A growing trend in the mental health field suggests that diet is as important to mental health as it is to physical health, and as such, treatments must go beyond traditional pharmacology and talk therapy to be integrated and holistic.
Let’s take a look at this recent Columbia University study that examines the link between depression and diet in post-menopausal women. In this study, refined carbohydrates led to increased depression symptoms (fatigue, mood changes, etc.) and high fiber foods and vegetables were found to lower depression symptoms.
Foods rich in fiber, vegetables and non-juice fruits lower symptoms of depression.
There is more and more evidence that a highly processed, nutrient-devoid Western diet contributes to mental illness. The Western diet, despite being highly caloric and fatty, does not contain vital nutrients that support healthy brain function. The research is basically showing us that our brains are not dissimilar from other organs in what it takes to be healthy.
“ Although the determinants of mental health are complex, the emerging and compelling evidence for nutrition as a crucial factor in the high prevalence and incidence of mental disorders suggests that diet is as important to psychiatry as it is to cardiology, endocrinology, and gastroenterology”
— International Society for Nutritional Psychiatry Research
Furthermore, many medical conditions caused or exacerbated by unhealthy diets and being overweight require weight loss as treatment. It is a vicious cycle. For many people, the interrelated effects of diet on our mind and body, combined with unhealthy habits, work to reinforce the very symptoms they wish to address.
The idea that diet and nutrition play an important role in mental health is common sense, yet it is considered a “novel” treatment when compared with prevailing psycho-pharmacology based approaches. Pharmaceutical companies, who are generally well funded and command impressive R&D resources, are charged with delivering solutions to mental health problems like depression and anxiety. The problem is that anti-anxiety and anti-depressant medications cannot fundamentally change your brain, body, mental health, or perspective in the long term. Most certainly these medications are helpful for many in alleviating suffering from anxiety, depression, and a range of other issues, but are they the only solution? The Columbia study asks us to consider that perhaps adherence to a low-glycemic Mediterranean diet, or just cutting out most refined, processed foods, could have as big of an impact in reducing symptoms. I think at the very least, diet should compliment medication, along with what I call proper "brain training".
Let’s face it – it can be much more simple to take a pill than to make the types of lifestyle choices necessary for our optimal health. This is where it gets complicated. If changing behaviors and lifestyle was really that easy, wouldn’t we all be perfectly fit and healthy? When I say you can start with training your brain to make the changes, I’m referring to using the concepts of cognitive behavioral therapy (CBT), which is established as effective in the treatment of many medical conditions.
The first step in introducing changes to your diet and elimination of the foods that are making you depressed or preventing you from living your fullest is to know yourself- understand this first- the more you exercise the restraint muscle, instead of giving-in, the more you build up your ability to resist. The behavior is secondary, and it serves to reinforce the resistance. Next ask yourself what is the trigger? What situations reinforce healthy habits and what situations interfere with them? Set up the conditions to support the healthy habits.
What is compelling you?
What is the trigger?
The next step is what to do about it.
Let's take “Healthy Doughnut” from the mobile application WeChat's Sticker Story. If you have friends or family in China as I do then you most likely know about this messaging platform and it’s wide range of goofy emoticon characters that can help you describe any type of mood. If you do not already know and love Healthy Doughnut, you will by the end of this post.
Healthy Doughnut has struggled with depression for most of his adult life, however he is keen on exercise since it helps him feel good about himself and boosts his endorphins. He is also very discouraged at times because his pizza habit is sabotaging his overall health and wellness progress, and to make matters worse, his doctor told him he is pre-diabetic and must drop 20 lbs! We're going to help him:
- set some goals
- evaluate his thoughts
- come up with some solutions and
- help Doughnut learn skills to continue managing on his own
For the purpose of this post – we will focus on our second point, "evaluating his thoughts", to get to the root of the issue. I am going to ask him to consider his "automatic thoughts" when it comes to his diet choices and lifestyle and how that impacts his goals. At first, he doesn't know what he thinks. He knows he feels good working out, inspiring others and making his green juice in his Ninja blender but he also feels pretty good at the thought of...pizza! In fact, he salivates even thinking about pizza. I tell him that we all have core beliefs & automatic thoughts that guide us in our decision making without even being conscious of them.
I ask Healthy Doughnut to think a little deeper and he comes up with this: “Well I have FOMO (fear of missing out) when it comes to food and especially pizza. I'm a bit of a foodie. I worry that I'm really missing out on something so divine and I'll be so bummed out if I can't have it, especially at a party when everyone else is eating it”.
Ok fair enough – he has fear of missing out of a good time. Next I might ask him questions to help him consider the helpfulness of this FOMO thinking and strategy by asking “how does that serve you? How do you feel after"? Also in the process uncovering another automatic thought of “it’s just not fair that I’m a doughnut and I’m so round compared to some of my banana friends”! What are some things Doughnut could think of to counter the “it’s not fair” thinking and the "FOMO” thinking that are not serving him well? Healthy Doughnut identifies that instead he could think about:
- "When I eat pizza, it sabotages the time I spend in the gym and robs me of my motivation".
- "Pizza actually makes me too full to be active".
- "The bigger FOMO will be the feeling of lack of self-control".
Healthy Doughnut counters his “it’s not fair” thinking with:
- "It doesn’t do any good to compare myself to others as I’m uniquely me".
- "I have many attributes to be grateful for, like; "I’m a good student, people say I inspire them, and I am lovable".
He loves to exercise, so to better understand the concept of“brain training”, he imagines he is giving his brain a workout. The negative thoughts inside his head operate like muscle memory and need to be challenged to avoid resorting back to the old, inefficient way of thinking. He states "I need to train my brain too, in order to do something different and change, just like I have to lift a kettle ball to get the quads I want".
From here we also come up with a plan and activity using “coping cards” to make this thinking as habitual as the "FOMO" and “Unfairness” ideas that pop into his head. To do this we write out what the problematic, automatic thoughts are and what the adaptive responses are. His assignment is to refer to these several times a day.
Healthy Doughnut and I uncover a core belief that deep down "it won't make a difference anyway so why bother". Further work involves changing his deeply held belief system.
What are your sabotaging thoughts when is comes to making decisions about food? Mine is scarcity and waste. For scarcity, I ask myself, "what's really going to happen if I'm hungry for another hour or two? Am I going to get sick, or worse, die"? If I see a bagel and doughnut spread at a meeting, I will think that I should help myself, so they don't go to waste. Instead, a more helpful or "adaptive" way to think about it is "What's the big deal"?, or, "you are not going to be the solution to the world's hunger problem by avoiding that bagel". Try making a "coping card" on your own or better yet, challenge a friend for accountability and see if it’s helpful for you!