oil all support brain function. We have known for years that a healthy gastrointestinal tract supports immune function, but we now have a deeper understanding of how it affects our brain, too. Healthy gut-flora and beneficial microorganisms are key. Taking a probiotic, eating fermented foods, yogurt and lots of fiber does affect the brain, mood and mental health.
Gluten is a naturally occurring protein found in wheat, barley and rye. According to Dr. Alessio Fasano MD of Massachusetts General Hospital Division of Pediatric Gastroenterology and Nutrition, in a small percentage of sensitive individuals, gluten can potentially increase anxiety, depression behavior problems and mental fog2,3. Exposure to gluten and its effects on mood and depression is well established in celiac patients. Even in non-celiac patients, however, there are individuals who may experience neuro-psychiatric disorders upon consuming gluten2,3,4. For some people, gluten creates an immune response that creates systemic inflammation that travels to and affects the brain. Not everyone is sensitive to gluten and going “gluten-free” is not necessary for everyone. Eliminating all wheat, barley and rye restricts the availability of foods that have B-vitamins, fiber, zinc and energy-producing carbohydrates. Therefore, talk with a dietitian if you want to try a gluten-free challenge to make sure nutritional needs are met and you’re not exacerbating any nutritional deficiencies.
#1. Reach out for help. Depression is a serious illness, and there are many different treatments available.
#2. Eat regularly scheduled meals and snacks throughout the day. Going for too long without eating affects mood, concentration and perceived stress.
#3. It’s important to eat at least something, but grabbing refined, processed foods and high sugar foods may make depression worse. Make it easy and convenient to grab fruit, carrot sticks, sweet peppers, whole grain crackers, oat rolls/energy bites, soy or coconut yogurt, granola, trail mix with nuts and seeds, even some rolled oats in almond milk with a sprinkle of hemp seeds. If comfort foods help, try pasta, mashed potatoes, sweet potato fries or easy to re-heat frozen meals.
#4. Talk to a registered dietitian if you’re considering going gluten-free if you have food allergies or food challenges or have nutrient deficiencies that could be affecting your mood or depression.
#5. Supplement with probiotics, Omega 3s (EPA & DHA), and take a multi-vitamin supplement with methyl-folate, methyl-B12, B-6, vitamin E and vitamin D3.
*All quotes are from real dancers; however, names have been changed for privacy.
By Emily C. Harrison MS, RD, LD of Dancer Nutrition.
Emily Cook Harrison MS, RDN, LD
Emily is a registered dietitian and holds both a bachelor’s and master’s degree in nutrition from Georgia State University. Her master’s thesis research was on elite level ballet dancers and nutrition and she has experience providing nutrition services for weight management, sports nutrition, disordered eating, disease prevention, and food allergies. Emily was a professional dancer for eleven years with the Atlanta Ballet and several other companies. She is a dance educator and the mother of two young children. She now runs the Centre for Dance Nutrition and Healthy Lifestyles. She can be reached at firstname.lastname@example.org
- Ansari WE, Adetunji H, Oskrochi R. Food and Mental Health: relationship between food and perceived stress and depressive symptoms among university students in the united kingdom. Cent Eur J Public Health 2014; 22 (2): 90-97.
- Fasano A. A Clinical Guide to Gluten-Related Disorders. Wolters Kluwer/ Lippincott Williams & Wilkins 2014.
- Fasano A. Gluten Freedom. John Wiley & Sons Canada Ltd. 2014.
- Casella G, et al. Mood disorders and non-celiac gluten sensitivity. Minerva Gastroenterologica E Dietologica: a journal of gastroenterology, nutrition and dietetics. March;63(1):32-7. 2017.
- Karakula H, et al. Does diet affect our mood? The significance of folic acid and homocysteine. Pol Merkur Lekarski. 2009 Feb;26(152):136-41.
- Coppen A, Bolander-Gouaille C. Treatment of depression: time to consider folic acid and vitamin B12.