By: Austin Perlmutter, M.D.
Depression is a global epidemic, a leading cause of disability that affects over 300 million people worldwide. Unfortunately, rates of diagnosed depression are continuing to rise in the United States, especially in our youth. When these disheartening statistics are combined with the relatively poor efficacy of our antidepressant medications, it becomes increasingly important to ask whether there may be non-pharmaceutical methods of treating this crippling condition. In recent years, scientific research has increasingly answered “yes.”
In the past (and even today), depression has been explained as a simple neurotransmitter deficiency. This is why and how the conventional treatment for depression, drugs called selective serotonin reuptake inhibitors (commonly known as SSRIs), is thought to work. The putative mechanism of these drugs is that they increase the neurotransmitter serotonin in the brain, resolving deficiency, improving mood, and alleviating depression. However, if it were this straightforward, we’d expect a much better response rate from these drugs.
Searching for a more comprehensive understanding of how to improve treatment for depression, researchers have examined practices like yoga, meditation, and exercise, affirmatively finding (rather unsurprisingly) that these activities improve mood. But perhaps most interesting is the recent science showing us the connection between the food we consume and the state of our mental health.
Even at a brief glance, this link makes practical sense. Our foods determine the makeup of our brains, and our brains determine our thoughts and actions, so of course our foods should influence our mood. And yet, it’s taken a long time for scientific research to catch up with this line of reasoning. This is why it’s so empowering to see research coming from top-level institutions on how to use food to help treat depression. An excellent example of this concept is the study, published in 2018 by Dr. Laura LaChance from the University of Toronto and Dr. Drew Ramsey from Columbia University.
The goal of this research was to find which foods had the highest density of the nutrients shown to prevent and reduce the symptoms of depression. The two authors reviewed hundreds of research publications and ranked the top foods using a novel “Antidepressant Food Score.”
Their research is synthesized into an easy to follow chart (reproduced below) of antidepressant foods. This helpful graphic notes that of animal foods, oysters and organ meats may be among the most beneficial for preventing and treating depression, while watercress and spinach claim the top spots in both the plant-based category and overall. The authors also call attention to the fact that intake of many of the most important antidepressant nutrients (like B12 and omega-3 fatty acids) may be inadequate in purely “plant-based diets,” though it’s worth noting that these can easily be obtained in supplement form.
This publication is an important step forward, providing an easily accessible framework for applying nutritional psychiatry to improve our mental health. When considering how to apply this research to your life, remember that the scientists reviewed the listed foods specifically for antidepressant effect, not the effect on overall health. For example, though tuna may have a high antidepressant score, it nevertheless contains high levels of mercury. If you decide to increase your intake of the foods on the antidepressant table, consider starting with some of the top plant foods like watercress and spinach, as there’s certainly plenty of evidence to support the benefit of these foods outside this study as well.
Finally, while we’re actively discovering the impact of diet on mood, there are already several probable mechanisms for this connection. These include the way diet modulates our immune system, changes our level of systemic inflammation and alters our microbiome. The specifics of exactly how this plays out in the body will no doubt be a topic of ongoing investigation in the coming years. And as we continue to learn about the fascinating world of nutritional psychiatry, there’s no reason not to use your fork to help better your mental health today.
If you want to continue learning about the fascinating connections between diet and mood, be sure to check out our upcoming book, Brain Wash (Jan 2020).