Depression is a multifaceted disorder with often many contributing factors in its development and course.

The mental and physical symptoms experienced may be very different between individuals. It is, therefore, unrealizable that all people be given the same diagnosis and same treatment plan, often with antidepressants being the only option offered.

Depression is a symptom with many causes. Effective treatment relies on uncovering these root causes. I, firmly, believe that we need to reframe how we think of mental health as rather an issue of brain health. The main objective in naturopathic medicine is to determine and address underlying biological/biochemical causes of depression.

It is completely normal, even healthy to feel sad at times, as life naturally has its ups and downs. In fact, our ability to fully experience our emotions is imperative to letting them go and processing the world around us. However, when these feelings of depression persist and begin to negatively affect our functioning and relationships, it is okay to seek help.

Despite that fact that depression is one of the most common mood disorders, the stigma surrounding mental health is still very much real and prevents up to one half of those suffering with the condition to seek help and thus suffer in silence. It is a condition that is often mismanaged due to a lack of understanding in depression pathophysiology.

Addressing the underlying causes of depression can often reduce or eliminate the need for medications that treat this condition.

Nutritional Deficiencies

Researchers are concluding that the diets of people with brain health disorders are lacking key nutrients for healthy brain functioning. The standard North American diet is laden with pro-inflammatory, allergenic foods full of artificial chemicals that are damaging to the brain and increase our risk of many mental health conditions, including depression. The major offenders are highly processed foods, trans fats, high glycemic foods (quickly spike blood sugar levels), low fiber, artificial sweeteners and food coloring, animal products raised with hormones & antibiotics, and GMO & glyphosate grown crops (corn, wheat, soy).

The most common nutrient deficiencies seen today are B12, iron, vitamin D, and protein. Here’s how they impact mood:

Vitamin B12 is primarily found in animal products, so vegans and vegetarians are at a higher risk of deficiency. Those with gastrointestinal issues such as acid reflux taking medications are also at high risk as they are not absorbing B12 and minerals properly. B12 is necessary to make blood cells and DNA and plays a major role in our mood and neurological functioning. It does this by facilitating proper communication between cells and being a key player in the methylation cycle which produces neurotransmitters and other hormones. Low levels have been linked to decreased brain volume, cognition, and low mood.

Vitamin D deficiency is common in Canada due to our northern latitude and unfortunately is not routinely tested. Many studies have correlated low levels with depression compared to controls. One possible explanation is that the area of the brain associated with depression is also a concentrated site for vitamin D receptors. People are spending more time indoors and most using sunscreen when outside. Certain medications, older adults, people with darker skin, and gut malabsorption issues put people at high risk of deficiency. Dramatic improvement in mood, memory, and cognition has been found in a number of studies in those who’s levels were corrected. Food sources are fatty fish like salmon and tuna, eggs, and mushrooms.

Protein in adequate dietary amounts is also essential as it provide amino acids to make neurotransmitters and hormones needed for a healthy brain. Dopamine and serotonin levels may be low with insufficient protein intake. A total of nine amino acids that our bodies cannot make need to obtained through a balanced diet. Dietary sources of amino acids include lean organic meat, eggs, nut & seeds, and lentils & legumes.

Iron is one of the most common deficiencies I see in practice, particularly in women. Iron is essential for red blood cells to carry oxygen to your tissues (including your brain!) and muscles. Low iron means low oxygenation to the brain and body which translates to fatigue, weakness, and depression. Low levels have also been associated with anxiety, psychotic, and sleep disorders. Like B12, a compromised gut impacts how well people absorb iron. Women’s requirements also change during pregnancy and may need supplementation if they suffer from heavy menses. Furthermore, iron is crucial in the production of thyroid hormone which is discussed in Part 2.

Unstable Blood Sugar & Inflammation

Many of us are reaching for foods full of sugar and simple carbohydrates, which causes a rapid spike in blood sugar and stimulates the pancreas to release insulin to stabilize levels. Blood sugar levels can then drop again quickly, leading us to reach for carbs perpetuating the cycle. This rollercoaster in blood sugar levels worsens symptoms of both anxiety and depression.

Researchers have found that people who ate processed, fried, and high sugar foods had a higher risk of depression than those who ate primarily whole foods and ample fiber, fruit and vegetables. Sugar is also linked to inflammation, a proposed mechanism in depression disorders and fatigue. Increased levels of proinflammatory cytokines and C reactive protein have been found in depressed individuals and can damage parts of the brain involved in mood. Choosing low glycemic foods shows promising results for depression.

Stay tuned for Part 2 to discuss additional underlying causes of depression including hormonal factors, genetics, neurotransmitter imbalance, toxins, and gut health.

To address possible nutrient deficiencies and dietary factors affecting your mental health, book a consultation with an Integrative Naturopathic Doctor for an individualized treatment plan appropriate for you. Ready to book your appointment? Click here.

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References

1. Aeberli, I., Gerber, P. A., Hochuli, M., Kohler, S., Haile, S. R., Gouni-Berthold, I., Berthold, H. K., Spinas, G. A., & Berneis, K. (2011). Low to moderate sugar-sweetened beverage consumption impairs glucose and lipid metabolism and promotes inflammation in healthy young men: a randomized controlled trial. The American Journal of Clinical Nutrition, 94(2), 479–485. https://doi.org/10.3945/ajcn.111.013540


2. AMEN, D. A. N. I. E. L. G. (2022). End Of Mental Illness: how neuroscience is transforming psychiatry and helping prevent or... reverse mood and anxiety disorders, adhd, addictio. TYNDALE MOMENTUM.

3. Gaby, A. R. (2017). Nutritional medicine. Fritz Perlberg Publishing.

4. Hintikka, J., Tolmunen, T., Tanskanen, A., & Viinamäki, H. (2003). High vitamin B12 level and good treatment outcome may be associated in major depressive disorder. BMC Psychiatry, 3(1). https://doi.org/10.1186/1471-244x-3-17


5. Jorde, R., Sneve, M., Figenschau, Y., Svartberg, J., & Waterloo, K. (2008). Effects of vitamin D supplementation on symptoms of depression in overweight and obese subjects: randomized double blind trial. Journal of Internal Medicine, 264(6), 599–609. https://doi.org/10.1111/j.1365-2796.2008.02008.x


6. Kim, J., & Wessling-Resnick, M. (2014). Iron and mechanisms of emotional behavior. The Journal of Nutritional Biochemistry, 25(11), 1101–1107. https://doi.org/10.1016/j.jnutbio.2014.07.003


7. Lee, C.-H., & Giuliani, F. (2019). The Role of Inflammation in Depression and Fatigue. Frontiers in Immunology, 10. https://doi.org/10.3389/fimmu.2019.01696