By Dr. Mercola

Depression is a pervasive health issue today. According to data from the US Centers for Disease Control and Prevention (CDC), one in 10 American adults report some form of depression.¹ Eleven percent of the US population over the age of 12 is on antidepressant medication.²

Just two years ago, Marcia Angell, former editor-in-chief of the New England Journal of Medicine, discussed how a shocking 46 percent of Americans fit a diagnosis for one form of mental illness or another.³ This problem is not limited to the United States, however.

In fact, according to a recent study published in The Lancet,⁴ mental disorders and substance abuse combined were the leading cause of non-fatal illness worldwide in 2010, contributing nearly 23 percent of the total global disease burden!

Data for the study was obtained from the 2010 Global Burden of Diseases, Injuries, and Risk Factors Study,⁵ which includes data from 187 countries. Depressive disorders were the most common, followed by anxiety disorders, drug use disorders, and schizophrenia.

Mental Health Problems on the Rise Across the Globe

The analysis⁶ also found that mental disorders and substance use disorders were the fifth leading cause of death and disease worldwide. Only China, North Korea, Japan and Nigeria had a statistically lower burden of death and disease from mental disorders and substance abuse. As reported in the featured article:⁷

“The authors say that this difference in non-fatal illness compared with the cause of death and disease is supported by the fact that mental and substance use disorders caused a low death rate in 2010 at 232,000, relative to the overall illness they caused.”

In all, mental and substance use disorders were responsible for higher global death and illness rates than HIV/AIDS, tuberculosis, diabetes, and car accidents. Females over the age of 14 had a higher risk of death and disease from mental disorders compared to males.

Males, on the other hand, had a higher risk of death and disease from drug and alcohol dependence across all age groups. According to the authors:⁸

“Despite the apparently small contribution of years of life lost to premature mortality—with deaths in people with mental disorders coded to the physical cause of death and suicide coded to the category of injuries under self-harm—our findings show the striking and growing challenge that these disorders pose for health systems in developed and developing regions.

In view of the magnitude of their contribution, improvement in population health is only possible if countries make the prevention and treatment of mental and substance use disorders a public health priority.”

This overall trend of rising mental disorders and drug abuse can also be seen in a 2010 US government survey⁹ in which 1 in 10 American children was found to have attention-deficit/hyperactivity disorder (ADHD)—a 22 percent increase from 2003.

A whopping 48.4 million prescriptions for ADHD stimulants were written in 2011 in the US,¹⁰ a 39 percent jump from 2007. Meanwhile, emergency room visits due to adverse reactions to such drugs rose by more than 400 percent between 2005 and 2011.

What’s Causing This Rise in Worldwide Mental Health Disturbances?

While I’m sure there are many contributing causes, from impoverished circumstances and poor health to poorly managed day-to-day stress and high-tension due to regional wars and strife just to name a few, I also think it’s important to consider massive recent shifts in food choices throughout the world.

Countries across the globe have shifted to far more industrialized processed and devitalized foods that rely heavily on the use of genetically engineered corn and soy. This denatured Western diet has spread its pernicious influence into the developing world as well.

I simply cannot overstate the importance of your food choices when it comes to your mental health. In a very real sense, you have TWO brains—one in your head, and one in your gut—both of which are created from the same tissue during fetal development.

These two systems are connected via the vagus nerve, the tenth cranial nerve that runs from your brain stem down to your abdomen. It is now well established that the vagus nerve is the primary route your gut bacteria use to transmit information to your brain.

Maintaining optimal gut health is therefore paramount when trying to address your mental state. In this regard, the modern “Western” diet has several things working against it:

• Genetically modified foods can significantly alter your gut flora, thereby promoting pathogens while decimating the beneficial microbes necessary for optimal mental and physical health
• Glyphosate—the most widely used herbicide on food crops in the world with nearly ONE BILLION pounds applied every year—has been shown to cause both nutritional deficiencies, especially minerals (which are critical for brain function), and systemic toxicity.

  According to the researchers, glyphosate is possibly the most important factor in the development of multiple chronic diseases and conditions, and this includes mental health disorders such as depression. Dr. Don Huber believes it is far more toxic than DDT

• High-fructose diets also feed pathogens in your gut, allowing them to overtake beneficial bacteria. Furthermore, sugar suppresses activity of a key growth hormone in your brain called BDNF. BDNF levels are critically low in both depression and schizophrenia.

  Sugar consumption also triggers a cascade of chemical reactions in your body that promote chronic inflammation. In the long term, inflammation disrupts the normal functioning of your immune system, and wreaks havoc on your brain. Last but not least, sugar (particularly fructose) and grains contribute to insulin and leptin resistance and impaired signaling, which also play a significant role in your mental health

• Artificial food ingredients, the artificial sweetener aspartame in particular, can wreak havoc with your brain function. Both depression and panic attacks are indeed known potential side effects of aspartame consumption

The Gut-Brain Connection Will Profoundly Influence Your Mental Health

The impact of your microflora on your brain function was recently reconfirmed by UCLA researchers who, in a proof-of-concept study,¹¹ found that probiotics (beneficial bacteria) indeed altered the brain function in the participants. As reported by UCLA:¹²

“Researchers have known that the brain sends signals to your gut, which is why stress and other emotions can contribute to gastrointestinal symptoms. This study shows what has been suspected but until now had been proved only in animal studies: that signals travel the opposite way as well. 'Time and time again, we hear from patients that they never felt depressed or anxious until they started experiencing problems with their gut,' [Dr. Kirsten] Tillisch said. 'Our study shows that the gut–brain connection is a two-way street.'"

Similarly, as explained by Dr. Natasha Campbell-McBride, a medical doctor with a postgraduate degree in neurology, toxicity in your gut can flow throughout your body and into your brain, where it can cause symptoms of autism, ADHD, depression, schizophrenia and a whole host of other mental and behavioral disorders. With this in mind, it should be crystal clear that nourishing your gut flora is extremely important from infancy into old age. To do so, I recommend the following strategies:

• Avoid processed, refined foods in your diet.
• Eat traditionally fermented, unpasteurized foods: Fermented foods are the best route to optimal digestive health, as long as you eat the traditionally made, unpasteurized versions. Some of the beneficial bacteria found in fermented foods are also excellent chelators of heavy metals and pesticides, which will also have a beneficial health effect by reducing your toxic load. Healthy choices include:
  • Fermented vegetables
  • Lassi (an Indian yoghurt drink, traditionally enjoyed before dinner)
  • Fermented milk, such as kefir
  • Natto (fermented soy)

  Ideally, you want to eat a variety of fermented foods to maximize the variety of bacteria you’re consuming. Fermented vegetables, which are one of my new passions, are an excellent way to supply beneficial bacteria back into our gut. And, unlike some other fermented foods, they tend to be palatable, if not downright delicious, to most people.

  As an added bonus, they can also a great source of vitamin K2 if you ferment your own using the proper starter culture. We tested samples of high-quality fermented organic vegetables made a specific starter culture, and a typical serving (about two to three ounces) contained not only 10 trillion beneficial bacteria, it also had 500 mcg of vitamin K2, which we now know is a vital co-nutrient to both vitamin D and calcium. Most high-quality probiotic supplements will only supply you with a fraction of the beneficial bacteria found in such homemade fermented veggies, so it’s your most economical route to optimal gut health as well. 

• Take a high-quality probiotic supplement. Although I'm not a major proponent of taking many supplements (as I believe the majority of your nutrients need to come from food), probiotics is an exception if you don’t eat fermented foods on a regular basis.

Things to Avoid to Protect Your Gut Flora

A variety of lifestyle factors can hinder optimal gut health, so as a general rule, it would be wise to avoid the following:

Antibiotics, unless absolutely necessary (and when you do, make sure to reseed your gut with fermented foods and/or a probiotic supplement)	Conventionally-raised meats and other animal products, as CAFO animals are routinely fed low-dose antibiotics, plus genetically engineered grains, which have also been implicated in the destruction of gut flora	Processed foods (as the excessive sugars, along with otherwise “dead” nutrients, feed pathogenic bacteria)
Chlorinated and/or fluoridated water	Antibacterial soap	Agricultural chemicals

There’s a Strong Link Between Sugar Consumption and Mental Disorders

There’s plenty of research showing the intimate link between high sugar consumption and mental and behavioral problems. Entire books have been written on this topic, such as William Duffy’s book, Sugar Blues. I will only include a few examples here.

Most recently, preliminary findings presented at the 65th annual meeting of the American Academy of Neurology showed that drinking sweetened beverages―whether they’re sweetened with sugar or artificial sweeteners—is associated with an increased risk of depression. Over the course of a decade, those who drank more than four cans or glasses of diet soda or other artificially sweetened beverages had a nearly 30 percent higher risk of depression compared to those who did not consume diet drinks. Regular soda drinkers had a 22 percent increased risk.

As reported by WebMD:¹³ “Researchers say the findings suggest that cutting down on sweetened drinks or replacing them entirely with non-sweetened beverages may help lower depression risk.”

In 2004, noted British psychiatric researcher Malcolm Peet published a provocative cross-cultural analysis of the relationship between diet and mental illness.¹⁴ His primary finding was a strong link between high sugar consumption and the risk of both depression and schizophrenia. Keep in mind that “sugar” refers not only to refined sugar, but to many other sources as well, including high fructose corn syrup (HFCS) and grains, which break down into sugar in your body. In fact, the evidence^{15, 16} suggesting that gluten sensitivity may be at the root of a number of neurological and psychiatric conditions is also quite compelling...

Now, according to Peet:

“A higher national dietary intake of refined sugar and dairy products predicted a worse 2-year outcome of schizophrenia.¹⁷ A high national prevalence of depression was predicted by a low dietary intake of fish and seafood. The dietary predictors of... prevalence of depression are similar to those that predict illnesses such as coronary heart disease and diabetes, which are more common in people with mental health problems and in which nutritional approaches are widely recommended. Dietary intervention studies are indicated in schizophrenia and depression.”

One of the key predictors of heart disease and diabetes is in fact chronic inflammation, which, as Peet mentions, is also associated with poor mental health. Sugar consumption is a primary driver of chronic inflammation in your body, so consuming excessive amounts of sugar can truly set off an avalanche of negative health events – both mental and physical. Following my recently revised nutrition plan is a simple way to automatically reduce your intake of sugar from all sources. As mentioned earlier, grains turn into sugar in your body and therefore must be accounted for. Beyond that, wheat and other grains also contain a variety of highly pro-inflammatory compounds that, in and of themselves, can contribute to mental health problems.

Another study published in the International Breastfeeding Journal¹⁸ found that inflammation may be more than just another risk factor. It may in fact be THE risk factor that underlies all others... According to the researchers:

“The old paradigm described inflammation as simply one of many risk factors for depression. The new paradigm is based on more recent research that has indicated that physical and psychological stressors increase inflammation. These recent studies constitute an important shift in the depression paradigm: inflammation is not simply a risk factor; it is the risk factor that underlies all the others. Moreover, inflammation explains why psychosocial, behavioral and physical risk factors increase the risk of depression.”

Key Factors to Optimize Your Mental Health

There’s no doubt in my mind that radically reducing or eliminating all forms of sugar and artificial sweeteners from your diet is a crucial step to prevent and/or address depression and other mental health problems. Simultaneously, you need to address your gut, and take steps to reseed your gut with beneficial microbes (probiotics) as delineated above.

Quite simply, if you fail to address the root of the problem you could be left floundering and struggling with ineffective and potentially toxic band-aids, such as antidepressants, for a long time. Your diet does play a huge part in your mental health, so please don’t ignore the impact it may be having. Here are six additional strategies that can help you even further:

1. Exercise – If you have depression, or even if you just feel down from time to time, exercise is a MUST. The research is overwhelmingly positive in this area, with studies confirming that physical exercise is at least as good as antidepressants for helping people who are depressed. One of the primary ways it does this is by increasing the level of endorphins, the "feel good" hormones, in your brain. It also helps to normalize your insulin and leptin signaling.
2. Eat a healthy diet – A factor that cannot be overlooked is your diet. Foods have an immense impact on your mood and ability to cope and be happy, and eating whole foods as described in my nutrition plan will best support your mental health. Avoiding sugar and grains will help normalize your insulin and leptin levels, and eliminating artificial sweeteners will eliminate your chances of suffering its toxic effects.
3. Optimize your gut health -- Fermented foods, such as fermented vegetables are also important for optimal mental health, as they are key for optimizing your gut health. Many fail to realize that your gut is literally your second brain, and can significantly influence your mind, mood, and behavior. Your gut actually produces more mood-boosting serotonin than your brain does.
4. Support optimal brain functioning with essential fats -- I also strongly recommend supplementing your diet with a high-quality, animal-based omega-3 fat, like krill oil. This may be the single most important nutrient to battle depression.
5. Get plenty of sunshine – Making sure you're getting enough sunlight exposure to have healthy vitamin D levels is also a crucial factor in treating depression or keeping it at bay. One previous study found that people with the lowest levels of vitamin D were 11 times more prone to be depressed than those who had normal levels. Vitamin D deficiency is actually more the norm than the exception, and has previously been implicated in both psychiatric and neurological disorders.
6. Address your stress -- Depression is a very serious condition, however it is not a "disease." Rather, it's a sign that your body and your life are out of balance. This is so important to remember, because as soon as you start to view depression as an "illness," you think you need to take a drug to fix it. In reality, all you need to do is return balance to your life, and one of the key ways to doing this is addressing stress.

   Meditation or yoga can help. Sometimes all you need to do is get outside for a walk. But in addition to that, I also recommend using a system that can help you address emotional issues that you may not even be consciously aware of. For this, my favorite is Emotional Freedom Technique (EFT). However, if you have depression or serious stress, I believe it would be best to consult with a mental health professional who is also an EFT practitioner to guide you.