BRAIN FOOD: THE NATURAL CURE FOR DEPRESSION
Some Practitioners Believe that Most People on Antidepressants
Could Really Just Use a Better Diet
Page 2

The new research has inspired the launch of at least one scientific journal devoted to the subject, Nutritional Neuroscience, and dozens of books - ten of them by Cass, including Natural Highs: Feel Good All the Time and the just-released 8 Weeks to Vibrant Health. "There have been huge advances over the past few years finding that nutritional intervention can treat many behavioral and mental conditions we used to think were untreatable," says Lewis Mehl-Madrona, associate professor of clinical psychiatry at the University of Arizona College of Medicine.

Why so much interest? Experts say nutritional therapy is catching on in part due to growing discomfort with antidepressants: Physicians are realizing they're not as effective long-term as was once hoped, and they often have nasty side effects, such as loss of libido and nausea. "We're becoming more realistic about the limitations of drugs," says Susan Lord, director of nutrition programs for the Center for Mind-Body Medicine in Washington, D.C. "They're not the magic bullets we once thought."

Much of the interest is also coming from patients themselves, says Cass. As more people realize they need to pay attention to what they eat in order to feel good, more are asking their doctors for nutritional help. Lord sees this in the growing popularity of the "Food as Medicine" workshops her center hosts for health care practitioners.

Within five years, she predicts, the demand among doctors for education about nutrition will be huge. "Most physicians already see the writing on the wall," she says, "and are in the uncomfortable position of not knowing the answers, but feeling they should."

While it's clear the brain can be greatly influenced by what we eat, researchers are just beginning to figure out why. The answer has at least something to do with the composition of neurotransmitters, whose intricate wiring controls thinking, actions, and moods; these chemicals are made of amino acids, and certain vitamins and minerals play critical roles in their formation. The very makeup of brain cells also depends on nutrients -- omega-3s are part of every cell membrane.

When a person's diet is deficient in some of these nutrients, neurotransmitters aren't made correctly or don't get what they need to function properly, and various emotional and mental disorders can result. For instance, low blood sugar can contribute to some forms of depression, and so can low levels of zinc in some people.

For all the recent research, Lesser and Cass are still among a maverick few who focus primarily on nutritional interventions for mental health problems. For most psychiatrists, drugs are better known, despite their problematic side effects -- and therefore less risky.

Both Lesser and Cass arrived at the notion that nutrition can influence brain chemistry early in their medical careers. Lesser, who was conventionally trained at Cornell and Albert Einstein Medical Center in New York City in the 1960s, started tinkering with nutrients after becoming frustrated by his field's emphasis on drugs.

Shortly after he'd finished his residency, Lesser came across a report that treating schizophrenics with niacin tended to improve their symptoms. He figured that if the niacin worked, he should also experiment with other dietary strategies that have been linked to mood.

So he tried the approach on a patient of his own and put the young man on a high-protein diet, gave him a slew of supplements, including niacin, vitamin C, and zinc, and told him to cut out caffeine and cigarettes. Soon after his patient showed dramatic improvement, Lesser founded the Orthomolecular Medical Society, with the stated objective of emphasizing natural substances such as vitamins, minerals, amino acids, and essential fats in the prevention and treatment of diseases.

As for Cass, even before she began her training she was predisposed to the idea that drugs aren't always the answer. The daughter of an old-fashioned family physician in Canada, she was drawn to a personalized kind of medicine that honored both mind and body. Shortly into her practice, she found that the standard "couch and Prozac" combination of talk therapy and pharmacology only goes so far.

Over time, she eventually developed the approach she uses today, which is to start by evaluating the patient in a number of ways -- emotionally, physically, and biochemically. Then she supplies specific health prescriptions, which include supplements and food, often in tandem with exercise, natural hormones, and mind-body techniques.

The approach isn't for everyone. It requires that a patient be a full partner in his or her care, and not everyone is motivated enough to make what can amount to pretty daunting lifestyle changes, including shopping for organic food, preparing meals without using a lot of salt, sugar, and unhealthy fats, and taking all those supplements -- especially people who are depressed to begin with.

Sometimes the best option is indeed medication, says Cass, particularly with severe cases of depression. "The most important thing is to help the patient," she says.

But even small changes - like cutting out processed foods, or adding daily fish oil pills - can make a big difference, they say. And once started, the process can develop its own momentum. "People start eating
a little better or taking a few supplements, and they often start feeling a little better," says Lord. "That's when they become open to trying more changes."

Many of the patients who do manage to stick to the program say it is worth the effort. After a couple of months on Cass's regimen, Rebecca Jones is certainly convinced. She hasn't had to make many dietary adjustments -- she was already eating reasonably well to begin with and exercising a few times a week. So the only change she's made was to start taking supplements. But the results have been dramatic.

The supplements are costly, she admits, running about $100 a month. "But that's all it takes -- I don't need any expensive prescription drugs." She expects to stay on some of the supplements for the rest of her life, and to continue to consult with Cass periodically. "But that's okay," she says. "My mood has evened out considerably -- all of the depressive symptoms I had are gone. I'm much, much better now."

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