Let’s assume for the moment that my problem is not the roosters that live within wake-me-up distance. The second fundamental ingredient for depression recovery is nutrition.
If I was writing a book — say, maybe, something like a memoir about depression and grief and estrangement? — I’d spend some time wading through the science to give you lots of facts and chemistry info about how our food intake works on our brain. There’s so much data available, and some of the current research is truly fascinating.
But let’s start with the basics. First of all, the “chemical imbalance” theory of depression that we all believed back in the 20th century — ie, that you’re depressed because you don’t have enough serotonin in your brain — has been largely disproven. If our brains worked that way, then taking a pill that increased our serotonin level should help us feel better right away, but actually SSRIs (selective serotonin reuptake inhibitors, ie Zoloft, Prozac, etc.) take several weeks to work, and that’s if they work at all. For more people than not, they don’t. In fact, according to a meta-analysis of a few decades worth of research, people with depression don’t have lower levels of serotonin than people without depression, anyway. Oops. It was a theory, and it hasn’t panned out.
The current theory is that depression is caused by something going on in the hippocampus, which is an area of the brain that affects memory and learning, maybe imagining the future, maybe a whole lot more. Neuro-imaging studies (aka brain scans) of people with major depressive disorder show noticeable differences in the volume of the hippocampus between depressed people and healthy people. One two-year study reported that the hippocampus showed signs of atrophy in people with long-term depression, and concluded, “Hippocampal atrophy is associated with greater and persistent depression severity.”
I am less than delighted to know that my depression might be shrinking my brain. Of course, it’s also possible that my shrinking brain is causing my depression. Again, is it a chicken or an egg? Either way, the obvious answer is to look for ways to a) stop my hippocampus from atrophying and b) help it grow again. But wait, you say, isn’t your brain fixed? Nope, not the hippocampus. It’s one of two regions in the brain that is continually undergoing neurogenesis, ie forming new neurons. Supposedly you get 700 new neurons every day, although apparently a lot of them quickly die.
And thus we come to nutrition (and eventually exercise.) Why do those neurons die? Well, maybe because we eat crap. A typical Western diet is high in saturated fat and processed sugar. When researchers fed rats a high fat, high sugar diet, and then looked at their brain cells, they found that their neurons had fewer synapses and shorter, thinner dendrites than the rats fed a healthier diet. They also found that the rats showed markers for inflammation in their glial cells, and inflammation in the body is never a good thing. (That link is fun, fyi, because it’s the kid-friendly version of the study — significantly more readable for the layperson than the official study.) One recent study found that insulin resistance (when your cells fail to effectively absorb the glucose in your blood, resulting in higher blood sugar levels) more than doubles your chance of developing major depressive disorder.
There’s also lots of random (and sometimes questionable) evidence about nutritional deficiencies and depression: “omega-3 fatty acids, vitamin B (e.g., folate), and magnesium deficiencies” all have at least some evidence indicating possible links to depression. Bi-polar disorder has also been linked to Vitamin C deficiencies and anemia.
So what you should you eat if you want to protect your hippocampus and fight your depression? The obvious: plenty of vegetables, fruit, legumes, nuts, olive oil, and seafood. Some dairy, but not daily. As little processed food, red meat and refined sugar as you can. And processed food does not just mean chips and candy bars: bread, pasta, granola bars, luncheon meats, salad dressings, tortillas, white rice, even peanut butter, is all processed. Technically, of course, cooking something is a form of processing it — so is chopping it! — but if you’re depressed and you’re eating anything that came wrapped in plastic, with added salt, corn syrup, food stabilizers, or preservatives, you should probably stop.
Frankly, that is a lot easier said than done for a depressed person living in America. Depression and sugar go together like peanut butter and jelly, cheese and crackers, popcorn and butter. I know diet matters, I’ve been doing all this research to prove it to myself, and yet I’m still craving sugar. And of course, sugar does make you feel better for the brief window of the immediate energy high — right before you crash and burn. There’s actually one study that suggests depressed people might crave carbs for their “serotonin-mediated psychotropic effects,” ie, we want them because they make us feel better. Sadly, only temporarily. In the long-term, it’s pouring gasoline on a burning fire, hoping to put the fire out. Not gonna work.
But, of course, depressed people have a motivation problem. It’s the classic catch-22; if you’re depressed, you probably don’t have the energy it takes to make healthy food choices. What to do?
In my case, I’m keeping it super simple: I’m trying to eat ten vegetables a day. Morning is when I have the most motivation, so I am veggie-loading in the mornings with a breakfast hash, basically a bunch of chopped-up vegetables sautéed in my wok. This morning’s included red onion, sweet potato, carrot, cabbage, napa cabbage, arugula, cilantro, leafy green lettuce and pea shoots. I’m keeping it easy by using the food processor to shred several days worth of vegetables at once, and keeping it interesting by varying whatever I add for protein and flavor. Today it was ground beef and serrano pepper sauce, but I mix it up as much as is realistic.
And I’m doing my best — my highly imperfect best! — to avoid sugar, and especially to avoid it in the evenings because, of course, eating sugar in the evening makes it more difficult to have restful sleep. It’s a double-whammy for increasing depression.
It’s not easy. Honestly, my step 2 of depression recovery — deciding that you’re going to do whatever it takes to get well — is really hard. I’ve joked about wishing I could force some young relatives of mine into my depression boot camp, because it’s so obvious from the outside that they’re making the wrong choices. And it’s not like eating vegetables for breakfast is a miracle cure. It’s not working any faster than the several weeks it might take for anti-depressants to kick in. But then again, all the side effects will be beneficial, and the vegetables alone are just one piece of the puzzle. Next up, exercise.