Lifestyle Tips
1.) Walk in nature - Any type of green exercise (aka forest bathing) appears to improve self-esteem and negative mood states, including tension, anger and depression. [i]
2.) Call your ‘upbeat’ friends - Call your joyful friends! Happiness is contagious. Evidence suggests that mood may spread from person to person. In general, increasing social connection reduces the risk of depression. [ii]
3.) Increase fruit and veggies - Adopting a healthier diet, will boost your mood. [iii]
4.) Increase exercise - Increasing levels of physical activity can improve happiness. A happiness boost seems to ensue whether you exercise 150 minutes or 300+ minutes per week. [iv]
5.) Offer kindness to offers - Those who practice loving kindness, or wish others well, feel more connected and empathetic, with less anxiety. [v]
Nutrients to Boost Mood
Omega 3 Fatty Acids
What are Omega 3’s?
-Omega 3 fatty acids are an essential building block of the brain, with 20% of brain cell membranes composed of fatty acids.
-They are deemed an ‘essential nutrient’, meaning they must be obtained from your diet as your body cannot produce them.
-In addition to contributing to cellular structure, Omega 3’s have an anti-inflammatory effect on brain cells.
=There are two types of Omega 3’s: EPA and DHA.
Omega 3’s and Your Mood
-Omega 3’s possibly support mood because they reduce brain inflammation (e.g., neuro-inflammation). [vi]
-Diets with reduced amounts of Omega 3’s have been associated with many depression and anxiety disorders.
-Individuals diagnosed with depression or anxiety, have significantly lower levels of Omega 3’s in their blood and brain.
-Several epidemiological studies have found that individuals with low fish consumption (less than 1x/week) present with higher scores of depression. [vii]
-A 2019 study determined that taking an Omega 3 supplement with more than 60% EPA at 1 gram/day has beneficial effects on depression.
Sources of Omega 3’s
-Fish and other seafood (specifically cold water fatty fish like salmon)
-Nuts and seeds (e.g., flaxseed, chia seeds and walnuts)
-Marine algae (e.g., seaweed)
Note: Our oceans are contaminated, so it is important to purchase fish oil that has been tested by a 3rd party for contaminants. This includes plastics and heavy metals such as mercury. These types of fish oil are widely available in health food stores and you can always ask the company directly for their testing certificates if it is not displayed on the label.
FYI: Large quantities of fish oil can interact with blood thinners, so discuss with your primary care provider prior to initiating.
Vitamin B12
I recommend a Vitamin B12 blood test to all patients who are experiencing mood symptoms (e.g., depression, anxiety).
Vitamin B12 has a foundational role in synthesizing neurotransmitters (e.g., serotonin, dopamine, epinephrine) that are important in maintaining mood, as well as myelin (the insulation around nerves that keeps information flowing smoothly). A chronic deficiency in Vitamin B12 can result in a diversity of neurological symptoms.
Mood Effects:
-A decrease in Vitamin B12 blood levels, correlates with an increase in depression.[vii]⠀
-Higher Vitamin B12 levels, may be associated with improved outcomes in depression.⠀
-Vitamin B12 supplementation with antidepressants significantly improves symptoms of depression, compared to just antidepressants alone. [ix]
Sources of B12:
-Vegetarians and vegans are at particular risk of having a Vitamin B12 deficiency, given that animal protein (e.g., red meat) is the predominant source of B12. Vegan sources include certain seaweeds and algaes, as well as nutritional yeast.
Supplements:
-When looking for a B12 supplement, choose methylcobalamin, as cyanocobalamin is -a synthetic form of B12 that is generally not well absorbed.
-Sublingual or liquid formulations will be best for optimal absorption.
-Discuss with your primary healthcare provider if a B Vitamin supplement is right for you.
Vitamin D3
I screen Vitamin D levels in all patients, especially those that have depression.
Mood Improvements:
- Supplementing with Vitamin D has been shown to improve mood, while reducing inflammatory markers in women with anxiety and Vitamin D deficiency. [x]
-A 2018 study of 126 women found that lower Vitamin D levels were correlated with higher levels of depressive symptoms. [xi]
-There is a significant relationship between depression and Vitamin D deficiency, meaning the lower the levels of Vitamin D, the higher the rates of depression. [xii]
Should I Supplement?
-At this latitude on Vancouver Island in Canada, we simply do not get enough sun exposure throughout the year to allow our body to produce an adequate amount of Vitamin D.
-Current Health Canada recommendations are that everyone should supplement Vitamin D throughout the year.
What Dosage?
-Dosing of Vitamin D3 depends on the level of deficiency, I recommend getting your blood levels of Vitamin D tested. From this, it can be determined how much Vitamin D you should be taking. Doses vary between 1,000 IU and 10,000 IU a day.
-Vitamin D3 is the optimal form of Vitamin D to supplement with, and since it is a fat-soluble vitamin, taking it as an oil emulsion or with another fat source is ideal for absorption.
Safety
-Since it is a fat-soluble vitamin, it will accumulate, therefore do not supplement high doses without guidance from your primary healthcare provider as it can cause toxicity.
References
[i] Pretty, J., Peacock, J., Sellens, M., & Griffin, M. (2005). The mental and physical health outcomes of green exercise. International journal of environmental health research, 15(5), 319-337.
[ii] Eyre, R. W., House, T., Hill, E. M., & Griffiths, F. E. (2017). Spreading of components of mood in adolescent social networks. Royal Society open science, 4(9), 170336.
[iii] Firth, J., Marx, W., Dash, S., Carney, R., Teasdale, S. B., Solmi, M., ... & Sarris, J. (2019). The effects of dietary improvement on symptoms of depression and anxiety: a meta-analysis of randomized controlled trials. Psychosomatic medicine, 81(3), 265.
[iv] Zhang, Z., & Chen, W. (2019). A systematic review of the relationship between physical activity and happiness. Journal of happiness studies, 20(4), 1305-1322.⠀
[v] Gentile, D. A., Sweet, D. M., & He, L. (2019). Caring for others cares for the self: An experimental test of brief downward social comparison, loving-kindness, and interconnectedness contemplations. Journal of Happiness Studies, 1-14.
[vi] Liao, Y., Xie, B., Zhang, H., He, Q., Guo, L., Subramaniapillai, M., ... & Mclntyer, R. S. (2019). Efficacy of omega-3 PUFAs in depression: a meta-analysis. Translational psychiatry, 9(1), 1-9.
[vii] Larrieu, T., & Layé, S. (2018). Food for mood: relevance of nutritional omega-3 fatty acids for depression and anxiety. Frontiers in physiology, 9, 1047.
[viii] Petridou, E. T., Kousoulis, A. A., Michelakos, T., Papathoma, P., Dessypris, N., Papadopoulos, F. C., & Stefanadis, C. (2016). Folate and B12 serum levels in association with depression in the aged: a systematic review and meta-analysis. Aging & mental health, 20(9), 965-973.
[ix] Syed, E. U., Wasay, M., & Awan, S. (2013). Vitamin B12 supplementation in treating major depressive disorder: a randomized controlled trial. The open neurology journal, 7, 44.
[x] Fazelian, S., Amani, R., Paknahad, Z., Kheiri, S., & Khajehali, L. (2019). Effect of Vitamin D supplement on mood status and inflammation in Vitamin D deficient Type 2 diabetic women with anxiety: A randomized clinical trial. International journal of preventive medicine, 10.
[xi] Lamb, A. R., Lutenbacher, M., Wallston, K. A., Pepkowitz, S. H., Holmquist, B., & Hobel, C. J. (2018). Vitamin D deficiency and depressive symptoms in the perinatal period. Archives of women's mental health, 21(6), 745-755.
[xii] Giordano, N., Goracci, A., & Fagiolini, A. (2017). Depression and vitamin D deficiency: causality, assessment, and clinical practice implications. Neuropsychiatry, 7(5), 606-614.