Optimize Your Mental Health
Many people are struggling with mental health issues as a result of the COVID-19 global
pandemic, which has turned our lives upside down. We’ve all struggled to find a “new normal.”
It has been more difficult for those who have lost their jobs and only source of income as a
result of this crisis, but it has not been smooth sailing for anyone. If you are dealing with mental
health issues as a result of this health crisis, know that you are not alone and that help is available.
Depression is characterized as feelings of sadness, hopelessness and may present as anger and irritability in some people. It is often accompanied by appetite and sleep changes as well as apathy, lack of motivation, and indecision.
Anxiety is an emotion characterized by intense, persistent worry or fears about future events, possibly intrusive or ruminating thoughts, and is often accompanied by physical symptoms, such as increased blood pressure. People with social anxiety may avoid social situations they fear will trigger these uncomfortable feelings.
These emotional states are influenced by the neurotransmitters, serotonin, dopamine, and norepinephrine. A deficiency or excess of these neurotransmitters can cause depression or anxiety and can be affected by hormonal balance, nutrition, and a number of other factors. You can learn how to influence your neurotransmitters to control your moods and anxiety.
The following are some things you can do to support your brain to maintain mental wellness.
Exercise for a Sense of Wellbeing
Physical exercise is crucial for optimal brain function, as it increases the production of your “feel good” neurotransmitters, serotonin, which elevates mood, dopamine, which helps with focus and learning, and norepinephrine, which is responsible for motivation. Intense exercise increases two neurotransmitters, gamma-aminobutyric acid (GABA), which lowers anxiety, and glutamate, which helps support mood. High-intensity interval training (HIIT) increases brain-derived neurotrophic factor (BDNF), which is a nerve growth factor that promotes neurogenesis, the development of new brain cells.
A study published in the Archives of Internal Medicine suggests that exercise is as effective as the SSRI medication, Zoloft, for reducing symptoms of depression. There is an increase in B-endorphins post-exercise, but exercising once a week will not be enough to support keeping neurotransmitters elevated throughout the week. The key to keeping depression and anxiety at bay is exercising frequently, and the more intense the workout, the better for your brain and mood. Aerobic exercise is not the only type of exercise that provides mental health benefits. Research has shown that weight-bearing leg exercise is particularly beneficial because it stimulates neurological signaling in the brain that results in the development of new neural cells in the subventricular zone of the brain. This explains why people who sustain injuries that limit the movement of their legs, experience a rapid decline when the use of their legs becomes limited. The larger muscles in the legs and buttocks utilize more oxygen, which is why for exercise to be aerobic, sustained movement of the legs over an extended period is required.
Meditation for Peace of Mind
There are a plethora of studies that support the efficacy of meditation to lower anxiety and improve mood. Meditation is the act of combining deep breathing and focused attention to keep oneself in the present moment rather than focusing on feelings or events of the past or thoughts about the future. There are many different types of meditation, such as mindfulness meditation, guided meditation, or transcendental meditation. I find that each individual has to find the meditation that is right for them. I do a chakra meditation of my own design combined with binaural beats audio, which is a form of auditory sound wave therapy that is only effective through the use of stereo headphones or earbuds because the right and left ears receive a slightly different frequency tone (lower than 1000 Hz) while the brain perceives it as a single tone. For meditation, you need a binaural beat pattern that is set to a frequency of 4-7 Hz, which induces theta brain waves, perfect for creativity, or a frequency of 7-13, which induces alpha brain waves, which encourages relaxation. Avoid the use of binaural beats audio if you have a history of seizures because the pulsed audio frequencies may trigger a seizure.
If done regularly, meditation can help sharpen your intuition. Anxiety often interferes with intuition, as it is extremely difficult to gain access to your gut feeling when you are experiencing anxiety. Effective meditation involves 20 -30 minutes of uninterrupted, focused, deep breathing first thing in the morning while your brain waves are still in theta wave. The act of deep breathing shifts your autonomic nervous system into parasympathetic rest and digest mode. It increases the calming neurotransmitter GABA, which seems to be inhibited as a result of anxiety. While doing deep diaphragmatic breathing, you focus internally. If thoughts or noises from the external environment interrupt your focus, merely acknowledge the distraction (eg: the dog is barking) and refocus on your breath.
It takes practice to develop an effective meditation practice. I used to think I was incapable of meditation because I had attention deficit disorder and couldn’t focus for longer than a few minutes. In the beginning, it was a struggle to remain seated for 5 minutes, but now I can easily meditate for 30-50 minutes without even realizing that the time has passed. The peaceful state of mind that results from a deep meditative state makes you want to continue meditating. You can use meditation as a way to adjust your attitude if you are feeling stressed, depressed, anxious, irritable, or angry. Oxygenating the brain helps shift you from sympathetic “fight or flight” mode to a healing parasympathetic “rest and digest” mode. It is like a natural tranquilizer without the risk of physiological dependence!
Medications That Cause Depressive Symptoms
If you take benzodiazepine medication, it may reduce your anxiety temporarily, but it can also lead to depressive symptoms. If you are feeling depressed, be sure to talk with your doctor about this, especially if you are on any of the following medications which have depression as a side effect.
· Benzodiazepines such as Xanax or Valium
· Fluoroquinolone antibiotics such as Levaquin and Cipro
· Opioid pain relievers such as Oxycodone or Fentanyl
· Corticosteroids such as prednisone (Deltasone) and triamcinolone (Aristocort)
· Beta-blockers such as metoprolol (Lopressor) and Carvedilol (Coreg)
· Statins such as Zocor and Pravachol
· Anticholinergic drugs such as dicyclomine (Bentyl)
· Anticonvulsant drugs such as gabapentin (Neurontin) and Topiramate (Topomax).
· Mood stabilizers such as Abilify and Seroquel are sometimes prescribed along with antidepressants and can exacerbate depressive symptoms.
Pranayama breathing is a formal practice of controlled breathing patterns that influences the brain and neurological system. All forms of pranayama stimulate the vagus nerve, which is a nerve that connects the brain and gut and impacts many of the organs in the body. Both Ujjayi breathing and Nadi Shodhana (alternate nostril breathing) reduce stress and anxiety, while Shanmuki and Brahmari improve cognitive focus in addition to relaxing you. If you want to learn pranayama breathing, you can find Youtube videos that will show you how to exercise your lungs with these pranayama breathing patterns.
Exercise and meditation support pulmonary and brain health by increasing the flow of oxygen to the cerebellum, which has been shown to increase cognitive function. The following is also an activity that utilizes oxygen through deep breathing and supports the connection between the brain and the heart.
HeartMath is an innovative technology with over 300 peer-reviewed independent studies that demonstrate the efficacy of this technology to improve emotional wellbeing. The HeartMath Institute has conducted studies that demonstrate the efficacy of this technology. Over 11,500 people who used the HeartMath training technology experienced improvements in their mental and emotional well-being in 6-9 weeks.
24% increased ability to focus
30% improved quality of sleep
38% increased sense of calmness
46% reduction in anxiety
48% reduction in fatigue
56% reduction in depression
You can use this technology on your smartphone. It allows you to improve your brain and heart coherence by increasing your heart rate variability. It is like playing a game, and you learn to control the game with your thoughts and your breath. It enables you to lower your heart rate and blood pressure as well.
Nutrition for Optimal Health and Happiness
Many studies have demonstrated a correlation between poor-quality nutrition and impaired cognitive function as well as mood and anxiety disorders. Inflammatory foods such as meat products from grain-fed animals that contain hormones and antibiotics and processed foods that contain artificial colors or flavorings, inflammatory oils, sugar, artificial sweeteners, and grains (especially gluten) may trigger anxiety.
While coffee has a lot of health benefits and can even have an anti-depressant effect in some people, if used in excess, it is a common trigger for anxiety. If you suffer from anxiety, you may be better off drinking green tea in place of coffee because it has less caffeine.
A diet that supports good mental health is one that includes highly nutrient-dense anti-inflammatory foods such as the following:
· Omega 3 fatty acids in salmon, oysters, herring, sardines, olive oil, flaxseeds, and walnuts have been shown to reduce the depressive symptoms because these anti-inflammatory omega 3 fatty acids are precursors to the production of serotonin.
· Polyphenol-rich foods are showing promise in improving cognitive function and reducing the risk of depression. They help to mitigate the damage done by oxidative stress and can be protective against cancer. Flavonoids are phytonutrient compounds found in color-rich fruits and vegetables such as pomegranate, blueberries, berries, grapes, berries, citrus fruits, broccoli, and leafy greens.
· Vegetable fiber is important because the short-chain fatty acids (SCFA), butyrate, proprionate, and acetate are produced in the digestive tract when vegetable fiber is digested. SCFAs are speculated to have a positive effect on psychological functioning. Prebiotic fiber feeds beneficial bacteria so they can proliferate, which promotes good gut health.
· Medium-chain triglycerides (MCT) are important for the gut-brain axis. The brain is nearly 60% fat and requires dietary fat to nourish the myelin sheath that surrounds neurons. Medium-chain fats are rich in lauric, caprylic, and capric acids which inhibit bacterial and fungal growth in the gut and can optimize beneficial gut bacteria. Coconut oil is an ideal MCT.
· Red meat (beef and lamb) is important for mental health if consumed in small amounts. Functional psychiatrist, Dr. Kelly Brogan, recommends consuming for 3 to 4 six-ounce servings of grass-fed beef, bison, or lamb per week.
Exercise caution when taking collagen supplements
Collagen is an incomplete protein because it does not include the essential amino acid, tryptophan, which is the precursor to serotonin production. Serotonin is the neurotransmitter responsible for feelings of happiness and contentment as well as for cognitive functioning including memory and learning. Relying on collagen as a sole source of protein could result in a tryptophan deficit, which can lower your serotonin levels and lead to depression, anxiety, and irritability, especially if you are already suffering from a mood disorder.
If you are going to consume collagen, you may want to be sure you are also eating a complete protein along with it. A complete protein has all 9 essential amino acids, such as animal proteins or plant proteins such as lentils, chickpeas, quinoa, or pea protein.
Nutrient deficiencies can lead to depression
1. Vitamin D is actually a hormone, and we need 5000 to 10,000 IU of this nutrient daily. We can get our daily dose by exposing bare skin (with no sunscreen) to the sunlight for at least 20 minutes daily.
2. Magnesium is a mineral that has a relaxing effect on the body, so a deficiency can lead to anxiety and depression. Our magnesium stores can be depleted by excess alcohol, coffee, sugar, salt, phosphoric acid, diuretics, and antibiotics. Adult women require 310-320 mg daily, and men need about 400-420 mg daily.
3. Amino acids are the building blocks of protein that are critical for brain function. Deficiencies in certain essential amino acids can cause brain fog, inability to focus, as well as sluggishness and depression.
4. Vitamin B-Complex is one of the most important supplements you can take for your mental health as it is critical for energy production and thyroid health. Make sure your B-complex contains folate or L-methyl folate (aka: 5MTHF) rather than folic acid, which is the synthetic form that requires the body to convert it to methyl folate to make it usable by the body.
5. Folate (Vitamin B9) supports cell division and promotes the conversion of food to energy in the body. Folate deficiency is a risk factor for depression. Foods high in folate include leafy greens, asparagus, beets, lentils, and eggs.
AVOID SUPPLEMENTS THAT CONTAIN FOLIC ACID!!! Folic acid is a synthetic form of folate that can be detrimental to those with certain genotypes who lack the enzyme to convert folic acid to folate. Instead, opt for methyl folate (5-MRHF). I will cover this in more detail when I discuss MTHFR as a risk factor for anxiety and mood disorders.
6. Iodine, selenium, and zinc are all critical nutrients for optimum thyroid function. If iodine levels are too low, the thyroid gland cannot produce T4 and T3 thyroid hormones. If selenium and zinc are deficient, the T4 hormone cannot be converted to T3, the active thyroid hormone.
7. A diet rich in vegetable fiber is paramount for mental health because when this vegetable fiber is digested, it produces short-chain fatty acids (SCFA), important metabolites that help to increase the beneficial bacteria in the gut that can affect one’s sense of well-being. The SCFAs, butyrate, proprionate, and acetate also mitigate the damage done by the over-production of lipopolysaccharides (LPS), which can wreak havoc with the gut-brain axis. LPS are endotoxins that cause oxidative stress in the body, which can result in apoptosis (cell death). LPS activates the production of inflammatory cytokines and induces neuroendocrine changes that can impact the neurotransmission of the neurotransmitter serotonin, which can contribute to depression.
Probiotics that support mood
Probiotics are beneficial bacteria that help to maintain health in the digestive tract. New research suggests that certain probiotic strains may help improve mood and well-being by positively impacting the gut-brain axis. It has been estimated that 90% of the serotonin is produced in the digestive tract.
In clinical studies, Lactobacillus rhamnosus, Lactobacillus helveticus, Bifidobacterium longum, Bifidobacterium infantis have been shown to have the greatest positive impact on mood.
However, it is believed that the combination of the following strains may improve mood:
Lactobacillus rhamnosus
Lactobacillus acidophilus
Bifidobacterium lactis
Lactobacillus casei
Lactococcus lactis
Lactobacillus gasseri
Bifidobacterium breve
Lactobacillus paracasei
Bifidobacterium bifidum
Lactobacillus plantarum
Lactobacillus reuteri
Bifidobacterium longum
Lactobacillus salivarius
Bifidobacterium infantis
Lactobacillus bulgaricus
This combination of probiotic strains can be found in one capsule in the MegaFood Probiotic for Mood formula.
Balance Hormones
Depression and anxiety can result from a hormone imbalance. This can happen in young men and women due to physical or emotional stressors affecting Hypothalmic Pituitary Adrenal (HPA) axis function or exposure to endocrine-disrupting toxins. It is common in men during andropause but is more prevalent in women, especially when they are experiencing the normal hormonal shifts associated with the menstrual cycle, pregnancy, perimenopause, or menopause. It is common for women going through perimenopause to experience mood swings because hormones are frequently shifting. Depression and anxiety can result from fluctuating progesterone levels during perimenopause. Estrogen can help boost serotonin and endorphin levels, which can increase GABA, the calming neurotransmitter. When estrogen and progesterone are perfectly balanced for your unique biochemistry, they work in concert to keep depression at bay. What constitutes the perfect balance for you may not coincide with laboratory “normal” ranges.
Cortisol is another hormone that can contribute to depression if the levels are either too high or too low. If cortisol is too low, the result may be mood instability, low libido, and extreme fatigue, which is a recipe for depression. When cortisol is too high, it can cause agitation and insomnia as well as sugar cravings. If sugar cravings are indulged, sugar consumption can lead to depression when blood sugar levels drop too low after the sugar-induced insulin surge.
Bioidentical hormone replacement can help to balance your hormones if you are going through midlife hormone transition when your hormones are not producing like they did when you were younger. Keep in mind that not all physicians have adequate training in prescribing bioidentical hormones. It is crucial to seek out a health care practitioner who is well-versed in bioidentical hormone replacement and will respect that the levels that are right for you may differ from what is considered to be within “normal” laboratory ranges. The goal is for you to find a balance that feels good for you and a physician who will respect that you know your body.
Serum blood lab tests can be helpful to some degree but are not an accurate measure of cortisol levels because it is only capturing the amount of serum cortisol present at the time the blood is drawn in the lab. The normal cortisol rhythm should be highest in the morning and drop through the day so it is lowest at bedtime. It is, therefore, important to measure cortisol at least four times throughout the day. The best test for measuring hormones is called the Dutch Plus Test, which measures cortisol upon wakening, 30 minutes after wakening, before lunch, around 5:00 pm, and before bed. It can even be measured in the middle of the night if someone is struggling with insomnia. This test also measures hormone metabolites as well as free levels of hormones. If you are interested in doing a DUTCH Plus test, I’m happy to order the test for you. It is unlikely that your conventional medicine doctor will be able to order this test for you, as they are generally restricted to using commercial laboratories such as Quest and Lab Corp, which cannot process DUTCH tests.
To compare the results of the DUTCH Plus and the serum blood hormone tests, I decided to collect urine and saliva samples on the same day I had my blood drawn to measure serum hormone levels. The results were not the same between the DUTCH Plus and the blood test. Knowing that the DUTCH Plus test results are more accurate, my doctor used the DUTCH results rather than the serum blood lab results to determine the ideal dose for my bioidentical hormone replacement.
MTHFR and Mental Health
Methylenetetrahydrofolate reductase (MTHFR) is an enzyme required for efficient recycling of vitamins B6, B12, and folate (B9) in the body. If you have a genetic mutation in the gene that makes the MTHFR enzyme, your body will have difficulty recycling these nutrients. This can cause elevated homocysteine levels, which can lead to heart disease. MTHFR is a complicated issue that requires an entire article dedicated to it. Because MTHFR is germane to the topic of mental health, I would be remiss not to mention it in this article since those with an MTHFR single nucleotide polymorphism (SNP) have a genetic predisposition for mental health issues. If you have inherited either the C677T, or the A1298C variation of this genotype, you are more likely to suffer from depression, anxiety, bipolar disorder, and schizophrenia in addition to chronic pain, fatigue, migraines, blood clots, stroke, embolisms, heart attacks, and first trimester miscarriages.
It is estimated that around 30% of the world’s population possesses an MTHFR gene, and it is more prevalent in Caucasians and Hispanics. The MTHFR test is available through commercial laboratories and insurance companies will pay for this test if your health care provider orders it for you. Unless you’ve had a lab test specific for the MTHFR gene or have done a genetic test, such as 23andMe, you will have no way of knowing that you possess this genetic SNP. If you have this genetic mutation, you can take methylated forms of B6, B12, and folate to minimize your risk of heart disease. There are also lifestyle strategies you can employ to stave off mood and anxiety disorders, chronic fatigue, and fibromyalgia. It is helpful to know if you have this genotype so you can take measures to avoid the physical and mental health issues to which you are genetically predisposed.
If you find yourself struggling with depression and/or anxiety, you may find it immensely helpful to talk with a professional counselor, who can support you during this difficult time. My passion for helping people runs deep, and I am more than happy to talk with you if you would like to take advantage of my free 30-minute consultation. This will give you a chance to determine whether my therapeutic style would be a good fit for you. If you are not looking for counseling and just have questions about any of the information in this article I am happy to answer any questions you have. Feel free to email me at val@synergyhealthsolutions.net if you would like to schedule a 30-minute consultation.
In good health,
Valerie Folsom-Martin, MSW, LCSW, CIMHP, CCTP, FDN-P, CHHC
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