Depression and Lifestyle

Evidence-based lifestyle modifications for depression

Michelle Blum, who practices Acupuncture and Naturopathy in Brisbane's south, lists some evidence-based lifestyle modifications that can improve outcomes for depression.

Depression is now considered the second leading cause of years of life lost to disability (YLD), trailing just behind cardiovascular disease [1]. It is highly likely that either you experience depression personally, or are close to someone who does. As rates of depression rise, the ripple effect expands outwards from the individual to the families, friends, social and medical systems that support those affected.

Whilst depression can have various underlying causes, the influence of diet and lifestyle on mood is undeniable. Fortunately, we have the scientific evidence to back this up.

An anti-inflammatory, Mediterranean style diet improves depression scores

An interesting link between depression and cardiovascular disease is that systemic inflammation has been identified as both a risk factor and an exacerbating factor driving their development [2].

A 2017 trial wherein participants adopted a Mediterranean style diet in addition to omega-3 fatty acid supplementation demonstrated positive results for depression at both the three and six-month mark [3]. Indeed, 60% of participants reported experiencing less severe depression, 72% experienced less anxiety and 69% experienced less stress after following a Mediterranean style diet. Importantly, there was also an emphasis on the social and lifestyle elements that feature in a Mediterranean lifestyle – those participants who cooked and ate together reported improvements in other measures of mental health as well [3].

Does chocolate make you happier?

Wouldn’t it be nice? Chocolate has long been proclaimed as being able to increase levels of the ‘happy hormone’ serotonin. Further research is required to establish a causal mechanism, however, psychoactive compounds found in
chocolate may induce feelings of euphoria by acting upon the endocannabinoid system4. A study that was based on a survey of over 13 000 people found that those who did not consume any dark chocolate were more likely to experience depression than those who regularly consumed dark chocolate [4]. So for now, the link between chocolate consumption and reduced rates of depression is one of association, rather than one of causation.

Vitamin D supplementation in depression

Deficient levels of vitamin D are a frequent finding in depression sufferers. To validate her positive observations of vitamin D supplementation in depressed patients, Marissa Flaherty MD, conducted a review of the scientific evidence. An analysis of five clinical trials confirmed that vitamin D supplementation does lead to improvements in depression. One trial showed that vitamin D in combination with fluoxetine yielded better results for patients than fluoxetine alone, meaning that vitamin D can be administered alongside conventional pharmaceutical treatment [5]. Getting sunshine in addition to having your vitamin D levels checked could make a significant difference!

Meditation and mindfulness – powerful tools for managing depression

Those with regular mindfulness or meditation practice will not need any convincing when it comes to the benefits of these techniques. There is a reason such practices have persisted for thousands of years - now there is modern-day evidence to prove why. Most of the population will experience a mild depressive episode at some point, with a percentage of people going on to develop major depression [6].

For many patients, treatment with anti-depressant medications does not lead to complete remission. Recently, a study found that when combined with usual depression care, online mindfulness-based cognitive behaviour therapy had better outcomes for patients compared to usual depression care alone [7].  The study found that patients were less likely to relapse if they were also provided with web-based ‘Mindfulness Mood Balance’. The same group also experienced reduced levels of anxiety, more frequent depression-free days and better mental functioning [7].

An earlier trial of people with sub-threshold depression (who didn’t quite meet the diagnostic criteria for clinical depression) was provided with behavioural activation mindfulness treatment (BAM) for 12 months. They received training in mindfulness, body scanning, lifestyle planning and walking meditation in addition to guided meditation tapes for home practice.  Another group who received only usual care, without the mindfulness treatment were also studied as a comparison. At the end of the trial, the BAM group were less likely to have developed major depression
(10.8% compared to 26.8%) and reported slightly higher improvements to depressive symptoms [6].

The best part?

These research-backed lifestyle modifications are of low cost and can be safely implemented for many people who experience chronic depression. They also provide a solid foundation for wellness and disease prevention in those without a mental health condition.

If you or someone you know is suffering from depression and would like to discuss some natural options please do not hesitate to contact Michelle Blum Natural Health here.

Reference List:

1.       Mendis S, Armstrong T, Bettcher D, et al. Global Status Report on Noncommunicable Diseases 2014. World Health Organisation.; 2014. doi:ISBN 9789241564854

2.       Dowlati Y, Herrmann N, Swardfager W, et al. A Meta-Analysis of Cytokines in Major Depression. Biol Psychiatry. 2010. doi:10.1016/j.biopsych.2009.09.033

3.       Parletta N, Zarnowiecki D, Cho J, et al. A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression: A randomized controlled trial (HELFIMED). Nutr Neurosci. 2019.
doi:10.1080/1028415X.2017.1411320

4.       Jackson SE, Smith L, Firth J, et al. Is there a relationship between chocolate consumption and symptoms of depression? A cross-sectional survey of 13,626 US adults. Depress Anxiety. 2019. doi:10.1002/da.22950

5.       Khoraminya N, Tehrani-Doost M, Jazayeri S, Hosseini A, Djazayery A. Therapeutic effects of vitamin D as adjunctive therapy to fluoxetine in patients with major depressive disorder. Aust N Z J Psychiatry. 2013. doi:10.1177/0004867412465022

6.       Wong SYS, Sun YY, Chan ATY, et al. Treating subthreshold depression in primary care: A randomized controlled trial of behavioural activation with mindfulness. Ann Fam Med. 2018. doi:10.1370/afm.2206

7.       Segal Z V., Dimidjian S, Beck A, et al. Outcomes of Online Mindfulness-Based Cognitive Therapy for Patients with Residual Depressive Symptoms: A Randomized Clinical Trial. JAMA Psychiatry. 2020. doi:10.1001/jamapsychiatry.2019.4693