There's no magic food or supplement that will make depression disappear, but a nutritious, balanced diet is vital to staying healthy both mentally and physically.

Depression is a serious illness that should be treated by a therapist and/or physician. But there are also changes you can make in your daily life, including getting regular physical activity and eating well.

Fish oil. The omega-3 fatty acids in fish oil have been getting a lot of press in recent years. Research suggests that omega-3's may have a wide range of health benefits, from your heart to your brain. Omega-3's help your brain function properly, and some research has found a deficiency of these fatty acids in depressed people.

It's hard to say whether the depression or the omega-3 deficiency happened first. Still, experts say that including foods that are high in omega-3's in your daily diet is a good idea. The best dietary sources of omega-3's are fatty fish such as salmon, as well as in flaxseed, canola oil, soybeans, pumpkin seeds, and walnuts. (Tuna is rich in omega-3s as well, but citing dangers of mercury contamination, the Environmental Protection Agency has warned that young children and pregnant or nursing women should eat no more than one can of albacore tuna and two cans of regular tuna a week. It has also urged women of child-bearing age to avoid shark, mackerel, tilefish, and swordfish, all of which are high in mercury.)

Some health professionals recommend taking a fish oil supplement, but check with your doctor first. Supplements can cause digestive upset, and may not be a good idea if you have certain health problems.

Get your share of D. A study reported in the May 2008 issue of Archives of General Psychiatry suggests that low levels of vitamin D -- sometimes called the sunshine vitamin -- may be linked to depression in older people. The study of 1,282 people aged 65 and older found that levels of vitamin D were 14 percent lower in people who were depressed than in people who weren't depressed.

Low levels of vitamin D are often found in people who have seasonal affective disorder, or SAD -- a sense of sadness or depression that usually occurs in the wintertime when there is less sunshine. One small study found that vitamin D helped sufferers of SAD to feel less depressed.

Although the link between depression and low levels of the vitamin has yet to be proven, it won’t hurt and may boost your overall health to correct a vitamin D deficiency: Make sure you get plenty of vitamin D in your diet, include foods like milk, yogurt, fortified cereals, mushrooms, and fish such as salmon, mackerel, or sardines. A vitamin D supplement can help, too, but check with your doctor because it may interact with other medicines you're taking. You can get an extra vitamin D boost by spending a little time out in the sun in the early morning or late afternoon, since ultraviolet rays from the sun triggers its production in the body (but be careful if you are sensitive to the sun or have a history of skin cancer).

Vitamin B-12. People with low levels of B-12 are at higher risk of suffering depression than people who have a sufficient supply of the vitamin, although we don’t always know which came first -- the vitamin deficiency or the depression. They may also suffer from confusion and memory problems that may be mistaken for dementia. B vitamins help in the production of brain chemicals that regulate mood, so it's important to include foods rich in B-12 in your diet every day. Good sources of vitamin B-12 are fish, meat, poultry, eggs, milk, and fortified cereals. (Many sources of B-12 are animal-based, so vegans and vegetarians may need to take a supplement to get enough in their diet.)

About one-third of people over age 50 have trouble absorbing the vitamin from their diets. If you think you might be low on B-12, your doctor can give you a simple test and let you know whether you should take a supplement.

Folate (folic acid): A number of studies have examined the possible links between depression and low levels of folate. In the January 2005 issue of the Journal of Pharmacology, researchers reviewed findings that people with major depression often had levels of vitamin B12 and folic acid in their blood. The researchers concluded that low levels of the two vitamins were associated with depression. “On the basis of current data,” the researchers concluded, “we suggest that oral doses of both folic acid (800 micrograms daily) and vitamin B12 (1 mg daily) should be tried to improve treatment outcome in depression.”

Many people find a cup of coffee gives them just the boost they need to get going in the morning, but according to the Mayo Clinic, caffeine may worsen existing depression in some people. Just why this happens isn't clear, but one theory is that caffeine causes blood sugar levels to fluctuate, which can affect mood. Caffeine can also make it harder to get a good night's sleep, which can worsen depression. And some people may feel a drop in mood after the initial caffeine boost wears off.

If you're a coffee drinker and think that caffeine might be contributing to your depression, taper off gradually. Quitting abruptly can cause withdrawal symptoms such as headaches, fatigue, irritability and nervousness

Other people look to alcohol for a little pick-me-up when they're feeling down. But if you're suffering from depression, a cocktail or glass of wine may only worsen your mood. Most important, alcohol can be dangerous when combined with certain antidepressant medications because you may feel extra drowsy or intoxicated. And when combined with antidepressants called monoamine oxidase inhibitors, alcohol can cause a spike in blood pressure that could lead to a stroke.

If you still plan to have the occasional drink, check with your doctor to see if alcohol could interfere with the medication you're taking. Never stop taking antidepressants without checking with your doctor first. Most antidepressants need to stay at a consistent level in your body in order to work properly.

Several over-the-counter (OTC) supplements have been tested as treatments for depression with mixed results. Keep in mind that OTC supplements are not regulated by the Food and Drug Administration the way prescription medicines are, so there is no way to tell how pure the ingredient is or whether you're getting the amount the label says. Always check with your doctor before taking any OTC medicine -- some may interact with other prescription or OTC medicines you take,. Here are a few common supplements sometimes promoted for depression relief.

SAM-e. Short for S-Adenosyl-L-Methionine, SAM-e is a synthetic form of a natural compound with many different roles in your body's chemistry. In some studies, SAM-e has been more effective than a fake pill, or placebo, in improving symptoms of depression. However, experts feel that more research using larger numbers of people and precise dosages is needed before it can be determined whether SAM-e can truly relieve depression.

Don't take SAM-e if you have been diagnosed with bipolar disorder because it may trigger extreme mood swings. Some people experience digestive upsets with this supplement.

St. John's wort. Various forms of this yellow-flowered plant have been used over the centuries to treat depression and anxiety. Some studies have found it helpful in easing mild depression but not major depression. Though it's not clear how St. John's wort functions in the body, one theory is that it acts on the chemical messengers in the brain. It has some drawbacks, however: Side effects can include dry mouth, dizziness, diarrhea, nausea, sensitivity to sunlight, and fatigue. St. John's wort can also interfere with prescription anticancer medicines, HIV medicines, birth control pills, blood thinners and heart medicines, and cyclosporine (a medicine that helps prevent the rejection of transplanted organs). It can also increase the side effects of prescription antidepressants, so talk to your doctor before trying this OTC remedy.

•Use this food diary to see whether you're getting all the nutrients you need.

•Think about what you eat and how it makes you feel. If you notice your mood sags after eating certain foods, try avoiding them for a week and see if you notice a difference.

•Print our Healthy Eating Guide to help you stay on target.

•Use our Daily Nutrition Calculator to find out what nutrients you need.

Future classes:

Managing Depression 101, Part 5: Complementary Treatments

-- Nancy Montgomery is a senior editor for Consumer Health Interactive.

References

First published December 18, 2009
Copyright © 2009 Consumer Health Interactive

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