Mary had been depressed since her early twenties, including a few severe episodes in which she’d stayed in bed for two or three weeks at a time, unable even to get dressed or perform basic household tasks. As she’d approached menopause, her depression had worsened, and now, in her early fifties, she had been taking Paxil, an SSRI, for three years. Mary had always struggled a bit with her weight, but by the time she came to me, she had gained twenty-five pounds and was in despair.
“I don’t know whether it’s my hormones, the Paxil, or the way this depression gets me down,” she told me. I could see that she was trying to put a happy face on things, but beneath the surface cheerfulness, her voice sounded tired and discouraged. “I just don’t seem to have any energy anymore, and so of course, I don’t exercise. I feel like a big whale just beached up on the shore somewhere.”
Although Mary had supposedly come to me for help with her depression, I could see that her weight was almost as pressing a concern. “I just don’t know how I got this heavy,” she kept repeating. The more we talked, the clearer it became that Mary’s weight gain was integrally bound up in her feelings of hopelessness, worthlessness, and despair. “I know I don’t have any willpower,” she said once. Another time she remarked, “I should be able to stop eating so much, but somehow I just don’t.”
Mary’s sense of failure, and her increased sense of helplessness about being able to change her life, were clearly making her depression worse. And, as she talked on, I could see that her depression was contributing to her weight gain as well. “I get to feeling so low, and then I just eat,” she told me. “Sometimes it seems like food is the only thing that cheers me up.”
Mary was struggling with a problem that many of my patients encounter: the close connection between food choices, weight, depression, and brain chemistry. And, like many of my patients, she was caught in a vicious cycle. The choices she was making led her to feel worse—and the worse she felt, the harder it was for her to make healthy choices.
The good news, though, for Mary and for you, is that diet can have a revolutionary effect on your brain chemistry. Once you know what you need to eat, you can feel markedly better almost immediately, simply by cutting out a few unhealthy choices and adding the foods for which your brain and body are literally starving. It can be hard to make the switch, at first, especially when you’re feeling low. The thought of giving up that sack of chips while you watch TV or of switching from pasta to brown rice might seem to be a terrible bereavement, the loss of one of your few reliable pleasures. But I promise you, if you’re willing to try the suggestions in this chapter, you’ll experience an almost instantaneous improvement in your mood. You’ll almost certainly feel more energized and healthy—and you’ll probably lose some weight.
One word of warning: All of us tend to be emotional about our food choices, and it can be hard to hear someone suggest any changes, particularly when we’re feeling low. So if you find that reading this chapter—or just thinking about reading this chapter—makes you anxious, sad, or fearful, take a deep breath, remind yourself that you’re allowed to make changes at your own pace, and keep reading. You really can eat your way into a better mood—and your brain will start rewarding you as soon as you do.
For Mary, as for many depressed people, weight and depression were interconnected. Although it’s too simple to say either that weight gain leads to depression or that depression causes obesity, there are many ways in which being overweight and being depressed reinforce each other.
First, many people, like Mary, find it soothing to eat, and often turn to food when they’re stressed, upset, or anxious. And the foods to which they turn tend to be high in sugar (candy, ice cream, pastries, sodas) and in refined carbs (potatoes, bread, pasta, crackers, chips, and other foods made with white flour), both of which raise the blood sugar very quickly. Indeed, Mary told me that when she felt lonely, sad, or anxious, she liked to fill up on sweet and starchy foods, which seemed, at least temporarily, to have a cheering effect.
I explained to Mary that this temporary relief from anxiety or sadness was not a purely psychological phenomenon. She was probably suffering from a beta-endorphin deficiency on top of a serotonin-deficient depression.
Beta-endorphins are another type of neurotransmitter. Like serotonin, they also help create a sense of well-being, not so much by soothing us as by boosting our feelings of self-esteem, connectedness to others, and emotional stability. They help us tolerate pain—both physical and emotional—and they also seem to be involved in our ability to take personal responsibility for our actions.
Sugar—along with alcohol, heroin, morphine, and other pain medications known as opiates—stimulates the release of these vital chemicals, at least for a short time. As a result, we often crave sugar when we’re low on beta-endorphins, in an unconscious attempt to rebalance our brain chemistry. Other symptoms of beta-endorphin depression include low tolerance of pain; feeling tearful and reactive; low self-esteem; feeling overwhelmed by others’ pain; feeling isolated, depressed, and hopeless; thinking like a victim; and feeling emotionally overwhelmed.
So, I told Mary, when she ate sweet and starchy foods, she triggered a release of beta-endorphin molecules, temporarily boosting her b-e levels and soothing her emotional pain. But hitting her body with this sudden influx of “feel-good” chemicals caused her body to metabolize the chemical even more quickly. Thus Mary’s momentary beta-endorphin “high” was followed by a longer-lasting “low”—which in turn set off a new craving for sugar or starch.
As a result, the more often Mary ate sweet or starchy foods, the more intensely she craved them. She had inadvertently created a near-addictive situation in which she literally needed high-sugar, high-carb foods to balance her brain chemistry—even though this type of food was guaranteed to keep her off balance.
Frankly, if eating sweet foods had no other effects, I’d probably counsel all my patients to self-medicate with them. Unfortunately, sugar is terrifically bad for your health, causing weight gain and associated with cancer, heart disease, and a host of other disorders. Moreover, the kind of relief you get from eating sweet and starchy foods is by its very nature short-lived and problematic. Yes, the sugar sets off a temporary release of beta-endorphins that makes you feel better for a while. But your relief is soon erased by the crash that comes when your body metabolizes the beta-endorphins too quickly. The result is a sugar-addicted cycle that actively interferes with the long-term well-being you’re really looking for. I do want to help you release more beta-endorphins—but in a slower, more steady way, through healthy diet, vigorous exercise, and the mental/spiritual approaches I explain in Step Three. I want you to enjoy long-term high levels of this feel-good chemical, rather than having you ride the emotional roller coaster induced by refined carbs and processed sugar.
Meanwhile, as I told Mary, every time you reach for a sweet dessert or starchy snack, you’re actually trying to medicate your depression. So although I’d like you to switch to other foods, you shouldn’t wonder that it’s so difficult to do so—or to lose weight. You’re not greedy, undisciplined, or out of control (although it may feel as if you are). You’re simply responding to a very real biological problem.
People with frequent or intense sugar/carb cravings, as well as people who respond strongly to refined sugar and starchy foods, suffer from a condition known as sugar sensitivity, a term coined by researcher Kathleen DesMaisons and discussed in her book Potatoes Not Prozac.2 Although diet books often talk in terms of willpower or “making healthy choices,” sugar-sensitive people may be genetically predisposed to both sugar craving and other addictions by having naturally low beta-endorphin levels. Their response to sweet foods (and narcotics) is thus exaggerated. Eating something sweet tends to send their blood sugar levels shooting sky-high, producing a corresponding rush of insulin. The insulin—released in extra-large doses to respond to the sugar spike—tends to overdo its job, with a correspondingly oversized drop in blood-sugar levels. Symptoms like dizziness, mental fog, irritability, or headaches are common along the way, as is a more or less constant state of stress as the body copes with too many extremes in too short a time. This stress in turn induces the adrenal glands to release excess amounts of stress hormones, exhausting the adrenal glands from their continual use. The result is often fatigue and—yet again—depression.
Like many aspects of nutrition, sugar sensitivity is a spectrum rather than a clearly identifiable condition. Some people may be highly sensitive to sugar, while others have milder versions of this condition. Depending on your diet, lifestyle, and emotional state, you may experience greater or lesser degrees of sugar sensitivity over your lifetime. Women in particular often become more or less sensitive to sugar at various times in their menstrual cycle or in response to menopause or menarche (the onset of menstruation). Some people become sugar-sensitive only or primarily in response to stress; others are sugar-sensitive all the time. As a result, there’s no one test for this condition, and many conventional doctors are rather skeptical about it. From my observation and clinical practice, however, I believe sugar sensitivity is an important factor in weight gain as well as depression.
If you are sugar-sensitive, your strategy should be a slow but steady elimination of foods containing processed sugar and refined carbs, even as you gradually add complex carbs into your diet. You probably shouldn’t get off sugar “cold turkey,” but you should make a concerted effort to switch from processed sugar to complex carbs. You’ll be amazed at how much better you feel in the long run.
Even if you’re not sugar-sensitive, you should take the advice I just gave, which will have enormous benefits for your mood, energy, and overall health: switch from refined to complex carbohydrates. Refined carbohydrates include processed sugar, honey, white rice, and products made with white flour, including breads, pastas, crackers, cookies, and pastries. Complex carbs include legumes, starchy vegetables, and whole grains. Your brain desperately needs complex carbs to function, while refined carbohydrates tend to throw you off balance. So anytime you’re struggling with mood, energy, or depression, cut back on the refined carbs or cut them out entirely, even as you up your intake of complex carbohydrates.
Let’s take a closer look at what carbohydrates are and why your brain needs them—in the right form. Carbohydrates, also known as starches, provide fuel for the brain and the rest of your body. As you consume a chickpea stew, a bag of corn chips, or a big bowl of ice cream, your body metabolizes the carbohydrates contained in the food and converts them into glucose, or blood sugar. When your blood sugar levels are low, you feel hungry, and sometimes you experience a number of other symptoms as well—fatigue, dizziness, mental fog, irritability, and for some people, headache. When your blood-sugar levels are high, on the other hand, you feel full, energized, alert, and able to function at peak efficiency. And if your blood-sugar levels are too high, such as after you gobble down a candy bar or quickly drink a large soda, you might get a “sugar rush”—the feeling of being revved up, agitated, or overly stimulated.
As you can see, blood-sugar levels are crucial to energy, functioning, and mood. But not all carbohydrates affect our blood sugar in the same way. Refined carbohydrates are already broken down, leaving the body little work in order to turn them into blood sugar. As a result, they tend to send blood-sugar levels skyrocketing—that quick rush we know so well—often followed by a crash that leaves us craving another fix, more sweet and starchy foods to boost our blood sugar once again.
The more quickly a food is converted into glucose, the more rapid are its effects—and the less time they last. That’s why a refined carb— like a candy bar or some fruit juice—gives you a quick lift. It’s also why, soon after you’ve consumed it, you experience an equally quick drop in energy, efficiency, and mood. The sudden influx of glucose triggers an equally sudden rush of insulin, the hormone your body uses to break down blood sugar. For many people, the “low” that follows a sugar rush is even lower than where they were before, creating yet another craving for something sweet.
Complex or unrefined carbohydrates, by contrast, are not yet processed. They contain a tough substance called fiber, which slows down the process of metabolizing these foods. You’ll never get a sugar rush from complex carbs—your body has to work too hard and too long to convert them into sugar. As a result, these foods offer a slow, steady release of glucose into your system, a much more stable way of feeling full, alert, and energized.
You can see why complex carbs are so much better for your moods. They’re also better for your brain, which much prefers to get a relatively constant supply of glucose. So switching from refined to complex carbs will immediately help you to feel calmer, “fuller,” and more in control of your appetite—especially if you’re sugar-sensitive.
Another key problem with Mary’s diet was her excess consumption of unhealthy fats and her underconsumption of healthy ones. When I tell my depressed patients that certain fats are an essential component in their “healthy brain” diets, they often stare at me in surprise. By now, most of us realize that fats provide a much more concentrated source of calories than any other food source (nine calories per gram of fat compared to four calories per gram in proteins or carbs). This high-calorie infusion was crucial for the survival of our ancestors, who often had to go for long periods without food and needed to store their calories in the form of body fat. Now that obesity is a greater danger than starvation to most Americans, fat has become a dietary evil in many people’s minds.
Certainly Mary had always viewed fat as “the enemy,” though she confessed that she found it hard to resist the high-fat chips and french fries she often craved. Mary had also noticed that fat wasn’t always beneficial to her mood. I often have to remind my patients that too much fat in a meal can leave you feeling sluggish, lethargic, and unhappy, especially if eaten in the middle of the day. Moreover, the wrong kinds of fats—hydrogenated fats and trans-fatty acids, found in margarine and processed foods—have been associated with numerous health problems, including cardiovascular disease, hypertension, and stroke.
But our bodies and brains need some fat to function—and the right kinds of fat contain elements that are crucial to overcoming depression. Moreover, extremely low levels of overall cholesterol—below 160—are associated with both depression and a higher risk of suicide, while cholesterol in adequate amounts helps boost the serotonin available within the synaptic fluid.3 Cholesterol also helps us produce the neurotransmitters—including serotonin, norepinephrine, dopamine, and beta-endorphins—that our brains need to function: It’s cholesterol that helps transport the proteins from which our brains make these vital chemicals. Finally, several key vitamins can be absorbed only in fat, so a fat deficiency can lead to a vitamin shortage—even if we’re taking supplements.
Just as our body needs essential amino acids, so does it need the so-called essential fatty acids (EFAs)—the food elements that our body can’t manufacture from other fats. The EFAs are the building blocks for nerve cells, and without them, the neurotransmitters and their receptors can’t function properly.
Yet many people—particularly those suffering from depression—are omitting these crucial substances from their diets. So here’s my second piece of simple advice: If you’re feeling depressed, boost your intake of essential fatty acids. You may well need to cut back on the chips and fries. That doesn’t mean you’re getting enough fatty fish, fish oil, flaxseed oil, olive oil, nuts, and seeds—all of which you need to fight depression.
EFAs come in two major categories: Omega-3s and Omega-6s. Omega-3s are found in fatty or cold-water fish (salmon, bluefish, tuna, and halibut, among others) as well as some northern grains and nuts (including flax, canola, and walnuts). They seem to offer numerous health benefits, including lower cholesterol and triglyceride levels, lower blood pressure, joint lubrication, protection against inflammation, and support for the immune system—and possibly, reduction of depression.
Omega-6 fatty acids are found in plant-seed oils (flax, evening primrose, black currant, and borage), polyunsaturated vegetable oils (safflower, sunflower, corn, and soybean oils), and animal products, especially egg yolks and organ meats. Generally, Omega-6s are important for bodily growth, maintenance of skin and hair, regulating metabolism, reproductive activity, and the absorption and retention of calcium, and to help prevent heart disease, cancer, stroke, diabetes, and rheumatoid arthritis.
Changes in our modern diet may have contributed to a relative increase in consumption of Omega-6 fatty acids and a corresponding decrease in Omega-3s. Generally speaking, Omega-3 acids reduce inflammation, while Omega-6s promote it. Inflammation affects all organs, including the brain, and is suspected as one of the key causes of Alzheimer’s disease and other causes of cognitive decline. So clearly, it would benefit your brain’s and your body’s health if you boost your Omega-3 intake and lower your consumption of Omega-6s.
Mary and I discussed her dietary choices at length. I told her that to overcome her depression and to boost her health in general, she needed to get at least half her fat calories from EFAs, making a determined effort to include more Omega-3s and fewer Omega-6s. Reorganizing her fat intake would not only improve Mary’s mood and mental clarity, I told her. It would probably also help her lose weight, which would have additional benefits in helping her to overcome depression.
Mary faced one final obstacle in her efforts to lose weight and overcome depression—antidepressants. Unfortunately, medication intended to combat depression, while helpful in improving mood and energy, can also make it harder to lose weight.
The connections between antidepressants and weight gain are complex. For one thing, medications often increase appetite, making it harder for some people to resist high-calorie foods. At the same time, antidepressants also seem to affect blood-sugar metabolism and insulin function. While we don’t fully understand the relationship between these processes and weight gain, we do know that as a result of their complex interactions, even people who reduce their calorie intake may find it hard to lose weight while on antidepressants.
To develop a healthier eating plan for Mary, we began by reviewing her current eating habits. She told me that she usually either skipped breakfast or relied on a starchy start to her day, such as toast or a bagel. In her efforts to avoid calories, she’d eat a large salad for lunch. She’d save her biggest meal for dinner, which she thought should ideally include chicken or fish along with a vegetable and starch of some sort.
Indeed, most days, Mary would succeed in sticking to this regime— until later in the evening. Then she would binge on starchy snacks and sweet junk foods. No matter how guilty and ashamed she felt when she was done, she saw herself as powerless to stop the cycle.
The first thing I told Mary was that her attempts to limit calories early in the day might actually make it harder for her to resist binging later on. Starting the day with a starchy breakfast set her up for sugar and carb cravings that built in intensity until she finally satisfied them at the end of the evening. And depriving herself of protein until dinner not only made her more vulnerable to those cravings, it also kept her foggy, low energy, and prone to blood-sugar fluctuations. Eating good sources of protein throughout the day, on the other hand, would keep her energetic and alert, besides helping to stabilize her blood sugar.
Ultimately, Mary’s emergence from depression involved several factors and required a great deal of support. After all, changing lifelong habits is no easy matter. She joined Weight Watchers for the group support, and also worked with a dietician well versed in the serotonin-food connection. (Although Mary seemed to have a beta-endorphin deficiency, she also suffered from serotonin depletion, which further intensified her depression and probably made it harder for her to lose weight as well.)
Mary began eating breakfasts that included fresh fruit (to satisfy her sugar cravings), high-fiber cereal (to provide the serotonin support she needed), and a good protein source like eggs, lean meat, or protein powder (to energize her for the day and help balance her blood sugar). She continued to have a salad at lunch, but now added a few ounces of chicken, tuna, or cottage cheese for protein (again, to boost her energy, balance her blood sugar, and combat her carbo cravings). She started eating a midafternoon snack of yogurt or a few nuts—both high in protein as well as rich in amino acids, which again helped her produce more serotonin—and finished the day with her usual well-balanced dinner. She felt as though she was eating a lot more than before, but this diet also helped her avoid her evening binges. Instead, she could get by with a small bedtime snack of a little cereal or a piece of whole-grain toast.
Mary didn’t lose much weight at first, but she did start feeling better almost immediately. Increasing her protein while cutting back on the sugar and starch made her mentally clearer, stabilized her mood, and helped her get motivated. Her passion had always been artwork, and suddenly she found herself painting again. Although she remained on Paxil, she was able to reduce her medication almost immediately, with no drop in mood, most likely because her improved diet was enabling her to produce more serotonin and beta-endorphins. The drop in medication in turn helped her lose some weight more easily.
Suddenly Mary was feeling better about herself, with a tentative newfound faith in her ability to overcome this lifelong problem. Although Mary’s severe history of depression meant that she might need to continue some form of medication for many years, we still both considered her a success story, as she’d cut her dose to less than half, was finally free of side effects, and felt better than she’d felt in twenty-five years.
I know there’s a lot of confusing information out there about diet and health. But what you eat can have such a revolutionary impact on how you feel that I strongly urge you to give the following “brain-healthy diet” a try, even if only for thirty days. I guarantee you’ll feel so much better that you’ll be motivated to eat well and feel better.
Your Brain-Healthy Diet: Eating for Improved Mental Health
• Eat fewer calories overall (unless you’re seriously underweight).
• Restrict fats to 25 percent to 30 percent of your overall calories, and avoid eating large amounts of fats in the middle of the day, when they will slow you down, cloud your thinking, and set you up for fat cravings later on that night.
• Try to get most of your fat from healthy fat sources (olive oil, avocados) and essential fatty acids, such as fish oil, safflower oil, flax seed, borage or evening primrose oil, and nuts.
• Restrict your intake of refined sugar to 10 percent or less of your total calories. If you’re sugar-sensitive, consider entirely eliminating sugar and refined carbohydrates (white rice and foods made from white flour, including most breads, pastas, and processed foods).
• Cut back to one or two cups per day of most caffeinated drinks—coffee, black tea, colas, chocolate drinks—and eliminate these drinks entirely if you suffer from anxiety, have trouble sleeping, or are prone to headache. You might substitute green tea for the other beverages, as it has very little caffeine and offers several other health benefits.
• Organize your diet around the following healthy foods:
1. Complex carbohydrates, especially whole grains (rye and pumpernickel bread, oatmeal, barley, brown rice, millet, spelt, amaranth), beans and legumes (adzuki, black beans, pinto beans, lentils) and root vegetables (onions, turnips, rutabagas, carrots, sweet potatoes). Three or more servings per day, four ounces per serving
2. Lean protein, especially cold-water seafood, legumes, and soy products (each of which has other health benefits as well). Three servings per day, four to six ounces per serving
3. Fresh fruits (including at least one fruit per day that is high in vitamin C, such as a citrus fruit or a cup of fresh berries) and dark green leafy vegetables (don’t overcook). Five servings per day, one fruit or one-half cup vegetable per serving
• Buy fresh, organic, seasonal, locally grown foods if you can afford them. They cost a bit more, but they’re worth it. Not only do they taste better, but organic produce is far more nutritious than its commercial counterpart, and more likely to contain micronutrients—trace elements of minerals that remain in the soil when produce is farmed organically. Your body needs those minerals to facilitate neurotransmission—the process by which your brain sends messages to itself. In addition, organic foods have not been exposed to toxins, which stress your endocrine and immune systems (weakening your brain indirectly) while interfering with your central nervous system (weakening your brain directly).8 Locally grown foods are more likely to be fresh, and eating them ensures that you get a wide variety of foods and nutrients.
• Drink plenty of pure water, at least six to eight glasses each day.
• Consider taking supplements, especially when your diet is poor, your stress levels are high, or you are suffering from depression (see Chapter 5).
People who are low in serotonin—whether over the short or the long term—should eat relatively more carbohydrates than other people, and they may not need quite as much protein. But if you’re struggling to boost your serotonin production, you’ll still need some quality protein throughout the day. In addition to protein’s role in energy and muscle development, your brain also needs the amino acids contained in proteins to create serotonin, norepinephrine, and dopamine.
Tryptophan is the basic building block for serotonin. It’s found in meats, dairy products, and nuts. However, tryptophan has trouble competing with the other amino acids found in proteins. That is, when you eat a high-protein meal, rich in several different types of amino acids, the other acids tend to shove tryptophan out of the way as the brain absorbs them first. That’s why people low in serotonin need a diet rich in complex carbohydrates. As we saw earlier, the fiber in complex carbs requires the body to work harder and makes the whole digestion process take longer. Slowing down the digestive process allows tryptophan to “hang around” longer, giving it enough time to get into your neurons and causing serotonin levels to rise.
If you’re a sugar-sensitive person, you’re probably also low in serotonin, so it’s especially important for you to replace sweet and starchy foods with complex carbs. Make the switch gradually, though. If you cut out the sweet things too quickly, you can actually go into a form of withdrawal after a few days or even a few weeks, experiencing somewhat milder versions of the symptoms you’d get from abruptly going off SSRIs or other serotogenic antidepressants. (For more on withdrawal symptoms, see Chapter 3.) If you’ve ever tried out a low-carb, high-protein diet, particularly one that restricts your carbs drastically for the first few weeks, you might have found yourself so moody and irritable that you just couldn’t stay away from the sugar and starch, aggravating your original problem and most likely increasing your weight. So if you’re a sugar-sensitive type, give yourself a few weeks to make the transition away from sugars. Eventually, you should cut out refined carbs almost completely while getting the largest percentage of your calories from complex carbs.
• Eat a wide variety of complex carbs throughout the day:
1. Whole grains, especially those that you cook, like brown rice, millet, barley, oats, amaranth. Don’t rely solely on whole-wheat bread or cold cereals. Your body needs nutrients from a wide variety of foods.
2. Beans/legumes, which are also good protein sources
3. Root vegetables, such as potatoes, sweet potatoes, carrots, onions, rutabagas, and turnips; as well as squash and pumpkins
• Get enough protein throughout the day. If you’re low in serotonin, I don’t recommend a high-protein diet. But you do need at least some protein in each meal and most snacks.
• Eat plenty of fresh fruits and green, leafy vegetables. While these don’t contain the elements used to manufacture serotonin, they do contain vitamins and minerals that the brain needs to undertake the production process.
• Eat a wide variety of nuts, which contain both essential fatty acids and a small amount of protein. Because of their concentrated fats, nuts are high in calories, so don’t overdo—a small handful each day will suffice.
• Eat regularly. Never skip breakfast. Try to eat something every four to five hours that you are awake. Have a small midmorning and midafternoon snack, and try a pure complex-carbohydrate snack at bedtime. By the way, there is some evidence to suggest that people with seasonal affective disorder may find light therapy more effective if they eat a midafternoon carbo-rich snack. (For more on seasonal affective disorder, see Chapter 6.)
• Eat plenty of serotonin-enhancing foods. (See Appendix A.)
I believe that people who suffer from an agitated depression—marked by feelings of anger, irritability, or excess energy—are responding to an imbalance that includes too little serotonin and too much norepi/dopa. You should eat to boost your serotonin levels, as described above—but with one modification. Given the excessive amounts of dopamine and/or norepinephrine in your brain, you would do well to eat very small amounts of protein, at least until things calm down. Get plenty of healthy carbs and essential fatty acids into your diet, and avoid highly concentrated protein sources, especially meat and seafood. In fact, I’d suggest a good old-fashioned vegetarian diet, in which you eat a combination of beans and whole grains as your protein source, at least until you recover.
In many ways, this is an easier task than eating for serotonin. The amino acids used to produce these energizing biochemicals are tyrosine for dopamine and phenylalanine for norepinephrine—amino acids readily found in all sorts of protein foods and more easily assimilated into the brain than is tryptophan. So if you’re suffering from a norepi/dopa deficiency, your main goal is to eat enough high-quality proteins throughout the day and to combine your protein sources with other appropriate foods.
Most of us don’t need to be as alert or energetic in the evening, when our bodies and brains want to calm down, preparing for bed and a deep sleep. So loading up on a high-protein meal only hours before the day is over is the worst possible timing, particularly if the high-protein dinner is preceded by a high-fat lunch. You’re much better off with a high-protein breakfast and lunch, and a moderate-protein dinner, with a relatively low amount of fat at each meal. (If you must load up on fat, save it for evening, as it will probably make you tired and sluggish—not a pleasant feeling, but less of a problem in the evening than in the midst of your workday. And a high-fat breakfast or lunch can set up powerful fat cravings that persist throughout the day.)
Breaking your old patterns can be challenging, but you’ll feel so much better, the change will seem worthwhile. As an added bonus, you’ll probably lose some weight!
My Recommendations
• Eat moderate amounts of high-quality, low-fat proteins with every meal and snack.
• Eat relatively small amounts of complex carbohydrates, but again, consume these throughout the day. If you’ve got really sluggish energy, and especially if you’ve got a weight problem, you can probably get by with far fewer carb-based calories, and you should focus, of course, on complex carbs. Ideally, each carb serving would equal one to two times the size of your palm.
• Enjoy unlimited servings of salad greens and fresh vegetables. These healthy choices have very few calories and lots of vitamins and minerals. They’re a great way to fill up and to get your system moving.
• Eat breakfast! Skipping breakfast is many people’s Achilles’ heel, and it’s a particular problem of people who need to consume more protein. If you enjoy breakfast meats, try some lean ham or Canadian bacon, which has less fat than regular bacon. If, like so many of us, you don’t have time to cook, consider one of the many good protein powders for your morning pick-me-up. (See the list of suggested protein powders, in Appendix B.) You can mix your powder into a glass of juice, or make a fruit smoothie with juice or milk plus fresh or frozen berries. If you’re feeling adventurous, sardines, tuna, or other cold-water fish makes a great protein-rich start to your day. And, if you can, vary your protein sources—eggs one morning, yogurt the next, protein powders on the third. The more variety, the more nutrients—and the less strain on your system.
• Enjoy your eggs. This nearly perfect food once had a bad rap as a dangerous source of cholesterol, but nutritionists now understand that eggs are actually good for your heart and circulation, especially if you get them from farm-raised free-range chickens, and even more so if you eat eggs from flax-fed chickens, which inserts some brain-healthy Omega-3 into your diet.
• Eat modest amounts of food often, at least three meals and two snacks daily. An average person needs four hundred to six hundred calories per meal and one hundred to two hundred calories per snack. To put this in perspective, one large order of fries at a fast-food restaurant has about six hundred calories—and so does a chicken stir-fry chock-full of vegetables, a flavorful sauce, and a bit of rice. Which do you think your brain would prefer?
• Eat light. Limit complex carbs, and reduce or eliminate refined carbs and unhealthy fats. Eat plenty of fresh fruits, vegetables, and salads. Think of how your body likes you to eat in the heat of summer—light, fresh foods with plenty of water content. Try to stay with those foods, especially if your energy drops noticeably during the winter.
• Go nuts! Eat a variety of nuts and seeds, choosing from the list in Appendix B. They are great sources of both protein and healthy fats, and a small handful of twelve to twenty nuts makes an ideal between-meal snack.
• Eat plenty of dopamine/norepinephrine—enhancing foods. (See Appendix B.)
Over the past few decades, alternative and complementary physicians have stressed the concept of “food sensitivity” or “food intolerance,” in which an otherwise healthy person has a poor reaction to certain types of foods, particularly wheat and other grains or dairy products. Food sensitivities are far subtler than true allergies, which tend to have far more obvious symptoms (diarrhea, hives, wheezing, and the like). Likewise, sensitivities are not the same as food addictions, in which eating a particular food gives short-term relief while producing symptoms later.
In food sensitivities, by contrast, the body reacts so subtly that we either don’t pay attention or we don’t associate the ill effect with having eaten something. So if you suffer from depression, I believe it’s important for you to consider the possibility that some of your food choices may be affecting your mood by setting off such sensitivities.
Foods to which many people are sensitive include wheat, corn, coffee, sugar, dairy, eggs, beef, potatoes, pork, oranges, carrots, yeast, apples, chicken, lettuce, soy, peanuts, green beans, oats, and chocolate. Of course, if you tried to eliminate everything to which you might be sensitive, you’d have very little left to eat! Some of my patients who have worked with alternative practitioners have indeed made such radical changes, only to get so bored or frustrated with the same few foods every day that they gave up on their diets entirely.
I think that the best way to find out if you are food-sensitive is to keep a food log, noting what you eat and how you feel within the next thirty to sixty minutes. If you begin to discover that certain foods seem to bring on the feeling of being spacey, tired, or depressed, try one of these strategies:
• Elimination diet: Try cutting out the suspected foods entirely for two to four weeks. Then add one back, noting how you feel in your food log. If you are sensitive to the food, you should have a pretty clear reaction, especially if you’ve gone without it for the suggested time. If you have no negative reaction, you know the food is safe. Repeat this process with each of your suspect foods until you’ve figured out how your diet affects your mood.
• Pulse test: Get a good baseline record of your pulse by checking it several times a day, such as before you get out of bed, before each meal, half an hour after each meal, and before bed. Then, during a testing period of a few days, consume different foods throughout the day, checking your pulse just before you eat and again half an hour later. Record the results. If your pulse increases significantly—by more than eight to ten beats per minute—you may have a food intolerance.
• Blood test: You can get a special blood test for food sensitivities pretty easily. These tests are sophisticated and reliable, but they are not cheap. If you’re interested, check the resources listed in Appendix C.
Even if you have a food sensitivity, you don’t necessarily have to cut the food out of your diet completely. If you avoid your “danger foods” for three to four weeks, your system will probably become less reactive. Then you can reintroduce these “trigger foods” in moderation, not eating any trigger food more than once every four or five days.