Mood and Substance Use Disorders
In 2017, it was estimated that 13% of the world’s population had a mental or substance use disorder. (1) According to the World Health Organization, poor mental health will become the second highest cause of the global disease burden by 2020. (2) In the UK, Australia, and the US, one in four adults in the general population will meet the criteria for DSM-IV. (3)
Those with Substance Use Disorders (SUD) have higher rates of suicide and more likely to be classified with a disability. That being said, there are four main reasons for the high co-occurrence rate of SUD’s with mental health disorders (3):
- Drugs and alcohol are used for self-medication;
- Drug and alcohol intoxication can trigger mental illness;
- Statistics imply that there is a likelihood of developing SUD if you have at least one mental health disorder;
- There are common characteristics of predisposition such as environment, poverty, or genetics that increase the risk of developing such disorders. (3)
In a recent article entitled The Importance of Managing Food Cravings in The Early Stages of Substance Abuse Treatment Programs, we established the cause and effect relationship of malnutrition and substance use disorder. A similar connection can be made between malnutrition and mood and we will expand on that concept here. (4)
What’s important to note here is that improving nutrition can have a positive impact on SUD and mental health disorders, regardless of the cause-effect relationship. Furthermore, if behavioral treatment centers are successfully minimizing the severity of mood disorder symptoms, the long-term outcomes of substance use treatment, not to mention quality of life, are improved as well. (4) Bear in mind, nutrition is not a substitute for psychiatric intervention, but rather a useful complement to treatment.
How is “Mood” Defined?
For the purpose of this discussion, the term “mood” is used to describe the following elements of mood symptoms:
- Energy or fatigue;
- Tension/anxiety or relaxation;
- Depression or elation;
- Focus, memory, or confusion;
- Anger, aggression; or withdrawn behavior.
Limitations of Research
Nutritional science is an exciting area of research, but the synergistic effect of whole foods is hard to recreate in a study. Some studies isolate the benefits and drawbacks of supplementing with specific vitamins, minerals, and other essential nutrients, but it is whole foods that provide the perfect combination of co-factors to aid the utilization of their nutrition in the body. It is important to always keep this in mind. (2)
Regardless, understanding the importance of specific nutrients allows us to understand what the body needs for specific body processes. In other cases, looking at specific foods and even diets can help us put together the pieces of how proper nutrition might look for individuals dealing with substance use and mental health disorders. (2)
Intriguing Case Studies
The Healthy Eating Project
A 2007 study dubbed “The Healthy Eating Project” discovered remarkable results regarding the impact of nutrition on mental health. A home for young offenders trialed a healthy diet that consisted of vegetables, fruit, and high-quality meats, for one year. They were given minimal fried foods; desserts and baked goods were replaced with fruit, and the overall focus was on whole foods. The results were measured one year following the introduction of the healthy eating project. The data revealed astonishing news: The use of physical restraints was decreased by 60% in a home for young offenders who were put on a healthy diet. (2)
A Powerful Mineral: Magnesium
Magnesium is commonly considered an essential mineral for psychiatric patients, and treatment with magnesium has been shown to induce rapid recovery from depression and other ailments. (7) With the nutritional value of our food declining, very little magnesium available in our water supply, and stress being a daily part of modern life, magnesium deficiency is much more common. In cases of magnesium deficiency, there is not enough magnesium present in the body for neural activity. The result, in some cases, is depression. (5)
The effects of magnesium on mental health, namely depression, have been researched and recognized since the 1920s. In a 2006 study, magnesium was tested in severe cases of depression in which the subjects did not get full benefits from pharmaceutical antidepressants. In one case, a 59-year old hypomanic-depressive with poor eating habits consisting of predominantly fast food was treated with 300 mg of magnesium nightly. Prior to magnesium supplementation, the patient had become suddenly anxious, irritable and was not able to sleep. Within days the depression started to lift and within months the patient was completely stable. (5)
In another case, an anxious, irritable, talkative, and mildly depressed 40-year old man who had poor dietary habits and was addicted to cocaine and alcohol agreed to try magnesium to help his symptoms. He was symptom-free within one week and his cravings for addictive substances completely disappeared. (5)
In most cases studied, the subject’s diet consisted mostly of fast food. We propose here that a nutrient-dense diet helps to address overall malnutrition, lessening the chances that magnesium deficiency might occur.
Putting It into Practice: Help Clients Receive the Benefits of Proper Nutrition
“You Are What You Eat”
First, diversity in the microbiome is essential. A growing body of evidence now suggests that chronic inflammation in the gut that inhibits the development of the mucosal immune system may be responsible for incidents of depression. Dysbiosis, the imbalance of gut bacteria, has become more common in the general population. The best way to address that is to eat a wide variety of fruits and vegetables. This is an area of research that is just beginning to gain momentum but may prove that proper nutrition is crucial in the quest for total health. (6)
As discussed in this recent article, fresh, unprocessed, locally-sourced, and seasonal foods are highest in nutritional value. (2)
Some of these nutrients are key players in the storyline of nutrition and behavioral health. Those are B vitamins, including B12, B6, thiamine, and folate, which are pivotal in addressing substance use disorders. Because they are essential for neurotransmitter production, their implications in mood disorders are vast. In fact, overall vitamin and mineral load may be the only effective way to increase neurotransmitter production, as they provide a key building block in healing. (6) Vitamins E, C, and D are also important to maintain a stable mood. Specifically, Vitamin D is often implicated in cases of seasonal depression. (2)
It is important to avoid sugar and processed foods with long shelf lives. Eating regularly and focusing on foods with low-glycemic index can help steady energy flow to the brain which will keep mood stable. In fact, a recent study found children who consumed high levels of sweets are more likely to be convicted of a violent crime later in life. (2)
Additionally, diets can be further personalized to each patient to eliminate individual food sensitivities. Common sensitivities are gluten, dairy, soy, corn, eggs, and nuts. By focusing on a total person approach, we can help minimize inflammation and other factors that contribute to depression. (2)
Mineral balancing is an important component of total nutrition. Minerals are cofactors necessary to help the absorption of vitamins. For example, magnesium, calcium, potassium, and K2 are essential for the body to properly absorb Vitamin D. Some key players when it comes to mood issues are chromium, calcium, zinc, and magnesium.
Chromium plays a special role in blood sugar regulation. Spikes and drops of blood sugar can cause fatigue, concentration issues, mood instability, anxiety, not to mention excessive cravings.
Zinc is a mineral essential to multiple chemical processes in the body – in some people, zinc deficiency can be responsible for aggressive behavior. Aggressive offenders have low levels of serotonin which can affect blood sugar regulation as well. This can only perpetuate the cycle of mood issues. Grievously, a comprehensive study that analyzed the nutrient content of our crops over time found that vegetables grown between 1961 and 1991 show a whopping 59% reduction in zinc. (2)
As mentioned in The Importance of Managing Food Cravings in The Early Stages of Substance Abuse Treatment Programs, those with SUD’s are commonly found to be deficient in tyrosine and tryptophan. These amino acids are responsible for the production of adrenaline, dopamine, and serotonin, important neurotransmitters that regulate mood, energy, improve sleep, and reduce cravings. Bananas, turkey, and sunflower seeds are good sources of both tyrosine and tryptophan. (6)
We have touched upon the importance of Omega 3’s in previous blog articles. We cannot emphasize enough the importance of having a proper balance of omegas in clients’ diets. Fish is critical to include in a well-rounded diet as it packs a punch when it comes to Omega 3’s. (2) In addition to many other nutritional benefits noted, Omega 3’s are proven to help depression. The same study found that saturated fat content of beef and chicken has risen four times, while Omega 3’s declined. This makes it all the more important to emphasize a proper balance of omegas in the diet of those dealing with substance use disorders. (2)
Any one of the above factors can influence mood but in cases of extended malnutrition, the chances of mood-related issues being present are higher. Physical or emotional stress in addition to low levels of minerals, vitamins, Omega 3’s, and other co-factors present a perfect storm to manifest depression. (2)
In conclusion, high protein, high caloric, nutrient-dense foods will replace nutrients that are lost in the addiction process. A well rounded, nutrient-packed menu will not only help clients manage cravings, but may also have a positive impact on mood symptoms. (5)
- Ritchie H, Roser M. Mental Health. Our World in Data. https://ourworldindata.org/mental-health. Published 2020. Accessed January 10, 2020.
- Watts M. Nutritional Therapy in Practice for Learning, Behavioural and Mood Disorders. Nutr Health. 2011;20(3-4):239-254. doi:10.1177/026010601102000408.
- Prior K, Mills K, Ross J, Teesson M. Substance use disorders comorbid with mood and anxiety disorders in the Australian general population. Drug Alcohol Rev. 2016;36(3):317-324. doi:10.1111/dar.12419.
- Jeynes K, Gibson E. The importance of nutrition in aiding recovery from substance use disorders: A review. Drug Alcohol Depend. 2017;179:229-239. doi:10.1016/j.drugalcdep.2017.07.006.
- Eby G, Eby K. Rapid recovery from major depression using magnesium treatment. Med Hypotheses. 2006;67(2):362-370. doi:10.1016/j.mehy.2006.01.047.
- Grotzkyj‐Giorgi M. Nutrition and addiction — can dietary changes assist with recovery? Drugs Alcohol Today. 2009;9(2):24-28. doi:10.1108/17459265200900016.
- Bartlik B, Bijlani V, Music D. Magnesium: An Essential Supplement for Psychiatric Patients. Psychiatry Advisor. https://www.psychiatryadvisor.com/home/therapies/magnesium-an-essential-supplement-for-psychiatric-patients. Published 2014.07.22.