1. NUTRITION- AN INEVITABLE LINK WITH DEPRESSION
PRESENTED BY.
PUSHPA DHAMI
M.SC FOODS AND NUTRITION
ANGRAU, Hyderabad

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Introduction
Prevalence of depression
Symptoms, Causes, Factors, Types of depression
Link between Nutrition, Neurotransmitters
and Depression
Role of amino acids
Role of carbohydrates, protein and fat
Role of vitamin and minerals
Probiotics and depression
Alcohol and depression
Caffiene and depression
Exercise, Sleep and depression
Natural herbs and depression
Antidepressants and Depression
Conclusion
Tips to follow
References

3. Introduction
• The General definition of Depression is a
psychological disorder that affects a person's
mood changes, physical functions and social
interactions.
• Depression is a common mental disorder that
causes people to experience depressed
mood, loss of interest or pleasure, feelings of
guilt or low self-worth, disturbed sleep or
appetite, low energy, and poor concentration.

4. Prevalence
• The World Health Organization has ranked depression on the 4th
place of causes of diseases worldwide.
• Until 2020, depression will, together with myocardial infarction, be
the main cause of disability (WHO Health Report 2006).
• One in seven people (15 per cent) in high-income countries
• One in nine (11 per cent) in middle- and low-income countries are
likely to get depression over their lifetime.
• Prevalence of major depressive disorder has been estimated to
be 2% of children and 4-8% of adolescents .

5. • Depression affects over 120 million people worldwide. It can interfere
with a person's ability to work, make relationships difficult, and
destroy quality of life.
• In severe cases it leads to suicide, causing 850,000 deaths a year.
• A study based on the World Health Organization‘s World Mental
Health Survey Initiative has said that India has the highest rate of
major depression (36%) in the world.
• The global study, based on interviews with 89,000 people, shows that
women are twice as likely to suffer depression as men.
• Unemployed tend to have higher rates of depression (almost 13
percent) than those who are employed full time (7 percent).

7. Causes of depression
Acc. To (CARMHA) Centre for Applied Research in Mental Health and Addiction (2009)

8. Factors contributes to depression
1.
Genetic factors- The genetic risk of developing clinical depression
is about 40% if a biological parent has been diagnosed with the
illness, with the remaining 60% being due to factors within the
individual‘s own environment.
2.
Biochemical factors- Three important neurotransmitters that affect
a person‘s mood are serotonin, noradrenaline and dopamine.
3.
Physical illness- Compromised immune functioning
4.
Gender - studies have shown that there is a much greater likelihood
of women developing non-melancholic depression than men.
5.
Ageing brain
6.
Stress
Fact sheet( Oct 2012)

9. Types of depression
1. Mild depression
• It has a limited negative effect on one‘s daily life.
For eg. difficulty concentrating at work or motivating yourself to do
the things you normally enjoy.
2. Major depression
• Interferes with an individual‘s daily life - with eating, sleeping and
other everyday activities.
• Some people may experience only one episode but it is more
common to experience several episodes in a lifetime.
3. Dysthymic disorder, or dysthymia,
• Characterized by long-term (2 years or longer).
• Symptoms are not be severe enough to disable a person but can
prevent normal functioning or feeling of well being.
According to NIMH( National institute of Mental Health)

10. 4. Bi-polar disorder
• Bipolar disorder is characterized by cycling mood changes—from
extreme highs (e.g., mania) to extreme lows (e.g., depression).
5. Post-natal depression
• Many new mothers experience what are sometimes called 'baby blues' a
few days after the birth.
• Mothers feeling completely overwhelmed, inadequate and unable to
cope.
• Also experience negative feelings towards their child. It affects one in ten
mothers and usually begins two to three weeks after the birth.
6. Seasonal Affective Disorder (SAD)
• Sometimes called ‗winter blues‘. SAD can make the sufferer feel
anxious, stressed and depressed. It may interfere with their moods and
with their sleeping and eating patterns.
According to NIMH( National institute of Mental Health)

11. Different Occupations and Depression
• Occupations with both high demand and low control over daily tasks
are known to cause stress.
• Jobs with long hours or shift work, which comes with irregular sleep
schedules, can be problematic for people with depression.
• Lawyers, Judges, or Police officers, are exposed to the worst human
behavior; these negative experiences can alter your perspective on
the world and the people may prone to depression.
• According to statistics from the 2007 National Survey on Drug Use
and Health, the jobs with the lowest rates of depression included
engineering, architecture, and the sciences (for both men and
women).

12. 2007 (SAMHSA), an agency within the U.S. Department of Health and Human Services.
The type of jobs people hold can also influence the likelihood that they will become depressed.
Profession
Rate of depression (%)
•
Personal Care and Service
10.8
•
Community and Social Services
9.6
•
Health Care Practitioners and
Technical
9.4
•
Education, Training and Library
8.7
•
Custodial, Gardening and
Maintenance
7.3
•
Sales and Related
6.7
•
Legal
6.4
•
Protective Service
4.8
•
Installation, Maintenance and
Repair
4.4

13. • Depression is primarily psychological,
and best dealt with by counselling.
• Depression
as
a
biochemical
phenomenon, best dealt with by
antidepressant medication.
• There is a third aspect to the onset and
treatment of depression. Nutrition.

14. Nutrition
Nutrition plays a key role in the
onset, severity, and duration of
depression, including daily mood swings.
• Common imbalances connected to nutrition that
worsen one‘s mood and motivation:
1.
2.
3.
4.
Blood sugar imbalances (often associated with
excessive sugar and stimulant intake)
Lack of amino acids (tryptophan and tyrosine
are precursors of serotonin and noradrenaline)
Lack of B vitamins (vitamin B6, folate, B12)
Lack of essential fats (omega-3)

15. Neurotransmitters
• The most prevalent biochemical theory for the cause of
these imbalances is a brain imbalance in two families of
neurotransmitters. These are:
1. Serotonin, thought to primarily influence mood
2. Dopamine,noradrenaline,and adrenaline, thought to
primarily influence motivation
(Primary Care Mental Health (2003),Radcliffe Medical Press)

16. Nutrition, Neurotransmission and Depression
Neurotransmission plays a role in
mood.
Important neurotransmitters (NT's)
such as
1. Serotonin (Ser),
2. Dopamine (DA),
3. Norepinephrine (NE),
4. Acetylcholine (Ach), and
5. Glutamate (Glu).
•Nutrients required for synthesis
of NT's includes
•Amino acids
(tryptophan, tyrosine, glutamine),
•Minerals
(zinc, copper, iron, magnesium), a
nd
•B-vitamins (B6, B12, folic acid).

17. Patrick Holford. (2003) and TS Sathyanarayana Rao et.al, (2008)

18. S-adenosine methionine
• SAMe is a methyl donor and is involved in the synthesis of various
neurotransmitters in the brain.
• Derived from the amino acid L-methionine through a metabolic pathway
called the one-carbon cycle, SAMe has been postulated to have antidepressant
properties.
• Over 100 placebo-controlled, double-blind studies have shown that SAMe
(200–1600 mg/d) is equal to or superior to antidepressants, works faster, most
often within a few days (most pharmaceutical antidepressants may take three
to six weeks to take effect) and with few side effects.
• Limitation- Very expensive and very unstable.
• An alternative that is much more stable and less costly is tri-methyl-glycine
(TMG).
David Mischoulon and Maurizio Fava (Am J Clin Nutr 2002)

19. Methyl
tetrahydrofolat
e reductase
Patrick Holford. (2003) and TS Sathyanarayana Rao et.al, (2008)
Tri methyl
glycine

20. Role of amino Acids

21. Tryptophan- reduces depression
• A study was conducted with hypothesis that what would happen if
you deprived people of tryptophan.
• They gave 15 volunteers who had a history of depression, but were
currently not depressed, a nutritionally balanced drink that excluded
tryptophan.
• Within seven hours, 10 out of 15 noticed a worsening of their mood
and started to show signs of depression.
• On being given the same drink, but this time with tryptophan
added, their mood improved.
• Supplementing the amino acid tryptophan is already proven to
improve mood.

22. 5-HTP- how it reduces depression
• The first study proving the moodboosting power of 5-HTP was done
in the 1970s in Japan, under the direction of Professor Isamu Sano
of the Osaka University Medical School.
• He gave 107 patients 50 to 300 mg of 5-HTP per day, and within
two weeks, more than half experienced improvements in their
symptoms.
• By the end of the fourth week of the study, nearly three-quarters of
the patients reported either complete relief or significant
improvement, with no side effects.
• This study was repeated by Nakajima et al. who also found that 69%
of patients improved their mood.

23. Recommended dosage
• The recommended dosage of this amino
acid, available in any health food shop, is
100mg of 5-HTP, two or three times a
day, for depression.
• Some supplements also provide various
vitamins and minerals such as B12 and
folic acid, which may be even more
effective because these nutrients help to
turn 5-HTP into serotonin.

24. Phenylalanine and depression
• In a double-blind study by Helmut Beckmann and colleagues at the
University of Wurzburg, Germany, 150 to 200mg of the amino acid
phenylalanine, or the antidepressant drug imipramine, were
administered to 40 depressed patients for one month.
• Both groups had the same degree of positive results less
depression, less anxiety and no sleep disturbance.
• A group of researchers at the Rush Medical Center, Chicago, USA
screened depressed patients by testing phenylethylamine in the
blood; low levels meant one needed more phenylalanine.
• They then gave 40 depressed patients supplements of
phenylalanine, and 31 of them improved.

25. Tyrosine
• In a pilot study administering 3200 mg tyrosine a day
to 12 patients , a significant improvement in mood and
sleep was observed on the very first day.
• Twenty-one cadets were put through a demanding oneweek military combat training course.
•
Ten cadets were given a drink containing 2 g of
tyrosine a day, while the remaining 11 were given an
identical drink without the tyrosine.
• Those on tyrosine consistently performed better, both
in memorising the task at hand and in tracking the
tasks they had performed.

26. Role of Carbohydrates, protein and Fat

27. Sugars and depression
• Since the brain depends on an even supply of glucose.
• Excessive consumption of refined sugar is undesirable is that it
uses up the body‘s vitamins and minerals.
• Every teaspoon of sugar uses up B vitamins for its
catabolism, thereby increasing demand.
• About 98% of the chromium present in sugarcane is lost in
turning it into sugar. This mineral is vital for keeping the blood
sugar level stable.
• Limit sugary foods and opt for smart carbs, such as whole
grains, fruits, vegetables, and legumes, which all contribute healthy
carbs as well as fiber.

28. • Wurtman et al. suggest that high-carbohydrate meals increase
serotonin synthesis.
• Consumption of a meal that is high in carbohydrate, branched chain
amino acids and tryptophan has a significant effect because both
glucose from the carbohydrate and the branched chain amino acids
(particularly leucine) increase insulin secretion.
• Insulin facilitates the transport of branched chain amino acids into
muscle cells, thereby reducing the competition for tryptophan by the
large neutral amino acids.
• Further tryptophan transporter protein carries it across the blood–brain
barrier.
• Drowsiness induced by increased serotonin is the common effect of a
large carbohydrate meal.

29. • Obese people prove more likely to suffer from depression.
Conversely, depressed people may become inclined to eat
carbohydrates as a way of boosting their serotonin to
create temporary solace from their depression.
• Habitually appeasing depression-triggered carbohydrate
cravings in turn increases caloric intake, leading to greater
fat production and more weight gain; creating a vicious
cycle.

30. Protein and Depression
• Depressed people have substantially lower levels of p11 in their
brain tissue than the non-depressed.
• P11 is a protein in brain which increases serotonin-signaling
receptors.
• The mice were given two older antidepressants — one known as a
tricyclic, the other an MAO(monoamine oxidase) inhibitor.
• Each treatment increased the amount of p11 in mice brains, even
though each therapy is known to work in different ways.
• So the researchers bred mice that had no p11-producing gene.
• They acted depressed, and had fewer seotonin receptors and less
serotonin activity than regular mice. (Per Svenningsson, 2007)

31. • Blendy, J.A (2006). Protein that could serve as a
convergence point for multiple classes of antidepressant
drugs is the transcription factor CREB (cyclic adenosine
monophosphate response element binding protein).
• CREB is upregulated by chronic antidepressant
treatment, and increasing CREB levels in rodent models
results in antidepressant-like behaviors.
• Good sources of healthy proteins: beans and peas, lean
beef, low-fat cheese, fish, milk, poultry, soy
products, yogurt.

32. High-Fat Diet Linked to Depression
• The research team fed mice already prone to obesity different
kinds of food and monitored how the diet affects the way the
animals behave.
• Mice that have been fed a higher-fat diet exhibit signs of
being anxious, such as an avoidance of open areas, and of
being depressed, such as making less of an effort to escape
when trapped.
• These mice have higher levels of corticosterone, a hormone
that is associated with stress.
ScienceDaily (May 23, 2012)

33. Omega 3 fatty acids
• Omega-3 fats are effective for severe depression.
• A recent trial published in the American Journal of Psychiatry
tested the effects of giving omega 3 FA to 20 people suffering
from depression (who were already on antidepressants but still
depressed).
• A highly concentrated form of omega-3 fat, ethyl-EPA, was
given versus a placebo.
• By the third week, the depressed patients were showing major
improvement in their mood, while those on placebo were not.

34. •
Taking a daily supplement of 1 g of omega-3 fatty acids has been
found to significantly reduce several of the symptoms associated
with depression, including- insomnia, anxiety, prolonged
experiences of sadness, and suicidal impulses.
•
Studies have shown that individuals suffering with depression have
seen their symptoms diminish as much as 50%. Foods that have high
levels of omega 3 include:
Salmon
Tuna
Dark leafy green vegetables
Flaxseed
Salted mackerel
Walnuts
Canola oil
Fresh basil
•
•
•
•
•
•
•
•

35. Role of vitamin and minerals

36. Vitamin B1 (thiamine)
• The brain uses this vitamin
to help convert glucose, or
blood sugar, into fuel, and
without it the brain rapidly
runs out of energy.
• This
can
lead
to
fatigue, depression, irritabilit
y, anxiety, and even thoughts
of suicide.
• The consumption of refined
carbohydrates,
such
as
simple sugars, drains the
body's B1 supply.
Vitamin B3 (niacin)
• Pellagra- which produces
psychosis
and
dementia,
among
other
symptoms-is
eventually
found to be caused by niacin
deficiency.
• Subclinical deficiencies of
vitamin B3 can produce
agitation and anxiety, as well
as mental and physical
slowness.

37. Vitamin B5 (pantothenic
acid)
• Vitamin B5 is needed for
hormone formation and the
uptake of amino acids and
the
brain
chemical
acetylcholine,
which
combine to prevent certain
types of depression.
• Symptoms of deficiency are
fatigue, chronic stress, and
depression.
Vitamin B6 (pyridoxine)
• It is needed in the manufacture
of serotonin, melatonin and
dopamine.
• Vitamin
B6
deficiencies,
although
very
rare,
cause
impaired
immunity, skin lesions, and
mental confusion.
• A
marginal
deficiency
sometimes
occurs
in
alcoholics, patients with kidney
failure, and women using oral
contraceptives.

38. Vitamin B12
Vitamin B9 (Folic acid)
• This B vitamin is needed for DNA
synthesis.
• It is also necessary for the
production of SAMe (S-adenosyl
methionine.
• It is usually administered along
with vitamin B12, since a B12
deficiency can mask a folic acid
deficiency.
• Pregnant women are often advised
to take this vitamin to prevent
neural tube defects in the
developing fetus.
•
•
B12 may help to fight depression by
inhibiting monoamine oxidase (MAO), an
enzyme that metabolizes some of the
neurotransmitters that help to elevate
mood.
In that sense, B12 works like the
monoamine
oxidase
inhibitors
(MAOI), drugs prescribed for depression.
•
When shortages do occur, they are often
due to a lack of intrinsic factor, an
enzyme that allows vitamin B12 to be
absorbed in the intestinal tract. Since
intrinsic factor diminishes with age, older
people are more prone to B12
deficiencies.
•
Can
cause
mood
swings, irritability, confusion, dementia, h
allucinations, or mania.

39. B Vitamins
Vitamin B1 (thiamine)
Vitamin B2 (Riboflavin)
Vitamin B3 (niacin)
Vitamin B5 (pantothenic
acid)
Sources
Recommendation
Brown rice, egg yolk's, fish,
wheat germ, and whole
grains.
1mg to 1.5mg, maximum
amount for adults, 300mg.
Meats, eggs and dairy, as
well as in green vegetables
and legumes.
1.1 to 1.3 mg per day for
adult. Maximum amount for
adults, 200mg.
Lean meat, peanuts, wheat
germ, fish, poultry.
18mg for men daily, 13mg
for women daily, maximum
amount for adults is 100 to
3,000mg.
Bran, peanuts, brewers
yeast, avocados, beef, eggs,
fresh vegetables, and whole
wheat.
2.2mg a day, maximum
dosage, is 100mg to
1,000mg a day for adults.

40. B Vitamins
Sources
Recommendation
Vitamin B6 (pyridoxine)
Meats, fish, peanuts,
2.2mg per day for an adult,
soybeans, bananas, whole
maximum dosage is 100 to
grains, spinach and broccoli. 1000mg per day for an
adult.
Vitamin B12
Meat, clams, eggs, milk, and 6mcg daily, maximum adult
dosage is 1mg.
dairy products.
Folic acid
Green leafy vegetables, 400mcg a day for adults,
wheat germ, dried beans and maximum dosage is 800 to
peas.
3,000mcg per day for adults

41. Vitamin C
• The link between vitamin C deficiency and depression may be
caused by lower neurotransmitter levels.
• According to an August 2003 article in "Nutrition Journal," vitamin
C works together with the enzyme dopamine-beta-hydroxylase to
convert dopamine into norepinephrine, which plays an important role
in the regulation of mood.
• Symptoms of vitamin C deficiency include fatigue and depression.
• Found in- citrus fruit, strawberries, tomatoes, peppers and broccoli.
• Recommended dosages- Consume between 75 and 90 mg of
vitamin C each day.

42. Vitamin D
• Researchers note that people suffering from depression, particularly
those with seasonal affective disorder, tend to have reduced vitamin D
levels in the body.
• There are receptors for parathyroid hormone (PTH) and 1,25–
dihydroxyvitamin D in the brain, and there are clinical and experimental
data indicating that PTH and vitamin D may affect cerebral function.
• The authors also have concluded that there ―appears to be a relation
between serum levels of 25-(OH) D and symptoms of depression.
• Supplementation with high doses of vitamin D(400 IU to 800 IU of
vitamin D, ) seems to ameliorate these symptoms indicating a possible
causal relationship.‖

43. • In a study published in Clinical Rheumatology in
2007, researchers found that there might be a correlation
between vitamin D deficiency and depressive symptoms if
associated with other illnesses.
• For example, if someone has rheumatoid arthritis and vitamin D
deficiency, they are more likely to suffer depression.
• The Institute of Medicine recently raised the recommended daily
intake to 600 IU for people aged 1-70 and to 800 IU for adults
older than 70.

44. Minerals
Magnesium
• Deficiency can result in depressive symptoms, along with confusion,
agitation, anxiety, and hallucinations, as well as a variety of physical
problems.
Calcium
• Depletion affects the central nervous system. Low levels of calcium
cause nervousness, apprehension, irritability, and numbness.
They work best when taken together.
• Dosage: Take a calcium and magnesium combination formula that
supplies 500 milligrams of calcium and 250 to 500 milligrams of
magnesium twice daily.

45. Zinc:
• Inadequacies result in apathy, lack of appetite, and lethargy.
• When zinc is low, copper in the body can increase to toxic
levels, resulting in paranoia and fearfulness.
Dosage: 30-40 mg daily (as picolinate)
Selenium• Selenium is an antioxidant. It has a mood-elevating
effect.100-200 mcg daily.
Iron:
• Depression is often a symptom of chronic iron deficiency.
• It include general weakness, listlessness, exhaustion, lack of
appetite, and headaches. 10-30 mg daily.

46. Manganese:
• Since it also plays a role in amino-acid formation, a deficiency may
contribute to depression stemming from low levels of the
neurotransmitters serotonin and norepinephrine.
• Manganese also helps stabilize blood sugar and prevent
hypoglycemic mood swings.
• Dosage- 2-10 mg daily
Potassium
• Depletion
is
frequently
associated
depression, tearfulness, weakness, and fatigue.
Dosage- 1800-5625mg daily
Chromium
• Helps keep blood-sugar levels in balance.
• Dosage: 200 micrograms daily.
with

47. Additives
In the 1950s , 20% of our food items were controlled
by the supermarkets, now the figure is about 80%.
• 3,500 chemicals are used as food additives in the
manufacture of convenience foods and drinks.
• 75% of the Western diet is made up of various
processed foods, each person is now consuming an
average 8-10 lbs of food additives per year,
• Some additives are of particular concern because of
their potential effects on mental health.

48. Additive
Aspartame
Known
as/ ADI
E951
(40mg/kg
B.W)
Used in
Reasons to avoid
Diet coke, desserts, sugar free
gum, drink mixes, table top
sweeteners, cereal, breathmints, puddings, toothpaste,
cough syrup
Aspartame is a neurotoxin and
carcinogen.erode intelligence and
affect short-term memory ,
Parkinson's, Alzheimer's,
headaches, nausea, mental
confusion
High Fructose
Corn Syrup
HFCS
Most processed foods,
breads, candy, salad
dressings, canned vegetables,
cereals
Increases your LDL (―bad‖)
cholesterol levels, and contributes to
the development of obesity and
diabetes.
Monosodium
Glutamate
MSG /
E621
Chinese food, potato chips,
many snacks, chips, cookies,
lunch meats
Effects the neurological pathways of
the brain. MSG is an excito-toxin,
and regular consumption may result
in depression, disorientation, eye
damage, fatigue, headaches, and
obesity.
(10mg/kg
B.W)

49. Additive
Known as
Used in
BHA and
BHT
E320
(0.5 mg/kg
B.W/day)
Used as a preservative in Effects the neurological system
potato chips, gum,
of the brain, alters behavior and
cereal,, enriched rice,
has potential to cause cancer..
lard, shortening, candy
Food Dyes
Blue #1 & Blue
#2 Red #3 &
Red #40 Yellow
#6 & Yellow
Tartrazine
Sodium
Sulphite
E133 E124
E110 E102
(0-7.5mg/kg
B.W/ day)
E221
Reasons to avoid
Fruit cocktail, ice cream, Artificial colorings, may
candy, bakery products, contribute to behavioral
macaroni and cheese
problems like ADD and ADHD
in children and lead to a
significant reduction in IQ.
Wine and dried fruit
According to the FDA,
approximately one in 100 people
are sensitive to sulphites in food.
Individuals who are sulfite
sensitive may experience
asthma, headaches, breathing
problems and rashes.

50. Probiotics and depression
• Stress, a significant factor in MDD, is known to alter GI
microflora, lowering levels of lactobacilli and
bifidobacterium.
•
Research suggests that bacteria in the GI tract can
communicate with the central nervous system, even in the
absence of an immune response.
• The effect of probiotics on systemic inflammatory
cytokines and oxidative stress may ultimately lead to
increased brain derived neurotrophic factor (BDNF).
Logan, A. C. and M. Katzman (2005).

51. • The study, led by A. Venket Rao and co-authored by Dr. Alison C.
Bested, administered 39 CFS patients either three doses of
Lactobacillus casei a day, or a placebo, for two months.
• They found that 73 per cent of subjects taking the probiotic
experienced an increase in levels of Lactobacillus and Bifidobacteria
in the gut, which corresponded with a significant decrease in anxiety
symptoms.
• In the placebo group, only 37.5 per cent showed an increase in
Bifidobacteria, while only 43.8 per cent showed an increase in
Lactobacillus bacteria.
• Mice fed a broth containing Lactobacillus rhamnosus. It was
discovered that these rodents displayed significantly less behavior
linked with stress, anxiety and depression than mice fed plain
broth.(Charles Q. Choi , 2011)

52. The Mediterranean Diet
• Numerous studies have proven the beneficial effects of the
Mediterranean diet on a wide range of health issues including
anxiety and depression.
• It includes large amounts of fish, olive oil, fruits and
nuts, cereals, dark green vegetables and legumes.
• Because of this diet‘s high levels of essential nutrients, minerals and
vitamins is considered by some to be the optimal diet for proper
brain health and overall health in general.
• Studies have shown that in addition to reducing the risk of
depression by up to 30% the Mediterranean diet is also effective
against heart disease and other health issues related to inflammation.

53. Alcohol and depression
• Causal linkage between alcohol use disorders
and major depression, such that increasing
involvement with alcohol increases risk of
depression. (Joseph M. Boden et.al, 2011)
• Depression is primarily related to drinking
larger quantities per occasion, less related to
volume,
and
unrelated
to
drinking
frequency, and this effect is stronger for women
than for men.
• Former drinkers had slightly higher rates of
major depression and higher scores on
depressed affect compared with light drinkers.
( Kathryn Graham et.al, 2006)

54. Caffeine and depression
• Depression risk decreases with increasing caffeinated
coffee consumption. (Michel Lucas et.al, 2011)
• Caffeine sparks up neurotransmitters, serotonin and
dopamine and makes them come alive.
• Many find that when they drink coffee they become
more alert and able to concentrate.
Dark side
• Caffeine dehydrate the person since it is a diuretic.
• It depletes the body of the Vitamin B6. Those who
have low Vitamin B6 levels are more likely to suffer
from anxiety or depression.

55. Exercise and depression
• For mild to moderate depression, aerobic exercise is
usually a key component to a treatment plan.
( Birmaher B. et.al, 2007)
• A 2005 study at the University of Texas Southwest
Medical Center was the first study to look at exercise
alone in treating mild to moderate depression in adults
aged 20-45.
• It showed that depressive symptoms were reduced
almost 50 percent in individuals who participated in 30minute aerobic exercise sessions three to five times a
week.
• In addition, exercise stimulates the neurotransmitter
norepinephrine, which may directly improve a person‘s
mood.

56. Sleep and Depression
• For optimal physical and mental health, most people need
about 6-9 hours of sleep per day, at regular times. But many
people have difficulties with sleep.
• More than 80% of those suffering from depression experience
insomnia or some type of sleep disturbance which increase a
person‘s risk of developing depression or experiencing a
recurrence of depression.
• The psychological symptoms of sleep deprivation include:
mood
swings, irritability, impatience, anxiety, depression, fatigue, de
creased alertness and concentration, impaired memory, and
impaired judgment.
(Masley, J. et.al.2005).

57. Herbs and Depression
1. Ginkgo biloba• Ginkgo leaves contain flavonoids and terpenoids, which are powerful
antioxidants.
Laboratory studies have shown that ―GBE improves blood circulation
by dilating blood vessels and reducing the stickiness of blood
platelets.‖
2. Rhodiola Rosea (Golden Root)• Its ability to stimulate production of brain neurotransmitters such as
endorphins and serotonin.
3. St John’s wort• It is suggested that up to 900 mg of St John‘s wort per day is required
to effectively reduce symptoms of non-melancholic depression
.(Lawvere, S. and Mahoney, M. (2005)

58. Antidepressant drugs
• Selective serotonin reuptake inhibitors (SSRIs)
Block the reuptake of serotonin from the synapse to the nerve,
which increases levels of serotonin. Fluoxetine (20 mg),
sertraline (50 mg), paroxetine (20 mg) etc.
• Serotonin and norepinephrine reuptake inhibitors (SNRIs)
SNRIs include venlafaxine (75 mg ) and duloxetine (40-60
mg).
• Bupropion (150 mg)- It acts by blocking the reuptake of
dopamine and norepinephrine and increases these
neurotransmitters in the brain.

59. Antidepressant Drugs
• Mirtazapine (15-45 mg/ day)
Mirtazapine targets specific serotonin and norepinephrine receptors
in the brain, thus indirectly increasing the activity of several brain
circuits.
• Atypical antipsychotics. Aripiprazole (Abilify) and quetiapine
(Seroquel) are atypical antipsychotics that were approved by the
FDA in 2007, and used to augment depression when used along with
antidepressants.
• Tricyclic antidepressants (TCAs)
TCAs include amitriptyline (150 mg), desipramine (150-200
mg/day), doxepin (150 mg), imipramine (50-200 mg/day)

60. Side effects of Antidepressants
•
•
•
•
•
•
•
•
•
Nausea
Weight gain
Fatigue
Restlessness
Insomnia
Headache
Sexual side effects
Tremor
Dry mouth
•
•
•
•
•
•
•
Agitation
Rapid heartbeat
Dizziness
Constipation
Menstrual complaints
Skin rash
Gastrointestinal
problems.

61. Summary

62. Take home Message

63. Tips to follow
1.Eating a healthy and balanced diet is among the best diet tips for
depression. Eating three to four evenly spaced meals throughout the
day prevents a sudden rise or fall in blood sugar levels, which in
turn prevents depression.
2.Along with other diets tips for depression, do not forget to consume
adequate amounts of water as good hydration combats fatigue and
stress.
3. A natural diet tip for depression is to augment B vitamins in the
diet, especially vitamin, B12 found in fish, meat, poultry, eggs, and
milk, and folic acid present in mushrooms, lentils, and legumes.
4. One of the must follow diet tips for depression and anxiety is to opt
for smart carbs like whole grains, fruits, legumes, and vegetables
rather than refined sugars to stabilize the mood by keeping blood
glucose levels steady.
•

64. Tips to follow
5. There is a relationship between obesity and depression. Maintaining a healthy
weight is important for someone with depression.
6. Consuming natural proteins like beans, peas, low-fat cheese, fish, milk, soy
products, and yogurt is another diet tip for combating depression.
7. Selenium rich products like nuts (brazil nuts), seeds, sea food, lean meat, beans,
and legumes should be included in a diet for depression.
8. Eating foods rich in antioxidants and vitamins E and C prevents depression.
9. Consume plenty of vitamin D by getting adequate exposure to sunlight to boost
your mood.
10.Watch
the
amount
for
stimulants
like
coffee,
tea,
alcohol.

65. References
•
Bourre, J. M. (2005). "Dietary omega-3 Fatty acids and psychiatry:
mood, behaviour, stress, depression, dementia and aging." J Nutr Health Aging
9(1): 31-8.
• Coppen, A. and C. Bolander-Gouaille (2005). "Treatment of depression:
time to consider folic acid and vitamin B12." J Psychopharmacol 19(1): 5965.
•
•
David Mischoulon and Maurizio Fava, (2002). “Role of S-adenosyl-Lmethionine in the treatment of depression.” Am J Clin Nutr;76(suppl):1158S–
61S
Dianne Volker and Jade N.G. (2006). ―Depression: Does nutrition have an
adjunctive treatment role.‖ Nutrition & Dietetics(63): 213–226 DOI:
• Hvas, A. M., S. Juul, et al. (2004). "Vitamin B6 level is associated with
symptoms of depression."Psychother Psychosom 73(6): 340-3.
•
John I. Nurnberger, (2002). ―Is There a Genetic Relationship Between
Alcoholism and Depression‖. Alcohol research and health. Vol. 26, No. 3,
• Joseph M. Boden and David M. Fergusson .(2011 ). Alcohol and
depression Society for the Study of Addiction

66. References
References
• Link Between Fast Food and Depression . ScienceDaily (Mar. 30, 2012)
• Logan, A. C. (2004). "Omega-3 fatty acids and major depression: a primer
for the mental health professional." Lipids Health Dis 3: 25.
• Logan, A. C. and M. Katzman (2005). "Major depressive disorder:
probiotics may be an adjuvant therapy.― Med Hypotheses 64(3): 533-8.
• Patrick Holford, (2003) .Depression: the nutrition connection, Primary
Care Mental Health 1: 9- 16
• Practice Guideline for the Treatment of Patients With Major Depressive
Disorder, Third Edition, (October 2010).
• Rena Freedenberg, N. D. (2009). ―Naturopathic/Holistic Treatment of Mild
to Moderate Depression.‖ Natural Medicine Journal 1(4).
• Sachdev, P. S., R. A. Parslow, et al. (2005). "Relationship of
homocysteine, folic acid and vitamin B12 with depression in a middle-aged
community sample." Psychol Med 35(4): 529-38.
• Sathyanarayana Rao T. S, Asha M. R, Ramesh B. N, Jagannatha Rao K.S.
―Understanding nutrition, depression and mental illnesses.‖ Indian J
Psychiatry 2008;50:77-82