Affective Disorders
Depression, anxiety and stress are the most common affective disorders (also known as mood disorders) in the UK. A 2018 study by the Mental Health Foundation (MHF) questioned 4,619 respondents, to which 74% of people reported feeling stressed and overwhelmed or unable to cope. Bupa’s statistics suggest 1 in 4 people suffer from some kind of mood disorder, while an Adult Psychiatric Morbidity Survey (2014) highlights 1 in 6 adults with 19.7% of people in the UK aged 16 and over showing symptoms of anxiety or depression. And, worse still, 1 in 5 adults have considered taking their own life at some point. Numbers of those suffering from affective disorders may be higher as nearly half of adults questioned in the 2018 study believe that they have had a diagnosable mental health problem, yet only a third have received a diagnosis. These are worrying statistics.
What Exactly is Depression & Anxiety?
Most terms are used interchangeably but anxiety is defined as worry on most days for more than 6 months and difficulty controlling worry without logical cause. Depression is classed as a low mood for four weeks or longer, with a loss of interest in activities. Depression can cause: a loss of confidence, low self-esteem, despair, withdrawal from social activities, fatigue and chronic illness, guilt, past-focused thoughts, anger or subservient attitude, lack of productivity and decision making. These conditions can co-exist and usually with increased severity and for a longer duration. All affective disorders can cause weight changes, affect concentration, sleep and digestion - often a catch 22 with the effects creating further distress.
What Are the Causes of Mood Dis-orders?
Our world is becoming more stressful with employment pressures, longer working hours and less free time, economic uncertainty, political pressures, reduced family values and all taking place in an ever increasing toxic world with fake foods, chemicals, pesticides, pharmaceuticals and preservatives. Our wildlife is dying, our water is turning into a plastic sea and we are losing touch with nature. We are being bombarded with fear via the media and television which highlights violence, war and economic uncertainty. Not to mention the pressures of social media, day in day out, we have the weight of our friends list on our shoulders and being bombarded with information; crime and bullying on social media are on the rise, especially in younger circles. Our modern living is constantly bombarding us with information and we are becoming disconnected to the world we live in.
Within the 2018 MHF study, the leading stressors stated by the respondents were: a friend or relatives health condition, debt, instant messaging pressures, comparisons to others, appearance and body image, housing worries and pressure to succeed. All of which demonstrate stress in the form of pressure, judgment, fear, insecurity, isolation and a lack of support.
The solution to mood disorders in allopathic circles is a reliance on pharmaceuticals such as anti-depressants. Bupa report that doctors are giving medication for affective disorders without an official diagnosis. Giving medication isn’t enough, we need to be finding out why we are suffering as a nation and view mood disorders holistically.
Mood disorders are endemic within our modern world and statistics are increasing year on year, but why are some of us affected by stress more than others? It is likely that there are multiple factors which drive the extent to which an individual suffers. How we cope with difficult situations can be influenced by our emotional type, memories, motivational state, level of support we have and our general outlook on life, however, possible root causes include our environment (pesticides, preservatives, chemicals), nutrient deficiencies or food additives, hormonal imbalances as well as brain pathology and genetic factors which have all been shown to affect our mood.
Our emotions are also affected by energy, negative people, electromagnetic energy and a lack of sunlight. Longer working hours and nightshifts reduce our limited sunshine exposure. Depression can be triggered by limited sunlight known as Seasonal Affective Disorder which can cause mood disturbances; countries with fewer hours of sunlight correlates to higher suicide levels. Given the connection of vitamin D and sunlight, it is possible low levels may also contribute mood disorders but always take advice before embarking on supplementation.
Parkinson’s disease, cognitive disorders and mood disorders (anxiety, depression, suicide) have been associated with acute and chronic exposures from organophosphates. Mercury, lead, cadmium, aluminium, formaldehyde, pesticides and herbicides and organophosphates have an affinity for our nervous tissues (nerves and the brain) and are contributing to early onsets of brain degeneration and neurodegenerative diseases. Parkinson’s disease has been specifically linked to pesticide exposure and are now considered a risk for neurodegenerative disorders; whilst aluminium has been linked with the development of Alzheimer’s (Rondeau et al.,2009). Further, a review by Freier (2013) stated that four studies found increased suicide rates in agricultural areas with intensive pesticide use compared to areas with lower pesticide use. Epidemiological studies are inconclusive to date but for me, very significant; I have met a few gulf war heroes in my time who’s symptoms relate to nerve toxicity including, chronic fatigue, fibromyalgia, headaches, confusion, abnormal nerve function and depression. It is a bleak picture but simple changes such as removing offending toxins can make a difference to our mental health. Start by reducing aluminium intake by avoiding aluminium cookware and products that contain aluminium such as deodorants or try switching to natural forms.
Nutrition
Nutrition is a powerful ally to our cognition, emotion and behaviour. It is clear we need a solution to our depression endemic and nutrition is something you have control over. Hypoglycaemia, food allergies, hypothyroidism, nutritional deficiencies or chronic inflammation are causes of depression. We must fix our physiology with adequate nutrition if we wish to have a strong mind. Stress depletes essential vitamins so it is recommended to boost nutrition during stressful times such as healthy proteins, hydrating foods and coloured vegetables.
Nutritional deficiencies are a root cause of anxiety. Scientific studies have shown that low levels of B vitamins can cause mental depression, apathy, anxiety, behavioural issues, irritability, restlessness, fatigue, delirium and cognitive decline. Low B vitamin stores have been found in those suffering from dementia (Selhub 2000). The effects of vitamin B12 deficiencies can cause nerve damage and dementia while vitamin B6 deficiency has been linked to peripheral neuropathy and seizures. Vitamin D and Zinc are two other nutrients where low levels correlate with mood disorders. The role of nutrients in the body is complex and they play a part in complex functioning; congenital defects within enzyme function included mental retardation, psychiatric disturbances and seizures.
And, nutritional deficiencies are common. Food doesn't contain anywhere near the amount of vitamins and minerals it did pre-1940’s; long ago we kept fields fallow for the nutrients to replenish after a crop. Intensive farming is now mainstay and our soils are poor in nutrients which directly affects the nutrient status of our foods. Foods are grown in greenhouses under artificial light or flown half way across the world, so there are many factors that affect nutrient status, meaning that we should most probably be eating more than our five-a-day. So, unless you are eating a very healthy diet of organic meats and vegetables it is likely you will be under the required levels of vitamins and minerals which have a knock-on effect on our emotional health.
Tryptophan is commonly associated with mood. It is an amino-acid (protein) and is the pre-cursor to our happy neurotransmitter serotonin; low protein stores can reduce our circulating levels of serotonin which is associated with depression. A diet rich in tryptophan but also rich in antioxidants can have a positive impact on mood and cognition (Strasser, 2016).
Nutrition Tips for a Healthy Mind.
1. Our brain is 90% water, dehydration leads to fear. A dehydrated cell is a fearful cell and that fear resonates into our emotions. Our emotions and physiology are closely interlinked so if you get home with a headache or feeling very stressed, think about your water intake. Have you had around four pints? The body looses thirst and its desire for water in severe dehydration (you might be surprised to know a dry mouth is considered severe dehydration in naturopathic circles) and so sipping hot water is a easy way to rehydrate. If you find drinking water a chore try herbal teas or adding your own fruits or herbs. You could go the full monty and grow your own herbal garden to have on hand; you can’t beat mindfulness and aromatherapy - try a herbal infusion of bergamot or basil, they work great as a pick-me-up.
2. Pumpkin seeds, grains, red meats in particular venison and lamb, liver, kidneys, nuts, seeds and sea vegetables contain essential B vitamins. Turkey, chicken and dark chocolate are good sources of tryptophan. Sardines, mackerel and salmon contain B12, vitamin D and omega 3 - all essential for brain health. Veganism is very popular at the moment and understandably so however, it is important that vegans research safe practice and meet recommended nutrient levels, it is important to have adequate sources of B12 and vitamin D.
3. Omega 3 is an essential fatty acid, it reduces inflammation and it is beneficial to brain and nerve health. Omega 3 is found in oily fish and seed oils such as flaxseed and hemp oil; including more seeds and oily fish in our diet is an important foundation for our mental health. Our diet can help reduce inflammation in the body and anxiety in our emotions. I would also avoid trans-fats and processed oils as these have been implicated with heart disease and inflammatory conditions.
4. Blood sugar - our brain needs a regular source of glucose for a stable mood; eating nourishing and sustaining foods can help to reduce sugar lows. Hypoglycemia (low blood sugar) can present as anxiety, irritability, fatigue, headache, blurred vision and confusion to name but a few (these are also serious indicators and if you are suffering from any you these it is important to see a doctor to find out why). In our busy lives we usually eat on the go when we should be eating regular meals and sustaining foods with awareness. Simple swaps can make a good start. Why not try swapping white bread for a wholemeal or seedy choice? It would provide you with a healthier sugar spike and more sustained as well as extra nutrition.
5. Reduce or remove fake foods and preservatives; although inconsistent there is accumulating evidence for artificial food colours and preservatives as a cause of mood disturbances and behavioural issues such as ADHD. It is always best to eat the least processed foods where possible. Fake sugar, low-fat options aren’t necessarily healthy - stick to natural and organic where you can. Riverford or Abel & Cole do a great organic delivery service with inspiring recipes to cook from scratch if you are wanting to make a start.
And, after all of that if you feel no improvements you could be looking at a food sensitivity. Allergies and intolerances are on the increase. Gluten, milk, chocolate, soy, eggs, wheat, corn, legumes are some of the most common. It is recommended that you enrol on an elimination diet to rule out underlying food sensitivities.
So reducing pollutants, spending more time in nature and living seasonally and eating healthily are three easy and positive ways to keep your mental health in good shape.
Dealing with Reactive Depression & Anxiety
Short-term depression can be a reaction to loss such as a bereavement, a relationship, habit or thing. This is a time when we feel normal emotions and we must take time to grieve but if we do not deal with our emotions they can lead to long-term anxiety. Observing our thoughts or talking to someone can help. Meditation, Cognitive Behavioural Therapy (CBT) or Talk Therapy can be valuable aids.
Cognitive Behavioural Therapy - demonstrated to be effective for moderate depression. CBT helps you to recognise your negative thought patterns and question your thoughts, following, you focus on contrary evidence and generate new thoughts. You can do this yourself by replacing negative thoughts with positive mantras but checking in with a professional can help you to keep on track.
Talk Therapy - this helps your communication skills and increases confidence and self-esteem. It is great if you feel isolated or are suffering the effects of a difficult situation. Find yourself someone to talk to and begin to accept your emotions. We often feel guilty for our feelings but you may find that they are justified or at least work out what it is you need to change, stopping the downward spiral into longterm depression.
Is there a positive side to our emotions?
Anxiety has a bad reputation but what if anxiety had a purpose? Anxiety does have a purpose in our lives - it is a warning mechanism altering us to something that we must change. Anxiety would benefit our caveman ancestors by alerting them to a preying lion but in our urban jungle this mechanism becomes reductionist. And, for some of us we become reliant on anxiety as a guiding emotion (we make it permanent and react to it). Anxiety is created by the production of our stress hormone cortisol in response to the lion, making our ancestor strong and ready for action. But, imagine fighting that lion day in day out and you would become exhausted; or if you didn't take action you would likely have died. Long-term cortisol caused from prolonged stressful situations has been shown to damage the body.
So how can we protect ourselves from the lion (anxiety)?
If we can begin to see anxiety as a positive mechanism that alerts us to a need to assess a situation our life can seem less scary. Sit down with yourself and ask yourself: Why am I feeling anxiety? What is causing my anxiety? What am I supposed to be doing? What are my real fears? We often ignore this indicator and numb our thoughts, pain and worries instead, leading to dis-ease or addiction. Listening and splitting our thoughts up can help us find a way off the anxiety roundabout.
What do I mean by real worries?
Well, for this I will tell you a little story of a patient, highlighting how our superficial worries are actually often deeper rooted. It always stuck with me as I struggled with a similar situation myself.
I once had a consultation with a woman who was diagnosed with Mal de Debarquement syndrome (MdDS): a feeling of continuously rocking, swaying. One of our conversations was over a panic attack when she became unstable at the crossroads. We talked about how waiting for a diagnosis was affecting her and creating anxiety. Rightly she was scared she would fall but behind that were also worries about her future, financial status, career…and perhaps fears of asking for help with the pressures of embarrassment and judgement. It sometimes it helps to separate the fears so you can find the roots. You will realise some are not actually worth worrying about. Her solution wasn’t to sit around and wait for the diagnosis but rather about creating change. I doubt the beginning step was easy but change pulls you upwards. The next time she went to the crossroads with the intention of asking for help. Even though she didn't need help her planning for all eventualities reduced her fear of the unknown.And for her bravery her body created dopamine (our happy hormone) in response to reward. The positive effects helped provide her with motivation an allowed for a treat; most likely chocolate, wine and a bath.
So, it can be tough but we need to act on anxiety. Do something to face your lion. Consider what it is that is actually causing you anxiety and then make one small step, even if it is taking 5 minutes for yourself each day.
Keeping Motivation
Make your goal as small as you need but stick to it. And, treat yourself when you deserve it.
Ask yourself 'what would the best me do right now? ... and do it. There were times I just didn’t want to deal with situations, even the smallest; knowing that the to-do list would always be there created even more anxiety. Always try to minimise anxiety. Ask yourself the above question and then to what you need to do, the more you focus on the problem the more anxiety you create.
Ask yourself if your worries are valid. Work out what you have the power to change or resolve the situation. Imagine you are advising your friend and listen to the best you. If not, communicate with trusted friends from a variety of backgrounds and those that know you in different ways.
Always remember that somewhere someone else is going through the same thing. Buddhist Tonglen principals helped me personally and it makes for good bedtime reading.
There is no pressure other than your own. Keeping a diary can help you to analyse your thoughts and track progress. I tell my meditation group to ‘be the pond and not the fish. You are the pond and the emotions are the fish swimming around; the key is being aware of them but not reacting to them. Be in control.
10 Top Tips for Supporting Daily Anxiety!
Do the jobs that cause you the most anxiety first and get them out of the way, this way the worry does not follow you all day adding to your anxiety. Get a cup of tea or coffee or put some music on and just be in the ‘now’. You can rest, relax or treat yourself afterwards for being productive too.
Music, aromatherapy, meditation, art, colour engage our senses, being outside helps to distract us from our negative thoughts. If it all gets too much take time out. Make a playlist or dress in brightly coloured clothes… get creative.
In the dark months light up your home with fairy lights or candles (safely) to bring light inside. If you think you suffer from SAD you can buy yourself a day lamp which can ease symptoms.
The impact media can create extra worry -avoid or minimise your exposure to the news and social media; make a date with nature instead and stick to it. All the replies and posts CAN wait. And those that care understand we all need time out. What did we do before all this technology?
Smiling has been shown to make you happy - even if you don’t feel happy. So, - fake it till you make it. Try smiling at people and notice if you have a better day and if your anxiety levels lower.
Happiness is infectious. Laughter is catching. Increase your dopamine by being surrounded by happy people.
Seize opportunities. It doesn’t matter if you look a mess or have worries - just go and be. Accept where you are and just remain in the moment - the universe is waiting to provide for you.
And someone once told me to be 80% good and 20% bad, rather than worrying over the bad. Eat, drink, smoke - do what helps you, but be responsible 80% of the time. The 20%? Well do that without guilt! Stress is after all is the biggest killer.
Listen to meditations on You Tube. They are good for helping you sleep or just taking five minutes to yourself. The 5 Minute Miracle is a good one, it literally takes five minutes so work it into you schedule and keep routine. There are many sleep hypnosis meditations which I often recommend; I personally like the work of Lisa Beachy and Jody Whitely.
Do a good deed for someone else. "More than two million people in England over the age of 75 live alone, and more than a million older people say they often go for more than a month without speaking to a friend, neighbour or family member”. Why not reach out to an elderly person in your community. Use their experience and pearls of wisdom and in return you feed them a hearty meal helping them to keep those pearls in good health. Older people make good listeners and provide non-judgmental conversation without agenda. It seems a shame that so many of us need people to talk to, yet we don’t connect. Cognitive decline often progresses in older people who live on their on and off processed foods, obtaining few nutrients. Feeding a wholesome home cooked dinner to a friend in need is perfect way to benefit their health and show kindness. Get inspired by food and your community.
Mood Dis-order Consultations are available at the Leaf Retreat or if you are local you might like our Tuesday evenings which are positive community based meets with meditation, sharing, prayer and friendship.
References
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Coppen, A., & Bolander-Gouaille, C. (2005). Treatment of depression: time to consider folic acid and vitamin B12. Journal of Psychopharmacology, 19(1), 59–65.
Consuelo H.WilkinsM.D.Yvette I.Sheline M.D Catherine M.RoePh.D Stanley J.BirgeM.D. John C.MorrisM.D.(2006) Vitamin D Deficiency Is Associated With Low Mood and Worse Cognitive Performance in Older Adults The American Journal of Geriatric Psychiatry. 14, (12), pp.1032-1040
Evans, J., Macrory, I., & Randall, C. (2016). Measuring national wellbeing: Life in the UK, 2016. ONS.
Ferrari, A.J., Charlson, F.J., Norman, R.E., Patten, S.B., Freedman, G., Murray, C.J.L., ... & Whiteford, H.A., (2013). Burden of Depressive Disorders by Country, Sex, Age, and Year: Findings from the Global Burden of Disease study 2010. PLOS Medicine, 10 (11)
Fernando Gómez-Pinilla (2008) Brain foods: the effects of nutrients on brain function.NatureReviews Neuroscience. 9, pp. 568–578.
Freireab, C., Koifmana.,S (2013) Pesticides, depression and suicide: A systematic review of the epidemiological evidence. International Journal of Hygiene and Environmental Health. 216, 4, pp.445-460
Jacob Selhub, Laura C Bagley, Joshua Miller, Irwin H Rosenberg (2000) B vitamins, homocysteine, and neurocognitive function in the elderly, The American Journal of Clinical Nutrition, Volume 71, Issue 2, pp. 614S–620S
Rondeau V, Jacqmin-Gadda,H., Commenges, D., Helmer, C., Dartigues., JF (2009) Aluminum and Silica in Drinking Water and the Risk of Alzheimer's Disease or Cognitive Decline: Findings From 15-Year Follow-up of the PAQUID Cohort, American Journal of Epidemiology, Volume 169, Issue 4, 15 February 2009, pp.489–496
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Strasser, Barbaraa; Gostner, Johanna M.a; Fuchs, Dietmarb (2016) Mood, food, and cognition: role of tryptophan and serotonin Current Opinion in Clinical Nutrition and Metabolic Care. 19, 1, pp. 55–61
Websites
https://www.nhs.uk/conditions/stress-anxiety-depression/loneliness-in-older-people/
