How To Eat To Beat Depression And Anxiety with Dr Drew Ramsey #212

Oct 26, 2021 Episode Page ↗
Overview

Dr. Drew Ramsey, a psychiatrist and leader in nutritional psychiatry, discusses how food profoundly impacts brain and mental health. He shares actionable strategies to prevent and treat depression and anxiety by focusing on foods that feed gut microbes, fight inflammation, or put the brain in 'grow mode'.

At a Glance
50 Insights
1h 38m Duration
15 Topics
7 Concepts

Deep Dive Analysis

Dr. Drew Ramsey's Journey to Nutritional Psychiatry

Inflammation's Role in Physical and Mental Health

Connecting Gut, Brain, and Mental Health

Overcoming Skepticism in Nutritional Psychiatry

Developing the Antidepressant Food Scale

Nutrient-Dense 'Power Player' Foods

The Landmark SMILES Trial for Depression

Challenges in Translating Nutritional Science to Practice

Dietary Patterns for Depression Prevention and Treatment

Understanding 'Grow Mode' and BDNF for Brain Health

Perspective on Supplements and Probiotics

Making Brain-Healthy Eating Affordable

Environmental Considerations in Food Choices

Male Mental Health and Modern Masculinity

Cultivating Mental Fitness and Self-Care

Nutritional Psychiatry

An emerging field that explores the profound relationship between diet and mental well-being, focusing on how specific foods and nutrients can prevent and treat mental health conditions like depression and anxiety. It integrates evidence-based nutrition into mental health care, emphasizing food as a tool for brain health.

Inflammation (Chronic)

While acute inflammation is the body's protective response to injury or threat, chronic inflammation refers to a low-grade, unresolved immune response that can be stimulated by various factors like diet, pollution, or stress. This prolonged state is strongly linked to mental health issues like depression, anxiety, and brain fog.

Microbiome

The collection of microorganisms, mainly bacteria, residing in the gut, particularly the colon. It plays a crucial role in regulating various bodily functions, including the immune system and inflammatory responses, and is closely linked to brain and mental health via the gut-brain axis.

Antidepressant Food Scale

The first nutrient profiling system specifically designed for mental health, created by Dr. Ramsey and Laura Lachance. It identifies 12 key nutrients with strong scientific evidence for preventing and treating depression, and then ranks natural, whole foods based on their density of these nutrients per calorie.

Clinical Remission (Depression)

In the context of depression treatment, remission signifies a complete absence of depressive symptoms, meaning the individual no longer meets the diagnostic criteria for depression. This is distinct from a 'response,' which indicates some improvement in symptoms but not full recovery.

Brain 'Grow Mode' / Neuroplasticity

A state where the brain actively forms new connections and even some new brain cells, facilitated by neurohormones like Brain-Derived Neurotrophic Factor (BDNF). This process, known as neuroplasticity, enhances brain resilience, repair, and overall cognitive function, and can be supported by lifestyle choices like diet, exercise, and social connection.

BDNF

A crucial neurohormone that supports the growth, survival, and differentiation of neurons, playing a key role in neuroplasticity. It helps brain cells form new connections, which is fundamental for learning, memory, and overall brain health, contributing to resilience and repair.

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When did the connection between food and mood become apparent to Dr. Drew Ramsey?

Dr. Ramsey became aware of this connection early in his career, around 2002-2003, when data on omega-3 fats' antidepressant effects emerged, prompting him to question why food sources like fish weren't discussed in psychiatry.

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How does Dr. Ramsey view inflammation in the context of physical and mental health?

Inflammation is the body's protective immune system, but chronic, low-grade inflammation, often triggered by modern life stressors and diet, can inappropriately activate these alarms, leading to symptoms like anhedonia, sadness, anxiety, and brain fog, severely impacting mental health.

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How does food impact the brain and mental health?

Food impacts the brain both structurally, by providing essential nutrients like omega-3s for brain components, and through communication pathways, particularly via the gut-brain axis, where gut microbes influence inflammatory responses that affect brain function and mental well-being.

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How does Dr. Ramsey address patient skepticism about diet's role in mental health?

He takes a comprehensive psychiatric history, integrates food as one tool alongside medication and psychotherapy, and focuses on the hopefulness of nutrition rather than fear-mongering, aiming to understand each patient's unique relationship with food.

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What is the Antidepressant Food Scale and how was it developed?

The Antidepressant Food Scale identifies 12 key nutrients with strong scientific evidence for preventing and treating depression. It was developed by asking which natural, whole foods contain the highest amounts of these 12 nutrients per calorie.

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What were the key findings of the SMILES trial regarding diet and depression?

The SMILES trial showed that a third (32.3%) of participants with clinical depression who received dietary counseling on a modified Mediterranean diet achieved full clinical remission over 12 weeks, an outcome comparable to a blockbuster drug.

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Why is it challenging to translate nutritional psychiatry research into mainstream clinical practice?

Mainstream medicine is disease-focused and relies on established community standards, making clinicians hesitant to deviate due to perceived medical-legal risks. Additionally, there's a lack of standardized training on how to efficiently and responsibly incorporate nutrition into mental health consultations.

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Can dietary changes help prevent depression?

Yes, studies suggest that adopting a Mediterranean dietary pattern can significantly reduce the risk of developing clinical depression, with one study showing a 30-52% reduction in risk over four and a half years among university students.

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What does it mean to put the brain in 'grow mode' and what nutrients support it?

'Grow mode' refers to neuroplasticity, where the brain actively forms new connections and cells, supported by neurohormones like BDNF. Foods like nuts, wild seafoods, berries, and dark chocolate are associated with increased BDNF levels and enhanced brain resilience.

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What is Dr. Ramsey's stance on supplements and probiotics for mental health?

While some supplements like omega-3s (if not eating fish) and vitamin D (in winter) may have a role, Dr. Ramsey generally prefers a food-first approach. He notes limited specific data for probiotics in mental health, suggesting fermented foods and a plant-rich diet as better ways to support gut bacteria.

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Is eating for better mental health expensive?

No, according to research like the SMILES study, individuals can actually save money by adopting a Mediterranean-style diet, with estimated savings of around $140 per month. Focusing on affordable nutrient-dense foods like dried beans or canned wild salmon can make it economical.

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How can individuals make environmentally conscious food choices that also support brain health?

Dr. Ramsey suggests being conscientious about seafood choices, opting for wild-type seafood, smaller fish like anchovies and sardines, and farmed bivalves (mussels, clams, oysters) which are environmentally friendly. He also highlights the energy intensity of plant agriculture and the importance of supporting sustainable farming practices.

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What is the most important lesson Dr. Ramsey has learned in his 20+ years of practice?

The most important lesson is the value of spending quality time with one's partner and children, emphasizing that these deep, gratifying human connections, though not professionally rewarded, are foundational to personal happiness and mental well-being.

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What are common struggles men face regarding mental health?

Men often struggle with traditional masculinity ideals of being tough and stoic, leading them to suppress pain and depression. This can result in high rates of substance use disorders (50% of men in America) and disproportionately high suicide rates (75-80% of suicides in the U.S. are white males).

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What are Dr. Ramsey's closing thoughts on improving mental health?

He encourages validating self-care as foundational, being rigorous and kind in self-care, and actively engaging in 'mental fitness' by promoting lifestyle choices that enhance emotional connection, love, and creativity, recognizing that mental health is an evolving process.

1. Prioritize Mental Health Investment

Invest time and energy in your mental health as it offers the best dividends and rewards, leading to a life filled with love, creativity, spontaneity, and connection.

2. Practice Foundational Self-Care

Validate self-care as foundational, not selfish, by being rigorous, kind, and loving in your self-treatment, including positive self-talk, dedicated time, and brain-fueling nutrition.

3. Actively Build Mental Fitness

Engage in mental fitness as an active, ongoing process by cultivating daily rituals and lifestyle choices that enhance emotional connection, love, and creativity, based on scientific insights for brain health.

4. Embrace Hopeful Mental Health View

Adopt a hopeful and robust perspective on mental health, moving beyond a narrow focus on severe conditions and medications to embrace broader, proactive strategies.

5. Proactively Manage Mental Fitness

Shift your perspective to proactively manage your mental health and fitness, focusing on prevention rather than waiting for significant symptoms to seek help.

6. Holistic Mental Health Approach

View medications, psychotherapy, and lifestyle changes (including diet) as equally important and integrated tools for effectively managing depression and anxiety.

7. Eat for Mental Well-being

Understand that the right foods are crucial for your brain and mental well-being, not just physical health, and use this knowledge to enhance how you feel.

8. Choose Foods for Gut & Brain

Select foods that either nourish your gut microbes and combat inflammation, or promote your brain’s ‘grow mode’ to support overall mental health.

9. Focus on 12 Key Nutrients

Prioritize consuming foods rich in 12 key nutrients—including zinc, magnesium, B12, omega-3 fats, folate, and iron—which have strong scientific evidence for preventing and treating depression.

10. Choose Nutrient-Dense Whole Foods

Select natural, whole foods that offer the highest concentration of the 12 key mental health nutrients per calorie, focusing on both top plant and animal sources.

11. Implement SMILES Diet Changes

To improve mental health, aim for one more seafood meal per week, one more serving of vegetables and a half serving of fruit daily, a couple servings of beans/legumes weekly, and significantly reduce highly processed foods by 21 meals per week.

12. Aim for 3-4 Seafood Meals/Week

Strive to eat three to four seafood meals per week, including a mix of anchovies, sardines, oven-roasted wild salmon (around six ounces weekly per family member), and farmed mussels or other bivalves.

13. Build on Nutrient-Dense Foundation

Establish a foundation of nutrient-dense foods in your diet, which allows for occasional indulgences like pizza or chocolate cake without compromising overall mental health benefits.

14. Incorporate Red Peppers Daily

Add red peppers to your diet frequently due to their high vitamin C content, versatility in dishes, and ease of storage, making them a powerful mental health food.

15. Eat Clams for B12

Incorporate clams into your diet as they are an excellent natural source of vitamin B12, a crucial nutrient for mental health.

16. Choose Canned Wild Salmon

Opt for canned wild salmon as a fresh, economical, and convenient source of brain-healthy nutrients, suitable for salads or burgers.

17. Choose Sustainable, Small Wild Fish

Conscientiously choose wild-type seafood, prioritizing smaller fish like anchovies and sardines over farmed options or larger fish like tuna and wild salmon, for both health and environmental reasons.

18. Include Bivalves in Diet

Integrate bivalves such as mussels, clams, and oysters into your diet, recognizing their nutritional benefits for mental health.

19. Avoid Lake/River Fish

Do not consume fish from lakes or rivers due to concerns about pollution, prioritizing seafood from cleaner sources.

20. Avoid Processed Meats

Steer clear of highly processed and re-processed meat products, such as meat pockets or fried/sweetened meats, as they are detrimental to health.

21. Adapt Nutrition for Low Appetite

If you experience low appetite due to mental health struggles, opt for nutrient-dense options like soups, smoothies, or a handful of nuts to ensure adequate nourishment during recovery.

22. Consider Omega-3s from Fish

Incorporate omega-3 fats, primarily from fish, into your diet as they have shown antidepressant effects and are important for brain health.

23. Combine Anti-Inflammatories with Antidepressants

If taking antidepressants, consider discussing with your doctor the addition of anti-inflammatory agents, as this combination has been shown to significantly improve outcomes for depression.

24. Consider Probiotics for Bipolar

If you have bipolar disorder with a high inflammatory index, consider incorporating probiotics, as a study showed a significant reduction in rehospitalization rates when combined with standard treatment.

25. Reduce Body Inflammation for Brain

Actively work to reduce inflammation in your body, as this directly correlates with reducing inflammation and improving symptoms in your brain.

26. Recognize Inflammation’s Mental Impact

Be aware that inflammation can manifest as anhedonia, low mood, anxiety, and brain fog, similar to how you feel when sick, highlighting its link to mental health.

27. Eat Daily for Brain Health

Consume specific foods daily that are strongly supported by data to improve brain health and mental well-being, particularly in preventing and treating depression.

28. Experiment for Mental Health Growth

Embrace the idea that your brain and mental health can evolve; continuously learn about yourself and experiment with lifestyle factors like food, sleep, and movement to support this growth.

29. Invest Holistically in Mental Health

Recognize nutrition as a crucial but not exclusive component of mental health; invest time and energy holistically in all aspects of your well-being for rewarding results.

30. Develop Your Palate for New Foods

Be curious and intentionally develop your palate by exploring simple ways to prepare new, nutrient-dense foods, especially those you might not typically eat, like fish or bivalves.

31. Evolve Your Palate Over Time

Approach the development of your food preferences and palate as an ongoing evolutionary process, similar to how you approach your mental health journey.

32. Learn Simple Home Cooking

Acquire knowledge and skills for preparing and cooking simple, economical, and healthy meals at home to better support your overall well-being.

33. Seek Cooking & Nutrition Coaching

Join cooking classes or seek coaching to learn new recipes, integrate brain-healthy foods, and gain community support for improving mental fitness through nutrition.

34. Debunk Food Myths

Challenge common myths that eating for brain health is complicated, time-consuming, or expensive, as these beliefs can hinder adopting beneficial dietary changes.

35. Eat Economical Red Beans

Incorporate red beans into your diet as an economical and nutrient-dense ‘power player’ food for brain health, especially when bought dried and soaked.

36. Reclaim Personal Food Sense

Take a step back and reclaim your personal sense of taste and understanding of what’s healthy, rather than letting external influences dictate your nutritional choices.

37. Support Diverse Dietary Choices

Prioritize feeding your mental health and taking care of it, regardless of your specific dietary choices (e.g., vegan, omnivore), focusing on nutrient density and overall well-being.

38. Adopt Traditional Dietary Patterns

Focus on adopting a traditional dietary pattern, emphasizing real foods like those your grandparents might have eaten, rather than restrictive diets, to support mental health.

39. Understand Food Sourcing Complexity

Recognize the complex reality of food production, including the reliance of organic plant foods on animal byproducts like manure, to avoid overly simplistic views on ‘good’ versus ‘bad’ foods.

40. Practice Curiosity Before Judgment

Approach discussions about food and other complex topics with curiosity rather than immediate judgment, recognizing the nuances and avoiding uninformed strong positions.

41. Prioritize Family Time

Dedicate important, quality time to your partner and children, recognizing it as the most deeply gratifying human experience, despite not being externally rewarded.

42. Practice Deep Listening

Cultivate the habit of deep, attentive listening in your interactions, as it fosters profound understanding and connection with others, even in a distracted world.

43. Embrace Vulnerability as Strength

For men, redefine masculinity by embracing vulnerability, openness, humility, and non-defensiveness as sources of strength and emotional well-being, moving away from traditional stoicism.

44. Re-evaluate Gender Roles & Expectations

Reflect on how traditional upbringing and parental examples may have shaped your expectations of gender roles, and actively work to adapt to new ways of living and contributing in society.

45. Acknowledge Modern Life’s Gender Struggles

Recognize that both men and women face unique and evolving struggles with mental health and purpose in rapidly changing modern society.

46. Appreciate Motherhood’s Profundity

Cultivate a profound appreciation for motherhood, recognizing the incredible resilience and unique contributions of women, and advocate for better support for mothers.

47. Initiate Deeper Social Connection

For men, actively initiate and engage in deeper conversations, such as asking about family and children, to foster stronger social connections and combat isolation.

48. Acknowledge Women’s Strengths

For men, consciously acknowledge and commit to the idea that women excel in many areas, challenging traditional notions of male dominance and fostering a more balanced perspective.

49. Define Modern Masculinity

Engage in self-reflection to define what ‘good masculinity’ means in today’s evolving world, considering how to show respect and navigate relationships, especially if from a traditional cultural background.

50. Assess Diet’s Mood Impact

Reflect on how your current dietary choices personally affect your mood, energy levels, and emotional stability, as restrictive diets might not always be beneficial for mental well-being.

Nothing will give you better dividends and more rewards than taking care of and investing in mental health.

Dr. Drew Ramsey

When we feel in the upper echelon of our mental health, the world and life is amazing. We are filled with love and creativity and spontaneity and connection, and we live more.

Dr. Drew Ramsey

I don't think like that. I don't I don't in any way separate my body from my brain. When we're talking about inflammation in the body, that's synonymous with me. There is no inflammation in the body without inflammation in the brain.

Dr. Drew Ramsey

I think fear-mongering is just silliness. You can eat all kinds of different foods and have a reasonably healthy life. I really try and focus on the hopefulness of it.

Dr. Drew Ramsey

Remission is actually, you don't have depression anymore.

Dr. Drew Ramsey

Patients aren't interested in being evidence-based. Patients are interested, I think, in getting better and also doing things that matter.

Dr. Drew Ramsey

I just think, uh, and I like prescribing food better than supplements. I just trust it.

Dr. Drew Ramsey

Curiosity before judgment.

Dr. Drew Ramsey

Self-care isn't selfish. Self-care is foundational.

Dr. Drew Ramsey

Minimal Intervention for College Depression Prevention

Dr. Drew Ramsey (describing Heather Francis's trial)
  1. Watch a 13-minute educational video promoting mental health improvement through diet, emphasizing more vegetables and plants.
  2. Receive a package containing nuts, nut butter, olive oil, cinnamon, and turmeric.
  3. One week after watching the video, receive a 5-minute phone call check-in.
  4. Two weeks after the video (one week after the first call), receive a second 5-minute phone call check-in.
20 years
Dr. Ramsey's medical practice duration As a practicing medical doctor.
2002, 2003
Awareness of omega-3 data for mood When Dr. Ramsey first became aware of the data.
most disabling illness
Global ranking of depression Depression's impact worldwide.
twice as better
Improvement with anti-inflammatory medication alongside antidepressants For individuals on antidepressants also taking anti-inflammatory agents.
32.3%
Remission rate in SMILES trial Percentage of participants achieving full clinical remission from depression.
21 fewer meals
Processed food meals reduced in SMILES trial Reduction in highly processed meals per week.
86.3%
Percentage of severe depression in Healthy Med trial Participants with severe or extremely severe clinical depression.
45%
Reduction in anxiety and depression scores in Healthy Med trial Reduction in formal anxiety rating scales and similar for depression.
30% to 52%
Reduction in depression risk with Mediterranean diet (Spanish study) Over 4.5 years for university students following a Mediterranean diet.
13 minutes
Video length for college depression prevention Educational video in the Australian college student study.
a couple cubic millimeters
Brain size increase with healthy diet More brain in the left hippocampus for individuals aged 60-65 with a healthy diet.
78% fewer people
Reduction in low BDNF levels with nuts Had severely low levels of BDNF among those who ate nuts in a study.
90% reduction
Reduction in rehospitalization for bipolar disorder with probiotics Over six months for individuals with a high inflammatory index receiving probiotics.
$140
Estimated monthly savings from Mediterranean diet Estimated savings per month in the SMILES study.
three to four
Dr. Ramsey's personal goal for seafood meals Seafood meals per week.
75% to 80%
Percentage of suicides by white males in the U.S. Of all suicides in the U.S.