Being depressed is more than just feeling sad sometimes, and can extend beyond situational stress. When you are depressed, there are persistent feelings like hopelessness, fatigue, changes in appetite, or apathy about daily activities such as school, work, hobbies, or relationships. Stressful life situations such as divorce, job loss, addition, loneliness, or past trauma often play a role. In some cases genetics can also contribute to a person’s susceptibility as well.
Depression is more common than you might think. Available data suggests ~280 million people in the world suffer with depression. Professional treatment such as therapy with a psychologist or psychiatrist may be necessary for recovery. We typically think of these with possible use of antidepressants as the only treatments for depression. But did you know that several lifestyle factors such as sleep, time in nature, exercise, and nutrition play a foundational role in depression?
Whether it’s steps you take on your own, or in conjunction with professional treatments, consider the nutrition component of depression to help boost your mood and well-being.
The Status Quo of Treatment for Anxiety and Depression
For depression, the go to medical options include seeing a psychologist or psychiatrist. But psychotherapy and medication are not effective treatment for as much as 60% of patients with depression (some studies say 30-40%, so that varies from study to study, but it’s a large portion). More evidence-based therapies are needed to effectively treat this problem. Nutrition and exercise are big components to our well being.
Many psychologists now acknowledge that lifestyle behaviors like exercise and nutrition are foundational to mental health, and we are seeing more research in this area where nutraceuticals have increasing evidence as augmentative therapy or even stand-alone treatment. If you are starting to enact a plan for antidepressant treatment, nutrition and exercise make a pivotal difference in how effective that plan can be.
Nutraceuticals Increasingly Recognized as Adjective or Stand Alone Treatments
The world journal of psychiatry published an article called “‘an evidence-based nutrient profiling system for depression’. This was a systematic literature review that was conducted to derive a list of ‘Antidepressant Nutrients’ from the 34 nutrients known to be essential for humans using level of evidence criteria.
12 of these were considered ‘Antidepressant Nutrients’ due to their roles in supporting brain health and showing some evidence for having an impact on mental health and playing a role in the prevention and promotion of recovery from depressive disorders. I added vitamin D to the list as low maternal concentrations have been implicated in schizophrenia risk, and deficiency is linked to increased depressive symptoms.
Nutrients in Food Linked to Mental Health:
- Omega 3 fatty acids EPA & DHA
- Vitamin A
- Vitamin C
- Vitamin D
Feeding the Furnace of Neurotransmitter Production
But first, according to Wikipedia, a neurotransmitter is “a signaling molecule secreted by a neuron to affect another cell across a synapse. The cell receiving the signal, or target cell, may be another neuron, but could also be a gland or muscle cell.” You can think of them as chemical messengers, that when in balance and sufficient quantity, support a good mood. Depression has been linked to low serotonin levels as well as alterations in other neurotransmitters.
Nutrients Involved in Neurotransmitter Production
Let’s dig into how some of these nutrients play a role in the prevention and recovery from depression. Below are two charts from Integrative Therapeutics, a clinician driven supplement company. On the left, you can see the amino acids and nutrients needs to make the neurotransmitters serotonin, dopamine, and GABA. On the right, you can see how low levels of these neurotransmitters can make you feel.
Low folate levels have been well correlated with depression in research over the past 20 years. Deficiency of folate has been linked to suicide risk, prenatal depression, obesity, and non-responders to treatment with SSRI antidepressants. When compared to the non-depressed, depressed people consume less folate, and have lower blood serum levels of folate. But low folate levels may not always be due to low consumption of food sources of folate.
Inflammation contributes to folate depletion due to an increased metabolic need.
Depression has a major inflammatory component to it, and higher levels of inflammation require higher levels of folate to deal with and process that inflammation. Obesity has been well documented to be associated with inflammation, with higher markers of inflammation in people who are overweight or obese. It can also take higher levels of folate supplementation to raise folate levels in people who are obese.
Your genes may impact folate metabolism.
Another factor is nutrigenomics. On a genetic level, some people have a reduced ability to take the folic acid processed foods are enriched with and turn it into the active form of folate. This results in an increased need for the active form of folate, which can be found in unprocessed foods listed below, or vitamins made with L-methylfolate or 5-methyltetrahydrofolate.
Humans are unable to synthesize folate, it must be acquired in the diet. Naturally occurring and metabolically active folate is found in food.
High folate foods include:
- Spinach and other leafy green vegetables
- Whole grains
But why does folate contribute to depression?
Folate is required to recycle and increase BH4 levels (Tetrahydrobiopterin) . It serves as the cofactor that methylates BH2 to BH4, so you need that methyl group which is something folic acid does not have. Folate is foods does have the methyl group. BH4 is necessary to turn tryptophan and tyrosine, two amino acids (the building blocks of protein), into their respective neurotransmitters serotonin and dopamine. So even with a SSRI (selective serotonin reuptake inhibitor) antidepressant, having optimized serotonin production would be helpful, to boost levels of serotonin.
Iron deficiency anemia is higher in people with depression, and there is a correlation with severity of depression and severity of iron deficiency. This impact on health and well being can also include cognitive changes like poor memory and decreased physical abilities. Tiredness and fatigue are characteristics of iron deficiency anemia.
Aside from these problems, iron also has a direct role in the production of 5-HTP, a precursor to serotonin. Iron is a cofactor that converts tryptophan to 5 hydroxytryptophan. Checking serum iron and ferritin levels can help assess if low iron is impacting serotonin production.
B3: Niacin and B6: Pyridoxine or P5P
These B-vitamins are also involved as neurotransmitter precursors. Supplementing with these in addition to tryptophan effectively decreased depression symptoms young adults with mild depressive symptoms. And, a clinical trial of B6 in women with premenstrual syndrome found 80 mg of pyridoxine taken daily over the course of three menstrual cycles found significantly improved moodiness, irritability, forgetfulness, bloating, and, anxiety. These effects were attributed to the role of B6 as a cofactor in neurotransmitter biosynthesis.
The active form of B6 is P5P or Pyridoxal-5-Phosphate. Niacinamide is the active form of niacin. If buying a multivitamin or B-complex, look for these forms along with the active form of folate for the most effective supplement. People who are dependent on alcohol, people with with autoimmune disorders, and those with impaired kidney function are at higher risk of deficiency or insufficiency of B-vitamins.
Food Sources of B6:
|Food||Milligrams (mg) per serving||Percent DV*|
|Chickpeas, canned, 1 cup||1.1||65|
|Beef liver, pan fried, 3 ounces||0.9||53|
|Tuna, yellowfin, fresh, cooked, 3 ounces||0.9||53|
|Salmon, sockeye, cooked, 3 ounces||0.6||35|
|Chicken breast, roasted, 3 ounces||0.5||29|
|Breakfast cereals, fortified with 25% of the DV for vitamin B6||0.4||25|
|Potatoes, boiled, 1 cup||0.4||25|
|Turkey, meat only, roasted, 3 ounces||0.4||25|
|Banana, 1 medium||0.4||25|
|Marinara (spaghetti) sauce, ready to serve, 1 cup||0.4||25|
|Ground beef, patty, 85% lean, broiled, 3 ounces||0.3||18|
|Waffles, plain, ready to heat, toasted, 1 waffle0||0.3||18|
|Bulgur, cooked, 1 cup||0.2||12|
|Cottage cheese, 1% low-fat, 1 cup||0.2||12|
|Squash, winter, baked, ½ cup||0.2||12|
|Rice, white, long-grain, enriched, cooked, 1 cup||0.1||6|
|Nuts, mixed, dry-roasted, 1 ounce||0.1||6|
|Raisins, seedless, ½ cup||0.1||6|
|Onions, chopped, ½ cup||0.1||6|
|Spinach, frozen, chopped, boiled, ½ cup||0.1||6|
|Tofu, raw, firm, prepared with calcium sulfate, ½ cup||0.1||6|
|Watermelon, raw, 1 cup||0.1||6|
The U.S. Department of Agriculture’s (USDA’s) FoodData Central lists the nutrient content of many foods and provides a comprehensive list of foods containing vitamin B6 arranged by nutrient content and by food name.
Vitamin C, while also a precursor for neurotransmitter production, likely also has an impact on depression due to its ability to mitigate oxidative stress. Inflammation is a significant part of depression pathophysiology.
In a study of foods consumed by Americans (based on NHANES data among 25,895 individuals), 18,341 had completed data on vitamin C from vegetable sources, 10,700 had completed vitamin C data from fruit sources, and 8,132 were users of vitamin C supplements.
They found total vitamin C intake to be negatively associated with depression, meaning those who were getting more vitamin C had less depression.
Since vitamin C comes from fresh fruits and vegetables, it tells us diet quality may have also been better overall for those getting vitamin C regularly.
We know from other studies that those consuming unprocessed foods are less likely to be depressed than those consuming processed foods.
Choline is a precursor for acetylcholine, an important neurotransmitter synthesized by cholinergic neurons and involved in muscle control, circadian rhythm, memory, and many other neuronal functions.
By providing the necessary building blocks for acetylcholine synthesis, choline supports optimal neurotransmitter function. Sufficient levels of acetylcholine are essential for proper nerve signaling and communication between neurons. Adequate choline intake has been associated with improved cognitive function, memory, and attention.
In addition to its role in acetylcholine synthesis, choline is also involved in other aspects of brain health. It is a component of cell membranes and is important for maintaining the integrity and fluidity of these membranes. Choline is also involved in the production of phospholipids, which are essential for the formation and function of brain cells.
Good dietary sources of choline include eggs, meat, fish, poultry, dairy products, and certain plant-based foods like soybeans and cruciferous vegetables.
Eggs are considered one of the best dietary sources of choline.
In fact, eggs are one of the most concentrated sources of choline available. The choline content in eggs is primarily found in the yolk, so it’s important to consume the whole egg to obtain the full choline benefits. However, there are other foods that also provide significant amounts of choline.
Here are some other good dietary sources of choline:
- Beef liver: Beef liver is exceptionally rich in choline and provides a substantial amount per serving.
- Seafood: Fish like salmon, cod, and shrimp contain notable amounts of choline. Additionally, shellfish such as crab and scallops are good sources.
- Poultry: Chicken and turkey are good sources of choline, particularly in the dark meat and the skin.
- Dairy products: Milk, yogurt, and cheese contain choline. Whey protein, which is derived from milk, is also a source of choline.
- Legumes: Certain legumes, including chickpeas, lentils, and split peas, provide moderate amounts of choline.
- Cruciferous vegetables: Vegetables like broccoli, cauliflower, and Brussels sprouts contain choline, although in smaller quantities compared to animal-based sources.
It’s worth noting that the choline content can vary depending on factors such as the quality of animal feed and the cooking method used. For example, lightly cooking or poaching eggs may help preserve more of the choline compared to high-heat cooking methods like frying.
While eggs are an excellent source of choline, incorporating a variety of choline-rich foods into your diet can help ensure adequate intake. It is also important to consider individual dietary preferences, restrictions, and nutritional needs when selecting choline sources. If you have specific dietary concerns or restrictions, consulting a healthcare professional or registered dietitian can provide personalized guidance on meeting your choline needs.
Zinc is an essential mineral that plays a vital role in neurotransmitter production and function in the brain. It is involved in various aspects of neurotransmission, including the synthesis, release, and modulation of neurotransmitters. Here’s how zinc helps with neurotransmitter production:
- Enzyme activity: Zinc is a cofactor for several enzymes involved in neurotransmitter synthesis. For example, zinc is required for the activity of the enzyme aromatic L-amino acid decarboxylase, which converts L-DOPA to dopamine, a key neurotransmitter involved in mood regulation and movement control.
- Glutamate regulation: Zinc modulates the activity of glutamate, an excitatory neurotransmitter in the brain. It influences the release and reuptake of glutamate, thereby affecting the excitatory signaling between neurons. Proper regulation of glutamate is important for maintaining normal brain function.
- GABA function: Zinc also influences the function of gamma-aminobutyric acid (GABA), the main inhibitory neurotransmitter in the central nervous system. It enhances the binding of GABA to its receptors, increasing the inhibitory effects of GABA and promoting relaxation and calming effects.
- Neurotransmitter storage: Zinc is involved in the packaging and storage of neurotransmitters within vesicles in nerve cells. It helps maintain the integrity and stability of synaptic vesicles, ensuring proper storage and release of neurotransmitters when needed.
- Neurotransmitter receptors: Zinc can interact with neurotransmitter receptors, affecting their activity and sensitivity. It can modulate the function of receptors for neurotransmitters such as dopamine, serotonin, and norepinephrine, influencing their binding and signaling.
Maintaining adequate zinc levels is crucial for optimal neurotransmitter function. Zinc deficiency has been associated with alterations in neurotransmitter balance and can contribute to neurological disorders and mood disturbances. Conversely, adequate zinc intake supports normal neurotransmission and is important for cognitive function, mood regulation, and overall brain health.
Good dietary sources of zinc include:
- lean meats
- seafood (such as oysters, crab, and lobster)
- nuts and seeds
- whole grains
However, it’s important to note that excessive zinc intake can also have negative effects on neurotransmission, so it’s important to aim for a balanced and varied diet to ensure appropriate zinc levels.
As with any specific nutrient or mineral, individual needs may vary based on factors such as age, gender, health status, and specific dietary patterns. If you have concerns about zinc intake or its impact on neurotransmitters, consulting with a healthcare professional or registered dietitian can provide personalized advice and guidance.
Magnesium is an essential mineral that plays a crucial role in neurotransmitter production and function in the brain. It is involved in several processes related to neurotransmission. Here’s how magnesium contributes to neurotransmitter production:
- Enzyme activity: Magnesium acts as a cofactor for various enzymes involved in neurotransmitter synthesis. For instance, it is required for the activity of the enzyme tyrosine hydroxylase, which converts the amino acid tyrosine into dopamine, a key neurotransmitter involved in motivation, reward, and movement control.
- Glutamate regulation: Magnesium helps regulate the activity of the excitatory neurotransmitter glutamate. It acts as an antagonist to NMDA receptors, which are involved in synaptic plasticity and learning. By blocking excessive activation of these receptors, magnesium helps prevent excessive glutamate release and excitotoxicity.
- Calcium balance: Magnesium modulates calcium levels in neurons. Calcium influx is crucial for neurotransmitter release from synaptic vesicles. Magnesium acts as a natural calcium channel blocker, regulating calcium entry and preventing excessive calcium influx, which can disrupt neurotransmitter release.
- GABA function: Magnesium influences the function of gamma-aminobutyric acid (GABA), the main inhibitory neurotransmitter in the brain. It enhances the binding of GABA to its receptors, promoting the inhibitory effects of GABA and helping to maintain a balanced excitatory-inhibitory neurotransmitter system.
- Receptor function: Magnesium can modulate the activity and sensitivity of certain neurotransmitter receptors. For example, it influences the function of NMDA receptors, which play a crucial role in synaptic plasticity, learning, and memory.
Adequate magnesium levels are important for maintaining optimal neurotransmitter function and overall brain health. Magnesium deficiency can disrupt neurotransmitter balance and has been associated with various neurological and psychiatric disorders.
Good dietary sources of magnesium include:
- leafy green vegetables
- nuts and seeds (such as almonds, cashews, and pumpkin seeds)
- whole grains
- dark chocolate
However, individual magnesium needs may vary based on factors such as age, gender, health status, and specific dietary patterns. If you have concerns about magnesium intake or its impact on neurotransmitters, consulting with a healthcare professional or registered dietitian can provide personalized advice and guidance.
Dietary protein plays a critical role in neurotransmitter production as it provides the necessary amino acids, the building blocks of proteins, which are used in the synthesis of neurotransmitters. Neurotransmitters are chemical messengers that transmit signals between nerve cells in the brain and throughout the nervous system. Here’s how dietary protein contributes to neurotransmitter production:
- Amino acid availability: Proteins in the diet are broken down into individual amino acids during digestion. These amino acids are then absorbed into the bloodstream and can be used by the body for various functions, including neurotransmitter synthesis. Different neurotransmitters are synthesized from specific amino acids. For example, the amino acid tryptophan is used to produce serotonin, a neurotransmitter involved in mood regulation and sleep.
- Precursors for neurotransmitter synthesis: Certain amino acids serve as precursors for neurotransmitter synthesis. For instance, the amino acid tyrosine is a precursor for dopamine, norepinephrine, and epinephrine. Phenylalanine can also be converted to tyrosine. Similarly, tryptophan is converted to serotonin. Adequate intake of protein ensures sufficient availability of these precursor amino acids for neurotransmitter synthesis.
- Enzyme activation: Enzymes are involved in the conversion of amino acids into neurotransmitters. Some enzymes require specific cofactors, such as vitamins or minerals, to function properly. For example, the conversion of tryptophan to serotonin requires vitamin B6 as a cofactor. Adequate protein intake provides the necessary amino acids and supports the activation of these enzymes.
- Transport across the blood-brain barrier: The blood-brain barrier regulates the passage of molecules, including amino acids, from the bloodstream to the brain. Transporters facilitate the movement of amino acids across the blood-brain barrier, ensuring their availability for neurotransmitter synthesis. Protein-rich meals can increase the availability of amino acids in the bloodstream and enhance their transport into the brain.
It’s important to note that a balanced and varied diet that includes a variety of protein sources is necessary to provide all the essential amino acids required for neurotransmitter production.
Good dietary sources of protein include:
- lean meats
- dairy products
- nuts, and seeds
However, neurotransmitter synthesis is a complex process influenced by various factors, including the availability of other nutrients, co-factors, and overall brain health. Individual needs may vary based on factors such as age, gender, health status, and specific dietary patterns. If you have concerns about protein intake or its impact on neurotransmitter production, consulting with a healthcare professional or registered dietitian can provide personalized advice and guidance.
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