Food and Depression
Can depression be caused by what we eat?
Underneath the shining veneer there was a problem: Janet was unbelievably depressed. She found it hard to get out of bed in the mornings, but she forced herself because she wanted to keep up the impression of being a dutiful wife and mother. But as soon as she was left on her own she found it hard to do anything. Her GP had put her on Prozac but that was four months ago and still things were no better.
Janet had read more than one magazine article suggesting there was a link between emotions and food. Was her depression caused by what she ate? It hardly seemed possible for her - as far as she could tell she ate a very healthy diet. Admittedly, she did get a certain amount of bloating and in the last six months had put on about half a stone, but in all other respects she seemed to be physically very healthy.
A Hidden Allergy
Intolerance of certain foods that are perfectly healthy for the majority of us is nothing new. In Roman times, Lucretius said, “One man’s food is another man’s poison”. Chaucer referred to “blakke bread” as a cause of depression. Down the centuries people have had instincts about how food could be linked with the emotions. But they found it hard, of course, to support their suspicions with solid evidence. It was only in the 1950s and ‘60s that certain doctors, mostly American, began writing about how they found their patients’ mental and emotional states to be sometimes linked to food. Dr Walter Alvarez described how headaches and dulling of the brain could be brought on by food. Drs Rinkel, Randolph and Zeller in their book entitled FOOD ALLERGY described how depression, feeling drugged, hallucinations and insomnia could all be caused by food. Dr Speer, Dr Rowe, Dr Mandell and Dr Randolph all wrote books describing the astonishing power of food to produce not just physical symptoms but mental ones as well. In fact Dr Randolph went as far as to say that 60-70% of symptoms diagnosed as psychosomatic are in fact undiagnosed reactions to food, inhalants and chemicals.
Reluctant to Change
All the above books are well written, believable and convincing - to even the most intelligent and sceptical of laymen. So why have they not been embraced by doctors the world over? Maybe Dr Alvarez supplied the answer when he said, “We doctors are the most stubborn lot in the world. Many doctors are so stubborn they think a fact can’t be true if they were not taught it in medical school.” In Britain doctors are still taught practically nothing about nutrition and allergies as part of their medical training.
In 1976, for the first time, a British doctor published a book about food allergies and mental and physical symptoms. Called NOT ALL IN THE MIND by Dr Richard Mackarness, it sold a lot of copies and garnered much publicity. A few GPs, fed up with not seeing any improvement in their patients’ symptoms, read it, were fascinated, and went to meet Dr Mackarness at Basingstoke General Hospital where he was practising psychiatry. They were convinced; they left the NHS and set up in private practice. Many of those 20 or 30 doctors are still in practice today. But they, along with certain clinical nutritionists like myself, remain the only practitioners who really specialise in exploring the connection between food, mind and mood.
Back to Janet. When I analysed her diet it became obvious that she was doing something often seen in people with food intolerances; eating far too few foods. For breakfast she had Weetabix and semi-skimmed milk; for elevenses, two biscuits and a cup of tea; for lunch, a sandwich with either ham, cheese or tuna. At about 4.30pm she had a slice of carrot cake or a flapjack and at 7.00pm she had dinner - always a salad, occasionally with chicken and fish, but more often with pasta or couscous.
It doesn’t sound too unhealthy, does it? In fact, it is fairly close to the sort of diet recommended by dieticians in hospitals. But, unfortunately, many dieticians don’t know about (or refuse to recognise) food intolerances, so they don’t spot the clues that suggest food intolerance.
An experienced nutritionist would notice that Janet’s diet contained too much wheat. She ate it four or five times a day. That, coupled with the fact that her depression was always at its worst in the mornings, and often lifted as the day went on, strongly suggested wheat was her problem. I therefore recommended an exclusion diet (no wheat or other cereal grains for ten days) and then challenge testing by reintroduction of the suspect foods.
It is important in such a case to also cut out all the cereal grains which are closely related to wheat: rye, oats, barley, corn, millet. The last two don’t contain gluten but gluten is often a red herring; it applies only in the case of coeliac disease. Most people with wheat intolerance don’t have coeliac disease, they simply have food intolerances.
Because oats, rye, corn, barley and millet are all very closely related - who, apart from farmers, can tell them apart when they are growing in fields in the summer? - an intolerance of wheat often means the patient is not much better off with one of these other grains. Rice is different. Although in the same food family, it is sufficiently different to wheat (I call it a second cousin of wheat) for it not to be a problem for most British people.
Once Janet removed these grains from her diet, she was her old sparkling self. Her depression lifted and she lost the extra half a stone in weight. She was amazed at the connection between her diet and her mood.
The Allergy and Nutrition Centre
London, Sussex and Oxford