Best diet for depression, anxiety and bipolar syndrome, Folic acid and depression,

-What’s the Best Diet for
Depression, Anxiety and Bipolar Syndrome- © 2014
(Updated 21st  Sep 14)

Is there such a thing as the best diet depression, anxiety, bipolar syndrome and mental health problems in general?
Well actually there are a few fundamental dietary dos and don’ts and even a diet associated with a lower rate for mental health problems and what’s more the good news is this diet is super tasty and cheap.


The Importance of Diet

Personally I’ve never seen anybody fully recover from a mental health problem simply by changing their diet, however I have read stories of people that were allergic to wheat for significantly deficient in omega-3 oils who supposedly made a full recovery by correcting these two problems in their diet.

The Wrong Brain and Mental Health Diet

The important thing is a bad diet can definitely impede your recovery, you may not be able to recover your mental health.
  • If for example you have the more severe forms of the MTHFR gene mutation and you eat foods fortified with added folic acid it may block a metabolic pathway in your body (folate-methylation) which will impede your body’s ability to manufacture neurotransmitters (serotonin and dopamine) and lack of methylation also increases inflammation in the brain and can impede your recovery. Inflammation can damage delicate structures and neural pathways in the brain, it can also inhibit the brain’s ability to repair itself; damaged brain structures are consistently observed in people with ongoing mental health problems and may actually be the underlying root cause, the bottom line is if to recover from a mental health problem repair and make the brain healthy.
  • If you for example continue eating any foods (typically gluten, wheat or dairy) that provokes inflammation in the brain (allergic sensitivity reactions) you may not be able to recover.
  • If you do not feed yourself enough omega-3 fish oils and eliminate from your diet excesses of Omega-6 and fried oils which block the omega-3s you may not be able to recover.
  • If you eat foods containing trans fats including margarines, takeaway food and most ready-made supermarket bought foods you will impede your recovery.
  • If you eat a diet containing excessive amounts of carbohydrates (high GL) or carbohydrates that quickly turn into sugar (high GI) you may develop chronically high blood sugar which can downgrade the health of your brain and you may not be able to recover; alternatively eating high GI carbohydrates and the regular eating can cause fluctuations (highs followed by lows) in your blood sugar level which can cause rapid fluctuations in your serotonin and dopamine levels and is completely incompatible with making a full recovery from a mental health problem.
  • Controlling carbohydrates (together with other measures) is also a key component of preventing and reversing weight gain which is often an concurrent issue for people with mental health problems, whether a product of the inactivity and physically immobilising aspect of the mental illness or a side-effect of medication. 
  • If you eat foods that encourage inflammation in the brain like junk food and most ready-made meals with a high content of free radicals which damage your brain recovering your mental health will be impeded.

The Right Brain and Mental Health Diet

The best diet to support your treatment, recovery and then maintain your mental wellness is a diet that:-
  • Includes lots of fish/seafood (or omega-3 supplements) and no corn-fed meat, ready-made meals or junk foods which are high in omega-6.
  • Is very high in B vitamins in general but specifically: natural folate (B9) linked with depression from vegetables (cooked and raw) and beans, B6 needed to manufacture neurotransmitters from meat including chicken, fish especially tuner, sunflower seeds, bananas and spinach and many vegetables, B12 associated with mental health problems and needed to make neurotransmitters, only available from animal foods in any quantity so often a big problems for vegans, especially liver and salmon alternatively use B12 supplements, but you must choose the right ones. See Supplementing for B12).
  • Avoids synthetic folic acid (if you have the MTHFR gene mutation) in supplements and folate fortified ready-made foods.
  • Totally stabilises blood sugar by excluding all foods with a glycaemic index (GI) above 70 that quickly release sugar into the blood, also whenever you do eat carbohydrates always combe them with healthy oils and protein to slow down how quickly they are digested and turned into glucose. Most people should cut down on carbs to improve their diet. See stabilising blood sugar for mental health.
  • Avoids free radicals which encourage inflammation and cellular damage by avoiding burnt, barbecued and fried foods, however sautéing at low temperature is acceptable.
  • Avoids ready-made foods as practically all of them contain trans-fats which are linked to an increased risk of depression.
  • Although whole grains are a good source of vitamins too many people have hidden sensitivities to the gluten in grain, if half-digested gluten molecules leak through the gut-wall into the bloodstream and then leak through the blood-brain barrier and enter the brain it can repeatedly trigger the brain’s own immune system leading to chronic inflammation in the brain, so the best diet for to recover from a mental health problem should avoid gluten.
There’s one diet or type of cuisine that already fulfils most of the above criterion and that is what is called the Mediterranean. The Mediterranean style diet is associated with the lowest rate for heart disease, diabetes, cancer particularly prostate cancer in men, depression[i] and other mental health problems.
But you must understand exactly what the Mediterranean diet is and what it is not, if what comes to your mind when you think of the Mediterranean diet is the cuisine currently eaten in the south of France and Italy that would be a mistake. Today even in the south of France and Italy many people are increasingly eating ready-made meals, excess carbohydrates and high GI foods leading to a rising tide of diabetes and obesity; sadly the traditional Mediterranean diet is dying out as a widespread practice and this has led many people to rename this style of cuisine as the Miami Mediterranean diet.
Whatever we call it this diet is:-
  • Very high in brain healthy omega-3 fish oils,
  • Very high in vegetable, providing lots of brain healthy folate,
  • Very high in brain healthy antioxidants from vegetables, fruit, the olive oil, coffee and wine.
  • It also excludes junk foods and sugary foods and with just a few modifications we can adapt the Mediterranean diet to the best diet for mental health. 
The authentic traditional Mediterranean would best be characterised by the diet followed by peasant people on Greek Islands in the 1950s, at that time ready-made meals had not been invented and all food was cooked from scratch, because red meat and sugar was so expensive red meat and deserts would only consumed perhaps twice a month, poultry and eggs would be consumed up to 3 times a week, dairy foods (yoghurt and cheese) was consumed often but only in moderate amounts and sourced from a wide variety of different animals (goats, sheep, cow, buffalo), seafood was consumed three and often more days a week, the rest of the bulk of the diet was made up of vegetables, beans/lentils with the addition of whole grains and some fruit snacks. The only oil in the kitchen would be single bottle of fresh olive oil.

Perfecting the Brain And Mental Health Diet

One of the worst things for mental health problems if you have unhealthy blood sugar level, high blood sugar(insulin resistance, diabetes pre-diabetes) associated with inflammation in the brain which damages the brain and contributes to mental illness; fluctuating high and low blood sugar levels (reactive hypoglycaemia) causes fluctuations in neurotransmitter levels especially serotonin and dopamine which exasperates mental health problems, and the so the best diet for the brain and mental health will promote healthy blood sugar levels and by following the Mediterranean diet you already made a great head start in that direction. Actually the Mediterranean diet without breakfast has been shown to be the best choice people with type II diabetes[ii]The Mediterranean diet excludes refined carbohydrates and sugary foods so it’s naturally a low GI diet, however just to make sure your diet is the absolute best it can possibly be the stabilising blood sugar check the GI value of all the carbohydrates you eat and make sure you don’t consume anything with the GI about 70; also follow the zone diet principle of every time you eat any carbohydrates you must also include plenty protein and healthy oil to slow down the rate at which the carbohydrate is broken down and turned into glucose.
See: Understanding Carbohydrates and Natural Treatment for Blood Sugar. The Mediterranean diet traditionally includes lots of beans and lentils which as I explain elsewhere are super foods when it comes to stabilising blood sugar. Firstly beans and lentils contain naturally low GI carbohydrates combined with blood sugar stabilising protein and lots of fibre which lowers the glycaemic effect of any meal; beans and lentils also produce a magical blood sugar lowering effect called the lentil 2nd meal effect. The way this works is when the indigestible fibre contained in beans arrives in the large intestines several hours after we’d eaten them the friendly bacteria in the large intestines feeds on the indigestible fibre to produce a health promoting chemical called propionate[iii] which actually delay stomach emptying and lowers our incident response by a significant XX percent of the subsequent meal we eat several hours after eating beans[iv]….
Let me sum that up again fill yourself up on lots of beans and lentils, a wide variety of vegetables (not just potatoes), whole grains including whole-grain rice, quinoa, buckwheat, pot barley, teff (a gluten-free grain from Ethiopian), pasta sourdough bread made from spelt, kamut or rye flour.
Add to this lots of fish (fresh, frozen or tinned but not including smoked fish) or omit the fish increase the beans and use fish oil supplements.
Eat eggs and poultry several times a week, but it would be equally okay to substitute small portions of naturally reared non-corn-fed red meat (but not processed meats like bacon, salami or sausages).
Clear out all the multiple bottles of different types of oil you have a new kitchen because they’ll contain free radicals and replace them with one bottle of olive oil in a dark glass bottle for a tin, if you’re vegetarian/vegan and not consuming fish oils you can need a bottle of flaxseed oil as well as the olive oil (see below).
You can eat a piece or 2 of fruit combined with nuts especially almonds as snacks between meals.
You can in fact you should consume one or 2 small glasses of wine a day and several cups of fresh coffee
This style of cuisine is tasty, simple to prepare and low cost: The Mediterranean Diet for a more detailed description.
Below are discuss the key elements of the authentic Mediterranean diet that make it so good for brain and mental health.

More Omega-3 in the Diet Equals Less Depression

Numerous studies have shown an inverse relationship between the amount of long-chain omega-3 oils (basically fish oil) in the diet and the rate of depression[v].
Other studies suggest that my clinical observation concurs that it is primarily the EPA and not the DHA which produces an antidepressant effect[vi][vii], so when choosing an omega-3 oil supplement you should look at the amount of EPA it contains and aim for a typical daily dosage of 800 to 1200 mg of EPA, although some people do better on even higher doses.

You Don’t Have To Eat Fish to Get Enough EPA to Keep the Brain Healthy It’s Just Much Cheaper

There are surprisingly few dietary sources of EPA other than seafood which can present a significant problem for vegetarians and vegans. Our body can manufacture EPA from ALA (alpha linolenic acid) which is found in flaxseed and hemp seed oils however in order to get adequate amounts of EPA consuming flaxseed or linseed oil you would need to consume a lot of flaxseed. Estimates of how much ALA is converted into EPA and DHA varies considerably and has not been established with any certainty, you might think it makes sense to take an average of the estimates but these nutrients are so crucial to the health of the brain that we cannot afford to be deficient in them and therefore it makes sense to err on the side of caution and use the lowest estimates of how much ALA is converted EPA and DHA; conversion of ALA to EPA is about 5% or less and the conversion t DHA is even lower at 3.8% or less. Pure flaxseed oil contains about 57 g of ALA per 100 ml, therefore a 10 ml desert spoon contains 5700 mg of ALA which may deliver 285 mg of EPA, so you would need to consume 3 ½ deserts spoons a day to provide a decent antidepressant amount of EPA. This would also deliver about 315 cal which is fine as long as you’re watching the total amount of calories and oil in the rest of your diet.
Let me just break down some numbers for you here: if you’re an office worker and you wanted to aim at 1800 cal a day and you wanted to follow the zone diet-which I highly recommend as the best diet to stabilise blood sugar and brain energy- then you would be aiming for a total of 720 of your total daily calories coming from fats and oils (40%), therefore 3 ½-4 deserts spoons of flaxseed oil would contain half of the total calories you should be consuming from fats and oils.
Now if you ate a vegetarian diet that was otherwise very low in fats and oils because didn’t include fatty foods like cheese, avocado, peanut butter, coconut and other nuts then four deserts spoons of flaxseed oil would only be about half your total calories from oil allowance; however if you eat fatty meats or generous amounts of avocado, coconut, and peanut oils as I recommend you do to provide the brain with a an alternative balancing source of energy…
to get your total calorie intake up to 40% from oils you would need to consume about 7 deserts spoons of liquid oil allowing for small amounts of oil is naturally occurring in other foods, therefore you could use a 3 ½-4 deserts spoons of flax oil and about the same of olive oil. This is not however

Obtaining EPA from fish oil is cheaper than from flaxseed oil.

The cost of obtaining EPA from flaxseed oil is high. I did a quick calculation based on the price Viridian organic flaxseed oil from the Amazon website and obtaining 1000 mg of EPA day from flaxseed oil would cost about £1 or $.1.6 a day, however the 1000 mg of EPA from Natural Factors Rx omega-3 fish oil costs £0.67 or $0.4 a day. (Based on 2014 prices)
The even more economical way to obtain your EPA would be by eating things like tinned sardines because not only do you get the oil but you also more than enough protein for a single meal. A 120 g (4.2 ounces) tin of sardines will give contain approximately 635 mg of EPA, about half of your minimum daily protein requirements and other nutrients including lots of calcium if you choose the one with the bones left in an all for about £0.6 or $1. To top up the EPA to reach a total of about 1000 simply dribble a generous desert spoon of flaxseed oil over your vegetables. When choosing tinned fish choose sardines, pilchards, mackerel or salmon but not tuna as the processing of tuna into a tin results in a loss of omega-3 oil and choose the fish in either brine or tomato sauce but not polyunsaturated oils such as sunflower seed oil as these two vulnerable to oxidation and free radicals when stored for a long time, occasional use of tinned fish in all of oil might be okay.

What about Vegetarian EPA and DHA

The combination of having a mental health problem and being vegan can be seriously challenging, you may for example absolutely need 1000 or 1500 mg of EPA on a daily basis to maintain mental wellness but obtaining that quantity of EPA from non-fish sauces is expensive and difficult.
You can buy EPA/DHA supplements made from microalgae which would seem like a straightforward way for vegetarians and vegans to obtain these vital nutrients without consuming fish, unfortunately however there are 2 problems with this approach: firstly there are currently very expensive, obtaining 1000 mg of EPA from microalgae is likely to cost you 2 to 3 times more than obtaining it from fish oil; secondly omega-3 supplements obtained from microalgae tend to contain twice as much DHA as EPA which is a problem in terms of mental health, in general terms although we need both DHA and EPA it’s EPA that has the stronger effect against mental health problems, I can’t say this with any certainty but I have a concern that if you took 2000 DHA to obtain 1000 EPA from microalgae the large quantity of DHA may overload your system. You’ll need to shop around to find one containing adequate levels of EPA at a reasonable price.

Zombies are right the Best Source of Omega-3 Oils is Brains

Just in case the more astute among you are wondering if we really need to eat fish or flaxseed to get healthy amounts of omega-3 for our brains how did any of our ancestors that didn’t live near the coast survive, well the answer is they ate every single part of the animals they killed, not only would they eat the muscles the muscles like we do today but they would consume organs, the fat or suit around the kidneys which surprisingly can contain omega-3 but they also ate the richest ‘food’ source of omega-3 oil there is, they ate the animals brains! A lot of people today claim they eat a Stone Age or Paleolithic diet today but…
 to be on the safe side and make sure that we supply our brain with enough of the crucial nutrients the brain health I suggest we have to use the lowest estimate It estimated that only 8 to 20% of ALA is converted into EPA and between 0.5 and 9% is converted into DHA. So getting enough DHA from flax really isn’t an option, to get enough DHA vegans need to use algae plant based supplements which are very expensive and very low in EPA. 

Diet B Vitamins and Mental Health

Folate (B9)

Folate also known as vitamin B9 is one of the most important nutritional elements for mental health, it’s needed for the biosynthesis of serotonin, dopamine and pine a friend. Approximately one 3rd of depressed individuals have an outright deficiency of folate[viii] Reduced levels of folate in the diet has been associated with an increased incidence of depression[ix][x] and research has suggested that some people (with the MTHFR genetic mutation) cannot adequately metabolise or utilise folate so that they effectively end up with folate deficiency and this may be a factor causing bipolar syndrome which the researchers suggest could be corrected by folate supplementation[xi]. The take-home point here is a diet to reduce and recover from mental health problems must include lots of folate and that achieved by eating lots of vegetables.
In the UK there’s been a drive to persuade people to eat five portions of fruit and veg a day, this policy is flawed and inadequate, the original research showing the positive benefits of the consumption of lots of fruit and vegetables based on the Mediterranean diet in which people typically eat 7 to 9 (not 5) portions of fruit and veg day, it’s also a mistake to lump fruit and vegetables together as if they are interchangeable, they’re not. Certain fruits most notably the dark coloured berries are very rich in antioxidants however most fruit is low in minerals and often lower in fibre than other foods, fruit also comes with a lot of fructose sugar and as I’ve mentioned elsewhere high fructose consumption increases the risk of developing diabetes and accelerates the ageing process, so people who think they’re working on their five portions of fruit and veg a day by consuming fruit smoothies have been misguided. Vegetables on the other hand tend to be rich in fibre, minerals, folic acid and vegetables are also rich in the antioxidants which protect the brain from inflammatory damage which is one of the primary objectives of restoring good brain and mental health using functional medicine.

Top Sources of Folate

Half a cup of black-eyed peas supplies 104 µg of folate about ¼ of the RDA, half a cup of peanuts delivers about the same amount.
A cup of delicious pinto beans delivers 250 µg of folate, almost ¾ the RDA, pinto beans are also very high in heart healthy soluble fibre. I combine them with my own home-made tomato sauce on sourdough rye toast several days a week to make beans on toast for breakfast.
Avocados which I recommend you eat lots of (see Treating Blood Sugar) are rich in folate, the single avocado provides 163 µg of folate about 41% the RDA, an average avocado also delivers 322 cal which you’ll need to take out of your total calorie budget elsewhere, basically eat a lot less carbs.
If you eat soya -and I do- half a cup of dry roasted soybeans contains 176 µg of folate about 44% the RDA, this would also deliver about a surprising 388 cal and makes an excellent snack and sport snack.
The top of the list source of folate liver from poultry (only use organic liver), organic turkey liver is hard to find but comes in at 680 µg of folate for 100 g serving, organic chicken liver which is cheap and readily available comes in at 560 to 580, duck liver is very high in folate at 738 µg however when processed into duck liver pate i.e. foie gras most of the folate is destroyed leaving only 60 µg for 100 g serving compared to 738 for the fresh liver, it’s also barbaric to the animals

Use Methylfolate Not Folic Acid Supplements

Although I’m discussing diet here I’ll just mention something important about folate supplements.
Folate comes in different forms, there’s folic acid which is a synthetic form of folate typically used in supplements and there’s naturally occurring folate found in vegetables. There’s also L-methylfolate (also called 5-MTHF, or 5 methyltetrahydrofolate) which is an already partially broken (metabolised) down form of folate that the brain can use more readily to break down toxic inflammatory homocysteine into SAMe a natural and fast acting antidepressant which I think not only assist the formation of neurotransmitters but also reduces inflammation and assists regeneration of damaged neural pathways. In people the MTHFR gene mutation supplementing folate acid will actually inhibit the action of methylfolate and reduce SAMe production, so if you’re going to supplement folate always use the methylfolate form. (See Folic Acid, Methylfolate, MTHFR Gene Mutation and Depression under construction)

Eat to Feed the Brain a Constant Supply of Fuel

The best diet for mental health will provide the brain the constant and steady supply of fuel to manufacture the vast amounts of energy it consumes, even temporarily depleting your brain fuel can exasperate and precipitate about of your mental health problem seeBlood Sugar Neurotransmitters and Mental Health Problems. There are only 2 sources of fuel that the brain will readily utilise one is the glucose or sugar in the blood and the other is what are called medium-chain length saturated fats which are simply the oils found in avocados, coconuts and peanuts. To maintain stable fuel supply to the brain you should follow a low GI zone diet that maintains a stable level of sugar in the blood and eats lots of the above-mentioned oils, see Treating Blood Sugar.

Eat to Avoid Spikes in Blood Sugar and Chronic High Blood

Spikes in blood sugar can cause serotonin and dopamine levels to search and then rapidly decline over the next one to 2 hours upsetting your mood and adding an unacceptable element instability into your brain function and mental health. Chronically high blood sugar reduces the level of a protein called BDNF within the brain and low levels of this neuroprotective protein is probably what causes the degeneration seen in the brains of people with depression and bipolar syndrome in critical regions and pathways associated with mood disorders. See Brain Derived Neurotrophic Factors and Mental Health Problems and Treating Blood Sugar
Eliminate Gluten
Once provoked is the brain’s immune system can remain active for a prolonged period even occasionally but regularly eating provocative foods could maintain
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