Somebody asked me this week about depression – she wondered if there was any connection to diet and a worsening of symptoms. My answer: Yes!
Diet plays a huge role in brain chemistry, and when you feed yourself junk, your brain can start to misfire. Think of what happens when you put the low-grade gasoline in your fancy sports car as an analogy.
Depression is a big deal – it affects about 7% of American adults. That’s 16 million people. What’s worse is that depression seems to disproportionately affect middle-aged women: according to the CDC, women 40 – 59 have by far the highest incidence of major depression, clocking in at 12.3% - more than 50% higher than the rate for all adults.
The timing coincides perfectly with the menopause transition, and that’s probably no accident. Could it be that the women most affected by depression during midlife are the very same women struggling the most with menopause in general? I think they are.
Depression is typically accompanied by changes in sleep patterns, weight gain or loss, changes in memory or ability to concentrate, and chronic pain. This sounds familiar, doesn’t it? Here again, everything is connected.
Antidepressants are often the first line of defense when women seek help, although only a third of them do – in fact, SSRIs are the go-to drug class for depression, which also happen to be routinely prescribed for relief of hot flashes and other menopause symptoms. We need to be careful here – depression is not just a chemical disorder or a “Prozac deficiency” (to quote Dr. Christiane Northrup). The symptoms of depression are your body’s way of signaling that something is off, and while prescription drugs can make the symptoms go away, turning off the signal can be akin to shooting the messenger. And there are other reasons to be cautious about antidepressant use: several prominent studies have linked SSRIs to increased death and stroke; as well as a whole host of yucky side effects: nausea, headache, nervousness, insomnia, loss of libido/sexual dysfunction, and restless leg syndrome.
There is a lot going on at midlife, and the menopause transition can be difficult, even overwhelming. It’s not unlike the “growth spurt” that we had as teenagers – our bodies are changing and we are trying to figure out who we are and who we want to be – feelings of sadness and grief and even anger are normal. Viewed through this lens, when we take the time to ask ourselves what is really going on in our lives, both physically and mentally, we may be able to come up with a better solution to feelings of depression.
Here are a few suggestions for the physical side of things:
We’ve talked before about the link between diet and the brain, so this is an excellent place to start. A multitude of studies have shown that those following a whole foods plant-based diet experienced fewer negative emotions, less irritability and impatience, and more “vigor.” The reason for this may be that animal products (chicken, eggs, beef, pork and fish are the wort offenders) promote inflammation throughout the body, including the brain, where they increase the level of a certain enzyme that breaks down neurotransmitters. Foods high in fat and cholesterol also block the body’s natural ability to access tryptophan, a building block for serotonin, which is the brain’s chief feel-good hormone. So, in order to set your brain up for happiness, eat tons of leafy greens, berries, and nuts and seeds, as well as whole-grain carbohydrates.
Cut out aspartame and artificial sweeteners. Studies have shown that aspartame is especially detrimental to people that are already sensitive to feeling low (hello, menopause), but it is linked to a significant increase in depression, irritability, and brain function in general across all populations.
Get your folate! Depression has been linked to low folate levels for some time, and recent studies have shown that low folate intake increases the risk of severe depression by three times. Greens, beans, and anything with high antioxidant levels should be your go-to. For proof that it works, look to the large Canadian study of 300,000 people which found that those with the highest fruit and vegetable consumption had the lowest risk of depression, mood, anxiety and overall perceived mental health.
Take a look at your alcohol consumption, and the role it plays in your life. It’s like mainlining sugar, and it aggravates symptoms like hot flashes and insomnia, so if you are using it as a balm, it is going to backfire eventually.
Let me be clear that there is a place for prescription medication in the treatment of depression – but you may not need it. Different approaches will appeal to (and work for) different women, and you need to be willing to experiment to find what works best for you. Diet and lifestyle adjustments are an important first step, but sometimes they are not enough – and you should never feel bad about needing medical intervention. In fact, there is nothing that says you can’t take multiple approaches at once – sometimes the boost you get with a course of antidepressants is what you need to enable other changes in your lifestyle (and your life).