Neuroinflammation. A big word with heavy connotations. Over the last several years, I’ve written a lot about it, and for good reason. It is my firm belief that this, more than any other factor, is to blame for the rise in cases of anxiety, depression and other mood disorders all around the world. However, if neuroinflammation is a major cause of the global mental health burden, what’s causing it?
There are a number of theories, and as usual, the truth is probably a mixture of all of them. Stress, environmental toxins, lack of social connection, poor gut health, chronic disease, obesity…the list goes on. Our Western lifestyle promotes the creation and maintenance of a low grade, inflammatory response. In particular, our love for highly refined carbs, trans fats and our relatively low intake of fresh foods. The human body was simply not meant to metabolise these highly inflammatory substances, while at the same time compensating for nutrient deficits.
Inflammation and how it links to food.
Over the last year or so, more research has emerged suggesting that what we eat has a lot more to do with unresolved and chronic inflammation than first thought. Enter the “Dietary Inflammatory Index”, a way of measuring how ‘pro’ or ‘anti’ inflammatory individual dietary intake may be. DII does not apply just to mental health, but is also associated with chronic disease and cancer risk. A diet high in sugar, fats and refined carbohydrate is linked to a higher risk of depression, while eating a variety of fresh fruits, vegetables, fish and wholegrains (i.e the Mediterranean diet) is linked to a lower risk of depression and morbidity…no surprises there. While vegetables and fruits provide an amazing array of vitamins and minerals, there is also the yet poorly understood interplay between bioflavonoids, polyphenols, and other phytonutrients that interact with our genes, greatly influencing our health and wellbeing.
When treating anxiety, depression, or any other issue related to mental or cognitive health, it is important to assess for unresolved inflammation. Even if it is seemingly undetectable. Why? Because if there is inflammation present, even if it’s minimal, it will impact brain health. Just like an inflamed digestive tract results in ‘leaky gut’ so neuroinflammation results in ‘leaky brain’, and vice versa. People who suffer from depression show an increased permeability of the blood brain barrier, resulting in an increase of white blood cells that are able to penetrate the brain, contributing to the inflammatory cycle.
In years gone by, the neurotransmitter theory of depression was the thought leader in treating and preventing depression, but it’s now been discovered that the most commonly prescribed drug group for the condition – the selective serotonin reuptake inhibitor (SSRI) – actually seems to work better as an anti-inflammatory and promoter of brain derived neurotrophic factor (BDNF), than actually influencing brain serotonin levels directly (7, 8). BDNF is strongly involved to the neuroplasticity of the brain (growth and repair of neurons), a deficit of which is also seen in those who suffer from depression.
How to eat well – even when you don’t feel like it.
One of the major problems with treating depression and other mood disorders is that when we feel bad on the inside, it becomes really hard to make choices that are best for ourhealth and wellbeing. Diet is usually one of the first things to suffer when mood becomes low. Dietary intake of nutrients (or not) has a definite impact on how we feel, so it’s no surprise that the foods that provide satiety in the forms of fats and carbs also influence our neurotransmitters.
While highly palatable foods will often provide a quick (yet short lived) improvement in how we might feel, many people will also experience the inevitable mood ‘crash’ afterwards. The key to supporting mood with food is by making good, conscious choices in relation to what we put in our mouths, even when we don’t feel like it.
Eating foods that are rich in tryptophan, the major amino acid present in the neurotransmitter serotonin, is likely to result in an improvement in mood (6). Dairy products are naturally high in tryptophan, as is chicken, turkey – or you can choose to supplement with the pure form of the amino acid – under the care of a supervised practitioner.
The importance of antioxidants in the treatment of mood disorders.
Diet plays a huge role in reducing the inflammatory response, but is it possible to supplement with antioxidants and get a response? The research tells us an emphatic yes! This is not to say that we can still eat a terrible diet, only supplementing to get us out of trouble. The idea is that eating a healthful diet should be the first line of defence against mood disorders, not a last resort. Supplementation with any form of nutritional and/or herbal complex should be in addition to this. Studies examining antioxidant herbal compounds such as turmeric and saffron have had very promising results, exceeding expectations on a number of levels (1)(2). Other compounds, such as methylfolate (the only form of folate that can cross the blood-brain barrier), n.acetyl cysteine and vitamin C are also effective antioxidants, proven to be effective in the treatment of depression (3) (4) (5).
Reducing inflammation through diet and lifestyle
It may seem an impossible task – trying to take care of your mental health in these difficult times. Yet it can be done.
- Eat well – even when you don’t feel like it. Avoid last minute bad choices by planning your meals ahead. Eat 5-7 serves of fruits and vegetables each day, and don’t forget a serve of protein with each meal. Include essential fats from avocados, fish and grass fed meats.
- Sleep! 7-8 hours each night. If you have trouble sleeping, speak to your practitioner about herbal options to calm your nervous system.
- Exercise. Get that body moving, every day.
- Take time out to do something you love. Find a creative outlet, or spend time with family and friends.
- Stay connected. Did you know that loneliness and isolation contribute to inflammation? Talk to someone, reach out to an old friend, join a group.
- Relax. Meditate, go for a gentle stroll, take a bath or read a book.
As always, if you think you may be struggling with depression, or any other kind of mental health issues, it’s essential that you reach out for help. You are not alone. To talk to someone now, you can contact Beyond Blue by calling 1300 22 4636 or visiting their website https://www.beyondblue.org.au/.
(1) Hausenblas, H. A., Saha, D., Dubyak, P. J., & Anton, S. D. (2013). Saffron (Crocus sativus L.) and major depressive disorder: a meta-analysis of randomized clinical trials. Journal of integrative medicine, 11(6), 377–383. doi:10.3736/jintegrmed2013056
(2) Qin Xiang Ng, Shawn Shao Hong Koh et al.Clinical Use of Curcumin in Depression: A Meta-Analysis. Journal of the American Medical Directors Association, 18, 6, 6 2017
(3) Martone, G. (2018). Enhancement of recovery from mental illness with l-methylfolate supplementation. Perspectives in Psychiatric Care, 54(2), 331–334. https://doi.org/10.1111/ppc.12227
(4) Ooi, S. L., Green, R., & Pak, S. C. (2018). N-Acetylcysteine for the Treatment of Psychiatric Disorders: A Review of Current Evidence. BioMed research international, 2018, 2469486. doi:10.1155/2018/2469486
(5) Pullar, J. M., Carr, A. C., Bozonet, S. M., & Vissers, M. (2018). High Vitamin C Status Is Associated with Elevated Mood in Male Tertiary Students. Antioxidants (Basel, Switzerland), 7(7), 91. doi:10.3390/antiox7070091
(6) Lindseth, G., Helland, B., & Caspers, J. (2015). The effects of dietary tryptophan on affective disorders. Archives of psychiatric nursing, 29(2), 102–107. https://doi.org/10.1016/j.apnu.2014.11.008
(7) Björkholm, C., & Monteggia, L. M. (2016). BDNF – a key transducer of antidepressant effects. Neuropharmacology, 102, 72–79. https://doi.org/10.1016/j.neuropharm.2015.10.034
(8) Jeon, S. W., & Kim, Y. K. (2016). Neuroinflammation and cytokine abnormality in major depression: Cause or consequence in that illness? World Journal of Psychiatry, 6(3), 283–293. https://doi.org/10.5498/wjp.v6.i3.283