This past semester, I took a course called Mood Disorders where we explored all facets of Depression. Honestly, I have never learned more in a college class than I learned in this one. I can only imagine what it’s like living with a disease that is so crushing and that doctors don’t have answers for.
I believe in holistic health and wellness. In my term paper I wanted to explore how nutrition can play a role in the treatment of depression.
As a disclaimer, I DO NOT think simply modifying the diet can “cure” depression. Depression is an incredibly complex disease, not to be taken lightly. I do believe there is efficacy in nutritional therapy for the treatment and prevention of depression. This will be a two part series.
“Let food be thy medicine and medicine be thy food.” – Hippocrates
The father of modern medicine was on to something by making this statement. Hippocrates believed that mental illness was cause by imbalanced bodily fluid. He believed melancholia, or what we now call depression, was cause by too much black bile. To treat it, he utilized blood-letting, bathing, exercise and diet. We all know that good nutrition correlates to a healthy body. I firmly believe that nutrition also plays a critical role in mental health and that there could be efficacy in using nutritional therapy in the treatment of depression.
Referencing a Greek philosopher in the context of treating modern day depression may seem rudimentary. However, the fact that 2500 years later, depression is the leading cause of disability, with more than 300 million people living with the disease worldwide (WHO, 2017) suggests that we have not made all that much progress in terms of finding a treatment for depression.
What is Depression?
After taking the Mood Disorders course, I have learned that depression is an incredibly insidious disease, and it is a disease that as a medical and psychological community, we still know very little about. We have hypotheses but, there are no concrete answers as to how to go about preventing and treating the disease. There are so many variables that could be involved in the etiology of depression.
Some biological theories of the disease include abnormalities in genes, hormones and neurochemicals such as serotonin, norepinephrine and dopamine. There are theories that too much, too little or even variations of any given neurochemical cause depression. There is also a theory that prolonged hypercortisolism due to stress impairs the HPA system leading to decreased hippocampal volume which is seen in depressed patients. Then again, it is also unclear if some people are born with a smaller hippocampus and leads to depression.
As you can see, there are multiple conflicting theories in the realm of biology (and I only mentioned a few theories and causal factors) on causal factors of depression. Depression becomes even more complex when looking at psychological causal factors. There are multiple cognitive vulnerabilities associated with depression such as the helplessness and hopelessness theories, which are associated with a negative attribution styles. Behaviorally, excessive negative affect and neuroticism link to depression. There are theories on stressful life events causing depression. Interpersonal factors such as low social support may also help to promote and maintain depression.
Effectiveness of treatments for depression is another area full of unknowns. Medication and therapy are the two most popular treatment options. There are no guarantees that any one medication will work for an individual, and deciding which medication to prescribe is essentially an educated guess by the physician. In most cases, a patient will go through multiple medications to find one that works for them. I also firmly believe that medication should not be used as a stand-alone treatment. They must always be coupled with talk therapy of some type.
Studies show that cognitive behavioral therapy is effective in preventing relapses after the patient discontinues drug therapy (Fava et al, 1998). Medication may treat the symptoms of depression, but therapy addresses the root of the disease and therefor can be effective in sustaining recovery. Taking antidepressants is like taking pain medication when you have a broken bone. It will not fix the break, but it will relieve the pain until you can go to the doctor the get the bone set- like going to therapy. If the bone is not set, it will definitely cause problems down the road. If someone forgoes therapy and chooses to only take antidepressants, the likelihood that they will relapse is very high.
Food as Medicine
I believe that nutrition can play a key role in preventing depression and aid in the treatment of those currently diagnosed with the disease. As I have stated, the prevalence of depression is extremely high. As of 2014, in the United States, 15.7 million adults had experienced one or more major depressive episodes within the past year (ADAA,2016). These statistics imply that the current treatment options are not effective for all cases of the disease.
For this reason, I believe we need to be looking beyond antidepressants and therapy for treatment and prevention of depression. We need to look deeper into the neurobiology of the disease and come up with alternative treatment options. It is well established that poor nutrition leads to a multitude of physical ailments. It only makes sense that diet also plays a critical role in mental health. I would like to address the role of nutrition in the treatment and prevention of depression.
ADAA. (n.d.). Depression. Retrieved April 12, 2017, from https://www.adaa.org/understanding-anxiety/depression
Fava, G.A., Rafanelli, C., Grandi, S., Conti, S., & Belluardo, P. (1998). Prevention of recurrent depression with cognitive behavioral therapy. Archives of General Psychiatry, 55, 816-820.
Part two coming soon. Please feel free to share your thoughts in the comments.
Linking up with Amanda at Running With Spoons for Thinking Out Loud