Last week I mentioned feeling extremely low / no appetite, and I was shocked at how many individuals felt the same. This isn’t entirely surprising given there’s a pretty direct highway between the gut and the brain (and the reason why SSRIs and tricyclic antidepressants, medications for anxiety/depression, are sometimes prescribed for IBS symptoms – more on that here).
I started this account with the premise that food isn’t about looking a certain way, but about feeling our best and brightest so that we can go out and do what we’re most passionate about. We’re thinking clearly and healthfully to enact our passions with verve. More about my personal food philosophy here.
But this is a far too simplistic way of looking at things, and in order to cope with anxiety and depression, be it situational, environmental, and/or neurochemical, there are so many different spheres we have to look out for. I wrote about that a bit more in this post. To recap: I like to think about generalized anxiety and depression in terms of their biological, psychological, social, spiritual, and pharmaceutical realms.
So let’s break those down today.
Starting with biological (aka food, movement, sleep, and stress control). This is the category I think about for food / nutrition. When I’m feeling sad, down, anxious, overwhelmed, insecure, nervous (aka the feelings that have entirely taken over 2020), I try to really stick to a mental health focused diet, ie one that is mindful of sugar and processed/simple carbohydrate consumption (this also means alcohol!).
I think there can be a tendency to rely on the traditional form of “comfort foods” during these times. But because these foods are laden with sugars, simple carbohydrates and processed foods in general, they often end up spiking blood sugar and disrupting the microbiome, therein making us feel worse in the long run. Much more about this comfort food paradox in this post.
Of course food plays far more than just a physical role and is intrinsically linked to emotions as well, but for the most part, when I’m feeling low, I really look to nutrition to assist. And that means nutrient dense foods that are low in sugars and processed carbohydrates, and avoiding alcohol.
During these times of emotional unrest and unease, I think about each meal as a powerful intervention to modulate mood. I’m also deeply aware of the harsh realities of food disparity in terms of nutrition and access to healthy foods. So before moving on with the post, it’s most important to do the best we can with what we have.
The general tenets:
The basic principles of a mood enhancing diet is one that’s robust with nutrient dense whole-foods, and rich in variety with fruits and vegetables, fiber, whole grains, legumes, nuts and seeds, well sourced protein, and good fatty acids. And a diet that’s mindful about the intake of: processed foods, refined sugar, refined carbohydrates, high fructose corn syrup, and trans-fatty acids. These general tenets aim to decrease overall inflammation in the body, and control large spikes in blood sugar, as these spikes can sometimes mimic the feelings of anxiety and/or depression.
(this one pan salmon is rich in healthy fats, whole foods, fibers, and vegetables, and low in sugar!)
Now let’s get into sugar just a bit more here. The average American consumes 156 pounds of added sugar per year. That’s five grocery store shelves loaded with about 30 one-pound bags of sugar each.
The key word in all of the stats is “added.” While a healthful diet contains a significant amount of naturally occurring sugar (in fruits, grains, and dairy, for example), the problem is that we’re chronically consuming much more added sugar in processed foods, generally in the rapidly absorbed form of fructose.
Sugar has shown to decrease levels of BDNF (brain-derived neurotrophic factor), and low BDNF levels have been linked to both depression and dementia. New research shows the consumption of added sugar dulls the brain’s mechanism by reducing oxytocin. When oxytocin cells in the brain are blunted by over-consumption of sugar, you stop receiving the signals of satiety, aka when you’re full and ready to be finished with a meal. Oxytocin is also known as the “love hormone,” and leading to feelings of trust, empathy, and bonding. So we definitely want more of it, not less of it.
In one study, those who ate a high-sugar diet were more likely to develop depression or anxiety than those who ate a diet lower in sugar. Overall, studies found an increased risk of depression with higher baseline consumption of added sugars, soft drinks, juices and pastries.
Blood sugar irregularity can both mimic the symptoms of anxiety but also increase inflammation and stress response in the body. High glycemic-load carbohydrates shift HPA axis toward sympathetic overactivity (the flight, flight, or freeze response) and increase in cortisol (aka increase stress!).
In order to combat blood sugar spikes, we reach for foods low in glycemic index/load, and high in fiber. The daily fiber recommendation is 30g/day. Most Americans get 10-15g/day. Meals rich in fiber have been demonstrated to reduce the inflammatory response, as well as stabilize blood sugar and prevent constipation. Just a few examples of fibrous foods include: pear, strawberry, avocado, apples, raspberries, banana, carrots, beets, broccoli, artichoke, brussels sprouts, lentils, kidney beans, split peas, chickpeas, quinoa, brown rice, oats, popcorn, almonds, chia seeds, sweet potatoes, dark chocolate.
(these banana peach oat cups are full of fiber for an easy grab and go breakfast)
Most sources of fiber are also rich in prebiotics, or the food that feeds the good bacteria in our gut and allows it to fluorish. The gut is important for so many reasons, one being the gut-brain axis “acts as a bidirectional communication between the brain and the gut.” More about gut health here.
Prebiotic foods include: jerusalem artichokes, globe artichokes, asparagus, leek, garlic, rye, dandelion, bacon tubers, burdock roots, chicory roots, dandelion roots, onions, artichokes, legumes, brassica-family vegetables, fresh beans, beetroot, rye sourdough, sunflower seeds, pumpkin seeds, LSA mix, barley, banana (dried has more than raw), wheat, chicory, salsify, burdock, yacon, honey, beer, chinese chives, maple syrup, lentils, chickpeas/hummus, green peas, lima beans, kidney beans.
Probiotics are also extremely important for gut health, as they add in more good bacteria to the intestinal tract. One study found that participants experienced decreased anxiety with supplementation of a probiotic containing Lactobacillus and Bifidobacteria. A good guide on how to find a probiotic here.
Nearly 70% of the immune system is localized in digestive tract, and 95% of serotonin (the happy hormone and the main neurotransmitter responsible for anxiety and depression medication, called SSRIs – selective serotonin re-uptake inhibitors). Emerging evidence also suggests that the serotonergic system may be under the influence of gut microbiota. Serotonin in fact is required for control of gut motility, or keeping things moving.
Foods with may help boost serotonin include: butternuts, black walnuts, english walnuts, plantain, pecans, pineapple, banana, kiwi, plums, tomatoes, avocado, dates, grapefruit.
(read all about gut health in this post)
Let’s also talk about fats. We have oh so finally moved on from the “fat is bad and makes you fat!!!” conversation that filled our commercials and dinner tables in the 70s-90s. Our brains very much so need fat. In fact, 60% of the human brain IS fat. Essential fatty acids, as messengers, are involved in the synthesis and functions of brain neurotransmitters, and in the molecules of the immune system. These messengers in turn participate in signaling cascades that can either promote neuronal injury or neuroprotection.
Fats also help with satiety and nutrient absorption. The goal is a balanced ratio of omega-3 fatty acids (anti-inflammatory) and omega-6 fatty acids (pro-inflammatory), and being extra aware and mindful of low consumption of trans fats.
- high omega-3 (EAT abundantly): salmon, flax seed, chia seeds, sardines, cod liver, walnuts, bone broth, fatty fish, pasture raised meats / eggs), avocado
- some say these fight depression and improve cognition
- high omega-6 (limit): vegetable oils, grapes oil, sunflower oil, canola oil, mayonnaise, soybean oil, safflower oil, margarine, shortening)
- trans fat (avoid): crackers, cookies, cakes, frozen pies, fast foods, margarine, vegetable shortening
- promote insulin resistance and increase risk of T2D, increase risk of colon and breast cancer, allergic disease in children, neurodegenerative diseases
(this super simple mango tuna avocado stack is made from mostly pantry staples and loaded with healthy fats!)
The timing of food is also important in regards to eating for mental health. We want to avoid constant spikes in blood sugar, so aim to eat meals every 4-6 hours. This means each meal should have enough nutrients in it to allow for satiety, ie protein, healthy fats, fibers, fruits and/or vegetables. As much as you’re realistically able, reduce the amount of simple carbs, such as cakes, cookies, and breads. Keep these as occasional eats instead of everyday staples. And finally, fiber is your fierce friend! Adequate dietary fiber helps blood sugar remain stable by slowing entrance of sugar into the blood stream.
Allowing 12 hours in between your last meal of the day and first meal of the following day can also lend a hand with digestion and gut health. An entire post dedicated to intermittent fasting research can be found here.
Finally, eating food mindfully GREATLY impacts stress and digestion. Going slow, noticing how the food tastes, paying attention to hunger cues, and having meal times be filled with enjoyment rather than stress or dread can go a very long way not only in the experience of the meal and listening to satiation signals, but also how well you’re able to digest it.
Exercise also greatly impacts anxiety and depression. Find a combination that works best for you that keeps you excited to move your body and get those endorphins flying, baby!
Also included in this category is SLEEP!!! Sleep is so, so, so important in terms of regulating symptoms of anxiety and depression. Find a routine that works for you, power down the electronics, and hop into bed for a goal of 7-9 hours/night. If you need more or less, that’s fine too. Just find a routine that works best for you.
It is absolutely inevitable that we’ll all fall on difficult times in our lives. The key is ensuring we have enough tools at our disposal to utilize them when we need them most. I have personally relied on therapy many times to sort through some very heavy feelings. I’d recommend finding a therapist BEFORE you’re in the throes of despair. That way, you’re in a good flow and rhythm and have someone to call on when you need them. How to find a therapist post is here.
I also like to put a mindfulness practice in this category. And again, this isn’t only to be used WHEN sh!t hits the fan, but far before. I like to equate this to the chair that everyone has in their house that likes to accumulate massive amounts of clothing. Maybe you only wore it once and it’s not technically dirty? Toss it on the chair! And then the items on the chair just accumulate and accumulate until everything topples right over.
A daily mindfulness practice – and this can look like many different things – is kind of the equivalent of cleaning off the chair daily. So that you can allow for space, clarity, and a little less mental congestion. I like guided meditations by HeadSpace and Prezence. I also like a deep breathing practice, like the one in this post. Sometimes I’ll even incorporate mindfulness on a walk, going without my phone and seeing if I can only focus on one single thing as I put one foot in front of the other. You could even color, read, do a puzzle, try making a list of all of your favorite sounds, smells, tastes, etc. Really anything that gets your mind to focus on one thing and one thing only.
This is a bit tough considering we’re still in social distancing from COVID-19. But human connection and feeling like we’re not alone is so important when creating your anti-anxiety plan. I’ve been scheduling distanced walks, playing board games with friends online, calling my grandparents, facetiming with friends and family, and reading a lot more. Not that reading is technically social hour LOL this is possibly the most lonely sentence I’ve ever written, but I find great solace when reading a book and feeling like the characters are going through something I’ve also gone through. You can find some of my recent book reviews here.
I would be remiss if I didn’t mention that for me, getting OFF social media greatly helps me clear my mind. While it is certainly social, a break where I am fully immersed in life and off of the internet is absolutely imperative for my own mental health.
I can’t say I’m the most spiritual person. But my sister and family members are, and many of them read Scripture every morning and/or evening. My sister says this is her form of meditation and provides her great comfort in times of sadness and distress.
There is absolutely no shame or embarrassment in needing or trying medication for mental heath. I originally typed that in all capitals, but it looked a little scary and alarming which defeats the purpose. But I just feel so strongly about this. The most important thing is finding a provider and a combination that works best for you and your health. There is no point in suffering and trying to muscle through a deep and dark bout of anxiety or depression. Sometimes trying medications can provide a little light to start feeling well enough to enact some of the above behaviors again. I personally took medication when I was in elementary school for anxiety and compulsive behaviors and it made it so that I could continue on going to school, rather than touching every doorknob before leaving and washing my hands 100 times per day. Was I on it forever? No. But it provided great relief and acted as a wonderful bridge so I could continue on with my days.
As you can see, there are SO MANY spheres that are working together simultaneously. And even just one thing being “off” can lead to a chain reaction. Personally, my eating, sleep, and social, and mindfulness spheres have been WAY off. So it’s no wonder I’ve been feeling incredibly imbalanced. But when I break it down in this way, I’m able to see clearly the things I can work on to start to feel a little better.
My advice to you and what I do for myself: literally make a check list and make sure you’re paying attention to ALL of these different things. Anxiety and depression, in my opinion, is never just one thing. It’s learning all of the different ways we need to nurture ourselves, and having a plan in place BEFORE the darkness creeps in, to make things just a bit more manageable when you notice starting to feel a bit off.
Thinking of you all. Grateful that you’re here.