Depression, mental health and fatigue
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the Dutch version
With depression come associations of feeling bad and having disturbing emotions. For example the loss of a loved one or experiencing a broken heart. But depression being a result of physical problems is another possibility, which I'd like to point out in the following section.
How are magnesium, depression and suicidality related?
Which food products contain a lot of magnesium?
Depression, ADHD, bipolar disorder, schizophrenia and the omega-3 fatty acids EPA and DHA
Omega-3 fatty acids in fats and oils
Additional information on EPA and DHA
Recommended intakes of omega-3
"Depression is defined by feelings of sadness, despair, and discouragement. The severity of depression can range from the "blues" to incapaciting depression (can't get out of bed). Teens with depression report feelings of low self esteem and guilt, and they will often, withdraw people and isolate themselves. Parents will notice changes in their sleep habits and eating habits."
Symptons of Depressive Disorders can include:
Sadness, Difficulty sleeping, Fatigue, Hopelessness, Despair, Sense of inferiority, Dejection, Exaggerated guilt, Changes in appetite, Feelings of incompetence, Loss of interest, Inability to function effectively
Bi-polar symptoms include all of the above, with these additional indications of the manic phase of the disorder:
· Increased strength and energy, decreased sleep
· Extreme irritability
· Rapid, unpredictable emotional changes
· Racing thoughts, flights of ideas
· Increased interest in activities, overspending
· Grandiosity, inflated self-esteem
· Increased sexual drive
· Poor judgment, risk taking
(Source: http://www.adolescent-mood-disorders.com/adolescentmooddisorders.html )
It has been estimated that 9.5% of adults in the United States have a depressive disorder in a given one-year period, and that 5% of children and adolescents ages 9 to 17 have major depressive disorder in a given six-month period. (..) It has been estimated that 5 to 12% of men and 10 to 25% of women experience depression at some point in their lives.
(Source: http://pibhs.uams.edu/Depression/Depression_rates.asp )
Depression is stress related. This can be mental strees, but also physical stress. Two minerals play important roles on a physical level: calcium (Ca) and magnesium (Mg). Calcium functions a.o. as a mineral supporting muscle contractions and relaxation and in impulse transport in nerve and cell membranes.
Magnesium plays a role in over 300 enzyme systems, energy metabolism and - alike calcium- in muscle functions. In the case of muscle contraction and relaxation, calcium and magnesium fulfill antagonistic (opposing) roles (1,2).
After having completely dissolved his severe depression, George Eby dedicated a huge web site to this. Eby was caught in a severe depression from September 1999 till April 2000. After being put on lithium by his physician and after a literature search through the Internet and libraries, he decided to take magnesium glycinate tablets, about 400 milligrams 3 times a day.
Within a week his depression markedly dissolved.
By June 2000 he was completely freed from his depression.
By the way, magnesium taurate appears to be a better magnesium donor than magnesium glycinate, as Eby points out on his web site. The reason for this is that organic magnesium compounds are better absorbed by the body than are anorganic, like magnesium oxide of hydroxide (MgO and MgOH respectively).
How are magnesium, depression and suicidality related?
A study after the calcium and magnesium values of the cerebrospinal fluid (CSF, the fluid of the backbone) revealed that the calcium balance of depressed or schizophrenic people was higher than the control group. Furthermore the CSF values for magnesium were significantly lower in groups of people with depression, adaptation problems and people that had tried before to commit suicide (4).
Another trial studying depressed patients revealed that the blood values as well as the CSF values for the calcium / magnesium equilibrium was elevated compared to the controls (5).
More recent research in mice shows that a diet containing only 10% the RDI of magnesium, leads to higher depression rates and anxiety related diseases in these mice (6).
It is apparent anyway that magnesium influences the serotonin receptors in the brain and a variety of other neurotransmitters (7). Serotonin earned the nickname "happy hormone" because it gives you a sense of calm and satisfaction.
If a magnesium deficiency (lack) can affect the brain's biochemistry, the relation between this deficiency and depression is quickly made. More physically speaking, stress can be explained as a relative shortage of magnesium, which relaxes the muscles (3).
Which food products contain a lot of magnesium?
Wheat germ, toasted, 1 oz
Almonds, dry roasted, 1 oz
Cereal, shredded wheat, 2 rectangular biscuits
Seeds, pumpkin, 1/2 oz
Cashews, dry roasted, 1 oz
Nuts, mixed, dry roasted, 1 oz
Spinach, cooked, 1/2 c
Bran flakes, 1/2 c
Cereal, oats, instant/fortified, cooked w/ water, 1 c
Potato, baked w/ skin, 1 med
Soybeans, cooked, 1/2 c
Peanuts, dry roasted, 1 oz
Peanut butter, 2 Tbs.
Chocolate bar, 1.45 oz
Bran (pure), 2 Tbs
Vegetarian baked beans, 1/2 c
Potato, baked w/out skin, 1 med
Avocado, California, 1/2 med
Lentils, cooked, 1/2 c
Banana, raw, 1 medium
Shrimp, mixed species, raw, 3 oz (12 large)
Tahini (from sesame seed), 2 Tbs
Raisins, golden seedless, 1/2 c packed
Cocoa powder, unsweetened, 1 Tbs
Bread, whole wheat, 1 slice
Spinach, raw, 1 c
Kiwi fruit, raw, 1 med
Hummus, 2 Tbs
Broccoli, chopped, boiled, 1/2 c
Alfalfa, avocado, cashew nuts and pumpkin seeds are my personal favorites.
With refining and cooking grains, a lot of magnesium is lost. There are many factors that will increase your body's need of magnesium, like high sugar intake, alcohol consumption, high protein metabolism (e.g. in growth), intensive exercise, pregnancy, stress and the use of certain medicines (diuretics). When there is a elevated free radical stress (e.g. when making a large flying trip, in stress, trauma and disease) more magnesium will leak away out of the cells, and leaves the body via the urine.
A magnesium shortage has been related to a lot of symptoms including: irritability, PMS, fears, desorientation, arrhythmia, high blood pressure, muscle weakness and cramps, nausea, bowel spasms, constipation, headaches and fatigue (8).
If you suspect that you or someone in your environment is / are depressed, you might want to take a shot at supplementing magnesium. Be sure to get the right one, like George Eby did: preferably magnesium taurate, or equivalent.
Depression, ADHD, bipolar disorder, schizophrenia and the omega-3 fatty acids EPA and DHAAnother nutritional factor that may very likely offer beneficial effects on depression, ADHD, bipolar disorder and schizophrenia are omega-3 fatty acid supplements ("fish oil"), or a diet higher in these fatty acids. For an explanation of these substances, see here.
Research in the past decennia showed some really positive qualities for these omega-3 fatty acids in the fied of mental disorders. Check the "Studies" page for a couple of reviews on this matter.
Some conclusions and findings from these studies include the following (study 34 to 42):
Study 34
changeing the fatty acid profile of cells in the nerve system leads to alterations in the way receptors and membrane proteins function
epidemiologic studies reveal a relation between depression and low intakes of omega-3 fatty acids
if particularly EPA is supplemented next to the conventional medication in depression or schizophrenia, beneficial effects are observed in the patient
case studies show positive effects in the treatment of borderliners given EPA, and in persons with ADHD given omega-3 and -6 fatty acids
Study 35
in depression, there is strong epidemiologic evidence that fish consumption cuts back your risk of getting depressed
in depression, supplementation with ethyl-EPA has shown a strong therapeutic effect next to regular medication
Study 36
double blind placebo controlled studies in bipolar disorder shows positive effects with supplementation of vitamins, orthomoleculs, herbs, EPA and DHA
Study 37
there is substantial evidence for the potential role of EPA supplementation in schizophrenics
in one reported case a schizophrenic was succesfully treated with omega-3 fatty acids
Study 38
in depressed patients, significantly lower blood levels of omega-3 fatty acids were found, or higher omega-6/-3 ratios
the severity of a depression is larger when the amount of omega-3 fatty acids in the blood is lower or the omega-3/-6 ratio is smaller
Study 39
lowered blood levels of omega-3 fatty acids are associated with several neuropsychiatric diseases like ADD/ ADHD, Alzheimer's disease, schizophrenia and depression
Study 40
30 patients with bipolar disorder were given either a placebo or an omega-3-supplement; the group with omega-3-supplements had significantly better results in the course of the disease than the placebo group in the short term
Study 41
in schizophrenics the metabolism of phospholipids and PUFAs is disrupted
45 symptomatic schizophrenics still on classical medication were put on EPA, DHA or placebo treatment for 3 months
EPA came out strongest
at the end of the study only half of the EPA group was still on antipsychotics, compared to ALL the patients in the placebo group
Study 42
in schizophrenics, certain levels of omega-3 and -6 fatty acids are lowered in cell membranes of the nervous system
schizophrenics are likely to have an abnormal fatty acid metabolism
supplementation of omega-3 fatty acids in schizophrenics gives a higher score in a scale measuring mental health
My comment on these findings:
Obviously, people suffering from depression, AD(H)D, Alzheimer's disease, autism, schizophrenia and bipolar disorder can greatly benefit by the mor pronounced usage of certain omega-3 (or -6 supplements). I advise these people to immediately start supplementing these fatty acids.
the amount of EPA/DHa used in trials varies from 1 to 2 grams a day to over 9 grams a day. For optimal dodages, click here.
Where can you get your omega-3 fatty acids and what foods contain them?
Some suppliers of high quality omega-3 fish oils.
http://www.minami-nutrition.com
http://www.mercola.com/products/krill_oil.htm
You can also visit your local drug store, or organicshop. They'll probably also have some kinds of fish oil supplements.
UPDATE: momentarily, I fully recommend omega-3-supplements from MorEPA (Minami Nutrition). These are namely very concentrated ampules, and they are Environmentally Friendly Produced, and without heavy metal intoxication or PCBs. Not all fish oil supplements bear the same quality conditions. One pill contains about 580 mgs EPA and 83 mgs DHA.
Omega-3 fatty acids in fats and oils
Underneath, a list displaying the fatty acid profile of some very common sources of fats and oils.
Total fat
SFA
MUFA
PUFA (n-3 + n-6)
n-3
Fats and oils
ALA (no EPA or DHA)
Olive oil 100
14
73
8
0,7
Sun flower oil 100
12
21
63
0,1
Soy oil 100
15
22
59
7,3
Canola oil
100
7
59
29
10
Flax seed oil 100
10
16
65
55
Wheat germ oil 100
18,5
17
60
5
Walnut oil 100
9
16
70
11,5
Safflower oil 100
10
12
74
0,1
Corn oil 100
14,5
30
51
0,9
Palm oil 100
48
37
10,5
0,3
Coconut oil 100
87
6
1,5
0
Peanut oil 100
20
44
31
0
Lard 100
48
32
9
0,5
Butter 82
51
24
2
ca 1
Hardened margarine 80
34
20
21
1-2
Soft margarine (60% fat) 60
12
17
26
(ca 3)4
Frying fat 100
46
27
8
Ca 1
Frying fat fluid
100
13
23
59
Mayonaise 67
8
21
36
1-2
The best plant based source of omega-3 fatty acids is in my opinion flaxseed oil, followed at some distance by walnut oil. Flaxseed oil has 55 out of 65 grms PUFA as omega-3 fatty acids; the remaining 10 grams is thus omega-6. Walnut oil on the other hand has 11.5 grms n-3 fatty acids per 70 grms PUFA, leaving 58.5 grms of n-6 fatty acids.
The n-6 to n-3 ratio for flax seed oil is thus 1:5.5, whilst that of walnut oil is 5:1. This makes walnut oil basically thelesser choice, becasue this n-6/n-3 ratio is not fitting onto a sound dietary fatty acid profile.
Researchers emphasise that a lower n-6/n-3 ratio (that is, either relatively more n-3 OR relatively less n-6) is necessary for preventing cardiovascular disease, obesity, cancer, autoimmune disease and inflammatory diseases.
The pre-industrial hunter-gatherers diets always contained an omega-6/omega-3 ratio of around 1-2:1; most contemporary Western diets contain much higher ratios, in the range of 20-30:1 (7, also see studies 43-47)
Simopoulos AP. Essential fatty acids in health and chronic disease, Am J Clin Nutr. 1999 Sep;70(3 Suppl):560S-569S. Review , click to follow hyperlink
Additional information on EPA and DHA
ALA alfa linolenic acid 18:3 n-3 EPA eicosapentaenoic acid 20:5 n-3 DHA docosahexaenoic acid 22:6 n-3 LA linoleic acid 18:2 n-6 GLA gamma linolenic acid 18:3 n-6 AA arachidonic acid 20:4 n-6
Present-day dieticians, nutritionists and physicians point at increasing your intake of omega-3 fatty acids in proportion to the omega-6 fatty acids. The reason forthis is dat an unbalanced n-6/n-3-ratio is unfavourable for your health.
That depends. EPA and DHA differ in function. DHA (with AA) predominantly plays a structural role in the cell membranes of nerve cells, while EPA (with AA) predominantly plays a role as a precursor for the so called eicosanoids. These are hormonoïd substances that play important physiological roles in the body. The eicosanoids comprise:
prostaglandines (PG)
leukotrienes (LT) and
thromboxanes (TX)
Arachidonic acid (AA) can proliferate the PG-2, which are pro-inflammatory, while the prostaglandines from EPA (PG-1 and PG-3) actually work anti-inflammatory.
Thromboxanes derived from AA are vasoconstrictive, while the thromboxanes from EPA are vasodilatory. Can you see the connection with cardiovascular disease?
Children up to 5 years of age especially need brain development. That's why for this group DHA is more important. Children older than 5 profit more from EPA, because a) brain development doesn't play a predominant role any more and b) DHA hardly establishes any therapeutic effect at all. That's because it is EPA which delivers the eicosanoids, remember? The substances that play important roles in brain, heart, vascular, immune and other body functions.
Recommended intakes of omega-3
The following iformation comes from http://www.minami-nutrition.us/minami/faq2.php?id=7 :
"The recommended daily amount of EPA depends on the results you want to obtain to alleviate your specific problems and conditions.
The standard dose to maintain optimal health is minimum 500 mg per day.
For people suffering from dyslexia and dyspraxia, 500 mg per day is sufficient.
For those suffering from ADHD, a dose with a 500mg to a 1g is recommended.
For people with Depression and mood disorders a dose as 1000 mg EPA will be adviced.
In order to take in the recommended standard dose of EPA, you should eat 230 g of fatty fish daily or 860 g of less fatty fish. That's not a very practical solution as most people in the community don’t eat enough fish in the first place. Because there is a fear that fresh fish contains high levels of PCB's, dioxins, organochlorine pesticides and heavy metals, a carefully selected fish oil supplement may be a much better and also remove any concern you may have."
Sources
http://www.pfizer.be/Dutch/What_we_do/Health_info/Depressie.htm
"Understanding normal and clinical nutrition", Whitney, EN et al, 6e editie 2002, Wadsworth.
Banki CM et al, "Cerebrospinal fluid magnesium and calcium related to amine metabolites, diagnosis, and suicide attempts", Biol Psychiatry. 1985 Feb;20(2):163-71
Levine J et al, "High serum and cerebrospinal fluid Ca/Mg ratio in recently hospitalized acutely depressed patients", Neuropsychobiology. 1999;39(2):63-70
Singewald N et al, "Magnesium-deficient diet alters depression- and anxiety-related behavior in mice--influence of desipramine and Hypericum perforatum extract", Neuropharmacology. 2004 Dec;47(8):1189-97.
Mauskop A, Altura BM, "Role of magnesium in the pathogenesis and treatment of migraines", Clin Neurosci. 1998;5(1):24-7
