Article

Preventing depression:

lessons from a mental health expert

Notes from Dr, James Greenblatt's lecture

Malnourished Minds: The Link Between Nutrition

and Depression. October 28th, 2011, Toronto

Dr. Greenblatt is An acknowledged integrative medicine expert and published author.

Neurotransmitters and depression

Neurotransmitters are brain chemicals
that help transfer signals between neurons.

Good mental health is dependant on having adequate amounts of neurotransmitters in balanced proportions to ensure healthy brain function.

Important neurotransmitters for mental
health and prevention of depression are:

1. •serotonin
   

2. •dopamine
   

3. •oxytocin
   

Serotonin (made from the amino acid tryptophan)

1. •calm, blissful
   

2. •social engagement
   

3. •sleep regulation
   

4. •appetite regulation
   

Dopamine (made from the amino acid tyrosine)

1. •alertness, attention
   

2. •feelings of enjoyment
   

3. •motivation
   

4. •pain and pleasure perception
   

Oxytocin

1. •pair bonding + connection to partner
   

2. •inhibition of anxiety
   

Neurotransmitter deficiencies and imbalances are associated with:

1. •poor diet and lack of certain nutrients
   

2. •stress
   

3. •neurotoxins – including chemicals and heavy metals
   

4. •food allergies – which lead to inflammation in the body
   

Protein and neurotransmitters

Neurotransmitters are made from the building blocks of protein – amino acids.

Sufficient quantities of protein from foods, broken down to amino acids, are needed in order to have adequate amounts of neurotransmitters.

This means people need:

1. •enough protein foods in their diets
   

2. •good digestion – so they can break protein down to amino acids
   

Many people with depression do not:

1. •eat enough quality protein
   

2. •have enough stomach acid or enzymes to digest protein properly
   

The body requires stomach acid to digest protein properly.

Stomach acid is reduced by:

1. •nutrient deficiencies
   

2. •stress
   

3. •use of antacids – which buffer stomach acid
   

Vegetarians must combine their foods properly to
ensure they are getting the proper balance of amino acids.

Young adolescent vegetarians tend to not do this, and are often deficient in protein and important amino acids.

Dr. Greenblatt: "In my experience and research, adolescent vegetarians are not a healthy group" (partially due to protein deficiency).

Folate and vitamin B12

Folate

Dr Greenblatt: Hundreds of studies show a relationship between folate deficiency and depression

Symptoms of folate deficiencies can include:

1. •depression and apathy
   

2. •poor response to anti-depressant medications – (folate can make some anti-depressant medications work better)
   

Folate is depleted by:

1. •cooking and processing of foods
   

2. •many medications
   

Food sources of folate include:

1. •dark leafy greens
   

2. •beans and peas
   

3. •sweet potatoes
   

4. •whole grains
   

Vitamin B12

Symptoms of vitamin B12 deficiency can include:

1. •fatigue
   

2. •anxiety
   

3. •feeling of panic
   

4. •Obsessive Compulsive Disorder
   

5. •depression
   

Vitamin B12 deficiency is associated with:

1. •low stomach acid production
   

2. •vegetarian and vegan diets
   

Food sources of vitamin B12 include:

1. •animal foods – meat, eggs, dairy products
   

2. •fermented soy – miso, tempeh
   

3. •spirulina and chlorella
   

Exercise and depression

"Regular exercise may work as well as medication at improving symptoms of major depresssion, researchers have found." Reuters

Research shows that exercise is BETTER than anti-depressants at addressing depression.

Essential Fatty Acids (EFAs)

Many studies show that EFAs help with depression – especially EPA and DHA.
The most effective source of EPA and DHA is fish oils.

Flax oil is useful, but not as effective because it is not efficiently converted to EPA or DHA in many people.

Dr Greenblatt recommends a minimum of 3 grams fish oil per day for addressing depression.

Gluten and depression

Gluten is a protein molecule found in grains – and in especially high quantities in wheat.

Gluten in foods can cause problems including fatigue and depression – in people who are gluten sensitive.

According to Dr. Greenblatt:

1. •gluten affects 1 person in 133
   

2. •97% of the time gluten sensitivites go undiagnosed
   

3. •sometimes the ONLY sensitivity symptom is depression
   
   
   

Cholesterol and depression

Cholesterol is made by the body and also comes from animal-based foods.

Cholesterol has many roles the body and also has important roles in the brain.

Two key roles of cholesterol in the brain:

1. •needed for serotonin to function properly
   (to feel calm blissful)
   
   

2. •needed for oxytocin to work properly
   (to feel connection to others, reduce anxiety)
   

   
Cholesterol can be reduced by:

1. •cholesterol-lowering medications
   (these should be used with caution)
   

2. •low-cholesterol diets
   

Note: low-cholesterol levels are associated with increased risk of depression and suicide1.

(1) BMJ: British Medical Journal. 1996 Sep;14:649-652.
Serum cholesterol concentration and death from suicide in men: Paris prospective study I
Mahmoud Z et al.

http://www.jstor.org/pss/29732835

Mental Health Action Steps:

1. 1.eat sufficient amounts of protein
   
   

2. 2.ensure good digestion (if you have acid reflux, gas, or bloating look at digestive enzymes and hydrochloric acid supplements)
   
   

3. 3.if you are a vegetarian or vegan ensure you are combining foods properly to ensure complete amino acids
   
   

4. 4.ensure you are eating folate- and B12-containing foods (animal products, beans and dark leafy greens, fermented foods), and supplement with B-complex vitamins
   
   

5. 5.get regular exercise – even walking just 15 minutes a day has a positive effect
   
   

6. 6.reduce gluten-containing foods, avoid them completely if you suffer from depression
   
   

7. 7.if you are taking medications to lower cholesterol monitor your cholesterol levels to ensure they do not drop too low
   

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