by Henry Emmons, MD
In our approach to mood, anxiety, and stress disorders we aim to reverse the current order of things: instead of the common medication-first philosophy, we want to support healthy brain chemistry first through diet, then by adding a few targeted nutritional supplements when needed, and then if additional support is still necessary, considering medication.
Diet is the most elegant, straightforward and lasting way to give the brain what it needs to produce those all-important mood-enhancing chemicals. After all, the brain can only make what it needs by getting the necessary raw materials through the nutrients that we take into the body. Medications do not do that. They only manipulate the chemicals that are already there, but they do not increase them. And sometimes, unfortunately, they can throw off the delicate balance of things by changing one brain chemical at the expense of another.
Diet is the best way to get those ingredients, but let’s face it—none of us eats perfectly healthy all the time. And even if we really tried, it is still possible to fall behind for one of these reasons:
1. Our food may lack essential nutrients because of soil depletion, farming or processing methods or length of time before it is eaten;
2. Our bodies may not be able to use the good nutrients in our food due to poor digestion or metabolic problems;
3. We use up so many of the brain’s mood chemicals because of our highly stressed, overly active lives, or because we are genetically prone to some sort of imbalance.
There are times in all of our lives when we need a little extra support. I believe it makes sense to add the basic nutritional supports (below) whenever you…
…find yourself eating less nutritious food for a few days or more. Don’t use nutritional supplements as an excuse to eat poorly. But do recognize that all of us go through cycles when we’re too busy, don’t have access to really good food, or just get off our games for a time.
…are going through a prolonged period of stress. Your brain will chew up more of the feel-good chemicals, including serotonin, during challenging times. You need to give yourself a little extra TLC, which might come in the form of a vitamin, mineral or herb!
…are recovering from something like a bout of depression, intense anxiety or insomnia. While you are recovering, you need more of the raw ingredients so that your brain can replenish its reserves. Stay with the extra support for at least a few months after you’ve gotten back to your old self.
…are heading into some period that you know is going to be challenging. Back to the seasons for a moment—living in a northern latitude as we do, we may as well accept that we need a little extra help in the winters. You can either go to the beach for one week out of every month (not a bad idea!), or start taking your winter supplement package just like you put on your coat and mittens—to protect yourself!
Here are the basic supplements that I recommend. Remember that not everyone needs these, and if you do take them, you don’t need to stay on them forever. They are supplements, and when you feel balanced and all is well in your world, chances are you no longer need them.
Basic Supplements: (may use occasionally, seasonally or indefinitely)
All may be taken with meals, although you may get more out of the probiotics if taken on an empty stomach. All are safe to be used long-term. If you’re recovering from depression or anxiety, I would suggest taking them for at least 6 months. If you take any of them twice daily, it is best to do so with breakfast and supper. I will include some good brands, along with ordering information.
1. Multivitamin or B Complex
e.g. PhytoMulti (Metagenics) 1 twice daily. Or for more intense needs, consider Multigenics Intensive Care (by Metagenics): 1 twice daily if diet is good; 2 twice daily if diet is poor.
Another good multi-vitamin is Life Force (by Source Naturals) 1 twice daily A less expensive option is to simply take a B Complex. Good choices are Glycogenics (also made by Metagenics), or Source Naturals B-50 Complex: ½ to 1 twice daily
2. Omega 3
Start with a balanced EPA/DHA product like Metagenics EPA/DHA Extra Strength or Nordic Naturals Ultimate Omega. Begin with 1 capsule twice daily. If mood symptoms are not improving after 1 month, increase by 2 additional capsules per day. You may keep increasing each month up to a total of 8 capsules daily if needed.
You don’t have to take fish oil in order to get omega 3 (although people with mood disorders may benefit more from fish oil). Less expensive food sources include: 2 T. ground flax seeds per day, or 1-2 T. daily of chia seeds, hemp seeds or pumpkin seeds per day.
3. Vitamin D3
Take 2,000 IU daily if you have some sun exposure, or if blood levels are low normal. Take 5,000 IU daily if no sun exposure/very low blood levels. Metagenics or Source Naturals are both good products.
You should not need to take Vitamin D if you are in the sun for 15-20 minutes most days between April and October, or if you have a normal vitamin D blood level. By the way, I like the blood level to be above 40, even though most labs consider 20 or 30 to be normal.
Take 1 or 2 daily before breakfast, on an empty stomach if possible.
e.g. Metagenics’ UltraFlora Spectrum or Progressive Laboratories’ Bifido-Complex
This is optional if you get plenty of probiotics in your diet by eating yogurt, kefir or other foods with live cultures at least 3-4 times per week. However, an imbalance in the healthy gut bacteria is one of the common hidden causes of mood and anxiety disorders (see this month’s research summary). If you have taken large numbers of antibiotics, have a lot of gut issues, or simply are not recovering from mood or anxiety problems, I strongly recommend a probiotic.
5. Magnesium Citrate or Glycinate
Take 400-800 mg daily. It can work as a mild laxative: if you get loose stools, simply reduce the dose.
Magnesium is an important part of the process by which serotonin and other brain chemicals are made. It is also calming in its own right, so I recommend it for anxiety, insomnia and muscle tension.
Magnesium is often combined with calcium, which many people take for bone health; note that most men should not need extra calcium, and many women can get enough of it in their diets as well. But if you do take both, it is more economical to get them together in a single tablet.
That’s all the basic supplements you should need. If you’re wondering about specific brain chemical imbalances, you could also schedule an appointment with me firstname.lastname@example.org or with our nutritionist Carolyn Denton Carolyn@partnersinresilience.com to discuss further nutritional and brain chemistry measures that may make sense for you.
A few years ago, I was reminded not to take these simple nutritional supports lightly. I was speaking at a meditation center when an elderly man stood up wanting to share his story, which included a severe depression after his wife died. When he started antidepressants, his mood at first got much worse, and he was hospitalized. It was then that a neighbor gave him a copy of my book, The Chemistry of Joy. At this point in his story, he was holding the book in his hand and waving it emphatically, saying that it had helped save his life and turn the tide of depression. I was waiting expectantly to hear what he would say, and since we were in a Buddhist center I thought it might be about some spiritual insight he’d gotten. Instead, he smiled and said, “I only got to Chapter 4, and then I started the B vitamins. My mood lifted immediately!”
We human beings are obviously more than our brain chemistry—but we are partly our brain chemistry. Let’s do what we can to nurture and restore ourselves in all our elegant complexity!
If you’d like to order high quality, pharmaceutical-grade nutritional products like those that are listed here, you can go to www.nutri-dyn.com. You will create your own account, but at checkout, you will need to use the code number 102696. Doing so will get you a 20% discount on their products, courtesy of Partners in Resilience, supporting you in balancing your brain chemistry.