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mental health mondays :: eat happy

lots of people shy away from treating mental disorders with drugs, at least until they've tried other options and in milder or transient cases of depression or anxiety, that might be the best way to go. there is some evidence to indicate that unless someone is seriously depressed [although the threshold for determining seriousness is a little unclear], anti-depressant drugs aren't going to be particularly effective, which means you're taxing your liver for no reason. diet, on the other hand, is increasingly linked both to improving mental health and preventing mental issues to begin with. plus, for those who do need medication, eating specific foods and maintaining an overall healthy diet makes for good supplementary medicine.

there are, of course, a few tricks to getting the mental balance right and getting the maximum benefit from what you eat and it's possible to get very, very complicated very, very quickly. so while there is a lot more to learn on the subject, what follows is a very brief primer on how to eat the crazies away with a few key nutrients. first off, though, a little preface about how you should be getting those nutrients.

to supplement or not to supplement

the vitamin/ mineral supplement industry has gone through massive growth and continues to benefit from "superstar" products that become the rage and then are replaced by the next rising star cure-all. [ten years ago if you talked to someone about probiotics, they probably would have thought it was something to do with robots.] fads are often attached to perfectly valid science but, of course, it can be difficult to determine how closely the end product conforms to what's required to reproduce scientific results. moreover, fad products can be dangerous: they're often rushed to market, they can have disastrous impacts on the environment [thousands of pounds of fish are required to produce even a nominal amount of the fish oil used in omega-3 supplements] and they often don't take into account how the body processes ingredients on their own.

that last part is why most people i know who are well-informed professionally or personally about nutrition recommend getting whatever elements you can from your diet and not from supplements. our bodies are not built to process nutrients on their own. they're built to extract nutrients from a whole food. other elements in the food help the body absorb key nutrients, therefore maximizing the benefits and requiring a smaller quantity of those nutrients [since a greater portion of what's consumed is usable]. some elements are better absorbed in isolation than others, or can be difficult to obtain within certain diets that it's worth investing in supplements, but most people should be able to meet their dietary requirements through their food alone. [this leaves aside the question of cost. high quality supplements get expensive and since depression is culturally linked with poverty, they may just be outside the budget of a lot of people.]

with that out of the way, here are a few ingredients with decent science behind them that can help you feel better about yourself, the world and life in general. at least a little bit. [note :: i haven't dealt with omega-3 fatty acids because there's already a metal health mondays post dedicated entirely to them. same goes for vitamin d.]

tryptophan 

most people hadn't heard of tryptophan until a few years ago when everyone started talking about how turkey was loaded with it and that it was the element that made you get sleepy after a holiday dinner. ironically, neither of those things are true. turkey is not especially high in tryptophan, although it does contain it, and tryptophan does not make you especially sleepy. you're sleepy because you ate too much and your body is marshaling its resources to digest all the food you put in it. add in a couple of glasses of wine with dinner, potatoes or other carb-heavy foods that trigger the release of insulin, and dessert that caused your blood sugar to spike then drop, and you have yourself a perfect storm of nap time.

tryptophan is an amino acid, crucial for good health and it cannot be produced by the body. that means it has to come through an outside source. fortunately, tryptophan is extremely easy to find, existing in almost every form of protein we consume. eggs, particularly egg whites, are the best source, but it's also present in chocolate [hell yes chocolate is health food], soy beans, fish [especially cod], aged cheeses like cheddar or parmesan, dairy, sesame, chick peas and, yes, turkey and poultry. interestingly, dried foods [including dried egg whites, fruit, and fish] are often better sources than fresh.

tryptophan helps mental health because it allows the body to synthesize serotonin and we all know how important that is to fighting depression. [or do we?] people who are chronically tryptophan deficient [fairly rare and generally linked to an inability to absorb tryptophan] do exhibit signs of depression.

natural tryptophan supplements are generally marketed as 5-htp [5-hydroxytrytophan]. tryptophan is converted to 5-htp in the body, which is ultimately converted to serotonin, so it's like you're taking the nutrient at a more advanced stage. however, there's little research on the efficacy of these supplements and what there is, is inconclusive. additionally, there is some concern that supplementation could [in theory] cause problems for the heart. might be best to wait on this one until there's more evidence available.

one weird little thing that's important to remember about tryptophan is that getting too much of it can actually make you deficient in it. once you've exceeded the amount that your body can handle, it starts signalling that you need to stop and uses the existing tryptophan in your blood to prevent further absorption. but once your body stops absorbing tryptophan, it stops absorbing it entirely, which means that what you're getting is useless to you and what you already have is losing its power. bizarre, huh?

do not consume foods high in tryptophan if you are taking maoi drugs for your mental disorder as the combination can be dangerous. maoi's are not particularly common anymore, in part because of the onerous dietary restrictions they impose. however, in some resistant cases, they're still prescribed when newer drugs have failed. don't worry, your doctor and/ or pharmacist will tell you if your prescription falls within this category.
 



vitamin b-12

this one is of particular interest to people with bipolar disorder, as b-12 deficiency has been linked to episodes of psychosis and mania. for regular people, the deficiency would have to be extreme to trigger this sort of reaction, but for people who are already prone to mania, the shift in b-12 levels would not have to be as drastic. on the other side, vitamin b-12 deficiency can also cause depression, along with a host of other health problems, most notably anemia and myelin damage [often manifested as multiple sclerosis, but implicated in neurological disorders such as dementia].

the reason that b-12 deficiency is linked to both depression and mania is that it is necessary for the production of neurotransmitters [gaba, serotonin, dopamine, etc.], which control moods on both ends.  that's actually an extremely simplified way of saying what it does, because b-12 is the largest and most complex vitamin, implicated in some of the body's most complex procedures.

neither humans nor animals can produce vitamin b-12 on their own, so we rely on the enzymes in bacteria to do it for us. we consume the bacteria and absorb the vitamin b-12, thank you very much. the synthesis of vitamin b-12 has a trick to it, however: it is created through a process of fermentation. herbivorous animals have little fermentation factories in their bellies that allow this process to take place. we don't. so because our bodies can't do the fermentation, we generally rely on eating the animals who ate the bacteria to get our b-12. the most potent sources are shellfish [particularly mussels] and liver, while secondary animal products like eggs [especially when cooked] and dairy are less useful. vitamin b-12 supply is a major issue for vegetarians and especially vegans, since even the fermented foods that purport to supply active b-12 have not been adequately tested.

b-12 is widely available in supplement form, which is fortunate since, aside from vegetarianism, virtually everything can cause vitamin b-12 deficiency. seriously, estimates are that up to 40% of the population are at least mildly deficient, even in the overfed western world. conditions like crohn's and celiac disease make the absorption of b-12 from food very difficult. the presence of h. pylori, the virus that causes ulcers, also reduces our ability to absorb. a host of medications impair the body's ability to separate vitamin b-12 from foods and certain others can block the effects of b-12 supplementation. plus it seems like the recommended daily intake of vitamin b-12 might have been underestimated by almost half for decades. oh, and if you're taking a folate supplement, it can mask a b-12 deficiency on a standard blood test, so even checking b-12 levels isn't foolproof.

some foods have increasingly been supplemented with b-12, which is an excellent option for vegetarians looking to maintain optimal levels. there are also lots of pill-form supplements available and evidence is that the body can get what it needs from these. people with a significant deficiency may require daily injections for a month or two to get their levels back up. which, by the way, can deplete the body's potassium resources, which causes other problems. don't worry, they'll rebound, but it might require upping your potassium intake for a while. bodies are complicated.]

although you should probably consider doing it anyway, you'll definitely want to quit smoking if you have to supplement your b-12 intake. the most common form of b-12 supplementation involves binding the vitamin to a cyanide molecule, which is then shed in the body. for most people, the amount left over is never going to be an issue, however smokers naturally have increased cyanide levels and... well, better safe than sorry, right?

vitamin b-6

like b-12, vitamin b-6 [actually a group of vitamins] is implicated in the production of neurotransmitters, which makes it crucial for mental health. [among other things, it's one of the substances that converts tryptophan to serotonin.] of course, it's crucial for a whole lot of processes, because it's one of the things that allows nerve cells to communicate with each other. it's efficacy as a treatment for depression is unproven, but maintaining proper levels does at least ensure that neurotransmitters can be produced. where preliminary studies have shown some interesting results is in the treatment of attention deficit disorder, which could make it a much more attractive option for children than "meth" treatments like ritalin.

true deficiency in b-6 is uncommon, since it's present in a large number of foods from both plant and animal sources. plant sources are actually better in this case, since the form of b-6 they contain is more stable than that found in animals, which makes it better able to withstand cooking and processing.

this is one element that is better consumed as food, because there's an upper limit to how much the body can handle without getting sick [and incidents of toxicity have come exclusively through supplementation]. plus, it's going to end up being a lot cheaper to eat b-6 than to buy it separately.

vitamin b-9

you might know her better as folic acid, panacea for pregnant women, but generally important to the maintenance of good health for all of us. its link to mental health is a little more tenuous than b-6 or b-12, but consensus seems to be that it affects so many things related to mental health that it must tie in, even if research hasn't determined exactly how. besides, there are a lot of advantages to having adequate folic acid in your system.

like vitamin b-6, b-9 is plentiful in foods, which means that it isn't generally necessary to supplement it. [unless you're pregnant, because that baby you're carrying is going to siphon off folic acid like a vacuum to ensure that it matures properly. also, folic acid depletion is a danger for alcoholics.] leafy green things, avocados, nuts, grains, fruit, fish, meat, eggs and some beers. and you can get all sorts of things that are fortified with folic acid. under normal circumstances, you should not have a problem maintaining optimal levels, and it's relatively difficult to overdo it.

the only case in which you might want to reduce your folic acid intake and certainly not supplement would be if you are undergoing cancer treatment. while folic acid has shown some promise in help building resistance to certain forms of cancer, it is a considerable detriment if cancer has already developed. that's because one of the crucial functions of folic acid is assisting the division and proliferation of cells. normally that's a good thing, but proliferation of cancer cells is exactly what you don't want, which is why anti-cancer drugs tend to have an anti-folic effect. part of the treatment you receive will unsure that the depletion doesn't become dangerous [through the use of a folic acid derivative].

vitamin c

we'll round up today's look at eating your way out of mental illness with a look at the "sunshine vitamin". with a nickname like that, it pretty much has to be an antidepressant, right? well, kinda. there have been some studies that indicate increased vitamin c intake is associated with elevated mood, but it's not clear that there's a clear chemical effect responsible for this. that said, there is evidence that vitamin c plays a role in the synthesis of the all-important neurotransmitters, so it can't hurt, right? [actually, it totally can hurt, but we'll get to that later.]

sources of vitamin c are fairly simple: fruits and veggies. generally associated with citrus fruits, it's more plentiful in berries, broccoli and brussels sprouts, among others. although the most concentrated sources [kakadu plum, camu camu, acerola, sea buckthorn] remain exotic in north america and europe, there are plenty of easily accessible options, including citrus. but there's a catch: vitamin c is a finicky bastard. it's a highly unstable element that reacts badly to just about anything you do to it, including any form of storage, processing or cooking. concentrations of vitamin c can be reduced by about 70% during the heating process, which does throw a wrench into the whole "easily accessible" thing. this might be where the preference for citrus fruits comes from, since they can easily be consumed raw and whole. foods rich in vitamin c can be rough to digest raw [partially because they're loaded with vitamin c], so you're left with the option of trying to just squeeze more of them into your diet to account for what's lost in the cooking process, or you can use a supplement.

vitamin c supplements are the most widely consumed in the world, which makes sense in that they are manufactured to keep the active ingredient stable, but also sort of weird, because vitamin c is something that can get pretty unpleasant if you consume more than your body can handle. in its mildest form, you'll spend some quality time on the toilet, unless you don't quite make it, which is a distinct possibility. continue ignoring the vital signs and you'll likely develop kidney stones. in theory, you could die from a high enough dose, but no one ever has and honestly, if persistent diarrhea and kidney stones aren't enough to raise an alarm, you probably shouldn't be feeding yourself.

the fact is that most of us get close to adequate levels of vitamin c from our diets and can probably cross the threshold by ensuring that the fresh fruits and vegetables we get are high enough in concentration that we can avoid the potential pitfalls of supplements.

all of this might seem like standard "eat healthy" advice and i suppose it is. after all, the brain is part of the body and not subject to some mysterious divide as philosophers once thought. the things that make us function better tend to make us function better in every way and the processes that are going on all the time in the background effect every system in our body.

i can't guarantee that healthy eating will work on its own, but it's something that can only help.

p.s. :: embedding links to past posts, i have realised that i have a strange predilection for using images from sesame street and the muppets for mhm posts. i can't imagine what i'm trying to communicate with that.

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