Is there a link between mental health issues and nutrition?

DepressionIt seems that there is, at least in some cases, and links have been made between gluten – which is of course my main interest here – and:

  • ‘brain fog’
  • anxiety
  • depression
  • dementia
  • autism
  • and schizophrenia

Many people have reported ‘brain fog’ and anxiety as symptomatic of gluten poisoning, and depression is a classic symptom of coeliac disease. The Mayo Clinic believes that coeliacs are at increased risk of dementia, and Michael Gardner, Professor Emeritus at Bradford University is researching the theory that diet is involved with autism and schizophrenia.

Today, though, I want to look at depression, and will come back to schizophrenia and autism another time.

We know that depression is present in a higher percentage of people with coeliac disease than in the normal population, based on Italian studies in 2003 (and others).

You might ask: which came first? Are people depressed as a result of their diagnosis, or is the disease the cause of the depression?

The answer seems to be both.

Eating gluten can cause depression

Eating gluten if you are a coeliac (diagnosed or not) seems to have an impact not only on your physical health, but also on your mental health. There may be two reasons for this:

  • malabsorption

    coeliacs eating gluten fail to absorb tryptophan, which leads to a decrease in production of serotonin (the ‘feel-good’ brain chemical), and increasing the risk of mood disorder. Coeliacs eating gluten are also likely to be short on other vitamins as a result of their malnutrition, such as vitamin B6, vitamin C, folic acid and zinc, all of which are needed to help make serotonin from tryptophan.

  • the immune response

    cytokines are produced that may change the body’s ability to regulate mood

    Cytokines, signaling molecules of the immune system, have been implicated as a contributing factor for mood disorders such as depression (from Biopsychiatry 2003).

    Maes and Smith (Perspectives in Depression 1999) have proposed excessive cytokine secretion due to chronic immune system activation as a fundamental pathology underlying depressive symptoms. Cytokines as such cannot cross the blood-brain barrier, but growing evidence suggests that specific cytokines may signal the brain to produce neurochemical, neuroendocrine, neuroimmune, and behavioral changes.(Kronfol and Remick, Am J Psychiatry 2000). Cytokine activation is known to enhance the hypothalamus-pituitary-adrenal axis hyperactivity associated with major depression. (Maes and Smith Psychomeuroendocrinology 1995). … Any such mechanism could be operative in untreated CD and could cause disturbances in brain serotonin function, predisposing the patient to mood and behavioral disorders. (from Psychosomatics 2002)

Being diagnosed can cause depression

And of course having a lifelong condition that requires a lifestyle change is highly likely to trigger depression – whether the condition is coeliac disease or some other significant disorder.

The Royal College of Psychiatrists has a section on physical illness and depression, as a subset of its depression pages.

So what can we do?

The easy answer is, of course, to avoid gluten, though as we all know, this isn’t that easy.

Once you’ve eliminated gluten from your diet, then your nutrition should improve. Eating a healthy diet – not junk food that happens to be gluten free – will help. Gluten free sources of the elements mentioned above include:

  • meat, fish, beans and lentils for tryptophan
  • avocados, bananas, raisins, currants and sultanas, sunflower seeds and soya for vitamin B6
  • a wide range of fruit and vegetables for vitamin C
  • leafy green vegetables, avocados, oranges, almonds and walnuts for folic acid
  • and zinc can be found in peanuts, cheese, figs, nuts and seeds, and small amounts in green and yellow fruit and vegetables

Eat all of that lot, and you ought to be producing some serotonin, and feeling a lot better. Plus, of course, removing gluten from your diet will also remove the immune reaction.

But what about depression caused by the discovery of the condition, rather than the condition itself?

If you think (or those around you think) that you may be depressed, you should seek treatment. This isn’t something you can just ‘snap out of’. Do go and see your doctor.

Also, researchers have found that psychological support can help coeliacs with anxiety and depression stick to the gluten free diet – so if you are struggling with the diet, ask for professional help. There are also supportive amateur communities around who can offer advice – try the gluten free messageboard – but this isn’t a substitute for treatment.

Further reading:

Food and Behaviour Research and Food and Mood have interesting and valuable information about the relationship between nutrition and health.

If you need more information about dealing with mental health issues, visit the NHS section on mental health at National Library for Health and the Royal College of Psychiatrists section on mental health information.

Kathy at Gluten Free Kathy is researching the psychology of celiac disease, and is compiling a list of useful links.