Drew Ramsey - Eat to Beat Depression and Anxiety: Nourish Your Way to Better Mental Health in Six Weeks

To my colleagues working in mental health.
Keep up the good fight.

Psychiatric medicine and mental healthcare have a serious problem.

Experts around the globefrom the World Health Organization to the Pew Research Centerall agree: we are in the midst of a mental health epidemic. Diagnoses of depression and anxiety disorders have snowballed over the past decade, now occurring more frequently in teens and young children. The number of suicides across the United States has skyrocketed during this time as well to a level beyond tragic. Anyone reading the headlines is aware that substance abuse issues are at an all-time high, too. Approximately one in four individuals will be diagnosed with a mental health condition, like depression or anxiety, over the course of their life. Chances are, you or someone close to you has struggled with a mental health issue at some point.

In some ways, these statistics are not surprising. Our health is being challenged in ways we simply could not have anticipated even just a few years ago. Today, as a society, we are overworked, overstressed, and overstimulated by the demands of daily life. We eat too much, sleep too little, remain too sedentary, and discount what our bodies need to truly thrive. The modern Western lifestyle has wreaked havoc on our physical health, leading to increased incidence of medical conditions like diabetes, cancer, and heart disease. This lifestyle has greatly affected our mental health, too. More and more, people go about their days with depleted energy stores, feelings of hopelessness, and an overwhelming sense of worry. We seem to be at the mercy of our devices and smartphones, spending far too much time distracted by strangers instead of making strong connections with those closest to us. Over time, all these things add up, leading to mental health crisesand, perhaps, a clinical diagnosis.

Given this ongoing battle to preserve Americas mental health, patients, families, and doctors need all the tools they can get to win this fight. Over the past few decades, the field of psychiatry has gained remarkable insights into the biological factors that may underlie changes in mood and anxiety levels. Yet emerging scientific studies are now showing us that one of the most powerfuland underutilizedtools to help us combat depression and anxiety can be found at the end of your fork.

Today Im known as a nutritional psychiatrist. But I didnt always know that food played such a vital role in brain health.

As a practicing psychiatrist who specializes in mood and anxiety disorders, my job is to review and assess a patients complete medical history to get to the bottom of any mental health issue. My training helps me understand that physical and mental health are intrinsically linkedfor example, often a bodily issue like a thyroid problem can have great impact on a persons mood or anxiety levels. During an initial workup, psychiatrists will ask patients a lot of questions, some of which they may not expect to be asked, to gather the data needed to understand what may be at the root of a persons low mood or increased feelings of anxiety. When I was just starting out in my career, I learned a lot about how to ask questions about a persons medical history, family background, and what might be happening at work and at home.

But Id never been taught to ask my patients what they were eating.

This struck me, even then, as a bit odd. Thats likely because of my background. In the late seventies, when I was five years old, my parents moved our family from Long Island, New York, to a homestead in Crawford County, Indiana. There, they started caring for 123 acres of pasture farmland, planting, tending, and harvesting a variety of fruit, vegetables, greens, beans, and herbs. Today, I live on that same farm with my wife, children, and parents, commuting each week to my clinic in New York City. I spend my weekends battling the dense clay soil, weather, and bugsand marveling, with my children, at the miracle of seeds sprouting into nourishing food. I may not have been fully conscious of it at the time, but even as a child, I seemed to understand that eating fresh, whole foods just made me feel betterin body, mind, and spirit.

Years later, while a medical student at Indiana University, what I learned about nutrition can most succinctly be summed up as meat and dairy are bad, vegetables are good. Its probably not so different from what youve read over the years about what constitutes a healthy diet. And so, wanting to be happier and healthier, I decided to adopt a low-fat vegetarian diet. In fact, I didnt eat meat, including fish and seafood, for nearly twelve years.

While the data is clear that eating mainly plant-based foods plays an important role in overall health, I was so focused on maintaining a diet without steak or salmon that I didnt stop to consider whether my bodyand my brainwere getting the nutrients they needed to truly thrive. My go-to foods included veggie burgers, mac and cheese, and a lot of pizza. It wasnt until new research started to link levels of omega-3 fatty acids, a type of polyunsaturated fatty acids commonly found in seafood, to brain health that I started to wonder if maybe my diet wasnt as healthy as Id thought.

I began to wonder: are there foods that can better help promote brain and mental health? And, if so, why arent we talking about those foods, and how they affect mood and anxiety?

Traditionally, treatment protocols for depression and anxiety have focused on talk therapy and medication. These two tools, working alone or in tandem, work well for many people, when theyre available. Unfortunately, for others, these popular interventions do not bring as much relief as hopedor if they do, they come with a host of unpleasant side effects, including weight gain, drowsiness, sexual problems, and constipation. This can demoralize patients who are already struggling to just feel even a little bit better.

As a physician, who swore an oath to do no harm, its important to me to explore all the available options to help my patients feel better. And, as part of that, I also want to make sure anything I prescribe isnt just replacing one health issue with another. While antidepressant and antipsychotic medications have changed the face of psychiatry, and have been lifesavers for many patients, they cannot and should not be the only tools at a psychiatrists disposal to treat patients. Any safe, effective options we can add to our arsenal to help prevent, manage, or remit mental health conditions are more than welcome.

Healthy eating is one such tool. Yet good, nourishing foods that provide key nutrients setting the foundation for optimal brain function have been all but overlooked in the mental health arena. At this point, its hard to understand why. The science is clear. Weve known for over a decade that your dietary pattern, or the amount and variety of foods you habitually consume, is linked to brain function, and, by extension, your risk of developing a condition like depression or anxiety. Good mental health, just like physical health, depends on proper nutrition. If you are running low on a few key vitamins or minerals, you are more likely to experience issues with mood or excessive worrying. So why not focus on ways to increase those vital nutrients?

When I did finally start talking to my patients about what they ate, the results were startling, to say the least. Not only were the vast majority of them not eating the healthy nutrients that we now know are vital to maintaining a thriving body and brain, but they were also actively consuming foods that we know to be detrimental to their health. It became clear to me that here was a place where we, as clinicians, could better support our patients as they underwent treatment. And, in the process, empower them to make positive changes on their own to help improve their own mental health.