As a rule, during stress and the initial stage of depression, a person begins to consume a variety of foods in significant quantities. Indeed, at first, overeating reduces nervous tension. However, the consequences of such an excessive appetite are even more stressful. Many doctors recommend, at the first sign of depression, to reconsider your diet and, if possible, arrange "fasting" days.

One of the important components of comprehensive treatment for depression and stress should be a special diet aimed at replenishing the body's deficiency of substances that are intensively absorbed by stress hormones. Eating certain foods on a daily basis can significantly improve a person's mood and save them from excruciating depression.

What foods to include in the diet for depression?

Some of the leaders in the diet for depression are foods rich in carbohydrates. This is because the daily intake of sufficient carbohydrates in the body contributes to the production of tryptophan, which is converted in the brain into serotonin... Namely, a person's mood depends on the concentration of serotonin, and a lack of this neurotransmitter can cause depression. One of the most affordable carbohydrate-rich foods is wholemeal bread. It should be noted that in order for carbohydrates to stimulate the production of tryptophan, bread must be eaten separately from protein products.

Some foods contain endorphins and opiates- hormones responsible for "good" mood. Their action is aimed at reducing the effects of stress experienced, reducing the manifestations of depression, increasing vitality.

Cytofin- an opiate that improves mood, found in lettuce, spinach, cabbage, paprika. Natural milk contains a morphine-like substance - casomorphin... Bananas are rich in serotonin, which gives a light feeling and improves mood. They also contain the alkaloid harman, which is based on the "drug of happiness" - mescaline. As part of dark chocolate - andamine, an aphrodisiac substance, like hashish. The use of sweet treats makes a person more cheerful and cheerful due to the high content glucose.

"White" chicken and turkey meat contains a natural source of energy - tyrosine, which helps to increase the speed of reactions in the brain and increase concentration norepinephrine and dopamine.

Everyone knows that caffeine is an effective stimulant. However, drinking too much coffee can lead to irritability and fatigue.

Hot pepper contains a substance - capsaicin stimulating the production of endorphins that improve mood.

Vitamins and Minerals to Help Fight Depression

• Vitamin A. Found in carrots, pumpkin, leafy vegetables, and apricots.
• Vitamin C... Especially rich in citrus fruits, kiwi, black currant, rose hips, broccoli, cabbage.
• B vitamins present in cereals, nuts, liver, bran bread, yogurt, avocado, pumpkin, lean meat and sea fish, brewer's yeast. Vitamins of this group increase the concentration of omega-3 polyunsaturated fatty acids. It is known that the peoples of the Mediterranean suffer less from depressive disorders, as their diet is dominated by fish and seafood. Sources of vitamin B6, without which the synthesis of serotonin is impossible, are cereal grains, mollusks.
• Vitamin E found in vegetable oils.
• Magnesium: peas, buckwheat, oatmeal, grapefruit, nuts, figs, "green" herbs and vegetables, tomatoes, carrots. A deficiency in this mineral reduces stress resistance, while a higher content reduces anxiety and improves sleep quality.
• Calcium: dairy products.
• Zinc: seafood, oysters, cheese, eggs, turkey, nuts, yogurt, asparagus.
• Choline: beef liver, egg yolk, sprouted wheat grains.
• Glucose: honey, sweet fruits, bran bread.
• Folic acid, essential for the production of dopamine, found in broccoli and calf liver.
• Deficit gland in the human body, it causes a bad mood and a feeling of fatigue. Eating lean beef and apples can help prevent iron deficiency.

What should be considered for depression?

Also, with depression and prolonged stress, the body needs adaptogens - substances that increase the endurance of adaptive systems. Among the adaptogens are plant products: lemongrass, echinacea, ginseng, licorice, green tea, kombucha. Their reception is also effective for mental exhaustion resulting from intense mental work.

While monitoring your diet, you need to monitor the stool, since constipation is characteristic of depressive disorders.

From the point of view of the "water" theory, depressive conditions are the result of a lack of water in the cells of the brain. When dehydrated, significantly less energy is produced, as a result of which many functions of the brain are not fully performed. Such ineffective work also causes a decrease in mood, the appearance of a feeling of fatigue, and rapid fatigability. Therefore, in case of depression, it is recommended to consume a sufficient amount of fluids, at least 2 liters per day.

Also, in case of illness, one should completely abandon the use of all alcoholic beverages, since alcohol-containing compounds suppress the production of vasopressin, which causes acute dehydration of the body.

Depression is a rather serious mental condition that negatively affects a person's life. Therapy for this disease is long-term and complex. After recovery, each patient is prone to relapses, which necessitates periodic monitoring by the attending physician. In such a situation, medicines do not play a decisive role. Nutrition in depression is no less important. We will pay attention to this below.

Basic treatments for depression

Prescribing antidepressants is usually a required part of the treatment for this mental illness. But medication alone is rarely a way to lighten a person's mood for a long time. An important fact is that before the development of pharmaceuticals, people preferred to use tinctures from medicinal plants and music therapy for these purposes. Among the main treatments for depression are:

• walks in the open air;
• playing sports, dancing and any other kind of physical activity;
• rejection of bad habits;
• communication with family and friends;
• self-hypnosis, hypnosis, etc .;
• special diet for depression.

Usually, doctors, together with drugs, prescribe a whole range of additional measures, among which there are individual and group psychotherapy and nutritional recommendations.

The role of good nutrition

Numerous studies have shown that the diet of people in different countries affects the predisposition to depression in different ways. Citizens of Scandinavian and Asian countries have the lowest risk of experiencing this ailment. Despite the fact that a special diet has not yet been developed, nutrition in depression plays an important role, and a number of foods can even contribute to a speedy recovery.

So, for example, well-known carbohydrates are stimulants of good mood. They have a positive effect on the production of serotonin, which quickly improves overall well-being. It should be noted, however, that not all carbohydrates are considered healthy, but complex ones. This means that sweet baked goods are less beneficial than fruits, vegetables and grains. The latter, by the way, also have a cleansing effect on the body.

Protein products have another equally useful property. The tyrosine they contain helps to increase the level of dopamine in the body. Such a phenomenon eliminates the feeling of anxiety, contributes to better concentration and energy of a person. We'll talk about which foods improve your mood below.

The individual food is rich in endorphins and opiates. They reduce the manifestation of stress disorders, reduce the manifestation of depression and even increase vitality. Substances such as adaptogens increase the endurance of adaptive systems. They are found in herbal products (green tea, lemongrass, licorice, etc.) and are most effective for psychological exhaustion and overwork.

Fluid intake plays an equally important role in proper nutrition during a depressive disorder. Lack of water in the brain cells itself can contribute to the development of depression. Dehydration can significantly reduce performance and cause fatigue. That is why, in the fight against depression, you need to consume at least 2 liters of water per day.

With this disease, it is recommended to completely abandon alcohol and other bad habits. The fact is that alcohol-containing substances reduce the production of vasopressin, and this quickly dehydrates the body. The consequences of dehydration have already been described above.

The diet for depression should also take into account the presence of vitamins and minerals in the diet. It has been proven that some of them directly contribute to the cure of such a mental disorder. Mood-enhancing foods contain B vitamins (durum wheat, nuts, bran, cereals, vegetables, lean meat and fish), D (eggs, cod liver, mackerel), A (pumpkin, carrots, leafy vegetables), C ( citrus fruits, potatoes, kiwi, currants), E (vegetable oils).

Among other useful substances that help to cope with depression, magnesium (oatmeal, buckwheat, peas, vegetables, herbs), calcium (dairy products, green leafy vegetables, herbs, soy products), iron (pork liver, apples ), zinc (cheese, nuts, seafood, asparagus, turkey), glucose (honey, fruit).

Best foods for depression

The best foods for depression and mood improvement contain a variety of nutrients, rich in vitamins and minerals, and ample protein and carbohydrates. The most popular and effective among them are:

• Fatty fish. Rich in Omega-3, the product saturates the body with tryptophan, which promotes the production of serotonin. This amino acid is found in fish cooked in a variety of ways. Vitamin B6 plays an equally important role in strengthening the immune system and enhancing mood.
• Vegetables and fruits with bright colors (carrots, tomatoes, beets, peppers, eggplants, tangerines, oranges, persimmons, etc.). Such colorful products by their one kind charge a person with positive emotions. The bioflavonoids they contain promotes good blood circulation in the brain.
• Chicken bouillon. Chicken meat is rich in protein, which is easily absorbed by the body and raises a person's mood.
• Seaweed. Due to the content of B vitamins, this product regulates the level of adrenaline in the blood, the lack of which causes chronic fatigue in a person, which contributes to the appearance of a bad mood. It is uncanned seaweed without additives that has the properties that relieve symptoms of depression.
• Bananas. In addition to the high content of vitamin B6 in this fruit, it is also rich in the alkaloid harman. The latter is capable of causing a feeling of euphoria. Bananas are useful not only for depression, but also for less serious mental disorders (blues or chronic fatigue).
• Nuts. Another famous source of Omega-3, due to which the correct function of brain cells is ensured. They also contain vitamin B6, tryptophan and selenium. The indicator of the latter, by the way, decreases with age in people, therefore, in old age, experts recommend consuming at least 30 g of nuts per day.
• Chocolate. The well-known source of joy has earned its credibility in the fight against depression due to the increased production of endorphins. The hormone of happiness is not the only beneficial substance in it, because it also contains magnesium, which helps relieve stress. It is worth remembering that these properties of a popular delicacy are inherent only in dark chocolate.
• Cheese. The amino acids contained in this product: phenylethylamine, tyramine and tricamine - lift a person's mood.
• Eggs. They contain fatty acids, vitamins A, E, D, B and tryptophan.
• Oatmeal and buckwheat groats. These are cereals rich in tryptophan and complex carbohydrates that normalize glucose levels.

From these products for depression, you can easily make up a complete menu for a week. Such food will not only satiate a person, but also have a beneficial effect on his health. During therapy, do not forget about other important aspects: communication, physical activity and, of course, medications.

And in the spring there are even more depressed people. Scientists have proven that the foods we eat affect the processes in the brain. Some of them cheer up, while others, on the contrary, are capable of ruining it, suppressing joyful emotions.

Signs of depression:

1. Constant feeling of tiredness and sleepiness.
2. Waking up early and feeling unwell in the morning.
3. Decreased sex drive.
4. Complete lack of appetite or overeating.
5. Anger to the whole world.
6. Panic fear for no reason.
7. Feeling of own powerlessness and impossibility to change anything in your life.
8. It becomes difficult to concentrate.

During a period of decline in vitality, the diet should be as complete as possible. It should contain vitamins and minerals, and proteins, and carbohydrates, as well as fat. It is proven that deficiency of any nutrient undermines our body.

If the body is deficient folic acid then you cannot avoid a bad and depressed mood. Folic acid in the brain is involved in the metabolism serotonin... If you're tired, eat a piece of dark chocolate or banana- these products are recognized as the best antidepressants.

If you're tired, eat a banana.

Greens, salad, spinach, cabbage, lemons, lentils- these foods are high in folic acid.

Greens, lettuce, spinach, kale contain high amounts of folic acid

In the process of synthesis of serotonin, in addition to folic acid, is involved vitamin B6... By including foods rich in vitamin B6 in your diet, you can help your body fight the signs of depression. Vitamin B6 also acts as a tranquilizer and promotes good sleep. The deficiency of this vitamin is made up by the following foods: bananas, shrimps, salmon, chicken meat, beef liver, sunflower seeds, tuna, hazelnuts (hazelnuts), lentils.

Shrimp, salmon, tuna make up for the lack of vitamin B6

Recent medical research has shown that eating too much sweets can increase depression. Don't forget about healing vitamin C, in combination with vitamin B-6 and folic acid, it helps the body fight blues and bad moods. A large amount of vitamin C is found in black currant, sea ​​buckthorn, kiwi, citrus, garlic, bow, celery, red pepper, spinach, in rose hips.

Kiwi and citrus fruits are high in vitamin C

Vitamin D also increases the level of serotonin in the blood. Scientists from the University of Toronto noticed that people who suffered from depression were relieved as soon as summer came, because vitamin D is produced by the sun's rays.

Alexey Kovalkov

nutritionist, host of the programs "Food by the rules and without", "Family size"

Adding "healthy" foods to the diet helps to normalize the release of endorphins. Some plants contain phytohormones - substances similar in composition and action to human hormones. "Hormones of happiness" endorphins are produced not only for chocolate, but also for oats. After all, "Hercules" contains tryptophan in excess. So the tradition of the British to start the day with oatmeal makes some sense!

Products recognized as antidepressants:

Lean red meat (baked, boiled, stewed)

Vegetables, fruits and berries (frozen can be used)

Legumes (peas, lentils, and beans)

Nuts and dried fruits

Bitter chocolate, strawberries, bananas

An approximate diet for those who have noticed signs of depression:

First day

Breakfast- baked apple with cottage cheese, toast with fish caviar, tea with milk.
Lunch- bread with cereals with berry jam, cottage cheese.
Dinner- stew with vegetables, a cup of chicken broth, a slice of black bread, a cup of herbal tea.
Afternoon snack- a cup of cocoa or a slice of dark chocolate.
Dinner- steamed fish with herbs and lemon sauce, boiled vegetables, black bread, St. John's wort tea.
Before bedtime- banana.

Second day

Breakfast- boiled soft-boiled egg (or omelet), toast with fruit jam, green tea.
Lunch- kiwi with a slice of cheese.
Dinner- cream soup with mushrooms and cream, salad with chicken and vegetables, a glass of fruit juice.
Afternoon snack- banana and yogurt.
Dinner- baked salmon with herbs, vegetable salad, St. John's wort tea.

Third day

Breakfast - toast with liver pate, oatmeal, milk tea.
Lunch- cottage cheese casserole, banana.
Dinner- creamy chicken soup, fresh vegetable salad, green tea.
Afternoon snack- a cup of yogurt with honey and hazelnuts, juice.
Dinner- salad of beans and boiled beets, tea from the herb St. John's wort.

If we feel tired for no reason, often cry and yearn, suffer from panic attacks or have to go through a serious psychological shock, our body needs support. And we're not just talking about sedatives or antipsychotics prescribed by a doctor. We need a special diet and a healthy menu that will help us regain a good mood, joy of life, and a sense of calmness.

Food for depression - does it really exist and how does it work? In this article, we will share the best anti-stress foods that should be on the table in moments of depression and depression.

How to tell if your body needs help

Here are the most common signs of a depressed mental state:

Anhedonia or loss of the ability to experience joy.

Falling performance, constant feeling of fatigue.

Drowsiness, decreased physical activity.

Inhibition of movement.

Decreased libido.

Lack of appetite or uncontrolled overeating.

Panic attacks.

Feeling of own powerlessness, insignificance.

Decreased concentration and memory.

Tantrums.

Unreasonable tears.

Appetite loss in depression is a natural phenomenon, because when we feel bad, when we are mentally exhausted, we have no time for food. However, there are other cases: food acts as a stress reliever, absorbed in huge quantities. The development of events according to the first scenario leads to an extreme degree of exhaustion, anorexia, according to the second - to bulimia.

In order not to bring yourself to an eating disorder, it is important to use all known methods of dealing with depression. Including products that help increase the level of serotonin in the blood.

The missing hormone of happiness

Lack of serotonin, a neurotransmitter whose main task is to regulate our mood, to keep it on a positive wave, leads to stress, melancholy, depression caused by these states of neuroses. If this substance is not available, it must be obtained. It is made from the amino acid tryptophan. Scientists have found tryptophan in dietary protein. The beneficial amino acid has been found in many foods, from meat and fish to vegetables and fruits.

But during stress and lingering depression, the body needs more than just serotonin:

When we often worry, we are rarely calm and cheerful, but much more irritated or overly agitated, adrenaline and cortisol levels increase. For the production of these hormones, vitamins C, B are needed, as well as trace elements: zinc, magnesium. It turns out that all these valuable components are urgently confiscated. At the same time, we do not make up for their deficit in any way, which leads to negative consequences: mental abilities decrease, metabolism slows down, lethargy, lethargy, and weakness occur. Even the skin becomes less elastic and beautiful - because vitamin C together with zinc is necessary for collagen synthesis. And a lack of magnesium can lead to migraines and high blood pressure.

We also have an urgent need for adaptogens of natural origin - they help us adapt to stress - physical, emotional, mental or even chemical. They work in several directions at once: they increase the level of ATP, and with it the level of energy, protect the membranes of cells from damage, strengthen the heart and blood vessels - make us hardy, fast, and efficient. You can compare adaptogens to coffee. However, when we drink a cup of an invigorating drink, we know that the effect depends on how much we drink, which portion we choose. And in the case of the "tonics" it seems to us that the power lies in ourselves. This gives self-confidence, allows you to maintain emotional stability.

Depression Foods: Sources of Lost Vitamins and Minerals to Improve Mood

Vitamin A - it is found in green and orange plant foods: lettuce, pumpkin, carrots. There is also a lot of it in apricots.

Vitamin C - look for it in lemons, oranges, limes and other citrus fruits, as well as black, red and white currants, cabbage, medicinal rosehip broth.

B vitamins - found in seafood, avocado, liver, whole grain bread, nuts. These essential substances increase the content of PUFA (polyunsaturated fatty acids). Especially useful for depression are pine nuts, beans, sardines, unrefined cereal grains - sources of B6 or pyridoxine, which is necessary for the synthesis of the hormone of happiness - serotonin.

Vitamin E - enters our body with vegetable oil, green leafy vegetables, almonds, apple seeds, wheat germ.

Magnesium - found in peas, grapefruits, pumpkin seeds, peanuts, beans, walnuts, wheat bran.

Calcium is found primarily in dairy products, as well as mustard, pistachio, garlic, hazelnuts, and almonds.

Zinc - found in beef liver, cheese, eggs, legumes, plums, cabbage, carrots.

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Foods for stress and neurosis: adaptogens in the diet against depression

Asian ginseng root

It is one of the most famous "tonics" that strengthens the immune system, reduces inflammation, has anti-asthmatic and antioxidant effects. In China, red ginseng is traditionally used for overworking the body and spirit. Doctors have proven that the use of an extract of this strongest adaptogen helps to adapt to adverse conditions, it is easier to endure stressful situations, and to increase efficiency.

Attention: due to the strong stimulating effect, heart palpitations, insomnia may occur, and the use in conjunction with products containing caffeine can lead to stomach and intestinal upset. Ginseng extract as a remedy for stress and neuroses is not recommended for pregnant and lactating women.

Eleutherococcus

A shrub found in the mountains is widely used in traditional Chinese medicine for the treatment of flu and colds. But Eleutherococcus is also useful for chronic fatigue syndrome, apathy, decreased concentration.

Possible side effects and contraindications for this remedy are the same as for ginseng.

Rhodiola rosea

This adaptogen improves memory, improves performance, reduces cortisol levels, and increases serotonin levels. It is a herbal antidepressant - a product for raising mood and stimulating mental activity. In addition, rhodiola strengthens the heart and blood vessels, and has a positive effect on brain function.

Ashwagandha

Another root that the ancients actively used. He came to us from Ayurvedic medicine, but is less known and popular than the listed adaptogens. This plant is actively used in the fight against apathy, causeless fatigue, neuroses, increased anxiety and panic attacks. Ashwagandha has a mild sedative effect.

Contraindications: stomach ulcer, mucosal damage, pregnancy, lactation, hypersensitivity.

Popular adaptogens also include lemongrass, licorice, and green tea.

How to eat properly for depression: what to eat if the nerves are exhausted

Not only external stimuli, but also our diet can lead to a deterioration in the condition, unreasonable melancholy and sadness. Take a look at what you are eating.

You should have enough fresh fruits and vegetables, legumes in your menu.

Don't forget about whole grains, rice, lentils, and other fiber-rich foods.

Eat plenty of fish, and add flaxseeds to cereals and desserts - these are important sources of polyunsaturated fatty acids that can help you cope with a lack of energy and lack of mood.

We often remind you that diet is stressful for the body. We will repeat this time, since most of the methods based on restrictions and prohibitions are also bad in that they lead to a decrease in tryptophan consumption, a deficiency of protein foods on the table. Unsurprisingly, these changes negatively affect the mental health of those who lose weight.

• strong tea;
• coffee;
• energy drinks;
• cigarettes;
• sugar and sweets.

Taken together, all of these components of an improper diet can cause anxiety, sleep disturbances, and a sharp transition from joy to anxiety and sadness.

Mood-boosting foods: anti-stress nutrition that relieves depression

Fish - contains omega-3s, vitamins B6 and D, which are responsible for strengthening the immune system and resisting stress.

Eggs - they are high in fatty acids, as well as retinol, tocopherol and calciferol. In addition, eggs are rich in tryptophan.

Citrus, orange and red vegetables and fruits - all fiery foods are guaranteed to charge you with optimism and good mood. They contain not only useful vitamins, but also bioflavonoids that improve cerebral circulation.

Seafood - Shrimp, seaweed, shellfish, mussels, and other seafood are high in iodine. And this is help not only for our thyroid gland, but also for the psyche, brain activity. By consuming more iodine, we become more active and efficient, resistant to stress and negative environmental influences.

Spices - in cold weather, when we are sad especially often, nutmeg, cardamom, star anise, cinnamon will help us to restore vitality and revitalize our spirit. Add them to desserts, homemade cakes, and tea. But be warned: Do not consume large amounts of these natural antidepressants.

Chocolate is the most popular remedy for blues. But you should not buy a dairy product, but a bitter product with a cocoa content above 70%. It contains not only a large dose of tryptophan for sadness and chronic fatigue, but also caffeine, which will invigorate you and help you focus.

Bananas - they contain the alkaloid harman, which causes euphoria, and it is precisely this that we lack so much when we are experiencing stress or are struggling with a breakdown. Banana pulp also contains a lot of pyridoxine, which triggers the synthesis of serotonin. But with this antidepressant, as with spices, you need to know when to stop - it is high in calories.

Legumes - they contain a lot of B vitamins, which makes legumes an indispensable product for those who want to cheer up, get rid of insomnia, overcome irritability and nervousness.

Diet for depression and stress: form a diet

As you already understood, there should be more in our new menu:

• Vegetables and fruits.
• Vegetable oil, fish and other sources of fatty acids.
• Citrus fruits.
• Dairy products.
• Zlakov.
• Seafood.

Here's what a sample menu for the day would look like for those who want to cope with a bad mood without harming their figure:

Breakfast - apples baked with cottage cheese, muesli, tea with milk.

Second breakfast - tender pumpkin casserole, banana.

Lunch - baked fish with vegetables, a cup of low-fat chicken broth.

Afternoon snack - a cup of unsweetened yogurt with nuts and dried fruits.

Dinner - vegetable salad with white beans, steamed turkey fillet.

Before going to bed - a glass of kefir.

Our experts will draw up a nutritional program for you in case of depression, stress, neuroses and loss of energy. Come to us to change yourself by starting with a diet. Remember, the salvation from bad mood and melancholy is not in sweets, soda, and confectionery, but in mindfulness of your body and a healthy balance of nutrients.

V.N.Sergeev, d. MD, Head of the Nutrition Laboratory of the Biomedical Research Department of the Russian Scientific Center for Medical Rehabilitation and Balneology of the Ministry of Health of Russia

V. B. Lebedev, Researcher of the Federal State Budgetary Institution "Russian Scientific Center for Medical Rehabilitation and Balneology" of the Ministry of Health of Russia

V. I. Mikhailov, Doctor of Medicine, Professor of the Russian Scientific Center for Medical Rehabilitation and Balneology of the Ministry of Health of Russia

L. V. Tarasova, Doctor of Medicine, Head of the Gastroenterology Department of the Republican Clinical Hospital, Chief Gastroenterologist of the Ministry of Health and Social Development of Chuvashia

Depressive disorders are a fairly common diagnosis of a person in Western culture; currently, there are 5-7% of people suffering from a severe form of depression. The level of depressive disorders has increased significantly over the past century, especially after the Second World War - at that time, 20 times fewer people suffered from depression than today. Currently, at least 200 million people are diagnosed with depressive disorders every year. In addition, unlike other types of psychopathological disorders, depressive states in 40% of cases are not diagnosed on time, since with depressions of a non-psychotic level, affective pathology often manifests itself mainly in the form of neurosis-like somato-vegetative symptoms, therefore, patients in most cases are observed by internists. Depression is getting younger, more and more young people are experiencing depressive symptoms, and this is not only a consequence of changes in society or diagnostic criteria.

Causes of depression

Depression can be the result of dramatic experiences, such as the loss of a loved one, job, social status. In such cases, we are talking about reactive depression. It develops as a reaction to some external event, situation.

According to some theories, depression sometimes occurs when the brain is overworked as a result of stress, which can be based on both physiological and psychosocial factors. But if the psychological or somatic causes of depression are absent or not obvious, such depression is called endogenous, that is, as if "originating from the inside" (of the body, psyche).

In about one third (about 35%) of cases, manifest depression occurs autochthonously, that is, without any external influences. Structurally, such depressions are endogenous from the very beginning. For many people in sunless weather or those who are in darkened rooms, depression can occur due to the lack of bright light. This type is called seasonal depression, because it is most often seen in patients in the fall and winter. Monoamine theory links the development of depression with a deficiency of biogenic amines, namely serotonin, norepinephrine and dopamine.

Depression can result from the side effects of many medications. Most often, such depression quickly goes away on its own or is cured after the withdrawal of the corresponding drug. Neuroleptic depression (arising from the use of antipsychotics) can last from several months to 1.5 years, proceed with ideas of self-accusation and are of a vital nature. Also, depression, more precisely, somatogenic, that is, manifest as a consequence of somatic diseases (for example, Alzheimer's disease, atherosclerosis of the arteries of the brain, traumatic brain injury, or even the usual flu).

Somatic factors

The factors that may be suspected of underlying somatogenic depression are numerous:

• Neurological diseases: stroke; dementia; epilepsy; chorea of ​​Huntington; hydrocephalus; central nervous system infections; neoplasms of the central nervous system; Parkinson's disease; narcolepsy; sleep apnea syndrome; traumatic brain injury; Wilson-Konovalov disease (hepatocerebral dystrophy).
• Endocrine diseases: adrenal diseases (Itsenko-Cushing's disease, Addison's disease); hyperaldosteronism; hyper- or hypoparathyroidism (see parathyroid glands); hyper- or hypothyroidism; postpartum hormonal changes.
• Other somatic diseases: neoplasms; cardiopulmonary disease; porphyria; uremia; chronic hepatitis.
• Avitaminosis (lack of vitamin B12 , C, niacin or thiamine).

The mirror of depression

The main symptom of depressive disorders is periods of excessive depression. To make matters worse, depression often affects appetite, sleep, energy levels, cognitive performance, and also causes a loss of interest in previously enjoyable activities. With depression, not only the feeling of satisfaction disappears as a result of such activity, the patient has no motivation, there is no desire to start this activity, and interest in the activity itself is replaced by indifference and irritation.

From a psychoanalytic point of view, a frequent, if not universal, symptom of depression is dysregulation of self-esteem. The basis for the development of this vulnerability is a lack of acceptance and emotional understanding on the part of the mother. The child does not form internal psychological structures capable of regulating self-esteem; he needs its constant confirmation from the outside.

Depression develops in individuals with unstable self-esteem who lose the external support necessary to maintain a stable self-image. The degree of these disorders usually depends on the severity of the depressive state. With depression, almost all spheres are affected - emotional, intellectual, strong-willed and necessarily motivational, which manifests itself both subjectively - in the patient's complaints, and objectively - in changing behavior. A persistent decrease in mood in depression is combined with a loss of interest in what was previously perceived by the patient as attractive, bringing satisfaction or joy - in various forms of leisure, communication, reading, hobbies, professional activities, sex life, etc.

These disorders constitute one of the main diagnostic signs of depression, which in the ICD-10 is referred to as "loss of interest and pleasure." Depressive symptoms are divided into typical (main) and additional. In the presence of depression, according to ICD-10, two main symptoms and at least three additional symptoms must be present.

Depression symptoms

Typical (main) symptoms of depression include:

• Depressed mood, regardless of the circumstances, for a long time (from two weeks or more).
• Anhedonia is a loss of interest or pleasure in a previously enjoyable activity.
• Severe fatigue, loss of strength, characterized by the stability of this state (for example, within a month).

Additional symptoms:

• Pessimism.
• Feelings of guilt, worthlessness, anxiety and / or fear.
• Low self-esteem.
• Inability to concentrate and make decisions.
• Thoughts of death and / or suicide.
• Unstable appetite, marked decrease or gain in weight.
• Disturbed sleep, the presence of insomnia or oversleeping.

Diagnosing depression

According to the DSM-IV-TR Multiaxial Nosology System Diagnostic Criteria (Diagnostic and Statistical Manual of Mental Disorders), a patient must have five or more of the following nine symptoms over a two-week period (and these symptoms must include at least one of two main symptoms: depressed mood and / or loss of interest or pleasure):

• depressed mood (in children and adolescents, irritability can be manifested);
• a significant decrease in pleasure or interest in all or almost all activities;
• loss of weight and appetite (possibly increased appetite and weight gain);
• insomnia (hypersomnia is possible);
• psychomotor agitation or inhibition;
• decreased energy and increased fatigue;
• feelings of worthlessness and low self-esteem or inadequate feelings of guilt;
• retarded thinking or decreased ability to concentrate;
• suicidal tendencies.

Major forms of depression

Distinguish between unipolar depression, in which mood remains within one, reduced, "pole", and bipolar depression, which is an integral part of bipolar disorder, which are interspersed with manic, hypomanic or mixed affective episodes. Also, depressive episodes of mild severity can occur with cyclothymia. The following forms of unipolar depression can be distinguished (according to DSM-IV):

• Major depressive disorder, often referred to as clinical depression.
• Minor depression that does not meet all criteria for clinical depression, but in which at least two of the main diagnostic symptoms have been present for at least two weeks.
• Atypical depression is a form of depressive disorder in which, along with the typical symptoms of depression, there are specific signs such as increased appetite, weight gain, increased sleepiness and so-called emotional reactivity.
• Postnatal depression is a form of depressive disorder that develops immediately after childbirth.
• Recurrent transient depression (RBD), which differs from major depressive disorder mainly by the difference in duration. People with RBD experience depressive episodes about once a month, with occasional episodes lasting less than two weeks, and usually less than 2-3 days. For RBD to be diagnosed, the episodes must be present for at least one year and, if the patient is a woman, irrespective of the menstrual cycle. People with clinical depression can develop RBD and vice versa.
• Dysthymia is a mild, chronic mood disorder in which a person complains of an almost daily low mood for at least two years. Symptoms are not as severe as those of clinical depression, although people with dysthymia simultaneously experience recurrent episodes of clinical depression (sometimes called "double depression").

Sleep disturbance

With all types of depressive state, primary biological motivations suffer - food, appetite and sexual function are disturbed, sleep is disturbed.

So, according to various authors, sleep disorders are observed in 83-99% of patients with depression. In some patients, they are the leading complaint, in others they are noted in a number of other clinical symptoms characteristic of depression. One way or another, they are one of the criteria for diagnosing depression. The relationship between sleep disorders and depression is extremely close: the presence of persistent sleep disorders always serves as a basis for excluding latent, larvae depression, which manifests itself under the guise of these disorders.

Sexual dysfunction

A fairly common symptom of depression is a violation of sexual function: a decrease in libido, impotence and frigidity, a decrease in the intensity of orgasm or anorgasmia. Many patients refuse sexual intercourse because they do not experience pleasure; after intercourse, there may be an increase in depressive symptoms.

Sexual dysfunctions in men in most cases (up to 90%) are of a psychogenic nature. Periodic fluctuations in sexual activity, in particular its sharp decrease, in combination with an increase in depressive symptoms can be observed in patients with cyclothymic mood swings.

In women, in contrast to men, active complaints of violations in the sexual sphere are much less common.

In young women, depression can lead to various irregularities in the menstrual cycle: dysmenorrhea, amenorrhea, anovulatory cycles, and ultimately even infertility. With a detailed gynecological and endocrinological examination of such women, as a rule, no convincing reasons for menstrual dysfunction are found. In these cases, it is necessary to think about the possibility of depression and conduct appropriate research.

Power problems

It has been established, on the one hand, that with all types of depressive state, appetite is disturbed, nutritional function suffers, on the other hand, inadequate nutrition can affect the manifestation of seasonal affective disorder - this is a type of depression that usually begins in autumn and ends in early spring. The degree of these disorders usually depends on the severity of the depressive state.

Nutritional factors, studies have shown, affect not only monopolar depressive disorders, but also bipolar, or manic, depression, in which episodes of depression are replaced by periods of manic syndrome (excessive mood elevation and euphoria). A survey of patients with bipolar disorder revealed that 9.5% of the disease was accompanied by malnutrition. Loss of appetite and weight loss so often accompany depression that they are considered one of its obligatory signs and are included as criteria for diagnosing depression in all known questionnaires.

But a pathological increase in appetite (up to bulimia) can also accompany depressive conditions, although this happens less often. In such cases, the so-called emotiogenic eating behavior is noted - patients eat in order to improve their mood, get rid of melancholy, apathy, etc.

Association with metabolic syndrome

It is known that depression can contribute to the development of cardiovascular disease due to its association with metabolic syndrome. The latter is characterized by abdominal obesity, hypertension, an increase in triglycerides, fasting glucose and a decrease in the concentration of high-density lipoprotein cholesterol. To further explore this relationship, Dr. Kinder and colleagues analyzed data from the third NHANES study (National Health and Nutritional Examination Survey; 1988-1994), which included 3,186 men and 3,003 women aged 17-39. The prevalence of metabolic syndrome was the same among men and women (7.8% overall), however, depression was much more common in women. It turned out that women with a history of major depression were twice as likely to be diagnosed with metabolic syndrome as women with no history of depression, even after adjusting for various confounding factors. Among women, depression was often associated with high blood pressure and hypertriglyceridemia, as well as a trend towards lower high-density lipoprotein cholesterol and an increase in waist circumference.

A study of patients with depressive syndrome of various etiologies, carried out by domestic doctors in a hospital setting, revealed in the vast majority of these patients significant dietary disorders in the form of refusal or severe restriction in food intake, changes in the daily diet, pathological selectivity in the choice of foods and dishes. The authors noted a decrease in body weight (by 9-14 kg from the initial level) in 89% of patients, in 33% - a sharp decrease in skin turgor, in 85% - a decrease in the thickness of subcutaneous fat.

Decreased appetite

With depression, a decrease in appetite is more often observed, which is accompanied by a decrease in body weight.

Anorectic reactions in depression have a number of distinctive features. As a rule, not only is there a decrease in appetite or lack of it, but food is often perceived as tasteless or begins to cause disgust. Even the smell or sight of food can cause disgust. Such patients may experience a feeling of nausea, less often vomiting. Eating is not accompanied by pleasure, such patients eat because they need to eat or they are forced to eat. Loss of pleasure from eating is often combined with increased satiety, when the patient, after taking small amounts of food, feels a full stomach, a feeling of unpleasant heaviness, satiety, and nausea. Anorexia leads to a sharp reduction in the amount of food and weight loss.

Anorectic manifestations are closely related to the intensification of other manifestations of depression and are most pronounced in the morning. In some cases, they can be presented vividly and occupy a leading place in the clinical picture of the disease. In such patients, there is a need for differential diagnosis with anorexia nervosa, which is based on the desire to lose weight, which patients realize through diet, exhausting exercise, and often enemas, laxatives and vomiting. About half of people with anorexia nervosa have bouts of binge eating followed by or more unloading.

Treatment of anorexia

Psychotherapy is widely used to treat anorexia in depressed patients. For pharmacological correction, antidepressants are used, in particular, it is known that tricyclic antidepressants are capable of causing an increase in body weight, apparently due to increased appetite. At the same time, in the case of eating disorders of the type of emotionogenic eating, these drugs often, on the contrary, reduce appetite.

A decrease in food motivation followed by a decrease in body weight are secondary to depression and in most cases go away on their own as depressive manifestations decrease. With depression, there is rarely a significant deficit in body weight, as in anorexia nervosa, and concomitant metabolic, severe endocrine, cardiovascular and other disorders that require special correction.

Food drunkenness

Increased appetite or bulimia can also accompany depressive conditions, although this is less common. Typically, bulimia is associated with a lack or decrease in satiety and leads to weight gain and obesity. Overeating in depressed patients is not based on hunger, but on emotional discomfort. Patients eat in order to relieve a bad mood, get rid of melancholy, apathy, anxiety, and feelings of loneliness.

This type of bulimia is called compulsive bulimia, bulimia without unloading, hyperphagic reaction to stress, emotiogenic eating behavior, food drinking. In depression, food intake is often the only form of behavior that brings the patient positive emotions and reduces the symptoms of depression. Often bulimia with depression is accompanied by drowsiness and hypersomnia. The severity of emotiogenic eating behavior can lead to a significant increase in body weight.

Sleeping pills "night food"

Studies by T.G. Voznesenskaya showed that 60% of obese patients have emotiogenic food, which in such patients is the main mechanism for gaining body weight.

Emotional eating behavior is closely associated with depression and increased levels of anxiety. Night eating is a special type of emotiogenic eating behavior. Such patients wake up in the middle of the night, usually in the early morning hours (3-4 hours), and cannot fall asleep without a snack. An increase in appetite in such cases is not at all related to the amount of food eaten before bedtime and the feeling of hunger, but plays the role of a sedative, sleeping pill. These patients usually have sleep disturbances characteristic of depression and are overweight.

Carbohydrates are a "cure" for depression

Biochemical studies carried out by J. Fernstrom, R. Wurtman (1971) made it possible to understand and explain why a number of foods can serve as a kind of cure for depression.

In emotiogenic eating behavior, when patients eat in order to improve their mood, reduce feelings of depression and apathy, they prefer digestible carbohydrate foods. An increased intake of carbohydrates leads to hyperglycemia and, consequently, to hyperinsulinemia. In a state of hyperinsulinemia, the permeability of the blood-brain barrier for the amino acid tryptophan changes. Tryptophan is a precursor of serotonin, therefore, following an increase in tryptophan content in the central nervous system, serotonin synthesis increases. Food intake can act as a modulator of serotonin levels in the central nervous system. An increase in its synthesis, associated with the absorption of carbohydrate food, simultaneously leads to an increase in the feeling of satiety and a decrease in depressive manifestations.

Thus, it was clearly shown that bulimia and depression have common biochemical pathogenetic mechanisms - serotonin deficiency. The results of these studies were the basis for the use of selective serotonergic antidepressants for the treatment of depression accompanied by bulimia and obesity with disturbed eating behavior.

The renaissance of nutritional therapy. The use of an optimal balanced diet in the complex treatment of patients with depression

In recent years, there has been a certain renaissance in the use of an optimal balanced diet in the complex treatment of patients with depression, which was the result of numerous studies that confirmed the therapeutic effectiveness of this area. It should be noted that the field of science dealing with the study of the mutual influence of nutrition and the psyche is still quite young, and great hopes are pinned on it in the future. In particular, the possible effects of individual food components on mood, behavior and cognitive functions, as well as on physical activity, are being studied.

However, since most of the studies were carried out on patients receiving concurrent psychopharmaceuticals, the evidence-based level of these works was often limited due to the methodological problem - how to draw a clear line between the nutritional effect and the effect of drugs. In particular, the consumption of a large amount of carbohydrates increases the supply of tryptophan to the brain and thereby increases the level of serotonin, while the consumption of food rich in proteins, on the contrary, leads to its decrease (due to the mutual competition of amino acids as they pass through the blood-brain barrier). This should have an effect on the condition of patients with depression. However, some researchers doubt this, since in real life there was no significant effect of the consumption of carbohydrate-rich foods on mood.

Other chemical components of food have been studied, for example, the effect on the psyche of cholesterol. The data on the effects of low plasma cholesterol levels on depression symptoms are too conflicting, ranging from complete lack of effect to direct dependence. As one of the hypotheses that can combine different research results, it has been suggested that a violation of the ratio of essential fatty acids (omega-3 and omega-6) or a deficiency of omega-3 fatty acids, which is often observed with a decrease in plasma cholesterol, has been proposed for the leading role in the genesis of depressive symptoms. blood.

Chocolate mood

The effect on the psyche was studied not only of chemical food components, but also of individual food products. An example would be the question of the effect of chocolate on mood. Although the phenomenon of the effect of chocolate on depression has been established in a number of scientific works, the mechanism of this phenomenon is not completely clear.

It is thought to be due to the drug-like effects of components in chocolate such as anandamines, caffeine, phenylethylamine, and magnesium. In addition, any tasty food has been shown to stimulate the release of endorphins in the brain; apparently, this mechanism is the most general one.

Depression from fast food

Eating baked goods and fast food leads to depression, according to a study led by Spanish scientists. The results of the study showed that hamburger and fries lovers were 51% more likely to develop mental disorders compared to those who monitor their diet.

“The more junk food you eat, the higher your risk of depression,” says study lead author Almudena Sánchez Villegas of the University of Las Palmas de Gran Canaria.

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Medicine in food

In fact, the mechanisms of depression not only have psychological foundations by their nature, but are also quite versatile explained from the point of view of physiology.

As a rule, depressive states are characteristic of a person during those periods when there is a serious lack of nutrients in the subcortical structures of the brain, which are responsible for anti-stress states, the work of which is necessary for depressive tendencies. It is during this period that, in addition to specialists, a specially developed diet for depression based on a psychophysiological approach can come to the rescue.

This diet is especially necessary in the autumn periods, which, according to statistics, are especially "depressive" in our country. It is during the autumn periods that the number of suicides increases, and this is directly related to the mechanisms of depression. In the autumn, during the periods of the so-called exacerbation in our subcortical structures, very little of a special antidepressant substance is produced - serotonin.

Depression mechanism

According to scientists, in people prone to depression and suicide, serotonin is not produced at all or is not produced in sufficient quantity for self-preservation. Such people can be identified among our acquaintances - they all the time pathologically, almost reaching obsessive states, want something sweet.

Serotonin is a neurotransmitter, one of the substances that are a chemical transmitter of impulses between nerve cells in the human brain. Serotonin-responsive neurons are found throughout most of the brain. Most of them are in the so-called suture nuclei - areas of the brain stem. It is there that the synthesis of serotonin in the brain takes place. In addition to the brain, a large amount of serotonin is produced by the mucous membranes of the gastrointestinal tract. In order for serotonin to be produced in our body, two things are necessary:

• intake of the amino acid tryptophan with food, since it is it that is needed for the direct synthesis of serotonin in synapses;
• the intake of glucose from carbohydrate food - stimulation of the release of insulin into the blood - stimulation of protein catabolism in tissues - an increase in the level of tryptophan in the blood.

Phenomena such as bulimia and the so-called sweet tooth syndrome are directly related to these facts. The point is that serotonin is able to induce a subjective feeling of satiety. When food, including those containing tryptophan, is ingested, the production of serotonin increases, which improves mood. The brain quickly picks up the connection between these phenomena and in the case of depression (serotonin starvation) immediately requires additional food intake with tryptophan or glucose.

Oddly enough, the most tryptophan-rich foods are foods that are almost entirely carbohydrate, such as bread, bananas, chocolate, figs, or net carbohydrates such as table sugar or fructose. This indirectly confirms the assertion prevailing in society that those with a sweet tooth, overweight people are kinder than thin people.

In the front of the brain, serotonin stimulates the areas responsible for the process of cognitive activity. Serotonin entering the spinal cord has a positive effect on motor activity and muscle tone. This condition can be described by the phrase "I will move mountains." Consequently, the increase in serotonergic activity creates a feeling of uplifting mood in the cerebral cortex. Serotonin is metabolized in the body by monoamine oxidase-A (MAO-A) to 5-hydroxyindoleacetic acid, which is then excreted in the urine.

Depression hero

Serotonin has an antipode in the body - it is melatonin. It is synthesized in the pineal gland from serotonin. The secretion of melatonin directly depends on the general level of illumination - an excess of light inhibits its formation, and a decrease in illumination, on the contrary, increases the synthesis of melatonin.

It is under the influence of melatonin that gamma-aminobutyric acid is produced, which, in turn, inhibits the synthesis of serotonin. It is on these almost dialectical "unity and struggle of opposites" that the internal mechanism of self-regulation of circadian rhythms is arranged.

That is why, in a state of depression, people suffer from insomnia: in order to fall asleep, you need melatonin, and without serotonin you cannot get it. 70% of the daily production of melatonin occurs at night. It is the melatonin synthesized in the pineal gland that is responsible for circadian rhythms - the internal biological clock of a person. It is low light and, as a result, high melatonin production that are the main causes of seasonal depression. Remember the emotional uplift when a clear, fine day comes out in winter. On this day, your melatonin decreases and your serotonin increases.

Responsible for the decision

In addition to serotonin and melatonin, it is important to consider another neurotransmitter for depression, dopamine. He, like serotonin, acts as a neurotransmitter and a hormone at the same time. Cardiac activity, motor activity, and even the gag reflex indirectly depend on it.

The hormone dopamine is produced by the adrenal medulla, and the neurotransmitter dopamine is produced by an area of ​​the midbrain called the black body. There are four known "dopamine pathways" - the pathways of the brain, in which dopamine plays the role of a nerve impulse carrier. One of these, the mesolimbic pathway, is believed to be responsible for producing feelings of pleasure.

Recent studies show that dopamine production begins while waiting for pleasure. This effect is similar to the pre-salivation reflex in Pavlov's dog.

Dopamine is also believed to be involved in human decision making. At least among people with impaired dopamine synthesis / transport, many have difficulty making decisions. This is due to the fact that dopamine is responsible for the "feeling of reward", which often allows you to make a decision, considering a particular action on a subconscious level.

Combination of hormones

Unfortunately, neuroscience is still developing. In particular, the relatively recent 2000 Nobel Prize in Biology was awarded for discoveries in the field of "nervous system signaling." With various combinations of serotonin with other hormones, we get a full range of emotions of satisfaction and euphoria.

On the other hand, a lack of serotonin is associated with decreased mood and depression. In addition to mood, serotonin is responsible for self-control or emotional stability (Mehlman et al., 1994). Serotonin controls the sensitivity of the brain receptors to the stress hormones adrenaline and norepinephrine. In people with low serotonin levels, the slightest excuse causes an abundant stress response. Some researchers believe that the dominance of an individual in the social hierarchy is due precisely to the high level of serotonin.

Protein for depression

Numerous studies support the beneficial effects of the amino acids tryptophan, tyrosine and choline on brain function. Tryptophan is converted in the human body into serotonin, which is involved in the transmission of nerve impulses through synapses. Tyrosine is converted to dopamine, norepinephrine and adrenaline - biologically active substances and hormones. Choline is converted to acetylcholine, which is also required for the transmission of nerve impulses.

Tryptophan is abundant in cheeses, other animal products, and legumes. Choline is found in liver, chicken eggs, bread and cereals, dairy products, tyrosine - in meat, offal, milk, baked goods.

When the level of these compounds in brain tissue rises, the synthesis of serotonin, acetylcholine, dopamine, norepinephrine and adrenaline is enhanced. As a result, neurons produce more serotonin molecules to the cells that they innervate. Therefore, they receive a strong impulse.

Recently, it has been proven that even in small doses, tryptophan enhances the synthesis of serotonin. Research results indicate that if the food contains too much protein, then, despite the excess of amino acids, the concentration of tryptophan in the brain tissue decreases and the synthesis of serotonin decreases. This is because the concentration of tryptophan, which can be converted to serotonin, depends on the ratio between it and certain amino acids (with large molecules). Large molecules from the capillaries of the brain have difficulty penetrating neurons and other brain cells.

Most proteins contain less tryptophan than these amino acids, so their ratio in the blood decreases, with the result that less of it penetrates the blood-brain barrier and enters the neurons. Foods enriched with carbohydrates have the opposite effect, because they promote the release of a large amount of the pancreatic hormone insulin, which reduces the concentration of amino acids in the blood. Thus, the concentration of serotonin depends on nutrition (it increases with the use of protein foods and decreases with the predominance of carbohydrates in the diet).

From the above, it follows that the food intake affects the processes occurring in the brain. Some foods cheer you up, while others can spoil it and suppress positive emotions.

Ironically, most mood-enhancing foods, such as high glycemic foods, are not very good for your health, and therefore, as with everything else, it is advisable to exercise restraint and discretion when taking them. Countries that consume more sugar have higher rates of depression. When depressed, people eat more carbohydrates and sugar.

At the same time, it has been established that peoples whose diets include fish and seafood are less likely to suffer from depression. The same goes for individuals. The omega-3 fatty acids contained in the fat of marine fish, in particular eicosapentaenoic acid, increase the effectiveness of drug treatment for depression, while reducing the dose and reducing the duration of antidepressant use.

Lack of vitamins

Studies show that during depression, a person has a reduced level of B vitamins - a complex and folic acid, which have neuroprotective activity and improve the function of the central nervous system. So, taking only 500 mcg of folic acid improves the effectiveness and reduces the side effects of antidepressants, and an increase in thiamine levels has a beneficial effect on the mood of depressed patients.

Vitamin B6 is involved in the synthesis of serotonin. The inclusion of foods rich in vitamin B6 in the diet helps to increase the synthesis of serotonin and reduce the intensity of the clinical manifestation of depression. Low levels of riboflavin (vitamin B2) are common in depression. Multivitamin supplements, especially those containing riboflavin, may help improve mood. In depression, vitamin B12 levels are low, and its presence in the diet predicts more successful outcomes of standard treatment.

Vitamin D improves mood during the winter months. Due to the lack of sun in winter, the body produces less vitamin D; it may be worth taking this vitamin in supplements.

Saturation with minerals

With depression, zinc levels are low. Clinical studies show that taking a zinc supplement with 25 mg significantly improves the results of antidepressant treatment.

Many research authors show that low selenium levels are associated with bad mood. An increase in chromium levels improves mood in patients with symptoms of depression. Magnesium deficiency is observed in depressive disorders. In cases of severe mental and emotional distress, magnesium is rapidly excreted through the kidneys from the body, while magnesium is needed by the adrenal glands to produce cortisol. In addition, magnesium is involved in the synthesis of all known neuropeptides and provides the activation of glycine. It has been shown that, in combination with calcium, magnesium acts as a natural tranquilizer, relieving psycho-emotional stress in patients with depression.

In addition to pharmaceuticals

According to some reports, exercise can be significantly more effective than antidepressants in treating depression, and the combination of the two is even more effective.

Depression is also treated with art therapy, music therapy, hypnotherapy, and the effect of a magnetic field on the patient's brain. As a rule, these are purely supportive measures in treatment. Neither medications nor psychotherapy solve the patient's life problems, which can be the cause of depression, but they return energy and faith in their own capabilities. In addition, phototherapy is an effective treatment for all types of depression.

Diet therapy for depression

However, in our opinion, one of the main non-drug methods of treating depression is personalized nutritional support for patients with depression at all stages of medical support, such as: hospital, sanatorium-resort stage, polyclinic. The nutritional support algorithm should consist of two interrelated stages: diagnostic and corrective.

The diagnostic stage should include a complex of anthropometric instrumental and biochemical studies that allow assessing the nutritional (metabolic) status of the patient:

• a questionnaire, which should reflect the patient's food motivations, the regimen and time of eating, the composition of the traditional diet;
• anthropometric study (height and weight, BMI, waist-to-hip ratio);
• impedance method for assessing body composition;
• clinical and biochemical studies, including indicators of protein, fat and carbohydrate metabolism, hormonal, immunological and elemental status;
• assessment of the state of the symbiotic intestinal microflora, screening ultrasound examination of the thyroid gland, abdominal organs and kidneys.

Correctional stage - drawing up a personalized diet using the results of the diagnostic stage.

When compiling an individual diet for a patient with depression, in addition to the results of the diagnostic stage, it is also necessary to take into account the energy balance of the patient, his gender, age, the nature of the work performed, the stage of the disease, concomitant diseases, the nature of drug therapy, which can have a negative effect on the processes of food digestion and assimilation of nutrients.

Taking into account the results of studies of the patient's nutritional status, a personal program for correcting the identified deviations is drawn up using standard therapeutic and prophylactic diets, in accordance with the requirements of the Order of the Ministry of Health of Russia dated 05.08.2003 No. 330 "On measures to improve medical nutrition in medical institutions of the Russian Federation "(As amended on June 21, 2013). According to this order, standard diets differ in the quantitative and qualitative composition of the main nutrients and micronutrients, energy value, cooking technology and the average daily set of foods and include six options for standard diets.

For each of the six dietary options, the Order of the Ministry of Health of Russia dated June 21, 2013 No. 395n "On Approval of the Norms of Medical Nutrition" clearly defines the amount of gross and net dietary products in grams, including mixtures of protein composite dry (SBKS) and vitamin-mineral complexes (VMC ), introduced by the same order in the composition of the average daily set of products of the norms of medical nutrition. The inclusion of SBKS and IUDs in standard diets makes it possible to optimize the chemical composition and energy value of therapeutic and prophylactic diets in relation to the state of nutritional status, the characteristics of the clinical course of the phase and stage of the disease, the nature and severity of pathological disorders.

Diet for depression

So, the main variant of the diet (ATS) can be prescribed with a normal body mass index or its fluctuations in the range of 25-29.5. High Protein Diet (IAP) Recommended for Body Mass Index< 18, так как данное состояние трактуется как белково- энергетическая недостаточность. Низкокалорийная диета (НКД) положена при индексе массы тела >30 when the patient is diagnosed with obesity. In the presence of a concomitant dysfunction of the digestive system in a patient with depression, the option of nutritional support can begin with the use of a sparing diet option (SPD), the timing of which will be dictated by the achievement of normalization of the functional state of the gastrointestinal tract. The high-protein version of a gentle diet can also be used at the initial stages in patients with protein-energy malnutrition, given the decrease in appetite and dysfunction of the digestive system in this category of patients.

Protein antidepressant

It is quite difficult to compose a balanced diet from natural food products, especially in terms of protein (a nutrient necessary for the synthesis of serotonin), without the inclusion of protein composite dry mixtures. This type of specialized product is of particular importance in the complex of therapeutic, rehabilitation and prophylactic measures, when the natural way of replenishing the progressive deficiencies of basic nutrients is excluded or significantly limited. The use of these food products in the diets of patients with depression in order to optimize them is etiopathogenetically justified, since they have a declared, balanced composition, are distinguished by optimal assimilation against the background of minimal enzymatic and energy costs of the body.

So, in the presence of protein-energy deficiency in a patient with depression on the background of anorexia, it is necessary to use dry protein composite mixtures (for example, "Diso®" "Nutrinor") in addition to the standard diet option 1-2 times a day, and if the patient has with depression of obesity against the background of bulimia, SBKS can be used instead of 1-2 receptions of a low-calorie diet (LDC). If depression is caused by chronic diseases, then it is also important to recommend dry protein composite mixtures to optimize the diet. For example, the advantage of the "Diso®" "Nutrinor" mixture is the presence in them of a complex of optimal proteins containing essential and nonessential amino acids, including tryptophan, which is necessary for the synthesis of the neurotransmitter - the antidepressant serotonin.

Address correction

In addition, in order to optimize the diets of patients with depression, it is necessary to use vitamin-mineral complexes containing B vitamins, given their proven neuroprotective role and active participation in the synthesis of serotonin. It is desirable that these complexes also contain minerals magnesium, zinc, calcium, selenium, iodine, etc., which, on the one hand, play an important regulatory role in the body, being an integral part of hormones and enzymes, and the deficiency of which has been proven by the results of numerous studies in patients depression, on the other.

Given the important role of omega-3 polyunsaturated fatty acids in normalizing the function of the central nervous system (it has been proven that it contains 75% of decosahexaenoic acid), it is necessary to include preparations based on fish oil in nutritional support programs for patients with depression.

In recent years, more and more data have been accumulating indicating the active participation of the symbiotic normal flora of the gastrointestinal tract (GIT) in maintaining the body's homeostasis and regulating metabolism and immunity. For example, 95% of serotonin is synthesized with the participation of the gastrointestinal tract. In addition, it synthesizes melatonin, gamma-aminobutyric acid, nitric oxide, etc., more than 30 hormones and neurotransmitters in total.

Currently, many researchers consider the gastrointestinal tract the most powerful endocrine organ and the most important component of the immune system of the human body. Considering that in patients with depression, violations of the quantitative and qualitative composition of the gastrointestinal microflora (dysbiosis) are universally diagnosed, it is necessary to take corrective measures in patients with depression aimed at correcting dysbiotic manifestations using probiotics, prebiotics or synbiotics.

For targeted correction of the impaired function of certain organs and systems of the body in patients with depression, along with the recommended groups of functional and natural products, individual rehabilitation and prophylactic nutritional programs can include preparations based on animal organs (cytamins), bee products, algal preparations, as well as herbal preparations. phytoformulas hapatoprotectors, cardioprotectors, neuroprotectors, immunomodulators, etc.

It is always important to remember that maintaining good nutrition and maintaining good health is a lifelong process in which each phase determines the next. And, of course, there is no time to waste if you need to urgently address the problem of undernutrition!

// NS D