Synopsis
Depression is the leading cause of disability in the western world. The incidence of depression today is 10 times greater than it was in 1960 - and that rate doubles every decade. Changes in the way we live, work, eat, sleep, and interact have made us increasingly vulnerable to this mood disorder. We are living out of sync with nature, our bodies, our spirits, and one another. We are living in an age of depression. For 30 years, Dr. Jeffrey Rossman has been treating depressed people, many of whom do not want to take medication. Instead, they are looking for practical solutions that will help them get better naturally and permanently. In "The Mind-Body Mood Solution", Dr. Rossman offers a comprehensive, drug-free depression treatment program that fully integrates psychological tools with lifestyle practices such as nutrition, exercise, sleep, breathing, and meditation. In doing so, readers learn to make healthy, sustainable changes that have been proven to improve mood. In treating the mind and body, Dr. Rossman advocates for a new view of depression as not simply an illness, but a call from within to awaken to the possibility of a vital, fulfilling life.
Extrait
Chapter 1
EATING FOR WELLNESS
Let food be your medicine and medicine be your food. HIPPOCRATES, 500 BC
The food you eat has a profound effect on your energy, emotions, motivation, and outlook on life. The typical American diet, which is high in refined sugar and processed carbohydrates, causes a spike in blood sugar followed by a rapid crash, which can leave you feeling fatigued, hungry, irritable, depressed, or mentally confused. This vital connection between food and mood means that many cases of depression improve rapidly when changes are made to a patient's diet, including nutritional supplementation.
As we begin this chapter, I want to give you a heads up. At certain points, I'll be presenting scientific information about the connection between nutrition and mood. If you find it helpful, read on. But if all of this information feels a little overwhelming right now, feel free to skim or skip the sections you're struggling with and come back to them later.
Eating food that contains high levels of allergens, trans fats, and toxic substances such as herbicides, pesticides, and antibiotics can cause chronic inflammation in the body. Inflammation is a result of the immune system's effort to neutralize organisms and substances that it perceives as a threat. Although the immune system's response is intended to protect you from harm, it drains your energy, leaving you feeling sluggish, fatigued, and unmotivated. Think of the last time you had the flu: All of your body's resources were directed toward fighting the infection, and you had little energy left over to feel focused, energetic, or upbeat. The only difference between fighting an infection caused by illness and mounting an inflammatory response to a dietary trigger is that your body generally kills off an offending microbe and you feel better--whereas inflammation caused by poor diet continues until you change your diet.
What does this mean if you suffer from depression? It can be difficult to differentiate between the symptoms of a mood disorder and the malaise caused by poor or inadequate nutrition. If you experience a lack of focus, negative thinking, and an inability to greet the day with enthusiasm, you may describe yourself as depressed. But your symptoms may actually be related to your diet.
One way to determine whether your diet is affecting your mood is to examine your eating patterns. Are you eating healthy foods? Are you using food as a comfort to assuage the disappointments and tensions in your life? Are you skipping meals or eating too much in one meal, causing your blood sugar to soar and then drop like a roller coaster?
For some people who suffer from depressed mood and negative outlook, improving diet, adding specific vitamin and mineral supplements, and changing eating patterns can make a remarkable difference. In many cases these changes reverse the symptoms of depression without therapy or antidepressant medication. It is therefore important to determine to what extent dietary considerations are influencing your mood.
Bill's Story
Bill typically began his day by eating what he believed to be a reasonably healthy breakfast, consisting of a blueberry muffin with a cup of coffee and orange juice. On some days, for a midmorning snack, he would eat a doughnut or a bagel with cream cheese, both of which were usually available to him at work.
When he remembered to eat lunch, he often ordered either a turkey sandwich on a roll with potato chips and a soft drink or a cheeseburger. If he felt especially hungry, he would add french fries. On other days, he would skip both the snack and the lunch entirely.
By about 3:00 in the afternoon, Bill would feel lethargic and generally eat an "energy bar" from the vending machine with a cup of coffee or a caffeinated soft drink. After his midafternoon snack, he felt more focused. But by dinner he felt exhausted again and always ate more than a single portion. His evening meal usually consisted of a large serving of meat, a couple of rolls with margarine, a small serving of vegetables, and a large bowl of ice cream for dessert. Other times he ate a double serving of pasta with meat sauce, or even an entire pizza. Very often he ate an evening snack, such as chips or popcorn.
Bill was also depressed. He felt he was in a dead-end job but had too little energy and motivation to seek a different career path. He often felt passed over for advancement by his supervisor. Bill's symptoms included irritability, fatigue, lethargy, weight gain, and apathy.
If Bill's food choices represent a typical day for you, changing your diet might significantly improve your mood. The food choices Bill made not only lacked healthy vitamins and minerals; they were also high in fat, calories, sodium, refined carbohydrates, and sugar. His bad habit of skipping lunch caused his blood sugar to plummet, leaving him ravenous by afternoon. The energy bar he then ate contained little protein compared with its extremely high carbohydrate and sugar content. Eating this snack raised his blood sugar level dramatically, which dropped just in time for dinner, again resulting in excessive hunger, poor food choices, and overeating.
When Bill came to see me, the first thing I suggested was that we adjust his diet. He began to eat a healthy breakfast every day: either fresh fruit and a whole grain English muffin or an egg-white omelet with whole grain toast spread with almond butter, and coffee. He regularly planned for his midmorning snack, which consisted of whole grain crackers or veggie sticks with hummus or natural peanut butter.
He brought organic soups, salads, and sandwich wraps filled with lean protein and veggies to work for lunch. He would eat half of the wrap at lunch and save the rest for his afternoon snack, which also included a piece of fruit such as an apple, orange, or banana. And because he wasn't starving at dinnertime, he was able to make sensible choices then, too. He started eating more fish and other lean proteins, accompanied by lots of veggies.
Within days, Bill began to notice a difference in his mood. He discovered that eating healthier foods and regular meals and snacks not only improved his focus and attention but also helped him lose weight and feel more confident. Why? Bill's diet now supplied him with the amino acids that his body needed to make and regulate serotonin and dopamine. These two neurotransmitters--chemicals that relay signals across different parts of our brains--have a dramatic impact on mood. Seventy percent of our serotonin is found in the intestinal tract, and the food we eat plays a major role in its production. As he began to feel more positive about his skills in the workplace, Bill's colleagues noticed his buoyant attitude, and eventually his supervisor recommended him for a different position within the company, which entailed a salary increase.
The best strategy for maintaining balanced blood sugar levels is to avoid eating high-carbohydrate foods that contain refined flour and sugar. Eating some protein at every meal slows the absorption of healthy carbohydrates into the bloodstream. To keep your body and mood in balance, it's also important to eat three balanced meals and two healthy snacks every day. Eat one snack at midmorning, when you hit your energy slump (about 3 hours after breakfast), and the other as a healthy midafternoon snack (about 3 to 4 hours after lunch). Don't skip meals.
The quality of the food you eat is just as important as the quantity. I recommend purchasing organic produce, whole grains, and grass-fed (or "free- range") animal protein such as beef, chicken, turkey, and eggs. Animals that are not treated with antibiotics, hormones, and growth stimulants do not produce meat that causes inflammation.
One of the best ways to change your eating habits is to use mindful eating techniques. You can practice mindfulness by slowing down as you eat, focusing on one bite at a time. Reading or working at the computer while you mindlessly eat can distract you from the pleasures of delicious, healthy food.
Mindful eating can be especially helpful if you tend to overeat or make unhealthy food choices. By savoring each bite of your sandwich or focusing on the sweetness of the melon or strawberry on your tongue, you will experience heightened satisfaction in eating a small, appropriate serving of food. Eating healthy food feels good, and you can amplify that good feeling with mindful eating.
Try this experiment. Eat a small piece of cantaloupe or apple very slowly. Taste it fully. It's hard to overeat fruit, because it's high in fiber and natural sugars. Eat another piece of fruit; delightful again--right?
Now eat a small piece of chocolate. Savor its sweetness. Let it melt in your mouth. Now swallow. Try another small piece of chocolate. Is it as sweet as the first? Very likely it is not. Most chocolate is high in refined white sugar and hits all the sweetness receptors on your tongue in the first bite. The receptors are now blocked, and the sweetness of your next bite of chocolate doesn't register. It doesn't taste sweet; in fact, it may have no taste whatsoever. No comfort, no chocolate "joy." No wonder we mindlessly keep eating more, chasing the sweet "hit" we got from the first piece.
Mindful eating helps us slow down and enjoy our food and increases our awareness that we are nurturing ourselves with the building blocks of life. When we make the right food choices and eat mindfully, our bodies can build the biochemicals that relieve stress and provide us with a sense of peace, joy, and relaxation.
Due to many factors, however, dietary choices alone may not supply enough of the minerals and raw materials needed to alleviate depression. The nutrients provided by specific foods we eat are needed to support healthy brain chemistry. At night, during the deepest stage of sleep, our bodies convert nutrients from the food we ate during the day into a powerful reserve of natural antianxiety and antidepressant neurotransmitters. Some of these neurotransmitters, such as dopamine and norepinephrine, stimulate feelings of enthusiasm and excitement; others, such as serotonin and gamma- aminobutyric acid (GABA), help us feel calm and tranquil. If we don't get the necessary nutrients from our diet, our bodies are less able to combat depressed moods.
It's not just about eating the right foods, however--our bodies also have to metabolize food properly to gain nutritive benefit. Some people may not have enough of the healthy intestinal bacteria that line the digestive tract and aid in the absorption of the nutrients from food. Often, people who lack sufficient healthy bacteria have recently taken a course of antibiotics, which wipe out even the good bacteria. The active cultures in yogurt and probiotic foods and supplements containing acidophilus and bifidus bacteria can help to repopulate the gut with the healthy bacteria that aid digestion.
Excessive stress can also cause our bodies to use up our biochemical reserves too quickly. For instance, prolonged stress can cause depletion of B vitamins and calcium. In such cases, vitamin and mineral supplementation may be necessary for you to function at your best.
Serotonin is the primary antianxiety and antidepressant biochemical. When your body produces enough serotonin, you will have the requisite brain chemistry to support a positive, confident outlook and a flexible, easygoing manner. When you are deficient in serotonin, you may experience irritability, anxiety, negative thinking, and difficulty sleeping.
In order to create serotonin, your body needs a precursor chemical: an amino acid called tryptophan. Tryptophan is found in high-protein foods such as turkey, beef, eggs, and some dairy products, including cheese. Though these foods have been available to us for centuries and are widely consumed, the antibiotics, pesticides, and other toxic chemicals that have been added to our food supply in recent years have altered the nutritive benefit of the foods we eat. Whereas animals once ate a diet of grass and plants, which provided them with nutrients (including tryptophan) that were passed on to us when we ate their meat, most livestock today is fed grain, soy, growth hormones, and antibiotics. Thus, it's harder for us to get the nutrients our brains (and the rest of our bodies) need in order to function properly.
Some foods and food additives can contribute to depression. Processed sugar and high-fructose corn syrup can cause an immediate spike in blood sugar that is energizing in a way that makes some people feel hyperactive. However, prolonged, excessive consumption ultimately results in blood sugar lows that fuel exhaustion and depression. Many depressed people improve dramatically when they eliminate sugar from their diets. In addition, stimulants such as caffeine, diet pills, or aspartame (NutraSweet) directly interfere with the relaxing effects of serotonin.
When the brain does not receive the nutrients it needs to properly regulate our neurotransmitters, we may experience prolonged periods of stress or suffer from chronic pain. This pain is often caused by inflammation and lack of endorphins, our body's "feel-good" chemicals that promote feelings of well-being and help alleviate physical pain. Stress and chronic pain also contribute to the depletion of our serotonin reserves. One way to help counter the effects of the modern American diet is to supplement it with amino acid combinations of 5-hydroxytryptophan (5-HTP), tryptophan itself, or an herb called St. John's wort, which helps increase serotonin levels naturally.
Another set of biochemicals involved in maintaining a healthy mood are called catecholamines. These substances, which include dopamine, norepinephrine, and adrenaline, help us feel alert, upbeat, and energized. When we are deficient in one or more of these biochemicals, we may feel emotionally flat, lethargic, and unfocused.
Tyrosine is an amino acid needed to produce catecholamines. It is present in high-protein foods such as beef, fish, eggs, peanuts, almonds, avocados, and hummus. Tyrosine deficiency can be caused by a low-protein diet, prolonged sleep deprivation, or excessive stress. Many people with low catecholamine levels try to compensate for their lack of energy with stimulants such as caffeine. But while drinking a caffeinated beverage may temporarily increase energy and alertness, it does not provide the raw materials the body needs in order to sustain adequate levels of catecholamines.
Tyrosine is also needed to make thyroid hormones, which regulate our metabolism. Too little tyrosine in our bodies literally depletes us of life- force energy. No wonder people low in thyroid hormones often feel wiped out and overwhelmed. For people unable to make adequate supplies of catecholamines from dietary sources, adding the supplement L-tyrosine can dramatically enhance mood, energy, and the ability to focus.
Our bodies produce other biochemicals that help us feel relaxed, calm, and stress free. GABA, an amino acid, is our own natural antianxiety biochemical. The widely prescribed tranquilizer known as Valium is a synthetic form of this biochemical. GABA turns off the overstimulating effects of stress and reduces adrenaline levels. When we don't have adequate levels of GABA, we feel keyed up, stressed, and burdened by the demands of life. If you are feeling overwhelmed by the tasks of daily living, supplementation with GABA may help you feel calmer and better able to manage stress.
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