The prescribing of antidepressant medication has been on the rise and is now higher than ever. Depression, anxiety and other mental health conditions are becoming increasingly prevalent in the UK and increasingly more apparent in younger generations. Underlying risk factors for developing depression are numerous, from poor diet,...
The prescribing of antidepressant medication has been on the rise and is now higher than ever. Depression, anxiety and other mental health conditions are becoming increasingly prevalent in the UK and increasingly more apparent in younger generations.
Underlying risk factors for developing depression are numerous, from poor diet, sedentary lifestyle, increased alcohol intake, to circumstantial things like stress, a job loss, bereavement or after giving birth. Poor physical health also plays a role too like chronic pain or disease. Several factors can be in play at once layering the potential effect on our mental state.
The most commonly prescribed class of antidepressants is the selective serotonin reuptake inhibitors (SSRIs). These work by keeping the neurotransmitter serotonin, which makes us feel happy and relaxed, available for activating serotonin receptors in the brain, thereby enhancing its effects.
As with all medication, antidepressant medication comes with a patient information leaflet which lists potential side effects. What they don’t detail is any potential nutrients deficiencies which the medication could cause, or indeed which deficiencies in general could feed into your chance of developing depression in the first place.
Antidepressants and the risk of hyponatremia
It is well known that SSRIs and several other types of antidepressants can cause low sodium levels especially in older people. This should be discussed with your GP who may instigate blood tests to monitor your levels. Severe low sodium can cause nausea, vomiting, confusion, headaches, irritability and muscle weakness which need to be managed by your healthcare professional. Mild but chronic low sodium can cause difficulty with walking, increase falls, and affect attention so if you experience these whilst on an antidepressant, you should speak to your GP. Increasing sodium levels need to be done under their supervision, especially if you have high blood pressure and are taking medications for it. Sodium is an important electrolyte, and the body keeps it under tight regulation so taking too much is not good either.
SSRIs does not seem to be involved in other nutrient depletion, however research does suggest folic acid supplementation may improve their effectiveness, especially in those who have low levels. Studies also link low levels of some other B vitamins to an increased risk of depression including vitamins B1, B6 and B12.
Other research notes that those with depression typically have reduced vitamin D levels. However, up to 80% of these do not take a vitamin D supplement despite it being recommended to everyone during the winter months when the sun is not strong enough for active production in the skin. As well as impacting mood, vitamin D is important for immune and bone health so low levels can have more wide-ranging implications too.
Intakes of vitamin A, or beta-carotene which the body converts to vitamin A, also tend to be lower in those with low mood, whilst lower levels of the mineral’s magnesium, zinc, selenium manganese and potassium, and omega 3 fatty acids are linked to a greater likelihood of depression too.
You might be at more risk of nutrient depletion if you take other medication too.
Other medications you may take in addition to antidepressants may deplete nutrients so you could be more at risk of nutrient deficiency, especially if taken longer term. Common heart and digestive medication, but also those for blood glucose management and some painkillers over the counter are ones to look out for.
Eat to beat nutrient deficiencies and depression
To help prevent these deficiencies impacting your mood focus your diet around nutrient dense foods including nuts, seeds, leafy greens, wholegrains, fish and natural dairy products, avoiding ultra-processed foods when possible.
Try topping up with the following:
Folic acid: Add plenty of leafy green vegetables especially spinach and broccoli, asparagus, lentils, chickpeas, butterbeans, and avocado.
B vitamins generally: Include kidney beans, bananas, avocado, spinach, watercress, cauliflower, and poultry, salmon and meat if you don’t exclude them. If you are vegan you will need to supplement B12 as this is only found in animal products (there are tiny amounts in some fermented foods).
Vitamin A: Most of us don’t enjoy eating liver so top up with beta-carotene rich foods instead. Include plenty of green, yellow and orange vegetables and fruit like sweet potato, squash, carrots, mango and apricots.
Vitamin D: There is vitamin D in oily fish and some eggs, but most of us rely on our skin synthesising it during sun exposure during the summer months. It is recommended by government health experts to supplement 400iu over the winter months.
Magnesium: Eat plenty of leafy greens especially spinach, nuts especially Brazil’s, cashew and almonds, whole grains and pulses, and mackerel if you don’t exclude fish.
Zinc: Include nuts, seeds and wholegrains regularly and fish, shellfish, and meat if you don’t exclude them.
Omega 3 fats: Regularly include flax, chia and pumpkin seeds and walnuts, and oily fish if you don’t avoid it.
You may want to consider some testing with your GP who can test for some of these nutrients such as vitamin D, B12 or folic acid.
Conclusion
Your diet may not be providing you with the nutrients you need to help prevent depression or to enhance your antidepressant medications effects. Supplementing can help fill gaps, so your nutrient status is optimised. Choose a multivitamin and mineral which includes folic acid and other nutrients, add extra magnesium, and a high-quality omega 3 oil from algal, trout or flax seed sources as a good basis. Choose supplements with active ingredients with no binders and fillers. For more advice on supplements for you, visit your local independent health store: www.findahealthstore.com
Corin Sadler, BSc, DipION, FDSc is a Medical Herbalist and Senior Nutritionist at ethical vitamin company Viridian Nutrition. She has a Degree in Clinical Herbalism, and a Diploma and Foundation Degree in Nutritional Therapy. Corin has a wealth of clinical experience in natural health and wellbeing, and of using nutrition and herbs to optimise overall wellness.
References
Health Survey for England, 2016 - NHS England Digital
Zielińska M, Łuszczki E, Dereń K. Dietary Nutrient Deficiencies and Risk of Depression (Review Article 2018-2023). Nutrients. 2023 May 23;15(11):2433
LaChance LR, Ramsey D. Antidepressant foods: An evidence-based nutrient profiling system for depression. World J Psychiatry. 2018 Sep 20;8(3):97-104.
Zhang Y, Ding J, Liang J. Associations of Dietary Vitamin A and Beta-Carotene Intake With Depression. A Meta-Analysis of Observational Studies. Front Nutr. 2022 Apr 25;9:881139
National Institute of Mental Health. Understanding the link between chronic disease and depression (2024) .Understanding the Link Between Chronic Disease and Depression - National Institute of Mental Health (NIMH)
Cena H, Calder PC. Defining a Healthy Diet: Evidence for The Role of Contemporary Dietary Patterns in Health and Disease. Nutrients. 2020 Jan 27;12(2):334.
The information contained in this article is not intended to treat, diagnose or replace the advice of a health practitioner. Please consult a qualified health practitioner if you have a pre-existing health condition or are currently taking medication. Food supplements should not be used as a substitute for a varied and balanced diet.
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