Real answers to the mental health crisis
Do you want the bad news on mental health first, or the good news? OK, let’s go with the bad news first:
Ever since most of the world’s governments decided to ignore their own pandemic preparedness plans and impose ineffective, non-evidence-based and harmful lockdowns, ineffective and harmful face masks, and non-evidence-based physical/social distancing diktats on their populations, whilst the media deliberately hyped up fear of SARS-CoV-2 in order to boost ratings and serve the financial interests of their corporate masters, rates of depression, anxiety and stress have increased alarmingly, including in people whose mental health was previously good.
Prescription rates for antidepressants are skyrocketing, while the evidence base for antidepressant drugs continues to unravel; these drugs perform no better than placebo and may increase the likelihood of becoming depressed in the future.
So what are we to do? Fear not, it’s good news time! Evidence that simple changes in your everyday habits can reduce the risk of depression and anxiety, buffer stress, and alleviate these distressing states when they do occur, continues to mount.
Let’s examine some recent findings from the research literature.
1. Eat more fruits and vegetables
A study which examined the link between fruit and vegetable intake and perceived stress levels in more than 8600 Australians aged 25-91 enrolled in the Australian Diabetes, Obesity and Lifestyle (AusDiab) Study, found that people who ate at least 470 grams of fruit and vegetables daily had 10 percent lower self-reported stress levels than those who consumed less than 230 grams.
The stress-buffering effect of high fruit and vegetable consumption was observed in both men and women, and was particularly pronounced in middle-aged individuals (45-65).
A Canadian study of over 27 000 adults aged 45–85 found that higher intake of fruits and vegetables was protective against the development of depression in mid- and late-life, while those who consumed less than 3 serves of fruits and vegetables daily were at least 24% more likely to be diagnosed with an anxiety disorder.
The Australian researchers pointed out that the vitamins, minerals, flavonoids and carotenoids found in fresh produce reduce inflammation and oxidative stress, which are known to lead to increased stress, anxiety and lower mood.
These conclusions are reinforced by another study based on large genome-wide association study data sources involving hundreds of thousands of participants, which found that higher levels of C-reactive protein (CRP) level, a broad marker of inflammation, were linked with 9 characteristic symptoms of depression.
Importantly, the correlation between the genetic propensity to higher CRP levels and depressive symptoms was small, which means that they could easily be offset by eating a more anti-inflammatory diet… that is, more fruits, vegetables and other unprocessed plant foods.
2. Shift your sleep schedule
According to a study of nearly 840 000 adults who took part in a study which examined genetic variants that affect sleep timing preference, actual sleep habits, and mental health history, those with early-to-bed, early-to-rise sleep habits had a significantly lower risk of developing major depression.
In fact, the researchers calculated that going to sleep and waking one hour earlier than average was associated with a 23% decreased risk of major depression.
The researchers aren’t sure why going to bed earlier and getting up earlier help to prevent depression, but other research suggests that greater daytime light exposure – and especially, exposure to morning sunlight – along with reduced exposure to light at night, may play an important role via the cascading hormonal effects of light exposure.
Physical activity has so many benefits for mental health, it’s hard to know where to start. Psychiatrist and neuroscientist, Arash Javanbakht, provides an excellent and well-referenced summary of them here.
In brief, physical activity stimulates neurogenesis, meaning that it prompts the birth of new neurons (‘brain cells’) and connections between them, which allows us to learn from our experiences and regulate our emotions. It trigger the release of mood-boosting neurochemicals, and has an anti-inflammatory effect (as long as you don’t overdo it).
Clinical trials have found that exercise reduces the symptoms of both depression and anxiety. (And unlike medication, the only side-effects are good ones.)
Any form of movement that you enjoy offers significant mental health benefits, but you pick outdoor activities you’ll pick up bonus points for exposure to fresh air, sunlight and (hopefully) nature.
4. Address insulin insensitivity
A longitudinal study of over Dutch 1200 adults found that those with insulin resistance were 51% more likely to be currently suffering from major depressive disorder (MDD), whereas those who had suffered from MDD in the past but were now in remission had normal insulin sensitivity.
Insulin is a hormone that regulates the metabolism of carbohydrates, fats and protein by promoting the absorption of glucose from the blood into liver, fat and skeletal muscle cells. Insulin resistance results in elevated triglyceride (blood fat) levels, which in this study were found to be associated with both more severe and more chronic depressive symptoms.
Fortunately, insulin resistance can be overcome very rapidly by adopting a low fat, high fibre plant-based diet, regular exercise (especially strength training) and prioritising sleep to ensure optimal sleep duration and timing.
5. Encourage healthy lifestyle behaviours in your children, especially around puberty
A study which followed over 10 000 individuals from age 1 to 24 year, measuring their body mass index (BMI) and fasting insulin levels at regular intervals, found that persistently high fasting insulin levels from age 9 years were associated with psychosis at 24 years, and puberty-onset body mass index increase was associated with depression at 24 years.
A healthy diet and lifestyle are important are at all ages, but the period of rapid growth and development that occurs around the time of puberty may represent a particularly sensitive period for longer-term mental health outcomes.
As mentioned above, weight gain and impaired insulin sensitivity are both linked to poor dietary choices (too little fruits, vegetables, whole grains and legumes; too much processed food and animal-source food), physical inactivity, and disrupted sleeping habits – exacerbated by the digital technology that has invaded kids’ lives.
6. Choose a neighbourhood with street trees
A study of almost 10 000 people living in Leipzig, Germany found that living on a tree-lined street was associated with a lower rate of antidepressant prescriptions.
The effect was particularly strong for people for people with low socio-economic status (SES), who are more likely to be prescribed antidepressants: living within 100 metres of higher density of street trees knocked the rate of antidepressant prescription down to that seen among people with higher SES. The authors concluded that
“Some pathways through which low SES might lead to worse mental health are possibly modified by exposure to nearby nature.”
In summary, for all the hand-wringing about the dire state of mental health across the lifespan today, there is abundant evidence from well-conducted scientific studies that simple and inexpensive lifestyle changes such as increased fruit and vegetable consumption, regular physical activity, getting to bed on time and surrounding ourselves in nature, protect us against anxiety, stress and depression.
Of course, for someone who is already stressed, depressed or anxious, changing one’s habits can be challenging. Fortunately, Lifestyle Medicine practitioners are well-trained in coaching people through these challenges, helping to close the gap between research and practice.