Can a Whole-Foods, Plant-Based Diet Improve Depression?

tomatoes.jpg
A picture of several ripe tomatoes. Credit to flickr.com user Frédérique Voisin-Demery
. Used with permission under a Creative Commons license.

When speaking of dieting advice, Michael Pollen put it best: “Eat Food. Not too much. Mostly plants.” But not all diets are about dress size. The challenge in eating healthy is even more of a challenge when it comes to managing your mental health. I’ve already looked at How to Follow a Mediterranean Diet to Help Bipolar Depression. But what about different diets?

The whole-foods, plant-based diet (WFPBD) has gained traction in nutritional psychiatry circles in the past few years. Proponents claim that the diet can reduce the risk of or even reverse chronic diseases. But can vegetarian, vegan, or whole-foods, plant-based diets help depression?

That depends on what studies you look at. There have been a few studies that imply vegan diets can help you manage depression. But there are some other studies that imply the opposite. Few people have studied this subject, so finding answers is a lot of piecing together and guessing. The studies that have been done suffer from small sample sizes.

An oft-cited German study which examined diet and mental health in a group of about 4100 subjects said that vegetarians were 15% more likely to suffer from depression. But the study also said that these people tended to start their vegetarian diets after already developing depression. The conclusion? Plant-based diets did not cause depression, but people who were depressed were more likely to choose a plant-based diet. This was the biggest study on the subject to my knowledge.

These results have been replicated in other studies. Another UK study found that 350 vegans/vegetarians (out of a subset of 9700 men) were more likely to be depressed than those eating meat. But the researchers caution readers that correlation is not causation; these men may have been depressed before adopting their diets.

Interestingly, research shows that plant-based diets may actually have a protective effect on mood. A small study of Seventh-day Adventists found that a vegetarian diet was associated with better moods. A second study, also small, found that moods improved when people stopped eating meat. New moms in Austria and women in Iran who ate vegetarian diets also enjoyed better moods.

Research also points to an alarming trend in meat eaters: women with a high-inflammatory diet, including red meats and processed foods, were 41% more likely to suffer from depression. Diets high in sugar have been linked to depression as well. And a recent study from the American Journal of Health Promotion found that vegan diets improved the levels of anxiety and depression in 36 participants.

This sounds scary, but plant-based diets aren’t without their problems as well. There are some good reasons that people eating a plant-based diet might be prone to depression. If you want to follow this diet, here are some limitations to be aware of: Deficiencies in omega-3 fatty acids, vitamin B12, and folate are all linked to depression, and vegans and vegetarians might eat fewer of these supplements than omnivores. A lack of iron and zinc, two minerals most easily found in meat, is also associated with depression. Additionally, vegetarians may eat more omega-6 fatty acids, which increase inflammation and are correlated with depression. People eating a plant-based diet may also consume higher levels of pesticides, provided they’re not eating organic foods.

If you eat a vegetarian diet and are suffering from depression, talk to your doctor about supplementing your diet. B12 specifically is only found in meat. According to a recent study, depression was reduced up to 50% in people who started supplementing with B6, B12, and folic acid.

Of course, it is irresponsible to say that people are depressed because of what they eat. Depression is usually a chemical imbalance in the body, especially bipolar depression, and cannot be blamed solely on what we consume. It is also important to note that while diet can improve mental health, treating depression sometimes requires medication or therapy. Seeking adequate treatment for mental health problems carries an unfortunate stigma, and it shouldn’t. There is no shame in trying to live a healthy life, where you can be the best you can be. If you feel like diet and exercise is not enough to treat your depression, then talk to your doctor.

I wish you well.

Related:

 

Show me some love!

How to Manage Common Bipolar Triggers

Bipolar disorder is worsened by triggers, or events that occur in your life that may cause mood episodes. Stressful events can be positive, like a new baby or moving to a new home, or negative, like a job loss or ending a relationship. But there are other common

trigger
A picture of a fruit-and-oat granola bar with a wrapper that reads “trigger.” Credit to flickr.com user Martin Bekkelund. Used with permission under a Creative Commons license.

bipolar triggers as well.

Here’s some of the most common bipolar triggers (advice for minimizing the impact of these triggers will follow):

Common Triggers

  • Stressful positive or negative events, such as entering a relationship or ending one.
  • Sleep disturbances. Sleep is crucial for bipolar patients to maintain a healthy mood. A lack of a good night’s rest can contribute to manic or hypomanic episodes, and increases in sleep may increase the risk of depression. Jet lag or a new baby can cause people to miss out on their forty winks.
  • Overstimulation from external sources, such as clutter, chaos, or crowds.
  • Overstimulation from sources directly affecting the person, such as stimulants like caffeine or stimulants/depressants like nicotine, or excitement from achieving challenging goa
  • Substance abuse.
  • Unresolved conflict with others. Dealing with others can be stressful, especially if someone is angry at you and you don’t know why, or don’t know how to resolve the conflict.
  • Untreated or unmanaged illness, mental or physical.

These triggers are stressful for anyone regardless of the state of their mental health. But these events and issues are especially stressful for bipolar patients.

Here are some ways to minimize the effect of common bipolar triggers:

Minimizing the Effects of Triggers

  • Take prescribed medications and therapies for your bipolar disorder. Treating and managing your mental illness is incredibly important. Attend therapy sessions and take your meds to prevent relapse and hospitalizations. For a post on how to survive a stint in a mental hospital, click here.
  • Sleep regularly. Try to keep to a self-care routine. Take a nightly bath before bed, and stick to a regular bedtime. For advice on how specifically to get sleep with a baby, click here.
  • Maintain a basic routine. Keeping to a regular routine will help you better cope with stress, and hopefully prevent life events from impacting you poorly. Maintaining a schedule with kids is one of the best parenting strategies you can do for them. This will also help you sleep better.
  • Exercise. Working out can improve your mood and overall physical and mental health. You may also sleep better, and suffer less anxiety. For a post on how to exercise with a baby or toddler, click here.
  • Reduce stimulation. Learn how to cope with stress by attending therapy or reading self-help books. Set up quiet times between social engagements. Set realistic goals that won’t take too much out of you.
  • Eat a healthy diet. Like sleep, diet is crucial for maintaining a healthy mood in bipolar patients. Sugar harms your mental health. For a post on how to follow a Mediterranean diet to help manage your mental illnesses, click here.
  • Reduce reliance on substances, such as caffeine, alcohol, nicotine, or street drugs. Quitting an addiction is one of the hardest issues you’ll ever face. But your life will be better off.
  • Listen carefully to others. Resolving conflicts is sometimes difficult. But if you don’t resolve the problems, then they will eat at you. Listen to other people intentionally. Try not to think about what you’re going to say while they are talking. This makes people feel listened to and appreciated in your company. Keep in mind that this probably won’t resolve the issue on its own, but it will go a long, long way towards open communication.

The Bottom Line

Managing these common triggers is key to helping yourself maintain good mental health. If you find yourself being triggered by stressful events, then find a way to step back from your responsibilities, if just for a brief time.

Good luck!

Related:

Show me some love!

Bipolar Disorder Medication and Weight Gain

After a recent post, a commenter asked me what medications that are used to treat bipolar disorder also cause weight gain.

The short and unfortunate answer? Most of them. (See the chart below for a quick take.)

The more complicated answer involves looking at genetic predispositions, because gaining weight is highly individualized. Whether your treatment for bipolar disorder will cause you to gain weight depends heavily on the type of medication you take and how it interacts with your body. For example, the size of your thighs may

pills
A picture of yellow and pink pills. Credit to flickr.com user DraconianRain. Used with permission under a Creative Commons lig

grow while on one drug, but not on another, even if the second drug is associated with weight gain in other people.

The medications that are used to treat bipolar disorder are mood stabilizers, antidepressants, antipsychotics, and antidepressant-antipsychotics. Some of these medications are also anticonvulsants.

No one knows for sure why these medications cause weight gain. Research is still being done on these pills. However, scientists suspect that antidepressants and antipsychotics may trigger food cravings and increase the appetite. The drugs may also slow your metabolism, increase blood sugar, and cause diabetes-like symptoms. The mood stabilizer lithium is also likely to destroy your thyroid, which is part of the reason psychiatrists monitor blood draws every three months or so.

So which drugs are associated with weight gain, and which ones aren’t? Let’s dig in.

Mood Stabilizers

A mood stabilizer is just that: a medication used to steady your mood. These medications help manage the extreme highs of mania and extreme lows of depression. A mood stabilizer also prevents the reoccurrence of these manic and depressive episodes. Gains of 20 to 35 pounds are not uncommon when taking these drugs, especially lithium.

According to the Mayo Clinic, mood stabilizers are the most likely culprits when it comes to packing on the pounds, even more than other drugs like antidepressants. You will probably gain weight on them. Lithium, valproic acid (Depakene), divalproex sodium (Depakote), and carbamazepine (Tegretol) all may increase the risk of weight gain.

However, there is a drug that doesn’t cause weight gain in most patients: Lamotrigine, also known as Lamictal.

Antipsychotics

Antipsychotics are another class of medications that treat bipolar disorder, preventing psychotic symptoms like hallucinations and delusions. Antipsychotics that are associated with weight gain include olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), and asenapine (Saphris).

Antipsychotics that are less likely to cause weight gain are cariprazine (Vraylar), lurasidone (Latuda), ziprasidone (Geodon), and aripiprazole (Abilify). Whether these latter medications make you gain weight is highly dependent on the individual person, though these are associated with less weight gain than the others.

Antidepressants

Antidepressants are medications used to treat depression, both in bipolar patients and people with other forms of depression.

Antidepressants like tricyclics–like Elavil and Tofranil–and monoamine oxidase inhibitors (MAOIs)–like Parnate and Nardil–tend to cause patients to gain weight with both long-term and short-term use.

Other antidepressant medications may also have weight gain as a side effect. Selective serotonin reuptake inhibitors (SSRIs) are a class of medications that affect the brain’s ability to process serotonin, a feel-good chemical. Escitalopram (Lexapro), paroxetine (Paxil), fluoxetine (Prozac), and sertraline (Zoloft) are all members of this class that increase the risk of weight gain. These SSRIs are the most risky antidepressants when it comes to weight gain, and patients report gaining more on them than on other antidepressants.

The antidepressants venlafaxine (Effexor) and nefazodone (Serzone) are associated with the least weight gain, whereas bupropion (Wellbutrin) is actually associated with weight loss.

Antidepressant-antipsychotic

Antidepressant-antipsychotic combination medications both treat depression and stabilize moods. The medication Symbyax combines the antidepressant fluoxetine (Prosac) and the antipsychotic olanzapine and is associated with weight gain. Another combination medication, perphenazine/amitriptyline, also lists weight gain as a side effect. There are no weight-neutral combination medications.

The Bottom Line

Weight gain from bipolar medication use is a very common problem. Many of these drugs cause weight gain. As many as 25 percent of people report gaining some weight on antidepressants, and some people gain up to 100 pounds or more. I personally gained over 70 pounds on a combination of lithium and Depakote over a period of three-to-five years, weight which I have yet to shed.

But I still think that taking my medication was worth the weight gained. As I told my psychiatrist in the mental hospital when I was separated from my newborn, I didn’t mind gaining a few pounds if I could just get my sanity back and be reunited with my baby. While I gained more than I thought I would–and the weight has been stubborn to remove–I would still choose the medication if I had to make the decision over again. Lithium saved my life; Depakote saved my sanity. Gaining weight was an unfortunate side effect, but one as worth it by all means.

We take these drugs because we need to, not because we want to.

If you’re distressed about this side effect, talk to your doctors about the risk of weight gain associated with the medications you’re taking. Your doctor might consider changing the dosage amount or the medication you’re taking. Lifestyle changes might also help, though that’s less likely. Still, try to get some exercise to see if it helps. (For a post on how to work out with kids, click here.) And, of course, eat a healthy diet, which has many more benefits than managing your waistline.

Good luck!

medications and weight gain chart
Credit to Cassandra Stout of The Bipolar Parent. Protected under a Creative Commons license. Please ask permission before using.
Show me some love!

How to Work Out with a 40-pound Parasite Clinging to Your Leg

Or, to be more politically correct, “How to Exercise with Kids.”

As we’ve discussed in our previous post, exercise is one of the best activities you can do for your body and mind–especially if you have a mood disorder.  But parents often lack the time to tend to themselves. Between shuttling their children off to school, cleaning up potty-training accidents, and managing their own health care, exercise easily slips through the cracks of life.

However, like shredded zucchini hidden in a brownie, you can sneak in a workout while your kids play.  Here are some ideas:

If you have five minutes: Dance with your toddlers or play the game of, “catch me, catch me!” While pushing your kid in a swing, do some quick squats. Throw a ball and try to get to it before your playmates.  You can also get a good grip on their bodies and use them as curling weights.

If you have the strength, lie down on the floor and have your kid attach himself to your legs while you hold onto his arms. Lift your legs slowly, hold for a few seconds, drop quickly—and then repeat. These have never failed to produce shrieks of laughter from my son, Ryan.

If you have ten minutes: Strap weights to your wrists and ankles, or carry two gallons of milk. Pump your arms and lift your knees when you walk around the block or jog in place. After ten minutes, take them off.  Try again for another ten minutes, later.

If you have older kids or teenagers, play soccer or a sport of their choice. Get your heart rate up as much as you can.

If you have thirty minutes: If your kids still nap, try to squeeze in some exercise along with everything else you do during that “free” time. Hustle when you do chores or gardening. In addition to powerwalking between errands or running up and down stairs, you may be able to devote some time to a short yoga or aerobics video.

You can also purchase a jogging stroller, but watch out—these are inordinately expensive. But, as useful as the $20 umbrella strollers are for navigating through airports, they won’t cut it for intense exercises like running.

If you have an hour: Wow, lucky you! If you’re in this position, swimming is a great low-impact exercise, but if you’re looking to really sweat and can afford it, try a dance class or possibly martial arts. I’d highly recommend finding a suitable YMCA—with childcare available. Even if you never plan to use it, knowing that someone can watch your children during your workout in case your other arrangements fall apart is a relief.

Don’t be discouraged if you have physical disabilities! There are many braces, props, and specialized classes available to assist you. Yoga classes are especially accommodating. Swimming is easiest on the joints and can serve as a wonderful substitute for those who cannot lift weights. Team sports such as baseball leagues for the blind and basketball for persons in wheelchairs burn calories while building camaraderie, but there are solo sports like skiing available as well.

Best of luck in pursuing the best workout for you!

Not meant to take the place of a treatment plan created with licensed professionals.

Show me some love!