Andrea Paola Rojas Gil PhDLecturer of Biology and Biochemistry

Nursing SchoolUniversity of Peloponnese

Sparta-Greece

Annual Conference on Nursing Institute of Health Studies,

Technical University of Liberec and Regional Hospital of Liberec, Czech Republic.

“Innovative approaches in nursing” November 2012

Depression is a state of low mood and aversion to

activity can have a negative effect on a

person's thoughts, behavior, feelings, world view and physical well-being

Depressed mood is not necessarily a psychiatric disorder.

It is a normal reaction to certain life events, a symptom of some medical conditions and a side effect of some medical treatments.

Depressed mood is also a primary or associated feature of certain psychiatric syndromes such as clinical depression.

What causes Depression? Family History

Having a family members who has depression may increase a person’s risk

Imbalances of certain chemicals in the brain may lead to depression

Major Life Changes

Positive or negative events can trigger depression. Examples include the death of a loved one or a promotion.

menopause, financial difficulties, job problems, relationship troubles, separation and bereavement

Major Illnesses such as heart attack, stroke or cancer may trigger depression.

Certain medications used alone or in combination can cause side effects much like the symptoms of depression.

Use of Alcohol or other Drugs can lead to or worsen depression.

Depression can also occur for no apparent reason!

Symptoms of Depression Vary from person to

person

2 key signs are loss of interest in

things you like to do sadness or irritability

Additional Signs include: Changes in feelings which may

include:Feeling emptyInability to enjoy anythingHopelessnessLoss of sexual desireLoss of warm feelings for family or

friendsFeelings of self blame or guiltLoss of self esteemInexplicable crying spells, sadness or

irritability

Changes in behavior and attitude These may include:

General slowing downNeglect of responsibilities and

appearancePoor memoryInability to concentrateSuicidal thoughts, feelings or

behaviorsDifficulty making decisions

Physical Complaints These may include:

Sleep disturbances such as early morning waking, sleeping too much or insomnia

Lack of energyLoss of appetiteWeight loss or gainUnexplained headaches or

backachesStomachaches, indigestion or

changes in bowl habits

Major Depression This type causes symptoms that may:

Begin suddenly, possibly triggered by a loss, crisis or change

Interfere with normal functioningContinue for months or yearsIt is possible for a person to have only one

episode of major depression. It is more common for episodes to be long lasting or to occur several times during a person’s life

Dysthymia People with this illness are mildly

depressed for years. They function fairly well on a daily

basis but their relationships suffer over time.

Bipolar Disorder People with this type of illness change back and

forth between periods of depression and periods of mania (an extreme high).

Symptoms of mania may include:Less need for sleepOverconfidenceRacing thoughtsReckless behaviorIncreased energyMood changes are usually gradual, but can be sudden

Season Affective Disorder This is a depression that results from

changes in the season. Most cases begin in the fall or winter, or

when there is a decrease in sunlight.

Professional treatment is necessary for all these types

of depression.

Treatment for Depression Medication

Antidepressants can help ease the symptoms of depression and return a person to normal functioning. Antidepressants are not habit forming.

Psychotherapy This can help many depressed people

understand themselves and cope with their problems. For example:Interpersonal therapy works to change

relationships that affect depressionCognitive-behavioral therapy helps people

change negative thinking and behavior patterns

Food prevention of the depression

Neurotransmitters Αre types of hormones in the brain

that transmit information from one neuron to another.

Neurotransmitters control major body functions

including movement, emotional response, and the physical

ability to experience pleasure and pain.

The most familiar neurotransmitters which are thought to play a role in mood regulation are serotonin, norepinephrine, dopamine, acetylcholine, and GABA.

Neurotransmitter Effects on Mental Health:

· Modulate mood and thought processes

· Control ability to focus, concentrate, and remember things · Control the appetite center of the brain · Regulate sleep

Serotonin Serotonin is an inhibitory neurotransmitter involved

in the regulation of mood, anxiety, libido, compulsivity, headaches, aggression, body temperature, eating disorders, social anxiety, phobias, sleep, appetite, memory and learning, cardiovascular function, muscle contraction, and

endocrine regulation. Proper amounts of circulating serotonin promote

relaxation. Stress reduces our serotonin levels as our body

uses up serotonin in an attempt to calm itself.

Serotonin is created in the brain in a long series of reactions involving a precursor compound, 5-hydroxy-tryptophan or 5-HTP, and a methyl donor, S-adenosyl methionine or SAMe

The concentrations of these compounds can affect the synthesis of serotonin.

By increasing the synthesis, it may be possible to increase the concentration of serotonin in the brain.

Serotonin Proteins and healthy fats are pro-serotonin

foods while things like caffeine, soda, coffee, fake

sugars, and processed foods are all anti-serotonin foods.

Our serotonin levels become depleted when we are not consuming a balanced diet.

A low-calorie, low-fat, low-carb, or low-protein diet can significantly alter our serotonin levels and affect our mood

Tryptophan is an essential protein that we must obtain from the diet.

It is found in high-protein foods such as turkey, chicken, pork, beef, seafood and eggs.

In addition, a diet high in essential fats will support an increase in the availability of protein in the brain for serotonin production.

Vitamins and minerals, which are obtained from plenty of fresh fruits and vegetables, are needed to convert the tryptophan to serotonin.

The B-Complex Vitamins

The B-complex vitamins are essential to mental and emotional well-being.

They cannot be stored in our bodies, so we depend entirely on our daily diet to supply them.

B vitamins are destroyed by alcohol, refined sugars, nicotine, and caffeine so it is no surprise that many people may be deficient in these.

Vitamin B1 (thiamine) The brain uses this vitamin to help

convert glucose, or blood sugar, into fuel, and without it the brain rapidly runs out of energy.

This can lead to fatigue, depression, irritability, anxiety, and even thoughts of suicide.

Deficiencies can also cause memory problems, loss of appetite, insomnia, and gastrointestinal disorders.

The consumption of refined carbohydrates, such as simple sugars, drains the body's B1 supply.

Vitamin B3 (niacin) Pellagra produces psychosis and

dementia Many commercial food products

now contain niacin, and pellagra has virtually disappeared.

However, subclinical deficiencies of vitamin B3 can produce agitation and anxiety, as well as mental and physical slowness.

Vitamin B5 (pantothenic acid): Symptoms of deficiency are

fatigue, chronic stress, and depression.

Vitamin B5 is needed for hormone formation and the uptake of amino acids and the brain chemical acetylcholine, which combine to prevent certain types of depression.

Vitamin B6 (pyridoxine): This vitamin aids in the processing of

amino acids, which are the building blocks of all proteins and some hormones.

It is needed in the manufacture of serotonin, melatonin and dopamine.

Vitamin B6 deficiencies, although very rare, cause impaired immunity, skin lesions, and mental confusion.

A marginal deficiency sometimes occurs in alcoholics, patients with kidney failure, and women using oral contraceptives.

.

Vitamin B12: Because vitamin B12 is important to red blood

cell formation, deficiency leads to an oxygen-transport problem known as pernicious anemia.

This disorder can cause mood swings, paranoia, irritability, confusion, dementia, hallucinations, or mania, eventually followed by appetite loss, dizziness, weakness, shortage of breath, heart palpitations, diarrhea, and tingling sensations in the extremities.

Deficiencies take a long time to develop, since the body stores a three- to five-year supply in the liver.

Since intrinsic factor diminishes with age, older people are more prone to B12 deficiencies.

Folic acid This B vitamin is needed for DNA

synthesis. It is also necessary for the production of SAM (S-adenosyl methionine).

Poor dietary habits contribute to folic acid deficiencies, as do illness, alcoholism, and various drugs, including aspirin, birth control pills, barbiturates, and anticonvulsants.

Folic acid deficiencies have been linked to depression in clinical studies. Folic acid deficiency causes serotonin levels in the brain to decrease.

Psychiatric patients with depression have much higher rates of folic acid deficiency than the general public

Asparagus Bananas Broccoli Spinach Dried beans Oranges  Peanuts  Peas

Omega-3 fatty acids, Eat foods that are high in Omega-

3 fatty acids, have been shown to raise serotonin levels in the brain, which may reduce the feelings of depression.

These foods include nuts, grains, seeds, beans and deep-water fish such as salmon, mackerel, sardines and herring.

This is a more natural alternative to antidepressants

Magnesium According to the most recent researches low

magnesium plays a crucial role in the development of depression, attention deficit disorder, heart attack and diabetes.

Magnesium is essential: for the formation of healthy bones and teeth in the transmission of nerve impulses mostly for the relaxation of muscles in activating several enzymes in the conversion of carbohydrates, fats and proteins into

energy. Several hundred bodily functions require magnesium,

as blood coagulation, insulin production, normal heartbeat, muscle and nerve functions.

The symptoms of magnesium deficiency include anxiety, depression, restlessness, confusion, irritability, brain fog, fatigue irregular heartbeat and tight aching muscles.cold hands and feet, muscle cramps in legs

or feet

Magnesium

Magnesium Treat depression by adding foods that are

high in magnesium to your diet, since magnesium deficiencies have also been recently linked to this condition.

Foods that are high in magnesium include fish, barley, artichokes, buckwheat, oat bran, almonds, cashews, pine nuts, black beans, white beans, cornmeal, spinach, tomatoes, pumpkins seeds and soybeans.

You can also take a magnesium supplement as well, either isolated or as part of a multi-vitamin formula.

Selenium is an antioxidant which assists vitamin E to

protect cells from damage from free radicals. Selenium plays and important role in

supporting the immune system and in a healthy cardiovascular system.

Low levels of selenium have been linked to increased risks of cancer, inflammatory diseases and cataracts.

It is also important as it is necessary in the production of thyroid hormone. Selenium also helps to protect against heavy metal damage.

Selenium One symptom of hypothyroidism, or low

thyroid function, is depression. For the synthesis, activation, and

metabolism of thyroid hormones, selenium is required.

Deficiencies in selenium could exacerbate the affect thyroid disease has on mood.

Selenium deficiency has been linked to depression in adolescents who abuse alcohol.

Alcohol depletes minerals, such as selenium. Some people, such as those who have had gastrointestinal bypass surgery or have Crohn's disease, absorb selenium less efficiently and are at risk.

Meat and seafood are the best sources of selenium, and vegetarians may be at risk of low dietary intake and deficiency.

Selenium Lack of can cause bad moods.

Individuals suffering from a lack of selenium have been shown to be more anxious, irritable, hostile, and depressed than their non-lacking counterparts.

Correcting deficiencies normalizes mood, but getting more does not elevate mood further

Be sure to get your daily dose by eating a Brazil nut, or tuna sandwich, sunflower seeds, whole grain cereals, or swordfish.

CHROMIUM This mineral is vital for keeping blood sugar level stable

because insulin, which clears glucose from the blood, can't work properly without it.

Chromium helps maintain normal serum cholesterol levels and also helps to control the production of insulin.

It increases immunity, regulates blood sugar, food cravings, and the body’s use of proteins, carbohydrates, and fats.

It also helps in protein synthesis. Certain chromium compounds are being used to prevent

memory loss and arrest deterioration due to Alzheimer’s disease.

Chromium deficiency Symptoms

Fatigue, Anxiety, Depression, Hyperactivity, Irritability, Bipolar disease, Mood swings, Learning disabilities, Glucose intolerance, Elevated blood cholesterol and triglycerides Coronary blood vessel disease, Stunted growth, Infertility, Obesity, Neuropathy,

In fact it turns out that just supplying proper levels of chromium to people with atypical depression can make a big difference.

Chromium Food sources of Chromium include: Whole grains, Bread, Brown rice, Meat,

Broccoli, Mushrooms, Green beans, Brewer’s yeast, Beef, Beer, Chicken breast, Chicken legs, Calves’ liver, Cereals, Cheese, Eggs, Fish, Sea food, Corn, Potatoes, Diary products, and Fresh vegetables.

Herbs are also rich in chromium. Herb sources of chromium include:

Wild yam, Nettle, Catnip, Oat straw, Licorice, Horsetail, Yarrow, Red clover and Sarsaparilla.

About Chocolate??? Some of dark chocolate’s benefits come from

resveratrol, an antioxidant (immune system booster) found in red wine, among other products.

Its mental health benefits include the ability to boost brain levels of endorphins (natural opiates) as well as serotonin (a mood-altering chemical on which many antidepressants act).

Because it can increase serotonin levels in the brain, dark chocolate also may increase serotonin production in the gut, and thus help your immune system.

The recommended dose is one ounce per day. it may help reduce blood pressure and

increase arterial blood flow, reduce the chance of blood clots and lower LDL (bad) cholesterol.Eating too much chocolate each day can cause

complications including migraines, weight gain, digestive tract problems (such as diarrhea),kidney stones and heartburn Dark chocolate seems to have less of an

impact on heartburn than milk chocolate and it may also be less of a problem in gallbladder disease, but no promises there.

And all chocolate contains caffeine, which is a problem for some as well.

What to avoid!!! Reduce the amount of stimulants in

your diet, such as caffeine and high amounts of sugar.

While these substances may provide a temporary mood lift and an increased amount of energy, they may also cause insomnia, disruptive sleep patterns, irritability and moodiness that can easily aggravate the symptoms of depression

Food & Mood Rules① Take it slow.② Eat well and spread it out. ③ Cut back on sugar, caffeine, & saturated

and trans fats; eat more ω-3 rich foods④ Lace a real-foods diet with super mood

foods⑤ Exercise!!!⑥ Drink water.⑦ Supplement responsibly.

Take it easy and enjoy your life!!