Part 1
Depression is a multifactorial disease brought about by imbalances in neurotransmitters (brain “hormones”), our environment and life stressors, and our cognitive resilience. Traditionally this has been treated with medications and psychotherapy which can be effective but can have significant side effects. Are there ways to treat the symptoms of this disease more naturally? Absolutely! Here are 24 of my best tips on how you can start improving your mental health today without medications.
Since this is a long post with lots of suggestions, I will divide it into 2 parts to make it a little easier to read and digest!
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Many of us struggle with episodes of anxiety, overwhelm, sadness, lack of interest in daily life, and feelings of inadequacy. It is easy to “get stuck in a rut” and this happens to all of us. It is when these feelings start to persist and outweigh the times we are content or last months to years that this becomes a pathology. This then becomes clinically labeled as depression (different types and degrees) or anxiety (disorders).
While certain types of depression such as severe Major Depressive Disorder, Bipolar Disorder, Depression with Psychosis are categories of depression which would benefit from medications to help balance brain hormones there is a large spectrum of depressive disorders (Seasonal Affective Disorder, Premenstrual Dysphoric Disorder, and more mild dysthymic disorders, situational depression, etc.) which I think could be managed effectively by implementing some lifestyle strategies and are especially effective when combined with counseling. Here are my top 24 suggestions to help you do just that.
1. Eat “Happy Foods”
The key to understanding which foods can make you happier is by first understanding what neurotransmitters are involved in promoting depression. Neurotransmitters are chemical hormones in the brain that signal each other, send messages, and are involved in creating the environment in which your brain lives. They exist throughout the body but our focus here will be the brain and their effect on emotion. This is a very complex system,but stated simply, their balance keeps our brains and bodies healthy. When they are out of balance is when we start to see problems and can lead to alterations of thought processes, sleep patterns, emotions, and attention. In practice, this can lead to the symptoms of what we call “depression” including: persistent sadness, lack of interest, insomnia or excessive sleep, increase or decrease in appetite, agitation, difficulty concentrating, hopelessness, excessive guilt, and extreme fatigue/lack of energy.
The key neurotransmitters involved in mediating mood and which play a key role in depression and anxiety are serotonin, norepinephrine, dopamine, GABA, and glutamate. While there are others that play a role these are the most important ones and are often the targets of medications used to treat these conditions. We will focus on natural ways to increase the first three: serotonin, norepinephrine, and dopamine here.
Serotonin is arguably the most important neurotransmitter in depression. When serotonin is low this can affect mood, sleep, memory, appetite, and even digestion. This is what most of the typical SSRI (Selective Serotonin Reuptake Inhibitor) depression medications such as Zoloft, Prozac, Paxil, and Celexa are targeted at increasing.
Foods that increase serotonin naturally are typically what we think of as tryptophan-rich foods, since tryptophan is an amino acid that the body rapidly metabolizes and turns into serotonin, melatonin, and other molecules.
Foods that increase serotonin:
- Poultry (Chicken/Turkey)
- Red meats (Beef, venison, elk, pork)
- Fish (salmon/sardines)
- Soy beans/Tofu
- Pumpkin seeds
- Walnuts
- Peas/Beans
- Eggs
- Dairy
- Oatmeal
Norepinephrine/Noradrenaline is a neurotransmitter associated with regulating alertness, concentration, and also affects mood although to what degree is not fully understood. This neurotransmitter also plays an important role in ADHD. Usually this is determined by certain patients responding better to medications in the SNRI (Serotonin-Norepinephrine Reuptake Inhibitor) class than they do to the above SSRI class. Foods that contain tyrosine and phenylalanine can help improve levels of norepinephrine but the most powerful enhancers here are exercise and intense body temperature changing activities such as cold plunges or sauna time. Time-restricted eating aka intermittent fasting has also been shown to increase these levels.
Foods that increase Norepinephrine:
- Meats
- Cheeses
- Fish
- Nuts/legumes
- Avocados
- Oats
- Bananas
- Eggs
- Coffee
- Chocolate
- Nicotine (do not recommend this addictive substance)
Dopamine is the last neurotransmitter we will focus on here but it the key neurotransmitter that mediates motivation, the lack of which many depressed patients identify as one of their most troubling symptoms. Dopamine functions in the mesolimbic reward pathway and is associated with the ability to feel pleasure, experience reward, and is a key mediator in the motivation pathway. Medications called MAO-I’s (Monoamine Oxidase Inhibitors) such as Nardil, Marplan, Zelapar target multiple of these neurotransmitters including dopamine but have fallen out of favor due to their side effect profiles. However, some medications such as Pramipexole and Modafinil which target increasing dopamine levels are being used as an effective adjunct in difficult to treat depression.
Foods that increase Dopamine:
- Meats
- Cheeses
- Fish
- Nuts/legumes
- Avocados
- Bananas
- Eggs
- Chocolate
- Berries
- Leafy greens
- Probiotic rich/Fermented Foods
- Whole grains
- Taking a magnesium supplement
When it comes to diet there are a few other tips I recommend to help combat depression naturally other than just increasing the mood-boosting foods in your diet.
2. Quit Sugar and Ultra-processed foods
Added sugars and chemicals which make food hyperpalatable (extra tasty) over-activate the reward system in the brain (associated with excess dopamine release). Over time this leads to food addictions, cravings, dopamine depletion, and impaired pleasure/reward networks in the brain. They actually change our brain chemistry! Eating excess of these foods causes a short term pleasure response similar to what other addictive substances cause, but this is short-lived. This then causes naturally occurring substances to fall short. These foods are associated with the symptoms of depression characterized by overeating, binge eating, poor food choices, lack of motivation, impaired pleasure response, and also affect mood. Taking a vacation from these foods is one of the best things you can do for your body and your brain. We will talk more about the topic of food addiction in another post.
3. Try Intermittent Fasting
This may seem extreme, but it does not have to be! I once watched a talk given by a neuropsychologist and he was asked about the value of fasting for 12 hours a day. He seemed confused by the question, responding “I don’t see this as deprivation. I see this as the bare minimum of what you must do to take care of your body. No one should be eating for 24 hours in a day. That is not what our bodies are meant to do.” This was years ago at this point so I don’t recall the talk or the name of the neuropsychologist but what he said really stuck with me. Intermittent fasting does not have to be regimented. This should be incorporated into your way of life. Simply, you should not be eating at all hours of the day or night. You don’t need to stick with a 12:12, 16:8, 14:10 program. I recommend people stop eating when the sun goes down 2-3 hours before bedtime as eating too close to bedtime can impair your sleep and waiting to eat in the morning until you have had your morning “hydration time”. This is usually the 1-2 hours after you wake up when you should be focusing on liquid hydration (drinking water) before you start to eat solid food.
On a side note I will say that I do sometimes find it helpful to fast for a full day (24 hour) period to help me to regain control. This is something I am very in tune with and notice when I have had too many treats or foods that are affecting my mood or I am having a hard time controlling binge eating. I use this day as more of a day of reflection and resetting my mind back to where I need to be. This technique of fasting for reflection has been used in many different religions. I don’t typically do this more than a few times a year. Making it too scientific and focusing too much on what is happening at what time I believe negates the reflective effect of this practice.
4. Take your Vitamin D
The data on vitamin D Supplementation in major depressive disorder and in seasonal affective disorder are mixed. Some studies show benefit, while others show no difference. My take on this is that most patients I see have some degree of vitamin D deficiency at some point and would benefit from a vitamin D supplement. Depending on the level of vitamin D deficiency is how the decision is made regarding how much to supplement and whether you need a 50,000IU prescription dose of vitamin D or a 1000-5000IU maintenance dose daily. On average a majority of the population does not get enough direct sunlight to the skin on a daily basis to provide us with our daily vitamin D needs. Some of our foods are supplemented such as Vitamin D fortified whole milk you purchase in stores. We have a herdshare with a local farm where we get our milk from so there is no fortification or processing involved. Overall, the less processed/fortified foods you eat the less vitamin D you intake. Because of this I tend to supplement us and our children with a daily vitamin D supplement as there are many benefits and links between adequate vitamin D intake and preventing a whole host of different diseases.
5. Get Enough Magnesium
Magnesium depletion is very common in our western society. This is due to a number of factors including diets high in processed food which has been stripped of magnesium, filtered waters with minerals removed, soil depletion in our agricultural food systems, excess caffeine and sugar intake which increase magnesium excretion from the body and decreases magnesium absorption, as well as different medications, and chronic stress. Magnesium is a mineral which helps to relax both the body (muscles and heart) as well as the mind. Magnesium deficiency can promote insomnia and make sleep less effective. While you can improve this naturally by eating more whole grains, nuts, legumes, and leafy greens, most people find it easier to take a magnesium supplement. Learn more about different types of magnesium supplements HERE.
6. Declutter and Clean Your Space
Not only can getting rid of excess clutter and cleaning up your space help you to feel like you have accomplished an important task and overcome a hurdle, which is in itself important to improving self-esteem and feelings of inadequacy which often accompany depression, it also helps to calm your mind. A space that is too busy and dirty weighs heavily on the mind. Some even feel that coming home to a dirty or cluttered home can bring about feelings of sadness and anxiety. This can seem like a daunting task so starting with one room and making that room a clean, calm, and relaxing space can make a big impact on your mental health and provide and escape within your home.
7. Beautify Your Space
Just like certain foods can help to increase your serotonin and dopamine levels in your brain, so too can certain activities. Finding colors and pieces in your home that make you happy to look at and enjoy and have a small but meaningful chemical impact on your brain! These can be simple things like putting up photos, art pieces, new window treatments, or finding decor you like but can also be larger projects like painting a room, buying new furniture, or even renovating your kitchen!
8. Get Outside
There is something so special about connecting with nature and being outside. Depression and anxiety are often associated with feelings which are incongruent or discordant with the world around you. What this means is that we feel a certain way but our brains just can’t understand why because things seem fine when looking from the outside. We feel sad but feel like we shouldn’t because our lives are “not that bad”. Often when I feel like this, getting outside is the only way to ground myself. I think this often stems from a disconnect from the natural world and the only way to rebalance ourselves is to experience nature. Just feeling the sun on your skin, the grass under your feet, the cool breeze on your face can help you feel more connected and realize that you are just a small piece of what makes up the natural world.
9. Exercise
This is a huge topic! There are so many benefits to physical activity from maintaining muscle and bone strength, healthy aging, improving cardiovascular health, preventing dementia, decreasing chronic pain, to improving symptoms of depression and anxiety! There are huge impacts of exercise on our bodies and brain chemistry including: boosting dopamine and serotonin levels which as we learned above are our “happy hormones” which are off balance in these disorders; causing an endorphin surge with are the “feel-good” hormones our brains produce; decreasing stress hormones such as cortisol; improving sleep quality; as well as minimizing pain and improving energy which can help with physical manifestations of depression. Additionally, setting a goal and meeting it can provide a sense of fulfillment and achievement which helps get us out of our “rut” and can translate to other parts of our lives.
10. Be Productive
Often times when we get down, depressed, anxious, or sad it is incredibly difficult to get ourselves out of bed, off the couch, or doing anything productive. While it is ok to give ourselves rest days I find it’s often the case these days are not as restful as we think they will be. This is especially true of those days we just sit around binge watching netflix. This tends to result in a vicious cycle of laziness and disappointment which only worsens depression. Instead, try scheduling one productive task during the day, completing the task, and seeing how you feel. On days when I am down I find that being productive is the only thing that helps me to feel better and that I have accomplished something.
Continue on to Part 2 for 14 more tips on how to improve depression naturally!
In health and wellness,
Dr. S
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No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment.
References:
Hasler G. Pathophysiology of depression: do we have any solid evidence of interest to clinicians? World Psychiatry. 2010 Oct;9(3):155-61. doi: 10.1002/j.2051-5545.2010.tb00298.x. PMID: 20975857; PMCID: PMC2950973.